Aug24 18

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AUGUST 24, 2018

AIKEN-AUGUSTAʼS MOST SALUBRIOUS NEWSPAPER • FOUNDED IN 2006

PROFILES IN MEDICINE presented by Queensborough National Bank & Trust Co.

THE DOCTOR’S DOCTOR (who was never a doctor)

It is a measure of the depth of Augusta’s medical history that more than two dozen distinguished individuals have been profiled in this space since the start of this series, yet there is no shortage of qualified candidates.

If there was an Augusta Medical Hall of Fame (and there should be) this gentleman, Dr. Milton Antony, would certainly be a fi rst ballot inductee.

All he did was found the Medical College of Georgia, quite a feat when you consider his background.

Born in 1789 (the place of his birth unknown according to a 1920 biographical sketch and listed as Henry County, Virginia by other sources), his earliest years were spent in Jasper County, Georgia, roughly between Atlanta and Macon. His formal early schooling totaled less than three years.

He turns up next in the history books at age 16. By then the family had moved closer to Augusta, to nearby Wilkes County, and Antony was informally studying medicine just up the road from here as a helper to Dr. Joel Abbot of Washington, Georgia.

Deciding to pursue medicine as his career, at age 19 Antony was accepted as a medical student in Philadelphia, but due to

financial constraints was not able to complete the required curriculum. He returned to Georgia without a diploma.

According to the history of the Medical College of Georgia on the Augusta University website, Antony “never received a diploma” (although he did later receive two honorary M.D. degrees.)

Undeterred by this minor detail — not uncommon in that era — he went back to Jasper County and established a successful medical practice in Monticello. He continued there for seven years before seeking greener pastures in New Orleans. That foray was short-lived, and by 1819 he was back in Georgia, this time settling in Augusta.

Within a short time he was the clear leader of Augusta’s growing medical community.

In 1822 Antony and seven other physicians organized the Medical Society of Augusta for the furtherance of medical education.

But he was far more than an administrator. An 1823 issue of the Philadelphia Journal of Medical and Physical Sciences recounted an amazing instance of Antony’s surgical skill. The article reported an 1821 operation in which he successfully treated a patient with a gangrenous lung, a Please see PROFILES page 3

Editor’s note: this is a monthly series presented by Queensborough National Bank & Trust and the Medical Examiner profiling exceptional physicians and others of note in Augusta’s long and rich medical history.

AUGUSTARX.COM

POP QUIZ

ARE YOU A

JERK?

Hopefully not, because being a jerk can be hazardous to one’s health. It can cause stress, increase the risk of being in accidents, and make you the target (and victim) of other people’s anger and frustration. Grab a #2 pencil (neatness counts), take the following pop quiz and you should have a good idea where you stand on the Jerk-O-Meter Scale. Be honest: you get to grade your own paper.

Y N 1. When a new register opens up at the grocery store and a cashier calls out “I can help the next customer,” you immediately take the offer, even though you just walked up to the end of the line.

2. You have been known to travel in the right lane outbound on Walton Way as though you’ll be turning right onto Highland Ave, but your intention all along is to go straight at that intersection.

3. You throw cigarette butts and trash out of your car window. You don’t care that large items of trash blow out of the back of your pickup while driving.

4. You’re rude and condescending to waitresses, not to mention demanding, but don’t leave tips (or leave very small ones), even for stellar service.

5. You don’t really listen to other people when Please see JERK page 10

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IT’S INSIDE SUNRISE GRILL IN WEST TOWNE ON WASHINGTON ROAD

The end of an era The Old Medical College is more than just a key landmark of Augusta’s medical community; it is also the final resting place of one of its charter members, Dr. Milton Antony. His “mortal remains” are interred in the building’s yard, identified by a Mortale quisquid caduit his bronze marker with the Latin depositum, Milton Antony, epitaph shown to the right M. D., Conditor collegei (with its translation below). medici Georgiensis Exegit Ironically, the cause of monumentum aere perenius Dr. Antony’s death was the Vixit annos quinquaginta motivating factor of his entire Obit de XIX Septembris A. D. life: the practice of medicine.

MDCCCXXXIX When a yellow fever epidemic . . . . . . . . . . raged through the city in 1839, Here are deposited the he and other doctors were mortal remains of Milton on the front lines, selflessly Antony MD, Founder of the exposing themselves to many Medical Academy of Georgia. carrying the disease. In Dr. I have erected a monument Antony’s case, the exposure more lasting than bronze. He would prove fatal. lived 50 years and died 19 As his own Southern September 1839. + Medical Journal put it, “It is with feelings of the most poignant sorrow, that we have to announce the death of Dr. Milton Antony, editor of this Journal. He expired on Thursday afternoon, the 19th inst., after an illness of five days.

“His loss is indeed a public calamity, and greatly to be deplored by the profession throughout the country. He retained the entire possession of his mind to the last, and the closing hours of an honorable and useful life were brightened by the hopes of a glorious immortality.”

Another journal made this comment upon his passing: “Death in the great epidemic of 1839 brought to him in the zenith of his career the halo of martyrdom.”

Here’s a question about this great man and his legacy: why is there no city park, side street or major thoroughfare named in his honor in all of Augusta? And how ironic would it be if the Hill section’s Anthony Road is named after him — and is misspelled? +

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PROFILES… from page 1 procedure that required removing the 5th and 6th ribs, as well as excising a portion of the diseased lung. It would be quite a surgical event in 2018, let alone 1821. The accomplishment was of such note that decades later the Philadelphia paper was reprinted, this time in 1893 by Dr. George Foy of the Royal College of Surgeons in the Medical Press and Circular of Dublin, Ireland. The 1920 Antony biography also noted that he “was the first gynecologist to adopt and point out the knee-chest posture in the treatment of uterine displacement,” and that he “perfected the treatment of fractures of the thigh by weight extension.”

Not content to rest on his medical and surgical laurels, Antony was so instrumental in the founding of the Medical College of Georgia that many sources credit him alone (of course, many sources also consistently call him Milton Anthony, but there was no H in his last name).

In truth, Dr. Paul Eve and a number of physicians joined Antony as founding trustees and faculty of the College when it was chartered as the Medical Academy of Georgia on December 20, 1828.

Among the two dozen trustees were a few familiar names, but many who are not well remembered today. They were given a princely budget “not to exceed one hundred thousand dollars.” That sum resulted in the handsome Greek Revival structure still standing today on Telfair Street, the Old Medical College.

Prior to the construction of that handsome edifice, which opened its doors in 1835, Antony and others had been treating patients and teaching students

since about 1826 at the old City Hospital built in 1818 on Greene Street in today’s Olde Town on land currently occupied by Christ Community Health, perhaps better known as the Old Widow’s Home.

The original 1828 charter for the medical college was revised twice in those early days. Originally the school could only award Bachelor of Medicine degrees, so graduates would have to travel elsewhere to achieve M.D. status. The curriculum and charter were upgraded to address that situation, so the Medical Academy fi rst changed to the Medical Institute and finally, in 1833, to the Medical College of Georgia.

The Old Medical College, then new, was next door to the Academy of Richmond County, the city’s fi rst institution of higher learning and Georgia’s fi rst chartered academy (and the semi-recent home of the Augusta Museum of History). Its 1791 final examinations were attended by none other than George Washington. Students at the Academy, learning subjects like Latin, Greek, French, algebra and trigonometry, were sometimes invited to attend lectures next door at MCG. The knowledge acquired by the faculty of the Medical College of Georgia was freely shared thanks to another contribution by Dr. Antony: in 1836, he and Dr. Joseph Adams Eve launched the Southern Medical and Surgical Journal.

Among other significant topics, it carried the account of Crawford W. Long’s pioneering use of ether in surgery. Dr. Antony served as the Journal’s editor from its founding until his death in 1839 (see box on page 2). +

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What causes heartburn?

It might not be what you think. Spicy foods like pepperoni pizza and Italian cuisine often get the blame, and there might be as many food and beverage-related triggers as there are heartburn sufferers.

While it’s true that food can be a trigger, the real culprit is anatomic. A very strong valve at the base of the esophagus known as the lower esophageal sphincter or LES (yes, there are sphincters here and there around the body, not just...there). The job of the LES is simple: keep stomach acid in its place, which is in the stomach.

Good thing it’s on the job, too, because stomach acid’s last name is acid. It’s some powerful stuff. The digestive system keeps things rolling at all times, processing whatever we send down the hatch and moving it down the conveyor belt, but given enough time some sources say stomach acid will dissolve razor blades, staples and paper clips. (Do not try any of that at home, boys and girls.)

Gastric acid, whose key ingredient is hydrochloric acid, will dissolve meat, fruits, grains and vegetables. It’s said to be corrosive enough to dissolve a nail if, again, it’s given the time.

Despite that, there are some bacteria that can survive in the stomach’s harsh environment. That’s pretty amazing when we experience what stomach acid feels like, the experience known as heartburn.

The stomach’s lining insulates and protects it from acid, but if the LES allows even a little acid up into the esophagus, the pain can be pretty intense. Sometimes the sphincter itself is in pretty good shape, but if someone has a huge meal and then goes to bed or reclines in the old La-Z-Boy, it puts an abnormal amount of pressure on the valve.

Avoiding heartburn, then, can involve eating lighter meals and waiting at least an hour after before getting anywhere near horizontal. Avoiding the various foods and beverages that are your personal triggers is also a good strategy.

Doctors say there is no harm in taking antacids on a daily basis, and some people without heartburn take them as calcium supplements. But persistent, chronic heartburn is defi nitely not something to ignore. Confer with your doctor about it and get relief before it causes more serious problems. +

MEDICALEXAMINER

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DAVID D. BULLINGTON, JR.

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

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The appearance of advertisements in this publication does not constitute an endorsement of the products or services advertised. © 2018 PEARSON GRAPHIC 365 INC.

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AUGUSTAMEDICALEXAMiNER

#73 IN A SERIES

Who is this?

ON THE ROAD TO BETTER HEALTH A PATIENT’S PERSPECTIVE Editor’s note: Augusta writer Marcia Ribble, Ph.D., is a retired English and creative writing professor who offers her unique perspective as a patient. Contact her at marciaribble@hotmail.com

by Marcia Ribble

W

hile the subject of our profile this time is not someone associated with medicine, there is no disputing that he was an unparalleled expert in human anatomy — one part of human anatomy in particular.

His name was Edward Henry, born in London in 1850. At age 16 he began his first job as a clerk at Lloyd’s of London, the venerable insurance marketplace founded in 1686. But Henry’s sights were set on working as a civil servant in India, so he took night classes at University College London, to prepare for his civil service entrance exam. That hurdle successfully passed, Henry set sail for India in September of 1873 and subsequently served in a number of positions in Bengal (mostly in the Bengal Taxation Service), capped by a historic detour in 1891 when he was appointed Inspector-General of Police in Bengal.

In that position he became familiar with the work of Francis Galton (a second cousin of Charles Darwin’s) in identifying the unique patterns in fingerprints. Another Briton, William Herschel, had championed the use of fingerprints in India for some time as identification on contracts, similar to the current practice of requiring a thumbprint when cashing a check.

Although another man, Henry Faulds, had earlier suggested using fingerprints to identify criminals, Edward Henry was the first person to actually do it, combining the findings of Galton and Herschel into a workable system. But it wasn’t easy. It was one thing to compare a direct crime scene fingerprint in, let’s say, wet paint, with the actual fingerprint of a suspect already in custody. But what about matching a crime scene fingerprint from an unknown subject with fingerprints on file at the police department? By 1897, the Bengal police department had more than 7,000 sets of fingerprints on file. In the pre-digital, precomputer era, finding a match would seem like a hopelessly challenging task.

Enter Azizul Haque, a Bengali college student with a unique set of math and statistics skills whom Henry recruited to devise a classification system for matching fingerprints. A previous system based on what was called anthropometrics (a forerunner of ergonomics) enabled investigators to sometimes find a match in as little as an hour. Using Haque’s greatly simplified system, even hundreds of thousands of print sets could be quickly sorted and managed, and it could take as little as five minutes to arrive at an accurate and correct match. Although Haque later received credit, the system has always been known as the Henry Classification System, and its basic tenets are still in use today.

In 1901, Henry was recalled to Britain as Assistant Commissioner at Scotland Yard, where he immediately established a fingerprint bureau, England’s first. It passed its initial test, the trial of burglar Harry Jackson in 1902.

Fingerprinting entered the big leagues of forensic science in 1905 when it survived a determined challenge by the defense at the trial of two brothers accused of murder. Fingerprint evidence was central to their conviction.

Henry was appointed Commissioner of Scotland Yard in 1905, was knighted and became Sir Edward Henry in 1911, was shot in an assassination attempt in 1912, retired in 1918, and died at home of a heart attack in 1931 at age 80. +

I’ve been battling cellulitis again, home after a week in the hospital getting intravenous antibiotics, so glad to be with my dog KC again. She’s gotten good care, but it’s not the same if it thunders and I’m not here to comfort her. Right now she is happily snoring and peaceful after the house calmed down from kids and grand and great grandkids bringing me home, getting me settled in, and ensuring my ongoing safety. I also turned 75, so that added to the busyness.

My granddaughter stopped at Lanier’s this morning and brought me a nice big tongue to cook when it thaws out. I haven’t had tongue in years, and a lot of folks are totally grossed out by the idea alone, but for me it’s a real treat. It has been part of my ethnic-Germanic heritage for my whole life, so that includes memories of eating it, watching my mom cook it, and learning to cook it myself. My husband’s family didn’t eat tongue or liver or any of their close relatives, so my children never learned to enjoy tongue’s sweetness, tenderness, or multiple uses.

Tongue is one of those cuts of beef that benefits from hours of braising, low and slow as they say on the Food Network. I use plain water, bring it to a boil, reduce to a simmer, and let it hang out in that simmering pot until fork tender. Because it’s not skinned until after it’s cooked, adding a bunch of herbs and spices is pretty much a waste, but serving it with a nice horseradish sauce or a

nice mustard sauce adds plenty of additional flavor if desired. It’s good with mashed or boiled potatoes, and any of the cruciferous vegetables for its first ingestion, but then culinary creativity comes into play.

Save the gelatinous water if you want to make a terrine to use with crackers.

At that point some wine can be added for flavor along with mushrooms, onions, and garlic lightly sautéed and the finely cubed meat added. It can be ground and flavored with traditional spices for a mild sausage which is like bratwurst. But my favorite use of leftovers is in sandwiches. I like the meat thinly sliced with an added thin slice of sweet onion and the horseradish sauce made with mayonnaise traditionally served with beef, or mustard, or both.

This is my day off to relax and free myself from the hospital routines.

Tomorrow the home-health agency arrives and therapy begins. Being home does not mean the cellulitis has been conquered and destroyed. My blood sugars are still way too high; the swelling in my leg and knee still interferes with comfort and motion; and there’s the matter of the rib I broke when my leg refused to support me and I fell.

For me, as well as for many others, cellulitis has become chronic, with periods of relative silence followed by flare-ups that require more intensive medical treatment. I don’t particularly like the flare-ups, but with help and management I can live a pretty normal life. +

NO PAIN, NO GAIN?

WHICH WILL IT BE? We have all heard that maxim, that when it comes to physical strength, pain is the price to pay for gain. You can’t have one without the other.

True?

Sort of. Maybe. Possibly.

Sometimes, under certain circumstances.

As discussed in our last issue (go to issuu.com/ medicalexaminer and see QA on p. 3 of the Aug10 issue),

a condition abbreviated as DOMS (Delayed Onset Muscle Soreness) is common.

Everyone has experienced soreness the day after a strenous hike or workout that exceeds what we’re used to. It is not grounds for any particular concern, although the article discussed ways to avoid it. Even so, when it comes right down to it, we almost expect it: “I’m gonna be sore tomorrow!”

But pain that is delayed onset is quite different from sharp, sudden, acute pain.

That is pain we can’t afford to ignore, and if we do, the body will quite likely turn up the volume until it’s the only thing we can hear.

What could be the cause?

Maybe a sprained or strained muscle or joint. Sprain your ankle and try to walk it off and you may discover that your crutch-free, boot-free walking days could be severely curtailed for days, weeks, or even months.

Some sports medicine experts say the slogan should be “know pain, know gain.”

In other words, knowing the type of pain you’re experiencing can dictate whether you play through the pain or stop immediately.

When you do stop, remember the acronym RICE, which stands for rest, ice, compression and elevation to lessen pain and swelling.

And see a doctor if pain is severe or doesn’t go away. +

AUGUST 24, 2018

I

Musings of a Distractible Mind

by Augusta physician Rob Lamberts, MD, recovering physician, internet blogger extraordinaire, and TEDx Augusta 2018 speaker.

Reach him via Twitter: @doc_rob or via his website: moredistractible.org

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AUGUST 24, 2018

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recently went hiking in a beautiful national park outside of Columbia, SC. This park was in a swampy area and contained all sorts of wildlife (critters”) and plant life (like “trees and those other things”). When I was young, my dad would take us kids on hikes through the Adirondack Park in New York, so being on hikes in nature hits my soul in a very deep spot. It’s emotional, it’s physical, it’s a treat to my senses, and it’s a spiritual experience for me.

I was pondering what it was that moved me so much while hiking. I am the sort of guy who probably overdoes the pondering bit, as I find myself doing far too much pondering about my pondering. It’s what I refer to as being “too damn introspective.” Anyway, the forest in this park is fi lled with spider webs, and since it was misting rain while we were walking, the webs glistened with beads of water that sparkled in the sun. It was stunning. As I did my damn introspection bit, I saw an especially large web with a huge yellow-bodied spider in the middle. One of my hiking companions told me it was a golden orb weaver, and this spider sat in the center of this huge web as if to claim its beauty as her own. It was as if she wanted me to know that she had made that web and that I could applaud at any time.

I stood and appreciated both the creation and the creator for a while and then moved on, passing by hundreds of other amazing webs and proud creators

displaying their work. But did they really care about their audience? I thought about how many more webs there were in this forest that I would never see. I thought about how many webs of equal or even greater beauty there were in the world that no person would see. I thought about the irrelevance my life posed to these spiders (unless I

I do a lot of pondering about my pondering chanced into their web and destroyed their work), how they would continue living, dying, building webs, having young, catching food, and building beautiful creations.

I was but a lucky observer of a minuscule segment of the beauty that spiders spin each day.

I was humbled.

This is part of what makes nature a spiritual experience for me. I realize that I am but a small part of a huge tapestry painted on this planet. And even the entirety of the beauty that is and ever will be on this earth is but a minuscule portion of the beauty in the cosmos.

And that beauty is but a speck when you consider the beauty that has ever existed and will exist until time comes to a close.

I think about this kind of thing when I fly in a plane and see all of the tiny little cars darting around doing their crucial tasks. That’s me down there, a self-assured dot of unimportance in the

private practice doctors offices and to 14 area hospitals.

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big picture of things. Perhaps the birds look down on us as we see the spiders in the forest. Perhaps they have a more realistic perspective on things. Or maybe birds too are “too damn introspective” like us.

This all makes me take a much lighter view of life.

Yes, the things that are happening in this world are important. Yes, the pain that I see daily in my office, the struggles I have in my own life, and the fears I have about all of our futures are real things. But they are small things in the tapestry of space and time. They are spiders in a forest. The cosmos won’t be altered in any significant way by any decisions I make.

Does this make us not take things seriously? No, I think that this perspective gives us more reason to hold our small time and place here as being precious. Like those spiders, we need to build our webs with skill, care, and a desire to make them as beautiful as we can. Whether we are building them for our creator/God (which is what I believe), or doing it simply because that’s what we spiders do: we make beautiful webs.

So if someone cuts you off in traffic, if you are enraged by something on Facebook, if you are desperate for love, or if you are anxious about your future, just remember: we are all spiders making our webs. Be humble. Take it easy on the other spiders out there. And build the best damn web you can in the part of the forest you call home. +

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GARDENVARIETY

The rich, delicious flavor of this homemade spaghetti sauce with fresh roasted tomatoes is like stepping into a sweet Italian grandma’s kitchen, smelling the aroma of tomatoes and garlic, creating anticipation to the delicious bowl of spaghetti you soon will be eating. I was trying to figure out what to do with the abundance of cherry tomatoes that are growing now when I came up with the idea to create this homemade spaghetti sauce with fresh roasted cherry tomatoes. Roasting them was easy. I do have a tip, however, to get the roasted tomatoes to hold their flavor and shape.

After cutting them in half, toss them in a colander and sprinkle salt on them. Let them rest there for 30 mins in your sink. This will help draw the moisture out. After that, pat any excess moisture off with paper towel and then place the tomatoes in a dry bowl for the next step.

For this light pasta meal, I ramped up the nutrition and cut out the gluten by using quinoa pasta. Quinoa is an excellent alternative to wheat pasta, since it doesn’t get mushy when cooked. It tends to be higher in protein than other gluten-free varieties, and it contains high amounts of fiber and iron. Another Roast tomatoes mixture at • 1/4 nutritional yeast plus, it cooks quickly.

400° for 35 minutes without • 1/4 teaspoon pink stirring, or until most of the Himalayan salt Homemade Spaghetti moisture has evaporated.

Sauce With Fresh Roasted Remove from oven.

Instructions Tomatoes Place Italian bread crumbs, Cut tomatoes in half, place nutritional yeast, and salt in in a colander. Sprinkle lightly Ingredients a bowl. Stir until well mixed, with salt and toss. Allow • 3 cups of cherry tomatoes in set aside. to draining in the sink for various sizes and colors Place cooked pasta in 30 minutes. This will help • 1/4 cup extra virgin olive oil a large bowl, add cooked release some of the moisture • 1/4 cup garlic cloves, peeled tomato mixture over pasta, from the tomatoes which will and cut in half add balsamic vinegar and 1/4 help them roast quicker and • 1 cup diced zucchini, about cup fresh herbs and toss to hold their shape better the size of the tomatoes coat evenly.

Fill a large pan with water, • 1 tsp Himalayan pink salt bring to a boil. Drop in 2 Sprinkle vegan cheese • 1/2 teaspoon ground black servings of spaghetti and topping over pasta when pepper cook until done. serving. + • 1/2 crushed red pepper Line a large cookie sheet flakes

by Gina Dickson, Augusta with parchment paper • 1/2 cup of fresh chopped wife, mom and grandmother, Pat the tomatoe’s excess herbs such as parsley, colon cancer survivor, moisture off with paper oregano, basil, and thyme. passionate towels, then place in a large Divide these into half portions about creating bowl.

• 3 tablespoons balsamic a community Drizzle tomatoes with olive vinegar to help women oil, then add garlic, zucchini, • Trader Joe’s Brown Rice & serve healthy pepper, salt, 1/4 cup of Quinoa Spaghetti Pasta meals to their chopped herbs, and crushed family. Visit red peppers. Toss gently until Vegan Cheese Topping my blog at all coated, then place on • 1/4 cup fine Italian bread thelifegivingkitchen.com parchment paper crumbs

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Years ago I was amused when, after leading a recovery therapy group, an older group member approached a newer and younger client and announced “I’m your uncle!

And over there is another one of your uncles! And another uncle was here last month!”

What are the statistical odds of something like this happening in the “civilian” world? I’m not a statistician, but I would think it’s very rare.

When I give a talk on addiction to a community group and ask “How many of you have addiction or alcoholism in your family history?” about 10% of the audience raises their hands.

Occasionally as many as 20% do so. But when I give a lecture in my recovery groups and ask the same question, over the past 30 years I have never seen fewer than 80% of hands raised. Occasionally, 95-100% raise their hands!

Before the medical research we have today, famous philosophers noted the familial influence of alcohol. Plutarch even touted “Drunkards beget drunkards.”

Over the years various twin studies have been done to attempt to determine the genetic influence of alcoholism and addiction.

I just spent the better part of an hour wading through a plethora of studies with

THIS IS YOUR BRAIN A monthly series by an Augusta drug treatment professional various conclusions. This column is not meant to be scholarly in nature, but I can at least report on the scholars’ conclusions and if you want to spend the calories, by all means Google the the topic for yourself.

Many of the studies conclude that identical twins separated at birth and raised in different socio-economic environments ended up having a 50-60% incidence of both twins becoming alcoholics! One particular study done in Europe followed for 30 to 40 years nearly 200 identical twins who were separated at birth and raised in different households. The study found that almost 80% of the twins had both developed alcoholism, and in many cases they had even chosen the same beverage, unbeknownst to each other!

Facts and statistics

supporting this genetic hypothesis are overwhelming, yet some of us still resist accepting the evidence — and I include myself back in the day.

Initially, my reticence was about my blurring the difference between a disease and causation. I had a major paradigm shift when I realized: Lung cancer is a disease, no question. But smoking cigarettes is a choice.

And diabetes is a disease too – no doubt. But eating sugar is a choice.

Is alcoholism and addiction a disease? Without question.

(Reference my column last month about the AMA definition of a disease.) But is drinking and drugging a disease? No! It’s a choice!

Certainly we do bring some diseases upon ourselves.

We in the treatment field Please see DISEASE? page 10

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AUGUSTAMEDICALEXAMiNER

DON’T LICK THE BEATERS Useful food facts from dietetic interns with the Augusta University MS-Dietetic Internship Program

BACK TO SCHOOL TIPS

by Lianni Maldanado, Dietetic Intern August is here, fall is just around the corner and the children are already back in school. During the lazy hot days of summer, the children may be less active and have an extra snack or two while spending many hours on electronic devices.

This is fairly common among children of all ages during the summer months when their schedules are not as set in stone as they are during the school day. Childhood obesity is a major epidemic, and early intervention is important to prevent the disease and its associated risks. However, restrictive weight loss diets are inappropriate for children since they are still growing and developing and need to get nutrients from a variety of food groups.

Healthy food choices with the required nutrients and calories will allow the child

to grow into their weight and prevent them from being exposed to the physical, social and psychological stress associated with weight loss diets. A Registered Dietitian Nutritionist (RDN) is a health and nutrition expert who can help your child achieve a healthy body weight while meeting their nutritional needs for normal growth and development. A list of Registered Dietitian Nutritionists in our area can be found at www.eatright. com Avoid pressuring your child to lose weight. Focus instead on making healthy choices and lifestyle changes.

In fact, the whole family may benefit from a few changes.

It’s not too early to start meal planning and preparing for busy back to school schedules to keep your children and family healthy. Here are some

FLOYD & LEOPARD

easy tips for staying healthy during a busy school year.

• Have your child bring their lunch to school! Get creative and find new ways to incorporate fruits and vegetables into their meals instead of unhealthy snack foods like chips, and cookies.

Let children make choices about which fruits and vegetables they would like to bring to lunch with them.

• Swap out a bag of chips for some crunchy carrots sliced into rounds. Use 2 tablespoons of hummus or 1 tablespoon low fat ranch dressing as a dip for the carrots • Pack sliced apples with peanut butter or almond butter.

• Eat breakfast every day before school. Enjoy a meal together to get the day started. Avoid sugary treats like pop tarts, toaster strudels, and sugary breakfast cereals, which are high in sugar and calories, and low in protein, fiber, vitamins and minerals.

• Try making a yogurt parfait, with a base layer of Greek yogurt, your favorite granola, and topped with a serving of fruit like bananas, raspberries, strawberries, and blueberries.

• Make a breakfast

sandwich with whole wheat bread or a whole wheat English muffin, an egg, cheese, and low sodium turkey breast. Enjoy with a side of your favorite fruit.

• If you are unable to prepare breakfast, consider signing your child up for the school breakfast program if available at their school.

• Enjoy a fruit smoothie as an after school snack.

• Blend frozen berries with vanilla Greek yogurt, and add water for a smooth consistency. Add frozen cauliflower or spinach to increase your child’s vegetable intake.

• Make a healthy dinner together.

For more tips and resources on how to eat healthy for the whole family, visit www. choosemyplate.gov.

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• Increase the fiber content of meals by swapping out white breads, rice, and pastas for whole-wheat options that are higher in fiber, protein, vitamins and minerals. Whole grains, fruits and vegetables are also excellent source of fiber.

• Instead of frying vegetables, try steaming, boiling, roasting, or stirfrying with a teaspoon of olive oil for a few minutes.

These are healthier cooking methods that may retain more nutrients without adding additional calories.

Let your children help you make decisions on which vegetables to cook.

• Drink more water • Replace sugar sweetened beverages like sodas, lemonades, teas, sports drinks, and some juice products with water. Adding sliced lemons, or berries to your water can help enhance the flavor and increase your fluid intake.

• Select only 100% fruit juices and remember that water is always the best choice for hydration. +

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DISEASE?… from page 8 are often frustrated about the way modern medicine and insurance companies view addiction, and the ways they often give treatment for it with a different attitude and different reimbursement rates. I see families, too, reflecting similar responses to victims of cancer and diabetes. They’ll gather around the bedside of a relative to offer expressions of support and affection that are unknown to the loved one with the disease of addiction.

I do realize the need for tough love and intervention with loved ones as I have previously outlined, but I also advocate

*

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education of the affected family so they know how to constructively approach their addicted loved one without judgment, enabling, or provocation.

I encourage you affected ones to find support and knowledge of how to have peace of mind while in the midst of the frustration you are feeling by attending community education sessions on the subject and joining a support group for people just like you via programs such as Al Anon, Celebrate Recovery, and/or others.

So their disease won’t become your disease. +

Find eyes ™

Organs

Glands

Near Augusta GA Bones

Joints

d Other

JERK… from page 1 they’re speaking, and as a result you interrupt. A Y N lot.

6. On Riverwatch or Jefferson Davis Hwy (to take two examples) you drive in the left lane, sometimes next to another vehicle, oblivious to traffic stacked up behind you.

7. You aren’t honest in telling your doctor(s) whether you’ve been conscientious in complying with their instructions for your care.

8. You don’t use turn signals. Even when you can tell another motorist is waiting for you to pass an intersection or store entrance so they can pull out, you don’t use your blinker to let them know they can safely proceed because you’re turning in.

9. You regularly tailgate.

Knees

10. You berate your wife or husband or children in front of others.

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Please support us by buying a kneecap today! (Note: you wear them on your head.) +

Nora O. Aiken, SC

H H H H H 8/17/2018 Mobility and humor do not go hand in hand. My husband likes to tell jokes, most of them real knee-slappers. Well, over time his jokes have almost crippled me. I can barely walk. +

Arnold K. Appling, GA

H H H H H 8/20/2018 I was having a lot of trouble with my knees, so I went to an orthopedic doctor who supposedly is a knee specialist. He was incredibly rude to me and said there is nothing wrong with my knees. He did everything but call me a liar, so I punched him in the face. I think that is what’s known as a knee-jerk reaction. But you know what? For some reason it really did make my knees feel better. +

Jerry V. Jackson, SC

H H H H H 8/20/2018 I wonder if I went to the same doctor as the previous commenter. I was having plenty of knee pain and someone told me about a doctor who is a knee specialist. He poked and prodded and took x-rays and finally told me my knees were in tip-top shape. He said there’s no reason they should hurt and told me the pain was imaginary. I stood up to leave, shook his hand and tested his diagnosis by giving him a swift knee to the groin. Maybe he was right. My knee worked just fine for that. +

Leo G. Clearwater, SC

H H H H H 8/21/2018 I met this awesomely cute babe. All she has to do is say my name and I feel weak in the knees. I guess I need to join a gym and work on my lower body strength. +

Jennifer J. Augusta, GA

H H H H H 8/21/2018 My knees are super sensitive so I went to see a doctor, and right in front of them both he started talking about knee replacement. I’m sure they could hear everything! I mean, how would you like it if someone at your job started talking about replacing you right in front of you??? I thought they would be really hurt and take it out on me somehow, but as near as I can tell it didn’t seem to bother them at all. I thought it was very unprofessional of the doctor, but I am incredibly proud of my knees. I’m still replacing them, though. +

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WHAT THE RESULTS MEAN The Jerk-O-Meter scale is based on scientific analysis of responses that are expertly compiled and compared to a database of literally dozens of other responses - ok, a dozen other responses - using a complicated matrix developed without input from behavioral scientists at England’s Oxford University, as well as Harvard and Yale here in the US. • 1-3 YES answers: you aren’t a full-fledged jerk (maybe half-fledged), but you could be a carrier. You’re doing well, but your goal should be 1 or fewer YES responses.

• 4-6 YES answers: you are definitely infected with the jerk virus. Disagree? Denial is common. Symptoms are usually quite visible to observers but ironically, not to sufferers.

• 7-10 YES answers: you read this newspaper because its initials are ME. You don’t go to church, but at Luke 6:31 (the Golden Rule verse) your Bible says, “Do unto others,” and stops. You are at elevated risk of being the victim of attack, possibly heart, but more likely by a motorist, coworker or fellow shopper. You would be well advised to have a generous life insurance policy and to make sure your will is regularly updated. Alternately you could also strive to reduce your JQ through behavior modification. +

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AUGUSTAMEDICALEXAMiNER

The blog spot From the Bookshelf — posted by Praveen Suthrum on August 19, 2018 (edited)

REMEMBER YOUR DOCTOR IS ALSO HUMAN “I love what I do. I hate what I have to do.”

It’s a quote that doctors attribute to their profession behind closed doors. As patients, we are so overwhelmed with our own problems. We fail to notice that our doctor may be battling her own problems within a complicated system.

But what do we care? Our meeting with the doctor is a paid transaction. We are owed our money’s worth. Empathy can take a backseat. We’ve made medicine into a business affair.

If you have constipation, you will get a prescription based on your insurance coverage. You want a fi x. You get a fi x.

No conversations about how to help your body overcome its diseased state, let alone prevent it.

But we can think differently about health care by bringing empathy into the equation.

Empathy is a two-way street. Developing an understanding of our doctor’s problems is a beginning in that direction.

It’s tough being a doctor.

They are stuck in a systemic mess Insurances deny payments and prescriptions. Incentive schemes are skewed. Patients don’t pay. Paperwork mounts.

Mindless bureaucracy. Administrators demand financial performance. Legal threats loom large. Malpractice payments rise. Technology slows them down. Costs keep rising. Lifeand-death ethical dilemmas. Changing guidelines. Stringent medical community. Burnout. Loss of value in society.

Doctors are nudged and hassled in a system from which there’s no way out. Yet they are held to one of the highest performing standards of any profession.

It’s tough being a doctor today.

They are not making as much money as you think Unlike most high-end professionals, doctors begin making money only after about age 35. By then they accumulate debt through expensive, specialized education. Some add to it by buying big houses and cars out of social pressure.

When doctors start a solo practice, they are overwhelmed by the challenges of sustaining the business. When they join a group practice, they get short-end of the stick for many years before they become partners. When they join a hospital, they function under the thumb of rigid administration.

Most doctors don’t run profitable endeavors. Many give up medicine altogether because it’s tough making a living. The Physicians Foundation found that 40 percent of doctors want to drop out of clinical care during the next 1 to 3 years.

They are more depressed than you’d ever know According to the New York Times, about 400 doctors commit suicide every year. Physicians are more than two times likely to kill themselves than non-physicians.

Given the scrutiny they are in, doctors fear social stigma more than other professionals do. Plus they have easy access to prescription drugs (including opioids) to treat themselves.

Doctors face pressures that the average person doesn’t.

Seeing people die all the time. Constant lack of sleep, particularly among interns. Couple that with problems that many people do face. Financial pressures. Familial discord.

Loneliness. Erratic lifestyles.

Why should you care?

Your doctor is also human, one constantly being in the position of giving care and not receiving.

Bringing empathy to the patient-doctor relationship will accelerate the process of health care in its true sense.

It’s good for the patient. It’s good for the doctor. + Praveen Suthrum is president and co-founder, NextServices and blogs at redo | healthcare.

We live in a very very noisy world. And it isn’t all audible.

There is a constant din of background “noise” from texting, email, Facebook, Twitter, Instagram and dozens of other sources. In olden times, newspaper columnists had a voice; Paul Harvey had a voice; Austin Rhodes has a voice. Today, everyone does.

And then there’s literal noise. Television. Muzak.

Ipods and ear buds. Radio.

Author Susan Cain is not content with the noisy status quo. Her bestseller Quiet is the manifesto for a world drowning in its own cacophony of voices.

She explores the historic era a hundred years ago when the loud and brash person became the model for the ideal shaker and mover.

There’s just one problem.

Quiet is an absolute necessity. For everybody.

Including people like musicians who make their living from sound. Beethoven didn’t write his masterpieces with a radio or TV blaring in the background, right?

(Forgive the flawed analogy, but you get the point.)

We need quiet to innovate.

cards.

• If you’re an introvert, staying true to your temperament is the key to finding work you love and work that matters.

• Everyone shines, given the right lighting. For some, it’s a Broadway spotlight, for others, a lamp-lit desk.

• “Quiet leadership” is not an oxymoron.

We need to celebrate the quiet colleague, the quiet boss, the silent partner. There’s a word for people who are “in their heads” too much: thinkers.

That’s just one of many wise maxims this book brings to light: • Our culture rightly admires risk-takers, but we need our “heed-takers” more than ever.

• Solitude is a catalyst for innovation.

• Texting is popular because in an overly extroverted society, everyone craves asynchronous, non-face-toface communication.

• Rule of thumb for networking events: one genuine new relationship is worth a fistful of business

Many of us have probably worked for someone whose management style was yelling. People who cannot make a major point without cursing or yelling are, unfortunately, not an endangered species.

That doesn’t mean that quiet and introverted people cannot be good leaders — or simply good and valued employees. Cain extols the virtues of the introvert, and it’s a message many of us need to hear.

As Gandhi expressed it, ”In a gentle way, you can shake the world.” + Quiet: The Power of Introverts in a World That Can’t Stop Talking by Susan Cain, 368 pages, published in January 2013 by Broadway Books

Research News Little things add up There are millions of people who couldn’t see without their contact lenses. These visual aids have come a long way from the hardshell, longterm-use lenses of the past. In fact, many people have daily lenses. No need to disinfect, just wear and toss.

As mentioned above, that’s exactly what millions of people are doing, yesterday, today, and again tomorrow.

An estimated 45 million in the US alone. According to research presented last week in Boston before the American Chemical Society, just the people who flush them down the toilet or drop them in the sink (only about 20 percent of users) adds up to a shocking 6 to 10 metric tons of plastic lenses in wastewater annually. Experts say they are a significant contributor to microplastic pollution in waterways.

They’re clear, difficult to see or easy to mistake for

something else, especially if you’re a fish who doesn’t wear contacts. When eaten, they’re indigestible, but even so, they then become part of the food chain. That impacts you, me, and everything else on the planet.

Until a quickly biodegradable lens is introduced (assuming it will be), researchers say contact lenses should be disposed of by placing it with other solid waste, not down the drain.

Kidney cancer breakthrough Worldwide, more than 330,000 people are diagnosed with kidney cancer every year. When caught early, the five-year survival rate is above 90 percent. For later stage discoveries, the survival rate can be as low as 10 percent.

That’s why research just released by Beth Israel Deaconess Medical Center in Boston is such good news.

They isolated a molecule

called KIM-1 whose presence can detect kidney cancer up to five years earlier than would be possible via a traditional clinical diagnosis.

It bears further scrutiny before it’s routinely used in clinics across the land, but it’s a step in the right direction.

Carb news Plenty of people religiously observe low-carbohydrate diets. New research, however, has found that diets both low and high in carbohydrates are associated with higher risk of disease and death, while data shows that consuming carbs in moderation seems to be optimal for health and longevity.

The study, published in The Lancet Public Health, also found that low-carb diets which replace carbs with protein and fats from plant sources was a healthier option than replacing carbs with fats and protein from animal sources. +

+ 12

AUGUSTAMEDICALEXAMiNER

THE EXAMiNERS +

Happy Friday!

by Dan Pearson

Not for me.

I just got laid off from my job at the unemployment office.

What???

Employment is up, unemployment is down.

Something had to give.

Tell me about it. My boss What a bad said, “Clean out your way to start desk, and I’ll see you first your weekend. thing Monday morning. © 2018 Daniel Pearson All rights reserved.

EXAMINER CROSSWORD

PUZZLE

ACROSS 1. Chilled 5. Prefix meaning under 9. Banned chemicals 13. Col. County venue 15. Birth a lamb (archaic; poetic) 16. Part of 68-A 17. Pelvic exercise 18. Anti-drug acronym 19. Douglas of film 20. Even one 21. Epstein’s partner?

23. Providing 25. Lg. local employer 26. Bibb County seat 27. Hanging limply 29. Hindu god 32. Bird or plate color 33. Mournful poem 34. Former coin of France 36. Stiff 40. Intestinal cond.

41. Scull power 42. Acapulco gold 43. Minor prophet’s book 46. Vase 47. There’s one at the National 49. Augusta _______ 51. Augusta novelist Shivers 52. Hot follower 54. Emulate Miley?

56. Falsehood 57. Therefore 58. Before long 59. Class of chemical harmful to the ozone layer 62. Middle Easterner 64. Type of gas 66. African plague 68. Area abbrev.

69. Viral resp. disease 70. Capital of Jordan 71. Sicilian volcano

ME

2

3

4

13

5 14

17 20

21

6

7

30

16

18

19

22

23

34

40

41 44

45

49

35

11

46

47

50

57

VISIT WWW.AUGUSTARX.COM Click on “READER CONTESTS”

39

48

55

58 64

38

51 54

63

All Mystery Word finders will be eligible to win by random drawing.

We’ll announce the winner in our next issue!

QUOTATIONPUZZLE

28

37

Simply unscramble the letters, then begin exploring our ads. When you find the correctly spelled word hidden in one of our ads — enter at AugustaRx.com

12

25

36

The Mystery Word for this issue: RIMANUC

42

53

56 62

10

32

33

52

24

27

31

43

9

15

26 29

8

THE MYSTERY WORD

65

59 66

60

61

B A O H S N E U C I N E E L I C L R F K E T N S M T L

S S E O L R R L A N R N S O R O C O F O Y : R Y

67

by Daniel R. Pearson © 2018 All rights reserved

68

69

71

72

— Author unknown

70 73

by Daniel R. Pearson © 2018 All rights reserved. Built in part with software from www.crauswords.com

72. Formerly; while prefix 73. NBC 26 DOWN 1. Girl’s given name (Nordic) 2. City in NW France 3. Nervously irritable 4. Coloring material 5. Watery prefix 6. Long 7. National standard 8. Jennifer from Summer of ‘42 9. Se-Ri of the LPGA 10. Cordele’s County 11. Benson, atop Augusta’s Confederate monument 12. Fifth Ave. store 14. NY & GA city 22. Obamacare acronym 24. Doors in most cars 26. Coffee cup 28. Noted architect 29. Vessel 30. The Honest Co. founder 31. 20th letter of the Hebrew

alphabet 32. JMS unit 34. Downtown Bar 35. Oops... same as 41-A 37. Desert in E Asia 38. Greek rainbow goddess 39. Over 44. Fave actress of Quentin 45. State N. of Conn.

47. LASIK target 48. Diving bird 50. World’s 4th highest peak 51. Name of 13 popes 52. Freedom of speech Amendment 53. Acquire knowledge 54. Former Russian rulers 55. Most unfavorable 56. Ornamental fabric 59. Deep unconsciousness 60. Become tired 61. Slope; tilt 63. Bleat of a sheep 65. Organ of hearing 67. Car mfg. in SC Solution p. 14

DIRECTIONS: Recreate a timeless nugget of wisdom by using the letters in each vertical column to fill the boxes above them. Once any letter is used, cross it out in the lower half of the puzzle. Letters may be used only once.

Black squares indicate spaces between words, and words may extend onto a second line.

Solution on page 14.

E X A M I N E R

3 7 9 8 4 2 7 4 9 6

5 2

1 8

3 2 8 2

8 9 2

6 3 9 7

S U 6 D 4 O K 2 U

by Daniel R. Pearson © 2018 All rights reserved. Built with software from www.crauswords.com

DIRECTIONS: Every line, vertical and horizontal, and all nine 9-square boxes must each contain the numbers 1 though 9. Solution on page 14.

Use keypad letters to convert numbers into words suggested by the definitions provided. Sample: 742 (body part) = RIB. Solution on page 14.

1. 28 (diagnostic procedure) __

6. 262 (medical org.) ___

2. 67 (hospital area) __

7. 3926 (MD task) ____

3. 37 (hospital area) __

8. 2978 (exam finding) ____

4. 328 (body component) ___

9. 537466 (skin abnormality) ______

5. 466 (medical org.) ___

10. 463268 (small patient) ______

by Daniel R. Pearson © 2018 All rights reserved

TEXT

1

AUGUST 24, 2018

AUGUST 24, 2018

13 +

AUGUSTAMEDICALEXAMiNER

THEBESTMEDICINE

The

Advice Doctor

Moe: Do you know what DNA stands for?

Joe: Sure: National Dyslexia Association.

ha... ha...

©

Moe: Did you hear that fruit & vegetable stand on Main St. has gone into liquidation?

Joe: No way! I went there all the time. I’m really gonna miss that place.

Moe: They’re still there.

Joe: I thought you said they went out of business.

Moe: No, I said they’ve gone into liquidation. They sell smoothies now.

A

mother asks her son, “Did you see that your little sister lost her first tooth?”

“I know,” said the boy. “I guess she won’t touch my PlayStation again.”

Moe: What are you doing home?

Joe: I just quit my job.

Moe: At the fire hydrant factory? Why? Joe: Because you can’t park anywhere near the place.

Moe: I asked my personal trainer if he could teach me to do the splits.

Joe: Can he?

Moe: Well, he asked me if I’m very flexible. I told him I can come every day except Tuesdays and Thursdays.

A woman was in terrible pain during labor. Her husband tried to comfort her.

“I’m sorry you’re in so much pain, honey,” he said. “I’m sure it’ll all be ok! Tell me what’s wrong.”

“The contractions are killing me!” she screamed.

“Well excuse me,” said the husband. “I am sorry you are in so much pain, honey. I am sure it will all be ok. Tell me what is wrong.”

Moe: How was your fi rst appointment with your new doctor?

Joe: The guy is amazing. He walked in the room, barely glanced at me, and told me I have a severe iron deficiency. I said, “How can you tell? You just walked in here ten seconds ago.”

He said, “Your shirt is all wrinkled.”

Wife: Why are you all oily and covered in glitter?

Husband: To prove you wrong. You said I never glisten.

Wife: LISTEN! YOU NEVER LISTEN!

Moe: How was your surgery?

Joe: It was pretty amazing. They wheeled me in and the first thing I saw was the anesthesiologist. I asked him if I could administer my own anesthesia. “Sure,” he said.

“Knock yourself out.”

Moe: I hate autocorrect.

Joe: You and me both. Whoever invented it should burn in hello. +

Why subscribe to theMEDICALEXAMINER? What do you mean?

Staring at my phone all day has had no affect on ME!

Because try as they might, no one can stare at their phone all day.

Dear Advice Doctor, At a party recently I saw someone who looked vaguely familiar.

Before I could process who it might be, she walked right up and said hello. I admitted I couldn’t place her face, and when she told me her name it rang a bell, but I still couldn’t connect the dots. She was very offended by my inability to remember her and made an angry comment. How could I have handled this better?

— Memory Lapse

Dear Memory, The medical term for the ringing sound you described is tinnitus (it’s pronounced TIN-ih-tus, not tin-EYE-tis). This is not the normal temporary reaction a person might have after attending a screeching 110-decibel heavy metal concert.

Instead, tinnitus can plague a person all day every day. For some people the sound isn’t ringing; it can be a buzzing sound, crackling or chirping, whistling, or hissing. It can vary in volume and sometimes go away, but it always comes back.

As if that isn’t bad enough, it’s more tolerable during the day when we’re continuously assaulted by sound of every kind. But in silence, like at night when a person wants some peace and quiet to lie down and get some much-needed sleep, that’s when it can be most noticeable. But tinnitus can be loud enough that during the day it interferes with being able to hear speech at school or work, and can obviously affect concentration.

The #1 cause of tinnitus is prolonged exposure to loud sounds. People who work in noisy factories, operate chain saws, guns, lawn mowers, and power tools, or who habitually play or listen to music at high volume are most at risk for tinnitus.

Alternately, living a quiet life is no guarantee that you’ll tinnitus-free. Sometimes an ear infection can cause it, as can high blood pressure, aging, Meniere’s disease, diabetes, medication side effects, and even a buildup of wax in the ear.

Step 1 in a long-term plan to prevent tinnitus involves hearing protection. Don’t expose yourself to loud noise for prolonged periods. If you already have tinnitus, whether minor or severe, get thee to a doctor and have it checked out, the sooner the better.

I hope that answers your question. + Do you have a question for The Advice Doctor about life, love, personal relationships, career, raising children, or any other important topic? Send it to News@AugustaRx.com. Replies will be provided only in the Examiner.

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AUGUST 24, 2018

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AUGUSTAMEDICALEXAMiNER

THE MONEY DOCTOR

529 EDUCATION SAVINGS PLANS There have been some changes over the past few years for 529 plans, so with school starting it is a good time to revisit 529 plans. As a reminder, a 529 plan is a tax-advantaged education savings vehicle. The 529 plan is a great way to save for education costs such as tuition, fees, books, supplies, equipment, and room & board. Although each state has its own plan, they all have similar rules with slight differences.

All the plans allow the earnings on your contributions to grow taxfree if you use the funds for qualified education expenses.

Given this, the plans are most advantageous if you start contributing early. The more years the money has to grow the larger the tax-free benefit.

As an example, if you put $100 per month into a kids 529 plan for 18 years and it grows at 6% each year the account will be worth almost $40,000. This raises two important questions for any family not currently savings for their kids’ education: What other items are we as a family currently spending $100 or more a month on? Of those items, which ones are more important to us than our kids’ education?

To test each item say the following, (insert any item as the fi rst word) “Cable TV is more important than my kids education.”

This is a great technique to help you confi rm that your spending aligns with your family’s goals and values.

We are fortunate to live in

two states that have favorable rules to encourage families to save for kids’ educations.

The state tax deduction is one of the major differences across state plans. Each state has different rules, and in Georgia joint filers can receive a state income tax deduction up to $4,000 ($2,000 for single fi lers) each year per child you contribute for. In South Carolina, you can receive an unlimited state income tax deduction. It is nice that both states allow residents to receive very nice state income tax deductions.

The Tax Cuts and Jobs Act made a big change to 529s. As of 2018, you can now take $10,000 out each year for elementary or secondary public, private, or religious school. This does create some additional planning opportunities for families. We do recommend you talk with your financial planner and accountant to better understand if this is something you should consider. You will limit the tax-free growth if you take money out of the plan shortly after making a contribution.

Is your car healthy?

For some families, putting money in that you will use in a few months for education to get the state tax deduction may be advantageous.

One of the key features of the 529 plan is that the donor retains control of the account. For families that we work with, we find that is a very important part and reason many like to use 529 plans. This feature allows the owner of the account the flexibility to change the name of the beneficiary.

So, if one kid does not use the funds for education the owner can name another person as the beneficiary.

This can be a great estate or legacy planning tool that allows families to earmark funds for education for future generations.

The 529 plan can be used by grandparents or other family members as well. If you are a grandparent or family member considering a 529 plan contribution, we do recommend you coordinate

your contributions with the parents. This will help the family avoid under or over funding for a kids education.

Often times we find that retired grandparents do not have any state income tax liability given the large state retirement exclusions. If you have no state tax liability, you will not get any benefit from the state income tax deduction. Families may want to consider gifting the funds for the contribution to the working parents that have state income tax liability. A 529 owned by a grandparent or parent can also impact financial aid applications, so we strongly recommend you work with a financial planner and accountant when considering these strategies. +

by Clayton Quamme, a Certified Financial Planner (CFP®) with Calvary Wealth, LLC (calvarywealth.com), a fee-only financial planning and investment advisory firm with offices in Augusta, GA and Columbia, SC.

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