Medical Examiner 12-17-21 by Daniel Pearson

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DECEMBER 17, 2021

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IT’S ALL ABOUT

PART M OF A 26-PART SERIES

SURVIVAL “It’s the most wonderful time of the year” go the lyrics to a popular holiday song. And maybe it is for you. If so, congratulations; you’re enjoying a season that for many people is synonymous with anxiety and depression. Mental health — at any time of the year — is at least as important as physical health, and sometimes more. But it can be a lot more challenging to maintain during the holidays. Here are a few tips for maintaining physical and mental health all year long. • No is a small but very powerful word. Learn to use it. Say no to things you know in advance you will not enjoy (note: this doesn’t apply to classes or your job; choice is not in play there), things that will unnecessarily cause significant stress, or will require spending money you don’t have. There’s no need to offer explanations. Just politely say no. • Don’t fake it. That doesn’t mean it’s ok to be angry or annoyed and make sure everyone knows it. It means, as above, do your best to avoid optional situations that will require playing happy for hours when you’re seething inside. When you’re sad, mad, or lonely, talk to a trusted friend who is a good listener. • Fight the food fight — and play to win. Overeating is often something we deeply regret — until next time, that is. Then we regret it all over again and vow never again! — until the next time. As the experts always say, diets never work, mainly because they always end. But lifestyle changes can succeed. After a while, the habit of eating smaller portions becomes a habit. It’s not a diet; it’s just the way you live now. • Lock up your credit cards. Far too often, the most wonderful time of the year is closely followed by a painful fiscal hangover. Nobody wants that. The most wonderful time of the year should be all year long. +

IS FOR MEMORY

uick, name the author of Treasure Island. No doubt you quickly thought of the correct answer despite the fact that the first (and perhaps only) time you read that book might have been in middle school. How long ago was that? How is three pounds of soft, mushy tissue capable of its amazing feats of recall? Let’s acknowledge at the outset, coming up with Robert Louis Stevenson is child’s play for the brain. It can do far, far more. It has the ability to replay complex

events from long ago as though on a movie screen inside our head, complete with a vast array of details that include sights, sounds, smells, tastes and sensations, plus dialogue from a whole cast of characters. Just one scene the brain could replay from our memory banks would be too much to fit on a zip or thumb drive, and the brain has millions of videos in its files and zillions of facts and memories in storage. As far as scientists can determine, the brain’s capacity for long-term memory is for all practical

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purposes limitless. The best-guess estimate of its storage ability is 1,000,000,000,000,000 bytes, which would be sufficient to store around 5 billion copies of your favorite 350-page novel, or perhaps store the entire DNA code of every man, woman and child in the United States. If you went the DNA route, you would still have enough free memory space left over for a back-up copy for everyone. As amazing as it might be to contemplate your ability to clearly remember that time you fell off a pony at a petting zoo at age 5, it’s even more remarkable to consider that memory is essential to keeping us safe from diseases, including the one currently ravaging the world. There are really two kinds of memory, then; the first is the one we readily recall — the one that lets us remember the phone number of the house we grew up in — and then there’s the other one that we hardly ever remember: immunological memory. Both are astonishing capabilities that occur on a molecular level and that even the brightest minds in science and medicine don’t fully understand. With immunological Please see MEMORY page 3

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AUGUSTAMEDICALEXAMiNER

DECEMBER 17, 2021

THE FIRST 40 YEARS ARE ALWAYS THE HARDEST

PARENTHOOD by David W. Proefrock, PhD

Your 5 year-old son just said to you, “Santa Claus isn’t real, is he?” What do you do? A. Say, “Of course Santa is real! Where did you ever get the idea that he isn’t?” B. Tell him that he is right. There isn’t a real person named Santa Claus, but that the idea of people giving gifts and celebrating the holiday is real, so the idea of Santa Claus is real. C. Tell him that Santa, the Easter Bunny, and the Tooth Fairy are just made-up things to make children happy. None of them are real. D. Pretend you didn’t hear him or change the subject and go on to something else. He’ll probably forget he asked you. If you answered: A. If he asked the question, he already suspects that there is no Santa Claus. There’s no reason to lie to him. However, there’s also no reason to be brutal. Talk to him about the spirit of Christmas. B. This is the best way to handle this situation. Even though Santa may not be real, the things that Santa stands for are real. C. This is too direct, too unfeeling, and too inclusive. He didn’t even ask about the Easter Bunny or the Tooth Fairy. Talk with him about the Christmas spirit and how real it is. D. Does any parent ever get by with this response? Not for long to be sure. It’s best to respond with truth and sensitivity. We all know the idea of Christmas and the Christmas spirit is real even if the person of Santa Claus may not be. That is what should be emphasized in dealing with young children and childhood legends. Merry Christmas to all! + Dr. Proefrock is a retired clinical and forensic child psychologist.

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memory, the body is called upon to mount an effective defense against a dizzying array of antigens, bacteria, and other hostile invaders that are looking for a nice place to settle down and build a family. Our body’s immune system is given the daunting task of jealously guarding our internal real state against these unwelcome squatters, millions per day, who are trying to invade our personal space. Defeating them initially isn’t half the battle; it’s one-billionth of the battle: once an invader has attempted entry, even if it is swiftly defeated its face is plastered on wanted posters circulated throughout the body. If you see this invader, shoot to kill. Those posters sometimes stay up permanently, which is why some diseases are one-and-done. If you’ve had the measles or mumps, you’ll never have it again. You have lifetime immunity. If such diseases ever attempt a second assault, your immunological memory immediately recognizes them and doesn’t hesitate to fire. In other cases, however, the antibodies created by the body to ward off a certain disease are gradually sent off into retirement. A 2007 study published in the New England Journal of Medicine found that about half of the antibodies against chickenpox will be gone within 50 years, while the half-life of tetanus antibodies is only about 11 years. That explains why most people don’t get chickenpox boosters, but tetanus boosters every ten years or so are recommended. The immunological memory is sharper in some cases than in others. Sometimes, though, it seems like the immune system has lost its mind. It seems to have lost all immunological memory. We just got over a cold and then a month or two later

we get another one. What’s up with that? Some pathogens, like those responsible for the common cold, are simply not considered a big deal by the immune system. As a result, a massive army of antibodies is never mobilized, and so a huge occupation army isn’t left behind afterward either. In other cases, the immune system’s memory is just fine, but the invaders have changed enough to be unrecognizable. That is the case with seasonal flu, a virus that can and does regularly mutate into different versions. That’s why annual flu shots are recommended. The flu virus can change enough from one year to the next to pull off a complete disguise. A flu shot injects an inactivated (that is, dead) dose of the specific strains of flu virus experts believe are most likely to strike. That, in turn, stimulates the production of antibodies that will be on patrol should any live flu viruses try to crash the party. This is why we’re all encouraged to get flu shots and various preventive vaccines, including the one for COVID-19. Our opening question remains, however: “how is three pounds of soft, mushy tissue capable of its amazing feats of recall?” You thought we forgot, didn’t you? Actually, scientists don’t fully understand how memories are stored and retrieved in and from the hippocampus, a tiny (2inch) part of cranial real estate, and the adjacent amygdala (which is even smaller), but simply put, from the Jell-o that is the human brain chemical reactions upload whatever we’re looking for — someone’s name, that mental grocery list, the words to a song, memories of our wedding day — in short, everything except where we left our sunglasses. And our car keys. They’ll turn up eventually. +

WHY CAN’T I EAT BEFORE MY MEDICAL PROCEDURE? There are a number of reasons, but the top one might be that you want to survive the procedure. Yes, it’s that important. Generally speaking, the “nothing by mouth” order comes into play when a patient will be sedated or under general anesthesia. In such conditions, it’s possible that stomach contents can be aspirated. What does that exactly mean? Well, it isn’t a pretty picture. It means that while unconscious, a person may become nauseated and vomit. That’s no fun even when we’re awake, but under anesthesia it can be an absolute nightmare. It’s possible, even likely, that some of the vomit can be inhaled (or aspirated) into the lungs. Even if that happens during surgery and doctors can immediately apply suction, there is a significant risk for lung damage and infection. Heartburn is a reminder of the caustic nature of stomach acids. Imagine the damage they can cause to delicate lung tissue. Partially digested foods have no business in the lungs, and a common result of aspiration is infections, and they can be very serious, even fatal. There are countless cases in medical literature involving patients who lied to their doctor prior to surgery (“Nope, I haven’t eaten since last night”) who ended up paying a very high price: days or weeks on a ventilator, and sometimes death. Anyone playing that game is pulling a fast one on himself. Granted, it’s possible that a person could sail through an operation with flying colors despite ignoring doctor’s orders on NPO (from the Latin, nil per os, literally “nothing by mouth”). The instructions are a precaution, but they do add one more level of safety and remove one more source of potential risk. Some people counter, accurately, that victims of car accidents, gunshots and stabbings, etc., are operated on without having to go NPO for 8 hours prior to surgery. Trauma surgeons are aware of this and take action accordingly. The bottom line: not eating before a procedure helps doctors focus on the job at hand, not the unexpected complication of your doing. It helps you get well faster. +

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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. Direct editorial and advertising inquiries to: Daniel R. Pearson, Publisher & Editor E-mail: Dan@AugustaRx.com AUGUSTA MEDiCAL EXAMINER P.O. Box 397, Augusta, GA 30903-0397

(706) 860-5455 www.AugustaRx.com • E-mail: Dan@AugustaRX.com www.Facebook.com/AugustaRX Opinions expressed by the writers herein are their own and/or their respective institutions. Neither the Augusta Medical Examiner, Pearson Graphic 365 Inc., nor its agents or employees take any responsibility for the accuracy of submitted information, which is presented for general informational purposes only. For specific medical advice, diagnosis, and treatment, consult your doctor. The appearance of advertisements in this publication does not constitute an endorsement of the products or services advertised. © 2021 PEARSON GRAPHIC 365 INC.

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DECEMBER 17, 2021

#155 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

his installment, #155 of this award-wanting feature, could be viewed as a follow-up to #154, in that they both happened at about the same time, during the earliest days of cancer treatment that was actually effective. The treatment breakthroughs this man engineered date back to the mid- to late 1940s and are still employed today. He has been dead for almost 50 years, yet his name is still quite well known; you know it, and most likely you associate it with cancer treatment. All of which makes it very surprising that he was responsible for a major cancer treatment disaster. Major as in it killed every last person in his clinical trial. It all started innocently enough, when a couple of papers by researchers at Mount Sinai Hospital appeared in prestigious medical journals announcing an exciting discovery that stopped the growth of tumors in their tracks. Our subject, the doctor pictured above, was involved in the treatment of children with leukemia every day, so naturally he was excited about the potential to alleviate the suffering of his patients. In the studies, patients obtained the cancer-fighting benefit through an element provided by their diet, but our doctor went one better: he contacted a pharmaceutical company to obtain a purified form of the active ingredient noted in the journals. With the pure compound in hand, he administered it to eleven children, all of them suffering from acute lymphoblastic leukemia (ALL). What were the results? You Bet Your Life, by Paul Offit, M.D., a book we recently reviewed on these pages, summarized it thusly: “It’s not easy to treat a disease that has a mortality rate of 100 percent and a life span of only a few months and make it worse. But Sidney Farber had done exactly that.” Yes, we’re profiling the namesake of the famed Dana-Farber Cancer Institute, the man known as the father of chemotherapy. What went wrong? The papers Dr. Farber read touted “folic acid” as the key element in their discovery. And we mean that literally: every time they mentioned “folic acid,” they put it in quotes. They weren’t really sure what they were dealing with, but it had something to do with folic acid. Unfortunately, the Mount Sinai researchers’ third article wasn’t published until after Farber’s disastrous trial. By then they had isolated the anti-cancer element, and it was the very opposite of folic acid, which happens to be a cellular growth factor, the last thing you’d want to give a cancer patient. The opposite of folic acid, logically enough, is what is called a folic acid antagonist. As the name suggests, a folic acid antagonist would cancel out or fight against the cell-growing effects of folic acid, interfering with its promotion of cell division and replication. In short, it was ideal for cancer treatment. If you’ve ever heard of methotrexate (a word that pops up often in TV drug commercials), it is a folic acid antagonist. Within a year of his worst cancer-fighting experience, Farber atoned for that disaster by treating sixteen children with ALL, every one of them at death’s door, using an early version of methotrexate called aminopterin. It marked the first time childhood cancer had been successfully treated with medication. +

I recently took a quiz that asked which of the following things I’d experienced. The list was aimed at those of us who lived in the Forties and Fifties. Later I thought about how many things were not on the list that I have done. It was a large number of items and activities. Just for fun, let’s see how many of you have done the things on my list. ___ Blown the fuzzies off cattails ___ Pumped water from a well ___ Used an outhouse ___ Watched the Northern Lights dance ___ Played hopscotch ___ Know what “Ollie, Ollie, Oxen” refers to ___ Reclined on your back in the grass and watched the clouds drift by ___ Learned how to fold cloth diapers ___ Saw a red WWII penny or spent one ___ Contributed to a paper, cardboard, or cloth drive ___ Ridden in a rumble seat ___ Read a book by using the light from the bathroom when your room is dark ___ Gotten paid less than $1.00 an hour for doing some kind of work ___ Put a coin on a railroad track to see what happens when a train rolls over it ___ Fished using a cane pole ___ Listened to a coffee pot percolate

___ Woke up to the smell of bacon frying ___ Made your own Halloween costume ___ Done all your Christmas shopping for 6 people with $2.00 at a dime store ___ Marched through the house banging pots and pans to the music from a brass band on your record player ___ Cut down your own Christmas tree ___ Strung popcorn on a string for your Christmas tree ___ Memorized a prayer ___ Learned how to square dance ___ Sat up all night waiting for Christmas to finally arrive I have personally done all the things on my list and had a wonderful time doing them. There are an awful lot of good memories to be found in making your own list of things you’ve done in your childhood. For example, your list might include pulling out that first loose tooth, eating s’mores by a campfire, picking wild berries, grilling hot dogs on a stick, adding yellow food coloring to fat to make pretend butter, and so many, many more I haven’t thought of yet. I hope you have as much fun making your list as I had making mine! Merry Christmas, Happy New Year, and that reminds me, banging pots and pans outside at midnight! Attending midnight church services! Having to wait until your Grandma arrives to open your presents! +

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AUGUSTAMEDICALEXAMiNER

ADVENTURES IN

Middle Age

Fight for freedom from

BY J.B. COLLUM

{

One of the things that happens as you car. Sure, we can get joint replacements, get older is that days, weeks, months, and transplants, metal and plastic parts to shore even years seem to shorten considerably. I’ve up weakening biological ones, but we can’t heard of Einstein’s theory of relativity, and replace most of our parts at all, and even how it states that time is relative. Don’t get replacing the ones we can is much more me wrong. I’m no scientist, but I do know costly and risky for a human than it is for a that he meant that time is relative to our car — except maybe for a Bugatti Veyron. An speed through space, not that it’s a relative oil change for that car is $20,000 and a new thing in our heads based on our age. Still, set of tires is $42,000! But back to humans, maybe there’s another theory of relativity they haven’t figured out how to let us move out there connected to our age. I say this into a new body yet, and likely never will. because it is hard for me to believe that this But if they do, can I pick which body I want? issue is the last one of the year. But time If so, I’m thinking Tom Selleck would be a marches on, even if we are like the little dog good choice, and my wife agrees. who doesn’t want to go for a So, here we are. We are walk and gets dragged by the getting older. Our parts are Aging is like leash the whole way. wearing out. Time is zipping by When we are younger, it like a supersonic fighter jet with shopping is just the opposite. Getting the afterburners on, and there for a new car. older is something we really isn’t much we can do about it. I want as kids, but we feel like don’t mean to depress you, but we’ll never get there. Why the this is the state of things for us impatience? With age comes more privileges. folks in middle age. Things like staying up later, getting a driver’s Why doesn’t this get us down more than license, a car, dating, freedom, and so much it does? I think it is because despite all of the more. Of course, when we are young getting limitations imposed upon us by our aging older is sort of like shopping for a new car. bodies, life is still good for most of us, and we When we are looking at or test driving that still can have happiness despite our situashiny new perfect machine, all we can think tion, whatever it may be. We’ve learned a lot about is where it will take us and the style it over the years — hopefully you have anywill take us in. Or maybe like my last vehicle way — and we can use that knowledge and purchase, a truck, we are thinking where it experience to savor the moments we have and will tow our home on wheels. Then, too late, focus on the better things in life. We’ve sifted we find out how much the insurance for that through the worthless stuff when we were expensive new vehicle is going to cost (very younger and left just the good stuff to enjoy. high on trucks, I found out. And what is it Things like a beautiful sunrise that I am lookwith property insurance anyway? If we own ing at now here at the lake. The laughter of it, why do we have to pay someone else for children. A good book to read. A walk through the privilege of owning it? That keeps me up the woods on an autumn afternoon when at night. But I digress.) and so we struggle the usual green shades that surround us are to find room in the budget. Then our first joined with the vibrant yellows, reds, and orpayment comes due and we wonder what we anges in a symphony of color, and all of them were thinking. Then about 3,000 miles later, are dancing in the breeze to the beat of the we have to start paying for maintenance on wind. Of course, sometimes we are under the that vehicle. Finally the worst part comes weather and can’t enjoy them as much as we’d a few years later, when we are still making like, just like when it is raining on that trail, payments on that formerly shiny and new but we put our jackets and hats on and soldier vehicle, and it is now a little less shiny, out on through the rain or even the storm because of warranty and needs a costly repair. we know that life is sweet, and we know The good news with the car is that as long that we only have this campsite as we can afford it, we can keep repairing reserved for a limited time. + it by replacing old worn-out parts, and J.B. Collum is a local novelist, if that becomes too costly, we can buy a humorist and columnist who wants new one, again, as long as we can afford to be Mark Twain when he grows up. He may be it. Unfortunately, with the human body reached at johnbcollum@gmail.com we can’t do that as well as we can for a

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TRYTHISDISH DECEMBER 17, 2021

by Kim Beavers, MS, RDN, CDCES Registered Dietitian Nutritionist, Chef Coach, Author Follow Kim on Facebook: facebook.com/eatingwellwithkimb

BUTTERNUT SQUASH SOUP A healthy soup sure to keep you warm in the winter! Ingredients • 2 tablespoons butter • 1 large onion, chopped • 3 cloves garlic, pressed • ½ teaspoon chopped fresh ginger • ½ teaspoon cumin • ¼ teaspoon black pepper • 1 butternut squash (about 2lbs) peeled and diced into ½-inch cubes • 1 large potato, peeled and diced into ½-inch cubes • 1 quart chicken or vegetable stock • 2 tablespoons tomato paste • 1 tablespoon lemon juice • 1/3 cup heavy cream, plus more for garnish • ½ teaspoon salt (optional) • Cinnamon to garnish Instructions In a Dutch oven or similar large sturdy pot, melt the butter on medium heat. Add onion, garlic, ginger, cumin, and black pepper and cook stirring occasionally for 5 minutes. Add squash and potato mix thoroughly with the onion mixture to coat the vegetables. Add stock, tomato paste, and lemon juice and stir to combine. Bring the soup to a boil and then reduce to simmer.

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Simmer, covered for 20-30 minutes until vegetables are tender. Remove from heat and allow the soup to cool a bit before carefully processing. In small batches, purée the soup in the blender, pouring the puréed soup into another pot as you go. Alternatively, you can use an immersion blender and purée the soup in the pot. Once smooth, return the soup to the heat and stir in the cream. Stir in salt. Warm through and serve immediately, garnished with a spoonful of cream and cinnamon if desired.

Yield: 6 Servings (serving size: 1 cup) Nutrition Breakdown: Calories 190, Fat 7g (4g saturated fat), Cholesterol 30mg, Sodium 140mg, Carbohydrate 33g, Fiber 4g, Protein 7g. Nutrition Breakdown: 4% Vitamin A, 80% Vitamin C, 8% Calcium, 10% Iron Diabetes Exchange Value: 2 Starches, 1 Fat You can omit the cream or stir in a cashew cream for a reduction of saturated fat.

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I NEED WHAT?

YOU GOTTA BE KIDDING! by Ken Wilson Steppingstones to Recovery

I’m often amused by guys needing treatment who come to see me with their own pre-planned outcome in mind and who want me to sign on to their plan instead of hearing my recommendation because they just don’t want to hear it. Recently I’ve heard: • “I want help to stop drinking, but I’m gonna keep smoking weed.” • “I won’t go to inpatient treatment but I’ll come to your outpatient program.” • “You just want to make money off me, so I’m not gonna do treatment.” • “I refuse to go to a halfway house, but I’ll do treatment again.” Sometimes I think people think that we addiction counselors make recommendations on a pull-a-planout-of-a-hat approach, or we choose a plan because we personally like or dislike them. Much to the contrary, there is a patient placement

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“bible” that licensed/certified counselors use to make such recommendations. It’s called the American Society of Addiction Medicine Patient Placement Criteria (ASAM for short), and it’s a 450-page book guide to admission, continued stay, and discharge criteria for all levels of addiction counseling and treatment. 450 pages is a lot, I know, so I have a challenge to present this material to you in simple and abbreviated terms. Why bother? Because daily I hear, “Treatment Center X won’t take me!” or “They kicked me out of the hospital just when I was beginning to get better.” You should know and understand how this all works. It will decrease your anxiety and frustration when you’re up against the Big Bad Wolf of Insurance Re-Imbursement, at least. And at best, it will help you find and accept treatment/counseling for addictive disorders. The first “ASAM Dimension,” or criteria for admission addresses your Intoxication/Withdrawal Potential. I’ve referred a number of people to hospital-based inpatient treatment, and after a brief assessment in the emergency room they were sent home and told to enroll in an intensive outpatient treatment program. Why? Because they didn’t meet the criteria for admission to inpatient detox! Meaning, it had been 3-4 days since their last drink and they were “out of the woods” as far as needing medical detox – no DTs (look that up!) for them! Or they tried to get inpatient detox for opiate use. Not! I know of no insurance company who will authorize inpatient admission for opiate withdrawals only. Why not? It’s not life threatening. You won’t die from opiate withdrawals…you’ll only want to, but only for a minute!

THIS IS YOUR BRAIN A monthly series by an Augusta drug treatment professional

Story time. Years ago I know of a female in her 40s who sought outpatient ambulatory detox at home. This woman needed inpatient detox since she could not interrupt the habitual, compulsive intake of vodka and wine. She had completed multiple treatment and detox programs, but didn’t want to stay in the hospital. Her medical doctor was evidently not acquainted with the ASAM tool, and as a result gave her a prescription for 30 Librium tablets to take as instructed over a period of a week and sent her home. Now, for just a moment, think like an alcoholic. These pills were benzodiazepines that go straight to the GABA (gamma-aminobutyric acid, if you must know) receptors in the brain. Benzos and alcohol are basically the same thing to the brain, which can make benzodiazepines a good fit for withdrawals if — a very big if — monitored medically. Some people, usually with support at home, can be compliant with such a routine, but not this woman who had suffered the ravages of alcoholism for a lifetime. She didn’t show up to work or AA meetings for two days, and when officers made a wellness check at her home she was found dead on the kitchen floor, having taken the whole bottle of pills within two days and had consumed vodka on top of the pills! I know, I know…had the doctor only known about the ASAM Criteria... When an addiction professional, underscore professional, makes an informed recommendation, he or she is really not kidding. For your own good, it’s what you really need. +

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DECEMBER 17, 2021

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AUGUSTAMEDICALEXAMiNER

y h t l a e H

HAPPY

HOLIDAYS!

ARKS

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Hometown. Not big box.

DON’T SKIP BREAKFAST Not too long ago the American College of Cardiology released the results of a study in Madrid, Spain, which found that skipping breakfast or having a skimpy breakfast leads to an increased risk for atherosclerosis (hardening and narrowing of arteries) due to the build-up plaque. Ironically enough, breakfast skippers had the greatest waist circumference and the highest BMI (Body Mass Index), blood pressure, blood lipids (fats), and fasting glucose levels of any group in the study. Hand in hand with those findings, researchers not unsurprisingly found skippers to also have an overall unhealthy lifestyle, including

the greatest likelihood of smoking, frequent alcohol consumption, and overall poor diet. The habits are common: of the more than 4,000 study participants, only 27 percent ate a healthy breakfast (definition: consuming at least 20 percent of the day’s energy/calorie requirements). Those who skipped breakfast (definition: less than 5 percent of their energy needs; example: a cup of coffee) totaled the smallest group in the study at just under 3 percent of participants. The largest group, nearly 70 percent, were those who had a low-energy breakfast (definition: more than 5 percent of their energy needs but less than 20). Doctors who conducted the

research say people commonly compensate for skipping breakfast by eating more later in the day, usually not healthful choices. They added that skipping breakfast can cause hormonal imbalances and alter circadian rhythms. More proof, they say, that breakfast is the most important meal of the day. +

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DECEMBER 17, 2021

CRASH

COURSE

More Americans have died on US roads since 2000 than in World Wars I & II combined

{

anger, annoyance and loneliness, and one psyccident statistics for the past year or two chology professor quoted in news media calls have shocked traffic engineers and highway reckless driving a form of rebellion, acting out in safety experts. Deaths on U.S. roads during 2020 response to irritation. To illustrate, have you ever were the highest since 2007. That despite dramat- noticed a driver who can’t get around a slowically less driving during 2020 due to pandemic poke? The longer it goes on, the more frustrated restrictions and precautions. and impatient the driver gets. When they finally The predictions were that 2021 would see recan pass, they often do so very recklessly and ductions and a return to normalcy, but the latest aggressively. That, in effect, is what millions of us figures suggest another deadly peak in fatalities are doing in response to our frustrations over the for this year. ongoing pandemic situation. And guess what many analysts And it isn’t only happening on think is the reason for the rise. highways and byways either. One more thing to the The pandemic. Other trends that are being inked Are you rolling your eyes right to the pandemic include new blame on the now? Well, join the club. But if you records in drug overdoses, soarpandemic. disagree, how would you explain ing alcohol sales, and the biggest a year like 2020, when total miles nationwide increase in murder driven dropped like a rock and on record, according to the Los fatalities shot up like a rocket? Angeles Times. Those phrases are not mere hyperbole. After Back to the roads, since the start of the pandecades of gradual but steady improvements in demic, statistics reveal substantial increases in achighway fatalities, deaths rose by more than 7 cidents involving speeding, illegal substances and percent in 2020 despite a more than 13 percent failure to wear seat belts. An increase in ejections drop in miles driven, and during the first half of of beltless drivers and occupants corresponded this year, preliminary numbers show an 18 perto the onset of lockdowns last year. According to cent jump in fatalities. To put the numbers into reports, California Highway Patrol officers issued perspective compared to other years, for every nearly 28,500 citations for speeding over 100 mph 100 million miles driven, 2020 fatalities were 23 last year, a number nearly twice the 2019 total percent higher than 2019’s. despite sharply reduced 2020 driving. People who have devoted a significant amount At these trends most basic level, experts point of resources to investigating this curious develto a national decline in manners and civility that opment at places like the National Safety Council has accelerated during the pandemic. The effects and the Johns Hopkins Bloomberg School of are seen on our roads; in soaring numbers of Public Health blame the pandemic for creating a disruptive passenger incidents during flights; in sort of fatalistic approach to life and safety in the violent arguments over wearing masks that end minds of many. up in shootings, stabbings and deaths; in abuse of How is wearing a seat belt important in the drugs and alcohol; in physical disputes over vacmiddle of a pandemic that is killing hundreds of cines, and in countless other ways, some of them thousands of people in the U.S. alone, let alone headline-making, many nothing more than minor millions around the world? What’s the harm in skirmishes between individuals. one more drink for the road? It could be my last. In the end, we could ask legislators to enact Of course, no one entertains such thoughts more traffic safety laws. We could look to law consciously. It’s more of a subtle psychological enforcement to ensure greater compliance with change that boils down to blowing off steam after the rules of the road. more than a year and a half of being restrict Or, starting today we could apply the Golden ed, cooped up and locked down in one form or Rule and practice basic manners and common another. decency. The simplest solution is often the best. The various results are depression, isolation, But how likely is that to happen? +

MEDICALEXAMINER READ THE

ASAP!

*As salubriously as possible

HUMAN BEHAVIOR WHAT YOU CAN DO RIGHT NOW FOR YOUR MENTAL HEALTH Part One: Self-Care During the Holidays by Jeremy Hertza, Psy.D. and Lance Evans, PhD, MBA

In your family, the holidays often go like this: Your sister, Jane, is either snappy or pointedly ignores you. Uncle John says something triggering, which causes everyone to burst out into noisy arguing. Then again, maybe you’re usually alone during the holidays and dread knowing that you’re missing out on the fun and camaraderie everyone else seems to have. Add on top of a couple of years of COVID-19, strong opinions about vaccinations, and questions about whether or not to mask up. As a result, your holidays could be more highly charged than ever. Why Self-Care Is Key Emotional and mental stress can take a toll on you physically, causing headaches or making you more susceptible to illness. And if you’re depressed or anxious because of stress, it can also affect how well you take care of yourself, whether that’s exercising, eating well, managing your diabetes or handling your blood pressure. That’s why self-care is important at any time of the year, but especially during the holidays. Here are few strategies you can try: • Ask yourself, “How are you doing?” Take a few moments to check in with yourself. Are you sad or withdrawn, or are you happy and engaged? Are you nervous or are you excited? Take stock of clues, such as sweaty palms or a racing heart, that indicate you’re feeling jittery. • Then ask yourself why—and be realistic about your expectations. If you’re already anticipating challenges you may have during the holidays, instead of worrying about them, try accepting them. For example, don’t be surprised or upset that dinner doesn’t go well when it usually doesn’t go well. Or, avoid talking about COVID or sports with Uncle Fred, because you know it will only start an argument. By being realistic about what your family is like, you won’t set yourself up for a letdown or disappointment. • Also, work on a plan. Come up with easy escapes so you can maintain your joy, even during tense situations, whether that’s focusing on enjoying time with your favorite relatives, being the person who interjects a new conversation topic, or moving over to the kids’ table so you can have a breather. Try taking a walk or finding a quiet place where you can get away—everybody could use that at some point during the holidays. • Eat and drink wisely. How you feel physically also affects your mental and emotional health. So be careful about eating so much rich food that you feel uncomfortable, or drinking many holiday cocktails or cups of coffee, which could let down your inhibitions or make you jittery. If you’re about to be around family that you haven’t seen for a year, overdoPlease see SELF-CARE page 16

DECEMBER 17, 2021

the blog spot — posted by Ton La, Jr., JD, on December 10, 2021

WEAR YOUR MASK TO PROTECT YOUR FAMILY Below is a story a patient shared with me about how he went from being against mask-wearing to wearing one every day. Last year, my mom died from stage 4 lung cancer. Before she passed, she received a lung transplant, but it was too late for her. Now, I am fighting cancer. Lymphoma. Stage 2 verging on Stage 3. Before my diagnosis last summer, I never wore a mask. I walked around like the virus wasn’t here, and I felt free not wearing a cloth mask, N95, or what have you. I just hated the idea of these mask mandates and being told to do with my body. It’s my right to choose whether or not to wear a mask and to take on the consequences because it was my choice. But not long before my diagnosis, I started getting sick. Real sick. Lung infections landed me in the hospital a few times, which led to my lymphoma diagnosis. I went into shock at some point and nearly didn’t make it. But by the grace of the God above, I’m here in front of you as best as I can stand on my own two feet. Now, I religiously wear this N95 mask every time I step out of the door because I can’t afford to get COVID. I have an 8-year-old boy, and I have to be here for him and to beat both my cancer and this pandemic. I need to be his dad, do dad things with him, and tell me if I sound crazy, but I want to see him reach milestones. Graduations, moving out to college, and even marriage down the road. My son is the number one reason I decided to buy masks and wear them. Don’t get me wrong; I absolutely hate wearing this mask. It’s stupid. I honestly don’t know how nurses and doctors can wear these for hours on end. It’s genuinely hard to breathe, and I find myself reaching for the nearest wall to catch my breath before walking again. But I have to wear this mask for my son. I am taking a chemo pill right now, and I’m told it’s doing what it needs to do so far. Other treatment options are on the horizon, but the one thing every doctor is telling me is that I must do my very best in between appointments to keep myself as healthy as I can. That means I must wear this green, funny-looking, sometimes suffocating N95 mask to protect myself from COVID. To protect my family. I know that if I am in the hospital with COVID, I will die. And my son will have only his mom to support and love him. I can never let that happen because he is my world, and I know he looks up to me in everything that I do in this life. I am hoping my story will encourage others to wear their mask. I know how you feel. We all have the freedom to choose. But if you have anyone that you love in your life, you must protect their health and well-being. Wearing a mask is like wearing a seatbelt; both are designed to protect you and others around you. +

I hate wearing this mask. I don’t know how people wear them for hours on end.

Ton La, Jr. is a medical student

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AUGUSTAMEDICALEXAMiNER

From the Bookshelf A compendium of excerpts from reviews of this book: The outstanding feature of Do No Harm is the author’s completely candid description of the highs and lows of a neurosurgical career. ... For its unusual and admirable candor, wisdom and humor, Do No Harm is a smashing good read from which the most experienced and the most junior neurosurgeons have much to learn. (AANS Neurosurgeon) This thoughtful doctor provides a highly personal and fascinating look inside the elite world of neurosurgery, appraising both its amazing successes as well as its sobering failures. (Publishers Weekly (Starred Review)) One of the best books ever about a life in medicine, Do No Harm boldly and gracefully exposes the vulnerability and painful privilege of being a physician. (Booklist (starred review)) When a book opens like

Henry Marsh describes the soaring triumphs and the shattering tragedies that are part of every surgeon’s life. A remarkable achievement. (Michael J. Collins, author of Hot Lights, Cold Steel)

this - “I often have to cut into the brain, and it is something I hate doing” you can’t let it go, you have to read on, don’t you? (Karl Ove Knausgaard, Financial Times) Marsh, one of our leading neurosurgeons, is an eloquent and poetic writer. Do No Harm offers a rare behind-the-scenes look at the most mysterious part of human life. His descriptions of neurosurgery are at once fascinating and illuminating; a gripping memoir of an extraordinary career. (Daniel J. Levitin, PhD, author of The Organized Mind and This Is Your Brain On Music)

A soul-baring account of a practical-minded neurosurgeon who admits that a surgeon’s ultimate achievement is marked by patients who ‘recover completely and forget us completely.’ Readers, however, will not soon forget Dr. Marsh. (Katrina Firlik, author of Another Day in the Frontal Lobe: A Brain Surgeon Exposes Life on the Inside) Each story invites readers into the private thoughts of a neurosurgeon and astonishes them with the counterintuitive compassion required in the operating room. (Michael Paul Mason, author of Head Cases) + Do No Harm: Stories of Life, Death, and Brain Surgery, by Henry Marsh, M.D., 288 pages, published in May 2015 by Thomas Dunne Books

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The Examiners +

These pictures from your cruise are beautiful.

Thanks.

by Dan Pearson

Just look at that Not at all. The crew Were you concerned took every precaution crystal blue water, even Uh, that was actually in the ship’s pool! about COVID? to keep us safe. Listerine.

PUZZLE

ACROSS 1. Has to 5. Kiln for drying hops 9. Blood prefix 13. Seaward 14. Brief advertisement 16. Bedouin 17. Ella’s style 18. Sleep disorder 19. Tears 20. Peace salutation 22. This MLB team had both the Manager of the Year and the Rookie of the Year in 2018 24. Extinct emu-like bird 25. The 48th U.S. VP 26. Gaol in the U.S. 28. Hardwood source 29. Fed. farming/food agcy. 32. ___ smear 33. Quaker product 34. Capital of Canada 36. Doc’s org. 37. WACG network 38. Ginger-based drink 39. Augusta has two 40. Noir follows these two words 42. Military abbrev. 43. Annoy 44. There are seven of them 45. Small low island 46. Former dawg Gurley 48. Bibb County (GA) seat 50. Flash intro 51. Young salmon 53. Arrangements beginning 57. Finding ______ 58. Like dry skin 61. Tailless amphibian 62. Level 63. A little bit off upstairs 64. South American Indian

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2 0 2 Simply unscramble the letters, N then begin exploring I G our ads. When you Nfind the correctly spelled word I N R hidden in one U of our ads — enter at AugustaRx.com T E RWe’ll announce the winner in our next issue!

Click on “MYSTERY WORD” • DEADLINE TO ENTER: NOON, AUG. 30, 2021

E X A M I N E R

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30. DDE’s middle name 31. Prize 32. Friend 33. Choose 34. ___ Medical College 35. Inquire of 37. Related to the nose 38. Grant of Augusta 41. Hills of North Augusta 42. Pale 45. Candy ingredient? 46. The fox in The Fox and the Hound 47. _________ Media 49. To cover with a ceiling 50. Mega-hit for Outkast 51. Ballesteros to friends 52. Corner of fame 54. Marrow lead-in 55. Doctor; spike 56. Cheese coated with red wax 57. Fish follower 59. Dove sound 60. The most common STD

DOWN 1. Service at St. Mary on the Hill 2. Campus in Aiken (abbrev) 3. Heidi Klum’s ex 4. Japanese straw mat 5. President #44 6. High mountain 7. Type of roof or dress 8. The late “Mr. Jeopardy” 9. Gather in 10. Canal opened in 1825 11. Atlas pages 12. Childbirth docs 15. Building for storing hay 21. Popular ISP 23. Severe/sudden 25. Vanna’s partner 26. Famous Dean 27. With speed 28. Canoe propulsion system

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

65. Care for 66. Bright star 67. Appear

S U D 1 O K 9 U

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Solution p. 14

QUOTATIONPUZZLE 2 3 8 L Y T4 H E A7 6 I O5 O 9 1 — Lou Holtz

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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.

Use the letters provided at bottom to create words to solve the puzzle above. All the listed letters following #1 are the first letters of the various words; the letters following #2 are the second letters of each word, and so on. Try solving words with letter clues or numbers with minimal choices listed. A sample is shown. Solution on page 14.

D 1 2 3 4

1 2 1

N 4 5 6

1 1

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5 5

6 6

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D 1 2 3 4 5 6 7 8 9

1 2 3 4 — Edmund Burke

1.RREWWDLIT 2.EIEIOSIAI 3.GAFTTTK 4.LIDHHEE 5.SOONE 6.CUTUG 7.ITTT 8.IN

SAMPLE:

1. ILB 2. SLO 3. VI 4. NE 5. D =

L 1

O 2

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I 1

S 2

B 1

9.GN

L 2

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WORDS NUMBER

THE MYSTERY 2WORD ! The Mystery Word for this issue: BLOMMSAITE

EXAMINER CROSSWORD

DECEMBER 17, 2021

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DECEMBER 17, 2021

AUGUSTAMEDICALEXAMiNER

THEBESTMEDICINE ha... ha...

man was sitting in a bar after work having drinks when his phone rang. He reached into his pocket and brought out the phone and saw that it was his wife. “Where are you?” she moaned. “I thought you were coming straight home.” “I’m at the pub,” he told her. “I think the baby’s coming!” she panted. “They’ll never let him in,” he said. “He’s underage.” Moe: What’s the biggest change you’ve noticed since the pandemic hit? Joe: Ever since everybody started washing their hands all the time, the peanuts at the bar have lost their taste. A guy went to the supermarket for just one item and was in and out in literally five minutes But when he came out there was a motorcycle cop writing a parking ticket, so he went up to him and said, “Come on, man, how about giving a guy a break?” The cop ignored him and continued writing the ticket, so the man called him a cruel,

knuckle-dragging moron. The cop just glared at the man and started writing another ticket for worn tires. So the man asked the cop if his psychiatrist makes him lie face down on the couch because he’s so ugly. Without saying a word, the cop finished the second ticket and put it on the windshield with the first. Then he started writing a third one. This went on for about 10 minutes. The more the man insulted the cop, the more tickets he wrote. Finally the man said one more time, “I wish you could give a guy a break,” and then he turned and walked farther into the parking lot, got in his car and drove away. A guy saw an ad online for a trained police dog for sale for just $50. He thought it was too good to pass up, so he bought the dog, and the local owners offered to deliver it. When the sellers arrived at the man’s house a short time later, they opened their car door and a filthy, mangy mutt jumped out. “There is no way that’s a police dog,” said the buyer. “I want my money back.” “Hold on,” said the seller. “Don’t let looks deceive you. He works undercover.”

Moe: If you know anyone with no family, or someone who is alone and lonely during the holidays, maybe an elderly person who will be eating Christmas dinner all alone, please let me know. Joe: Aw, how sweet. What are you going to do? Moe: See if I can borrow some chairs. I’ve got a houseful coming. +

Why subscribe to theMEDICALEXAMINER? What do you mean?

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

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

The

13 +

Dear Advice Doctor, I am newly divorced and I want to get back into the dating scene, as distasteful as that feels to me. I know there are many options involving apps and the internet, but I wanted to go old school and actually meet people face-to-face. It has not gone well, which is a completely foreign experience for me. Am I losing my touch? That would be a real slap in the face on top of what I’ve already been through. It’s bad enough to suffer through a divorce. — Please Help One Become Two Dear Please Help, This is definitely a troubling situation, no doubt about it. I sympathize with you, and I’m sure many readers do too. Millions of people have to endure the same thing you’re experiencing. After all, neuropathy — a fancy medical word for losing your touch — can have a number of causes, including injury, diabetes, cancer treatment, autoimmune diseases like rheumatoid arthritis, and others. And if that isn’t enough, there is idiopathic neuropathy, which simply means the cause is unknown. Whatever the cause, neuropathy boils down to defects in our nerves resulting in weakness, numbness or pain (or all three), usually in hands and feet. Some people suffer from excruciating tingling in their hands and feet. It may sound trivial, but they will often wish for complete numbness. Closely related, sometimes neuropathy results in extreme sensitivity to touch. Neuropathy can be dangerous. For instance, when someone’s foot is numb and they can’t feel exactly where it is, the result can be a fall. Or someone might be unaware of a blister on their foot or a small pebble in their shoe. By the time it’s discovered, a serious infection could be raging. Sometimes that can even lead to amputations. Anyone experiencing neuropathy should check with their doctor to identify the cause and/or treatment. Being a compliant patient goes a long way toward successful treatment. Other helpful suggestions to minimize (or prevent) neuropathy: monitor and control your blood glucose levels, quit smoking, and drink alcohol moderately if at all. I hope this answers your question. Thanks for writing! + Do you have a question for The Advice Doctor about health, 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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By popular demand we’re making at-cost subscriptions available for the convenience of our readers. If you live beyond the Aiken-Augusta area, or miss issues between doctor’s appointments — don’t you hate it when that happens? — we’ll command your mail carrier to bring every issue to your house! NAME ADDRESS CITY STATE ZIP Choose six months for $20 ____ or one year for $36 ____. Mail this completed form with payment to Augusta Medical Examiner, PO Box 397, Augusta GA 30903-0397

BEFORE READING

AFTER READING

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THE MYSTERY SOLVED 2! The Mystery Word in our last issue was: METABOLISM

2 0 2 Nhair in the p. 15 ad for ...cleverly hidden in the woman’s I G READ US ON YOURIN SMARTPHONE OR TABLET N UR T E R

THE WINNER: TIMOTHY WILLIFORD! Want to find your name here next time? If it is, we’ll send you some cool swag from our goodie bag. The new Mystery Word is on page 12. Start looking!

THE PUZZLE SOLVED M A S S

U S C A

J P A A M L E S S N E E V T E

S E A L

T O A A B L T A P A A M M O A A I L O P O A A N P R C H A T E A S C M A C O A M L E T M O I T E N L O N D N

S T U R B N E A B R P E N A K T O A L W M D A Y N H E C H Y O P Y O V A

E R I E

M O A B P S S

D A V I T O D O T D I B T O I N S E

A W A A S R K D

A C U T E

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L A C E

E D A M

SEE PAGE 12

The Celebrated TheSUDOKUsolution MYSTERY WORD CONTEST 2 6 5 7 9 1 4 8 3

...wherein we hide (with fiendish cleverness) a simple word. All you have to do is unscramble the word (found on page 12), then find it concealed within one of our ads. Click in to the contest link at www.AugustaRx.com and enter. If we pick you in our random drawing of correct entries, you’ll score our goodie package! SEVEN SIMPLE RULES: 1. Unscramble and find the designated word hidden within one of the ads in this issue. 2. Visit the Reader Contests page at www.AugustaRx.com. 3. Tell us what you found and where you found it. 4. If you’re right and you’re the one we pick at random, you win. (Winners within the past six months are ineligible.) 5. Prizes awarded to winners may vary from issue to issue. Limited sizes are available for shirt prize. 6. A photo ID may be required to claim some prizes. 7. Other entrants may win a lesser prize at the sole discretion of the publisher. 8. Deadline to enter is shown on page 12.

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Love to stare at your phone? Visit issuu.com/ medicalexaminer and stare away.

DECEMBER 17, 2021

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QuotatioN QUOTATION PUZZLE SOLUTION “It’s not the load that breaks you down, it’s the way you carry it.” — Lou Holtz

WORDS BY NUMBER To read without refllecting is like eating without digesting. — Edmund Burke

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DERMATOLOGY

Georgia Dermatology & Skin Cancer Center 2283 Wrightsboro Rd. (at Johns Road) Augusta 30904 706-733-3373 SKIN CANCER CENTER www.GaDerm.com

Dr. Eric Sherrell, DACM, LAC Augusta Acupuncture Clinic 4141 Columbia Road 706-888-0707 www.AcuClinicGA.com

CHIROPRACTIC Evans Chiropractic Health Center Dr. William M. Rice 108 SRP Drive, Suite A 706-860-4001 www.evanschiro.net

COUNSELING Resolution Counseling Professionals 3633 Wheeler Rd, Suite 365 Augusta 30909 706-432-6866 www.visitrcp.com

DENTISTRY Jason H. Lee, DMD 116 Davis Road Augusta 30907 706-860-4048

DEVELOPMENTAL PEDIATRICS Karen L. Carter, MD 1303 D’Antignac St, Suite 2100 Augusta 30901 706-396-0600 www.augustadevelopmentalspecialists.com

DRUG REHAB Steppingstones to Recovery 2610 Commons Blvd. Augusta 30909 706-733-1935

YOUR LISTING Floss ‘em or lose ‘em!

Steven L. Wilson, DMD Family Dentistry 4059 Columbia Road Martinez 30907 706-863-9445

Augusta Area Healthcare Provider 4321 CSRA Boulevard Augusta 30901 706-555-1234 CALL 706.860.5455 TODAY!

EMF PROTECTION

EMF Safe Homes Sheila Reavill Certified Building Biology Specialist 209-625-8382 (landline) SURVEY•ASSESSMENT•REMEDIATION

IN-HOME CARE Everyday Elder Care LLC Certified Home Health/Caregiver 706-231-7001 everydayeldercare.com Zena Home Care Personal Care|Skilled Nursing|Companion 706-426-5967 www.zenahomecare.com

YOUR LISTING HERE Your Practice And up to four additional lines of your choosing and, if desired, your logo. Keep your contact information in this convenient place seen by thousands of patients every month. Call (706) 860-5455 for all the details!

LONG TERM CARE

WOODY MERRY www.woodymerry.com Long-Term Care Planning I CAN HELP! (706) 733-3190 • 733-5525 (fax)

PHARMACY Parks Pharmacy 437 Georgia Ave. ARKS N. Augusta 29841 HARMACY 803-279-7450 www.parkspharmacy.com

SLEEP MEDICINE Sleep Institute of Augusta Bashir Chaudhary, MD 3685 Wheeler Rd, Suite 101 Augusta 30909 706-868-8555

Thanks for using the Professional Directory

CALL THE MEDICAL EXAMINER (706-860-5455) TO BE LISTED HERE

THE MONEY DOCTOR

What do you need to retire?

y view is that wealth is more than simply the tangible asset or number we see on a net worth statement. I believe it’s deeper than that. Understanding the numbers is certainly important, but to truly measure wealth, we must consider intangible items like being able to invest time in your family and community, and leaving a worthwhile legacy to future generations. However, knowing what net worth you need to retire comfortably and maintain your lifestyle is still important. Net worth is the value of all the assets a person owns minus the liabilities they owe. It is an important metric to gauge a person’s financial health, providing a useful snapshot of his or her current financial position. Assets generally include bank accounts, investment accounts (non-retirement and retirement), home value, car values, business interests, and other high-value personal assets such as boats, campers, jewelry, collections, etc. Liabilities generally include balances on credit cards, auto loans, home loans, student loans, personal loans, or other loans and debts. The amount an individual or couple should have in net worth when they retire is very specific to their situation. The amount you plan to spend in retirement is a huge factor in determining the amount you need to have when you retire. Many academic studies have shown around 4% to be the safe withdrawal rate for a 30-year retirement. That means for someone who will spend around $60,000 a year from their investment portfolio, having $1,500,000 in investable assets is a good target. Your net worth should be higher than that, however, because some of your net worth comes from assets that are not liquid, like your home. We would not include the house value in the $1,500,000 you need to fund retirement expenses because likely you will be living in the house during retirement. It’s important to understand what assets are liquid, such as cash, mutual funds, stocks, or bonds, compared to illiquid assets such as business interests and homes. If you will need to use illiquid assets to pay for living expenses in retirement, you will need to plan how you will make those assets liquid. You may have heard of people being house rich and cash poor in retirement. Unfortunately, that is a great recipe for being stressed out in retirement. You want to optimize, not complicate your financial situation – especially in retirement! + by Clayton Quamme, a Certified Financial Planner (CFP®) with AP Wealth Management, LLC (www.apwealth.com). AP Wealth is a financial planning and investment advisory firm with offices in Augusta, GA.

AUGUSTAMEDICALEXAMiNER

DECEMBER 17, 2021

SELF-CARE… from page 10

ing it—as tempting as it might be—isn’t the wisest choice. • And if you’re alone, be good to yourself. Maybe you’re in the completely opposite situation: You’d love to be a part of a noisy family, even if it meant arguing and stress, instead of being alone. Your thoughts may start to spiral toward, “No one wants me” or “No one likes me.” Be a friend to yourself and stop those thoughts. Even if you’re a party of one, you can make the time special. Or, muster up your courage and find ways to connect with others during the holidays, whether that’s calling a friend, videoconferencing family, attending concerts or other events, or maybe hosting a holiday gathering of your own. Your physical, mental and emotional health are more closely linked than most of us realize. If you’re feeling anxious or headachey all the time, you may overindulge, which could affect your mental health even

more. By looking at yourself from all angles and working on taking better care of yourself physically, mentally and emotionally, you can emerge from the holidays—and from these two years of COVID—healthier than you have ever been. + Jeremy Hertza, PsyD, is the founder and medical director of Inpatient Psych Solutions, and Lance Evans, PhD, MBA, is the director of clinical development at Inpatient Dr. Hertza Psych Solutions. IPS is a health psychology and neuropsychology practice that works with health systems across the U.S. to provide outpatient and inpatient clinical care—both in-person and via teleDr. Evans health—for the emotional, cognitive and psychological needs of patients. For appointments and more, visit inpatientpsych. org or call 706-204-1366.

“And whoever saves one — it is as if he had saved mankind entirely.”

FREE HEALTH CLINIC for those who have no health insurance and whose income is at or below 200% of the federal poverty level. We provide ongoing primary care, limited prescription assistance, mental health referrals, and more.

Every Second Saturday from 9 AM to 1 PM Walk-ins welcome 9am-11am • By appointment 9am-1pm EVEN MONTHS: ODD MONTHS:

University Hospital POB 1, Suite 2-A First Islamic Center Building 820 St. Sebastian Way 3416 Middleton Dr. f Upcoming Next clinic clinic Augusta, GA 30901 Augusta, GA 30907 HERE HERE FEB. 12 JAN. 8

+ 16

TO MAKE AN APPOINTMENT OR GET MORE INFORMATION:

Phone: 706-513-0582 • Email: Shifacareclinic@yahoo.com