Dec21 18 by Daniel Pearson

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DECEMBER 21, 2018

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It’s a symptom of the season. But sleep is not a luxury. It is necessary for good health. Yet millions of us say we chronically don’t get enough sleep. Why is that a problem? Among the health conditions linked to a lack of sleep are: • High blood pressure When we’re asleep, our blood pressure naturally drops. Being awake hours longer than we should be means our blood pressure stays higher longer. • Type 2 diabetes Studies have linked sufficient good quality sleep with improved ability by the body to control blood sugar. • Obesity Research suggests that inadequate sleep affects the part of the brain that controls hunger. Insufficient sleep is connected to a higher rick for weight gain, particularly among children and adolescents, who need more sleep than adults to begin with. • Heart disease In addition to high blood pressure, insomnia also leads to higher risk of heart attack and stroke.

GET YOUR SHARE

Sleep deprivation is an important problem to address. Here’s how:

• Schedule a bedtime that gives you sufficient sleep before your wake-up tim, and the follow that schedule seven days a week. • Get physical activity during the day (but not too close to bedtime). • Don’t eat or drink within a few hours of bedtime. • Create a sanctuary of peace and serenity in your bedroom. Keep it free of televisions and other screens. Make sure your bedroom environment is what you like best for ideal sleep. If you like it cool and completely dark, make sure it is. • Talk to your doctor if you have poor sleep for a long time. “And the lion and the calf shall lie down together, but the calf won’t get much sleep.” — Woody Allen

Information source: Centers for Disease Control

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PEDIATRICS101 READY? TIPS, TRICKS & TALKS TO KEEP TOTS TO TEENS HAPPY AND HEALTHY

BY CAROLINE COLDEN, MD, PEDIATRICIAN

MAKE 2019 YOUR HEALTHIEST YEAR! WE’RE HERE TO HELP

RSV (short for Respiratory Syncytial - pronounced sin-SISH-uhl - Virus) is a hot topic in the fall-winter months as cough, cold, runny noses, and wheezing abounds among kids. I can’t tell you how many times a day every pediatrician hears the words “is it RSV?” or “3 kids at daycare have RSV, can you test my child now to see if he also has RSV?” And while most clinics can in fact swab a nose and test for RSV, it’s difficult getting parents to understand that most of the time - it doesn’t matter. There are times, though, when some parents just want to know (which is fine, of course), and there

are key instances when the pediatrician also really wants to know; this virus does after all affect different patients differently. So let’s talk about why this is the case and what RSV actually is. RSV is a virus that can cause upper and lower respiratory tract infections in patients of all ages, but can vary in severity and clinical significance depending on who the patient is, how old (or how little), and how sick at baseline he or she might be. In older kids and adults, RSV can cause just a basic common cold - snotty, runny noses, coughing, etc. For patients with underlying

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DECEMBER 21, 2018 asthma or predispositions to wheeze in the past, their illness can be more significant, and they may need to do their albuterol inhalers or neb machines until they get over the brunt of the infection. For younger kids and especially babies, RSV can be more of a problem and seem scarier to parents. Babies especially have a hard time with RSV, and frequently can end up in the hospital due to complications, or the need for greater respiratory support (I.e supplemental oxygen, monitoring of breathing, etc). RSV in infants younger than 3 months can cause episodes of apnea (temporary pauses in breathing for 20 seconds or longer), lower respiratory tract infection (aka bronchiolitis), and hypoxia (decreased oxygenation of blood, visible when skin or lips turn blue). Some babies (especially those who have family members with asthma) can have wheezing on top of the bronchiolitis and benefit from breathing treatments. It is very important to note that breathing treatments and the nebulizer machine DO NOT cure RSV. They simply alleviate swelling of the airway that causes wheezing in patients who have a tendency to wheeze with illness. It is also important to realize that there is no special medicine that can be given to cure RSV. All anyone - including doctors, nurses, and respiratory therapists in the hospital - can do is to support a sick patient until their infection resolves in its own time, and

Please see RSV page 3

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DECEMBER 21, 2018

WHAT IS DIABETES?

RSV… from page 2 this can take at least a week or two. The cough itself can last close to a month in some patients. Therefore knowing exactly whether a child’s cold or cough is caused by RSV does not necessarily make a difference, as RSV is ultimately a cold-virus. For pediatricians, a positive swab for RSV does help us predict what risk a patient may have for severe or worsening illness. Patients at risk for severe illness include infants (especially younger than 3 months), kids with asthma or other lung disease, immunocompromised kids, and formerly premature kids. A few key notes that differentiate RSV from other cold viruses is just how much trouble it can cause for patients - especially the babies. The snot and

A sick kid who’s still struggling to breathe (even after saline/suction or a home breathing treatment), and using muscles in belly and neck and/or breathing faster and harder than normal should be urgently evaluated by a healthcare provider. If there is ever a question of whether a child is wheezing or having difficulty breathing, being “safe rather than sorry” and seeking medical treatment and evaluation is always preferred. Parents should feel welcome to keep in close contact with their pediatric office. The best way to prevent RSV (or any infection for that matter) is handwashing. Good hand hygiene goes a long way and will help keep everyone healthier this cold/RSV season. Happy holidays to all! +

mucus with RSV can be especially thick, tenacious, and profuse. A “nasal freida” or any suction device/bulb with some saline drops from the cold section of a pharmacy can become a parent’s new best friend. Saline and suctioning is the mainstay of treatment for RSV, especially in infants (who can overwhelmed by their snot and mucus) and will help them stay comfortable and feed well. Maintaining hydration and nutrition is the other most important priority in caring for our sick kiddos, as dehydration is dangerous in itself, and additionally makes these thick secretions even thicker. The most important thing I can tell parents with a child sick with RSV (or any cold virus) is this:

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At least 30 million Americans know the answer to this question very well. They deal with it every day. But what about the rest of us? What exactly is diabetes? What’s the difference between type 1 and type 2? What is type 3? What is prediabetes? And what about gestational diabetes? Diabetes is serious business: it was the seventh-leading cause of death in the United States in 2015, showing up on well over 300,000 death certificates. Despite that sobering fact, many diabetics approach this deadly disease rather casually. It’s a disease that can be managed and controlled quite effectively with a little effort in eating a diabetic-friendly diet and knowing and managing blood sugar levels. But many diabetics test very sporadically and eat whatever they please because “I can just take a pill or a shot of insulin to make up for it.” That’s playing Russian roulette with life and health. Here’s a snapshot of this common disease: In type 2 diabetes, the more common form, the body does not use insulin properly, leading to high levels of blood sugar. Type 1 diabetes is diagnosed when the pancreas, the source of insulin, stops producing insulin, taking away the key that opens the door for glucose (also called blood sugar) to leave the bloodstream and enter the body’s cells. While many people believe type 2 to be the less severe form of the disease, the truth is that type 1 and type 2 are each very serious conditions both short- and long-term. Prediabetes is a condition in which blood glucose levels are higher than normal, but not high enough to be considered full-scale diabetes. People with prediabetes are at risk for developing type 2 diabetes, although lifestyle changes can often prevent that. According to the latest statistics, about 85 million Americans have prediabetes. Gestational diabetes describes women who develop diabetes during pregnancy, an occurrence in about 10 percent of all pregnancies. It can negatively affect both mother and baby. Finally, who are those with type 3 diabetes? Those are nondiabetic people living with diabetic family members. Their lives are often significantly affected too. +

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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. © 2018 PEARSON GRAPHIC 365 INC.

DECEMBER 21, 2018

AUGUSTAMEDICALEXAMiNER

#81 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

t would not be inaccurate to say that this man has played a direct role in every single bite of food you have ever eaten during your entire life, from your infant formula and those puréed peas and carrots that were your first solid food right down to and including what you just ate a little while ago. That kind of impact is rather amazing for someone who was born in a log cabin in 1844. His name is Harvey Wiley. He was a pioneering chemist during his academic career, teaching the first chemistry class ever offered in the state of Indiana, beginning in 1873 at Indiana Medical College. (He had earned an M.D. there in 1871.) He then traveled to Harvard in 1873, where he earned a B.S. in chemistry. Thus equipped, he accepted a faculty position back in Indiana, teaching chemistry at then just-opened Purdue University. He also held the title State Chemist of Indiana, a role which led to his being offered the position of Chief Chemist of the US Department of Agriculture (USDA) in 1882. He soon became known as an intrepid crusader for food safety on a national level (intrepid being a fitting word because Wiley was from a farm belt state). Indeed, many barons of the food industry - names like Chicago’s Armour meat packers and others who made fortunes off saccharine and adulterated soft drinks - bitterly opposed Wiley’s efforts to protect the food supply. He also had to deal with the political squabbles typical of Washington to this day, as well as back-stabbing schemes of his USDA chief chemist predecessor. Undaunted by it all, Wiley steered the passage of the Pure Food and Drug Act (often called the Wiley Act), which became law in 1906. Its passage was helped immeasurably by the efforts of Alice Lakey, a New Jersey housewife who invited Wiley to speak to a ladies group in her village association. Galvanized by that event, Lakey organized a campaign that eventually led to more than one million letters being written in support of the Act. She and Wiley met with President Theodore Roosevelt with their letters, garnering his support. Enforcement of the Act fell to the USDA’s Bureau of Chemistry headed by Wiley, but its efforts were often hampered by litigation on technicalities from powerful food industry groups. In 1927 its charter was altered and the Bureau was renamed the Food and Drug Administration (FDA), also headed by Wiley. The FDA was given greater scope still in 1938 when President Franklin Roosevelt signed a new act often abbreviated FD&C. If you’ve seen those letters, they stand for Food, Drug & Cosmetic Act. The laws banned advertising false claims, legislated purity standards, and relieved the FDA from the need to prove malicious or fraudulent intent in its enforcement actions. Wiley was often frustrated by the politics of his position, and in 1912 resigned to accept a similar position, guarding the safety of consumers: he took over the laboratories of Good Housekeeping Magazine, testing products and awarding the magazine’s coveted Seal to those that passed muster. Wiley remained at the magazine until his death 18 years later on June 30, 1930, the 24th anniversary of the signing of the Pure Food and Drug Act. + For more information, see From the Bookshelf on p. 11

This is one of those days which cannot quite decide what it wants to be, sunny, cloudy, rainy, or none of the above, just transiently moody. I recognize that feeling as I wonder what tomorrow will bring into my life. There have been too many events lately which have put large frames around the fragility of life, calling our attention to the absolute lack of stability we all face from time to time, even though most days we move from sunrise to sunset without giving it a thought. I used to think that when I got older my own eventual mortality would be foremost in my thoughts, but it’s not. I find my days occupied with the most trivial tasks, usually revolving around things like bringing in and reading the newspaper, fi xing breakfast, watching my favorite morning TV show (Let’s Make a Deal) to see what I’d choose, and taking a nap in the afternoon, fi xing dinner, watching the evening news, and finding time for Facebook. There are whole days when my most pressing thought is that I really ought to wash clothes before I run out of clean underwear. That isn’t even remotely an existential thought, although I am quite capable of being philosophical when it suits me. Eschatology, pondering the length, quality, and terminal reality of life, is a branch of philosophy focusing on death and its finality or lack thereof. It can also be used to talk about the final days of humankind. End times, whether they are mine or all of humanity’s, don’t seem terrible relevant to

me when I am shredding cabbage to make coleslaw. But once in a while someone dies rapidly and without time to even record astonishment that the time isn’t far off in the future, but right now, this very second, without time to go to the bathroom, make a planned call, or pet the dog. Such an event jangles my comfortable belief that the breath I am taking right now will be followed by another hundred thousand breaths. That kind of thinking about life being more certain than death is reasonable, given the fact that for all 75 years since I was born that next breath, and those following it, could be counted on just as surely as that sun will rise in the morning — even if it’s cloudy and I can’t see it. The question then, is, once aware of life’s impermanence, what will I focus on: life as I am living it right this second, or death? A while back I was in the hospital, very sick with life-threatening issues, and not one time while I spent nearly four months getting sort of better did I ever consider the possibility that I could die. People around me at that time can attest to the fact that I hated the hospital bed to the point where they eventually found a recliner I could sleep in. I was too weak to walk, too weak to even roll over in bed, too weak to bother with eating most of the time, but the essential me was able to resist when I didn’t like something they were doing to treat me – or not treat me. My mother used to say as long as a sick or injured child is making lots of noise they will probably be OK. It’s the quiet ones you need to worry about. I’ve always been among the quiet ones. +

I’M DIABETIC. NO SWEETS FOR ME!

WHICH WILL IT BE? Is that a true statement? Or is it a trick question? Is the answer, “Of course you can eat sweets if you are diabetic — if you want to be a cheater.” The truth is, diabetics can safely eat candy, chocolates, desserts and other foods that are not exactly short on sugar.

The key, just as it is for those who don’t have diabetes, is moderation. Dessert or chocolates are no more off limits for diabetics than they are for anyone else. But a diabetic should satisfy his or her craving with a small portion. A taste of ice cream, not a whole bowl; one bite of cake, not a huge slab or the corner piece with extra frosting. A person with diabetes who is an obedient and compliant patient can actually enjoy great overall health benefits. Healthful

meal planning and eating sweets in moderation are but two examples of healthful and salubrious living that might escape someone without diabetes. The non-diabetic might approach a holiday buffet with a “Game on!” mentality and end up overeating plenty of unhealthy foods, while a thoughtful and conscientious diabetic is going to skip the less healthful options and choose wisely and moderately. And yes, some of those choices can be sweets. +

DECEMBER 21, 2018

AUGUSTAMEDICALEXAMiNER

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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DECEMBER 21, 2018

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This is part of what makes nature a recently went hiking in a beautiful spiritual experience for me. I realize that national park outside of Columbia, I am but a small part of a huge tapestry SC. This park was in a swampy area and painted on this planet. And even the entirety contained all sorts of plant and wildlife. of the beauty that is and ever will be on When I was young, my dad would take us this earth is but a minuscule portion of the kids on hikes through the Adirondack Park beauty in the cosmos. And that beauty is but in New York, so being on hikes in nature hits a speck when you consider the beauty that my soul in a very deep spot. It’s emotional, has ever existed and will exist until time it’s physical, it’s a treat to my senses, and it’s comes to a close. a spiritual experience for me. I think about this kind of thing when I fly I was pondering what it was that moved me in a plane and see all of the tiny little cars so much while hiking. I am the sort of guy who darting around doing their crucial tasks. probably overdoes the pondering bit, as I fi nd That’s me down there, a self-assured dot of myself doing far too much pondering about unimportance in the big picture of things. my pondering. It’s what I refer to as being “too Perhaps the birds look down on us as we damn introspective.” Anyway, see the spiders in the forest. the forest in this park is filled If someone cuts you Perhaps they have a more with spider webs, and since realistic perspective on things. it was misting rain while off in traffic, if you are Or maybe birds are also “too we were walking, the webs enraged by something damn introspective” like us. glistened with beads of water This all makes me take a on Facebook, if you that sparkled in the sun. It much lighter view of life. Yes, was stunning. As I did my are desperate for love, the things that are happening damn introspection bit, I saw or if you are anxious in this world are important. an especially large web with a about your future, Yes, the pain that I see daily in huge yellow-bodied spider in my office, the struggles I have remember this. the middle. One of my hiking in my own life, and the fears companions told me it was a I have about all of our futures golden orb weaver spider, and this spider sat are real things. But they are small things, in the center of this huge web as if to claim its tiny individual threads in the tapestry of all beauty for her own. It was as if she wanted me space time. They are spiders in a forest. The to know that she had made that web and that cosmos won’t be altered in any significant I could applaud at any time. way by any decisions I make. I stood and appreciated both the creation So does this make us not take things and the creator for a while and then moved seriously? No, I think that this perspective on, passing by tens, hundreds of other gives us more reason to hold our small amazing webs and proud creators displaying time and place here as being precious. their work. But did they really care about Like those spiders, we need to build our their audience? I thought about how many webs with skill, care, and a desire to make more webs there were in this forest that I them as beautiful as we can. Whether would never see. I thought about how many we are building them for our creator/God webs there were in the world of equal or (which is what I believe), or doing it simply even greater beauty that no person would because that’s what we spiders do: we make ever see. I thought about the irrelevance my beautiful webs. life posed to these spiders (unless I chanced So if someone cuts you off in traffic, if into their web and destroyed their work), you are enraged by something on Facebook, how they would continue living, dying, if you are desperate for love, or if you are building webs, having young, catching food, anxious about your future, just remember: and building beautiful creations. I was but a we are all spiders making our webs. Be lucky observer of a minuscule segment of the humble. Take it easy on the other spiders out beauty that spiders spin each day. there. And build the best damn web you can And I was humbled. in the part of the forest you call home. +

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DECEMBER 21, 2018

MEDICALEXAMINER

NOWWITHEASIERSUDOKUS! Because really, how much fun is a puzzle you can never solve?

WE’RE BEGGING YOU We’re never too proud to beg. What we’re begging for is Medicine in the First Person stories. With your help, we’d like to make this a feature in every issue of the Medical Examiner. After all, everybody has a story of something health- or medicine-related, and lots of people have many stories. Send your interesting (or even semi-interesting) stories to the Medical Examiner, PO Box 397, Augusta, GA 30903 or e-mail to Dan@AugustaRx.com. Thanks!

“The cause was a mystery for a long time.” “And that’s when I fell.” nearest hospital “He doesn’t remember a thing.” “The was 30 miles away.” “I was a battlefield medic.” “He was just two when he died.”

“OUCH!”

“It was a terrible tragedy.” “She saved “I sure learned my lesson.” “I retired from medicine my life.” “It seemed like a miracle.” seven years ago.” “We had triplets.” “It was my first year “I thought, ‘Well, this is it’.” NOTHING SEEMED of medical school.” “They took me to the hospital by helicopter.” TO HELP, UNTIL. . “It took 48 stitches.”

ambulance crashed.” “Now THAT hurt!” “The “My leg was broken “I’m not supposed to be alive.”

“This was on my third day in Afghanistan.” in three places.” “I lost 23 pounds.” “Turned out it was just indigestion.” “At first I thought it was something I ate.” “The smoke detector woke me up.”

Everybody has a story. Tell us yours. Here’s our “No Rules Rules.” We’ll publish your name and city, or keep you anonymous. Your choice. Length? Up to you. Subject? It can be a monumental medical event or just a stubbed toe. It can make us laugh or make us cry. One thing we’re not interested in, however: please, no tirades against a certain doctor or hospital. Ain’t nobody got time for that.

DECEMBER 21, 2018

7 +

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GARDENVARIETY

The best parts about getting together for parties is fellowship and, of course, food. I love having unique appetizers to serve my company, whether we are watching football, having a game night or just mingling with new friends. It is also important to me that have some healthy alternatives to the usual fried and carb-loaded appetizers. That is why I created this creamy, slightly nutty Vegan Spinach Dip that has a hint of lemon, basil, and garlic which makes it a perfect accompaniment with raw veggies, toasted bread or crackers. It’s easy to make ahead, and every ingredient in this recipe is good for you. There is no dairy, and it’s packed with good-for-you greens and herbs. The base that creates the magic in this Vegan Spinach Dip is raw cashews. As far as nuts go, cashews are one of the lowest-fiber nuts, but they are packed with vitamins, minerals, and antioxidants. These include vitamin E, K, and B-6, along with minerals like copper, phosphorus, zinc, magnesium, iron, and selenium, all of which are important for helping our bodies function properly. This recipe is simple to make. Just soak raw cashews in hot water for a few hours, then mix it up in your food processor with some olive oil and almond milk until creamy. Then you can add your seasonings and veggies in the same processor. Just like that, you have a healthy creamy dip that is sure to please your Vegan Spinach Dip family and friends. Ingredients • 1 cup raw cashews • 3 cups hot water • 1/4 to 1/2 cup almond milk • 1 tablespoon virgin olive oil • 1 tablespoon of nutritional yeast • 1/3 cup roughly chopped spinach • 1/3 cup packed roughly-chopped fresh basil leaves • 1 garlic clove chopped fine • 1 teaspoon Himalayan salt • 1/2 teaspoon red pepper flakes • 1/4 teaspoon dried oregano • zest from one medium size lemon • 4 tsp fresh lemon juice

Drain cashews put in a food processor. Add 1/4 cup of almond milk and olive oil. Process for several minutes stopping every minute to scrape sides of the bowl. If the mixture is not creaming well, add more almond milk, a tablespoon at a time. Add nutritional yeast, spinach, basil, garlic, salt, red pepper flakes, oregano, lemon zest, and lemon juice. Process for 2 to 3 minutes or until mixture is creamy and smooth. Serve with raw veggies, toasted bread, crackers or chips. +

Instructions Soak raw cashews in 3 cups of hot water for 2 to 3 hours. This softens the nuts for processing.

by Gina Dickson, Augusta wife, mom and grandmother, colon cancer survivor, passionate about creating a community to help women serve healthy meals to their family. Visit my blog at thelifegivingkitchen.com

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THIS IS YOUR BRAIN A monthly series by an Augusta drug treatment professional responsibilities. Don’t overindulge. Go easy on the holiday sweets and follow a balanced diet. Monitor your intake of caffeine, nicotine and sugar. Exercise regularly to help maintain your energy level amid a busier schedule. Don’t try to do too much. Get plenty of sleep. Fatigue is a stressor. Maintain some kind of schedule and plan ahead; don’t wait until the last minute to purchase gifts or prepare to entertain. Enhance your support system. Holidays are a good time to reach out more frequently to your therapist, sponsor, spiritual advisor, or support group. If you’re in recovery, spend time with fellow recovering people. Let others help you realize your personal limits. Learn to say “no” in a way that is comfortable for you. Find new ways to celebrate. Create some new symbols and rituals that will help redefine a joyful holiday season. You might host a holiday gathering for special recovering friends and/or attend celebrations of your Twelve Step group. Avoid isolation and spend time with people you like who are not substance users. Don’t expose

yourself to unnecessary temptations, such as gatherings where alcohol is the center of entertainment. If there are people who have a negative influence on you, avoid them. Release your resentments. Resentment has been described as allowing a person you dislike to live in your head, rent-free. Resentments that gain steam during the holidays can be disastrous for anyone, especially recovering people. The Big Book of “Alcoholics Anonymous” refers to resentment as the No. 1 offender, or the most common factor in failed sobriety. Holidays may also be a time to evaluate your spirituality and find a personal way to draw support from the spirit of the season. Return the holidays to a spiritual base, and stress the power of unselfish giving. Recovery is serious work, but it is also important to have fun. Laugh a little and a little more. Start seeing the humor in those things that annoy you. Take from the holiday season what is important for you and leave the rest. + — article courtesy of hazelden.org

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Most people know the holidays can be a period of emotional highs and lows. Loneliness, anxiety, happiness and sadness are common feelings, sometimes experienced in startling succession. Holiday blues can trigger relapse for people recovering from alcoholism and odrug addiction, but the blues can be remedied by planning ahead. Why do the blues hit during this otherwise festive season? Many recovering people associate the holidays with memories of overindulgence, perhaps of big benders that resulted in relationship problems or great personal losses. Unlike clinical depression, which is more severe and can last for months or years, feelings from past memories are temporary. Anyone experiencing major symptoms of depression, such as persistent sadness, anxiety, guilt or helplessness; changes in sleep patterns; and a reduction in energy and libido, should seek help from a mental health professional. Whether you’re in recovery or not, develop a holiday plan to help prevent the blues, one that will confront unpleasant memories before they threaten your sobriety. Your plan should include improved self-care, enhanced support from others, and healthy ways to celebrate. Here are a few suggestions to achieve a happy, sober holiday season: Good self-care is vital. Remember to slow down. Take some quiet time each day and work on an attitude of gratitude. Plan relaxation and meditation into your day, even for a few minutes, no matter how busy you are. Reduce overwhelming demands and

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FINAL ISSUE (of 2018.)

We hope to see you in our next issue: January 11, 2019.

DECEMBER 21, 2018

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AUGUSTAMEDICALEXAMiNER

DONâ&#x20AC;&#x2122;T LICK THE BEATERS Useful food facts from dietetic interns with the Augusta University MS-Dietetic Internship Program

FOOD FIGHT! YES OR NO TO GMO? by Irene Erich, MS-Dietetic Intern

As the incidences of cancer and other chronic disease increases, medical scientists and practitioners are looking for answers. The rising rate has fueled speculation and suspicion about the causes of these life threatening diseases. Nutrition has become the focal point of several conversations, as more scientific evidence supports the critical role that nutrition plays in the prevention, treatment, and management of diseases. Easy access to research findings has become a reality through mass media and technology. In an attempt to find answers, some suspect a possible correlation between the abundance of genetically modified foods and disease incidences. These are commonly referred to as GMO foods. These foods generally have a poor reputation, but the negative stigma surrounding

GMOs is often misguided because of inaccurate, limited or nonexistent evidence. Understanding why farmers and food scientists continue to integrate genetic modification into food production may address some of the concerns. The genetic modification of foods alters the composition of a product in some way in order to develop a variety that does not occur naturally. Food scientists are able to experiment with the genes of a crop and make changes to their basic composition. Artificial selection of crops is a simplistic version of genetic engineering that dates all the way back to 7800 BC and the modern resurgence of these techniques started to take the scene in the 1970s. Genetic modification has undergone thorough review by many independent health and science agencies around the world, including the FDA, USDA, and EPA, and has been approved as safe. Research continues and these agencies constantly review new findings as they become

available. Through genetic enhancement of crops food scientists are able to tailor foods to meet the needs of an ever-changing society. Modification of food products can be beneficial to large agribusiness corporations as well as to farmers, consumers, and even the environment. By altering the genetic code of plants, scientists are able to enhance the nutrient profile of a crop, enhancing the nutrition of consumers in both developed and developing countries. An example of its positive impact on society is the mandate by the USDA in 1998 regarding folate. The mandate ordered a nationwide fortification of enriched grain products with folate. Folate deficiency is associated debilitating birth defects and infant mortality. The addition of folate has resulted in a 35% decrease in the occurrence of birth defects in newborns since 1998. Genetically modified foods have also addressed vitamin A deficiency, which is associated with several health conditions and diseases such as blindness. Food chemists have used a major food crop, rice, as the primary source for fortification. So-called Golden Rice has been fortified with vitamin A, and this has led to an international reduction of vitamin A deficiency and an overall improvement of health and nutritional status. Farmers experience the benefits of

nye 2 0 1 8

THIS IS OUR Please see GMO page 10

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IS RANKED AS THE #1 HEALTH PUBLICATION IN AMERICA!

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Irwin G. Augusta, GA

H H H H H 12/12/2018 I had a stroke three years ago, and I lost much of the use of my left arm. Physical therapy has helped, but it’s still nowhere near useful. I would give my right arm to have things back to normal again. +

Arnold W. Ft. Gordon, GA

H H H H H 12/12/2018 I would like to take this opportunity to give a big shout-out the members of our armed services, because, really, if they were armless I doubt if they could protect our country very well. +

Lucy K. Clearwater, SC

H H H H H 12/13/2018 They’re always talking about “the” arms race on the news. What arms race? I have never seen arms in a race. Not unless they’re attached to a body, anyway. Same deal with the term “foot race.” Do they not get that it’s the person they’re attached to that wins, not the body part? Duh! Who names these races??? +

Marty O. Aiken, SC

H H H H H 12/14/2018 I joined a gym last week and I have really been giving my arms a workout. Thank goodness all their chairs have arm rests. +

Gym J. Evans, GA

H H H H H 12/14/2018 I think I might know the previous poster. I go to the gym twice a day along with several other guys. All of us are really into building up our arms. We love arms! In fact, we’re thinking about starting up an arm band, so if you play any instruments, ask for me (Gym J.) at the gym. Let’s rock. +

Tonya R. Augusta, GA

H H H H H 12/14/2018 I work at a dress shop that specializes in plus sizes for big girls. I love my job and I love the ladies who come in and refuse to listen to the body shamers. A fat body doesn’t bother me in the least, but for some reason a fat arm does. I shouldn’t say this, but for me this place is a real armpit. +

Bobby B. Meriwether, SC

H H H H H 12/15/2018 I used to be a car salesman, but I had to quit. I couldn’t stand all the arm-twisting we were required to do to our poor customers. I hated it, but I felt even worse for them. +

Don T. Augusta, GA

H H H H H 12/16/2018 I know this guy who never shows up at any social event or party without his latest arm candy. And he’s a diabetic! Does he not know how foolish and unhealthy that is? +

Al O. Evans, GA

H H H H H 12/17/2018 Here’s a question I’ve been wondering about for years: when there is a call to prepare for war or a confrontation of some kind, it’s known as “a call to arms.” In such circumstances it’s extremely important that people respond. So shouldn’t it be a call to ears? +

DECEMBER 21, 2018

GMO… from page 9 genetic modification as the crops may be pest- and disease-resistant and require less input of resources (such as pesticides or water) for proper growth. Modified crops may enhance sustainability because their genetic makeup is more suited to withstand environmental threats without the overuse of chemicals. Reduction of pesticides will lessen the environmental burden of runoff, therefore preserving the surrounding landscape. Scientists also work with GMOs to decrease the rates of food waste through the alteration of appearance. Although this may sound concerning at first, the ability to maintain color and prevent bruising is considered a safe practice that allows perfectly ripe produce to stay on the market longer. Oftentimes, produce with bruising and malformation may be overlooked even though the nutrient composition is identical to the eventoned option beside it, thus causing food waste. Getting back to the original question about the link between GMOs and disease, correlation is not the same as causation. For example, many large cities experience high murder rates in summer, the same time of year when ice cream sales peak. There is a correlation between the two summertime peaks — hot weather — but not a causative link. In the same way, increased utilization of GMOs at the same time as increased rates of cancer and chronic disease does not establish genetic modification as the cause. Approval and support from health and science agencies — along with continued monitoring — ensures the safety of genetic modification. In fact the consumption of GMOs may actually improve an individual’s health and nutrition status. To learn more about relationship among organic foods, GMOs, nutrition and health, contact a registered dietitian nutritionist (RDN) or visit the Academy of Nutrition and Dietetics at www.eatrightpro.org. +

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The blog spot From the Bookshelf — posted by Jessica Ford, on May 23, 2018

MY HUSBAND IS YOUR DOCTOR. AND THERE’S NO ONE I’D RATHER SHARE HIM WITH Speeding through town, I had just dropped off one kid at football practice. I raced back to the church to drop off another kid, then drove quickly to a soccer practice for a third. At about 7:00, I start to lose my cool. I’m used to my husband being late. But tonight I was frustrated. I sat in the parking lot with two babies strapped in their seatbelts, fidgeting and whining behind me. I sent a rather meanspirited text to my husband. “You said you would be home tonight to help with carpools. Where are you?” He responded, “I’m sorry honey. I just made a grown man cry like a baby. I’m doing my best to hurry.” You see, my husband is a pediatric hematologist/ oncologist. I stared. At that blasted phone. It was that same phone I stared at months ago after driving with five kids in a freezing Nebraska blizzard to our child’s’ first piano recital. James never came. I had to take the two disruptive little kids out. I missed the performance. I sent a similar frustrated text to my husband. He responded, “I’m sorry honey. We just got some labs back for a patient. I had to tell his parents that there was nothing more we could do. They are crying. They asked if I could please help them tell their son.” These are not isolated instances. This is our life. A mom at home trying desperately to save her family. A dad at the hospital trying desperately to save yours. I continue to stare at the phone. Ashamed at my frustration. Knowing that at this moment a family needs my husband much more than I do. I sit in the parking lot and cry for you. I bow my head as our minivan becomes a sacred altar and I pray for you. And I pray for him. Every night. That he will be inspired how to help you. And your baby. I don’t know who you are. And I never will. But we share something in common: my husband and your doctor. He leaves the house before the kids are at school. He misses soccer games, Boy Scouts Court of Honors, piano recitals and football practices. We chose this life. And we chose it together. I forgive his absence. And he forgives my frustration. My husband has two lives. Ours and yours. I’m grateful that he’s mine. And grateful that he’s yours. There’s no one else I’d rather share him with. I think he’s pretty great. And sometimes I really miss him when he’s with you. But I know you need him more. +

We share something: my husband

Jessica Ford blogs at Seven is My Heaven.

READ EVERY ISSUE ONLINE! WWW.ISSUU.COM/ MEDICALEXAMINER

As Deborah Blum notes in her introduction to this fascinating book, many of us cast a romantic glow over the past, including the foods our forefathers ate. A hundred and more years ago, food was pure and chemical-free. Butter was really butter; milk was pure, free of all the adulterants we fear today. Everything was closer to its pure and natural state back in those simpler times. In a twist of irony, the more concerned someone is about the safety of today’s food supply, the more likely they are to long for the olden days of food purity. Oh how misguided we can sometimes be! The reality is just the opposite: at the turn of the 20th century, that “real” butter might be beef tallow dyed to look like butter; milk was often watered down, the standard formula being a pint of water for every quart of milk. Chalk or plaster of paris was added to mask the resulting thin appearance of the diluted milk.

It got worse: thousands of deaths in New York City alone were blamed on tainted milk every year. Formaldehyde was one of the most popular preservatives used in milk in that pre-refrigeration era. Such abuses of the food supply were rampant, and one man, Harvey Wiley, was determined to put a stop to it. But at the dawn of the 20th century not every chemical we know as harmful today had been unmasked. Wiley needed hard data to prove scientifically that various food additives were not conducive to good health. This probably wouldn’t

fly today, but Wiley’s plan was to assemble a group of human volunteers who agreed to eat the adulterated foods of the era. Wiley served them 3 squares a day and called the program “hygienic table trials.” That unwieldy name didn’t last long. Journalists who got wind of the experiment dubbed the participants the “Poison Squad.” Nausea, vomiting, diarrhea, liver damage, headaches, jaundice, and stomach aches were all endured by the Poison Squad volunteers — not to mention bad-tasting food. Wiley, who had a unique gift for generating publicity, made his point. The Squad helped ensure the passage of the Pure Food and Drug Act in 1906. More than 110 years later, all of us are the beneficiaries of Wiley’s unflinching resolve to protect food purity. + The Poison Squad: One Chemist’s Single-Minded Crusade for Food Safety at the Turn of the Twentieth Century, by Deborah Blum, 352 pages, published in September 2018 by Penguin Press

Research News The once-in-a-while workout University of Texas researchers studying neurons in the brain discovered that a single workout session can positively affect the activity of neurons that influence metabolism for as long as two days after exercise. The neurons displayed increased activity, resulting in reduced appetite and lowered blood sugar levels. One of the scientists involved in the research said “it doesn’t take much exercise” to trigger the activity of these neurons, with the primary longterm effect being a positive influence on glucose metabolism. Bullying batters brains A study of nearly 700 young people between the ages of 14 and 19 in England, France, Germany and Ireland suggests structural deformations in the brains of teens subjected to persistent

bullying. The King’s College of London research, published last week in Molecular Psychiatry, compared brain scans conducted during the study against questionnaires filled out by study participants detailing any bullying they experienced. Thirty-six of the research subjects reported they had experienced chronic bullying. Their brain scans were compared with others who endured no bullying, or less intense harassment. The team discovered sections of the brain known as the putamen and caudate had shrunk significantly in those who had experienced the most bullying over the longest time period. Those sections of the brain are associated with attention span, emotional and behavioral processing, and “reward sensitivity.” The study’s authors warned that their findings

suggest that bullying can lead to mental illness later in life. Length beats strength A German study published last month says that endurance exercises like cycling, swimming and running offer better antiaging benefits compared to resistance exercises like weight lifting. The researchers examined the protective caps on chromosomes known as telomeres that play a role in aging - or preventing aging. When the telomeres shorten as we age they can no longer protect the DNA in chromosomes, resulting in cell death. However, the researchers found that the shortening can be reversed by exercise. The best benefit in telomere regeneration was offered by endurance activities. Resistance exercises offered no anti-aging benefits. +

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AUGUSTAMEDICALEXAMiNER

THE EXAMiNERS +

by Dan Pearson

It’s so cruel for someone to make fun She’s extremely hurt. of your wife’s weight. But I think I smoothed things over. Is she upset?

I told her not to get upset if someone calls her fat.

What did you say?

Yeah. I said babe, you’re much bigger than that.

That’s good.

PUZZLE

ACROSS 1. This is in the heart of Augusta 5. Joe or Susan 10. Heavenly meats? 14. Word before temperature 15. Half of Ravel’s title pair 16. Black in poetry 17. River Region abbrev. 18. Spring up 19. Window division 20. Cardiac pulsation 22. Class of Indian society 23. True’s partner 24. Congregate 25. Spanish hero (with “El”) 28. Aye-aye on land 29. Prefix meaning “around” 30. Of the ear 32. Schematic arrangement 37. Tracks a band sends to a record company 39. Not in 40. Major leg bone 41. 11 through 13 44. Acronym for crib death 45. Neck back 46. Deep sleep letters 48. Part of a tennis match 49. Tightwads 52. Garden flower 54. Plentiful 55. Mother-to-fetus link 59. The ____ Report 60. Grain ground to powder 61. Valley (poetic) 62. S-shaped molding 63. Accustom 64. Paradise 65. Optimistic (as one’s outlook) 66. Small round shield 67. Area creek

31 38

43 46

Click on “READER CONTESTS”

QUOTATIONPUZZLE 34

45 49

VISIT WWW.AUGUSTARX.COM

29 32

All Mystery Word finders will be eligible to win by random drawing. We’ll announce the winner in our next issue!

24 28

23 25

! Y R A U N A J IN G N I N R U T E R

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

44 47

I E A A P N R M H H T R Y R E I W A A D R E I E D I H N G I

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T C W N G R L T I B A T N L E E F E T

DOWN 1. Mid-America landmark 2. Flower 3. The Pentateuch 4. _____ phone 5. Acariasis 6. Sixty 7. Greek epic poem 8. Not won 9. Shelter 10. Liver infection 11. Embarrass 12. Sano’s first name 13. Scoff 21. Attempt 22. Unit of weight for 24-D 24. Valued mineral 25. Conclusion (in music) 26. Individual unit 27. Smallest US coin 29. Boats that plied the Augusta Canal 31. Jennifer from “A Beautiful Mind”

33. Attila, for example 34. Large wading bird 35. Team 36. Pole 38. Frighten 42. Black _____ 43. Person drawing a pension 47. Famed drive-in owner 49. Like surgery sometimes 50. Idealized concept of someone (psych) 51. Secret agents 52. Love affair 53. Savannah is one 55. Forearm bone 56. Juniper 57. On sheltered side 58. Grant temporary use of 60. Appropriate

Solution p. 14

— George Carlin

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

9 6 5 5 3 4 7 2 1

3 5

7 5

S 2 U 7 D 5 O 8 K 9 U

9 6 7

1 8

5 3

6 3 2

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 1. 863 (body part) ___

6. 8346 (body part) ____

2. 534 (body part) ___

7. 25663 (body part) _____

3. 3668 (body part) ____

8. 72257 (body part) _____

4. 2663 (body part) ____

9. 847628 (body part) ______

5. 6325 (body part) ____

10. 26782 (body part) _____

TEXT

THE MYSTERY WORD The Mystery Word for this issue: REMUNST

EXAMINER CROSSWORD

DECEMBER 21, 2018

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AUGUSTAMEDICALEXAMiNER

THEBESTMEDICINE

The

Advice Doctor

Moe: How’s your new job driving a taxi? Joe: Not good. I got fired already. Moe: Already? What happened? Moe: Turns out people don’t like somebody who always go that extra mile.

ha... ha...

Moe: Scientists have cloned a new animal that’s one-third dog and two-thirds cat. Joe: What’s up with dat? Moe: Why didn’t the dinosaur cross the road? Joe: Ok, I’ll bite. Why not? Moe: Because there were no roads back then.

oming soon to a theater near you: Thesaurus, The Movie, The Film, The Motion Picture, The Cinematic Presentation, The Flick, The Pic, The Feature Film, The Hollywood Production.

Moe: I just realized that a good percentage of my friends are neo-Nazis. Joe: What??? Moe: 0% of my friends are neo-Nazis. Don’t you think that’s a good percentage?

Moe: I’m reading a biography of Neil Diamond. Joe: Anything interesting? Moe: Yeah. For starters, before he became famous his name was Neil Coal. Joe: The pressure must have gotten to him.

Moe: Here’s a riddle: I have 3 eyes, 2 mouths and 4 ears. What am I? Joe: Ugly.

Moe: Somebody broke into my house and stole that stick we use for playing limbo! Joe: How low can some people go, man?

Moe: Growing up, my teachers told me I was a complete failure and that I would never amount to anything in life. Moe: That was crazy. Joe: Wow, being homeschooled definitely Joe: What? Moe: I just went to the toy store looking for an sucks. Arnold Schwarzenegger action figure. Joe: My teacher told me a thousand times Joe: So? I would never get a job when all I did was Moe: I couldn’t find any, so I asked a clerk stare out the window all day. where they were and guess what he said? Moe: And? Joe: What? Joe: And look at me now. I’m a truck Moe: Aisle B, back. driver. +

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, What is with these people who think their destination is so important that they have to run red lights? They are breaking the law and jeopardizing their life and the lives of others. And it isn’t a rare occurrence either. I would guess that a car or two - and sometimes more! - goes through the intersection after my light turns green about 3/4 of the time. I practically go cross-eyed with anger when I see this day after day, light after light. What is the solution? Are we going to have to kill somebody before we change? — Seeing red over reds Dear Red, I know it seems serious, and it is definitely annoying, but this is not a life-threatening condition. The official medical term is strabismus, but simply put it’s just what you described: being “cross-eyed.” In other words, the eyes aren’t always aligned together; one may be looking left, the other right. Most people with this condition have had it since birth. For others it only presents itself when they’re fatigued or sick. Strabismus doesn’t always affect the same eye. One time you’re talking to a person and their right eye is looking straight at you while the left isn’t. The next time you talk to that person, it’s the left eye that will be zeroed in, while the right eye is straying. Again, this condition is not fatal, but some people who have it wish it was. It can lead to a lifetime of psychosocial effects. Studies have shown it can have significant impact on vision, self-esteem, personal happiness and quality of life, employability, lifetime earning potential, marital happiness, and even a person’s risk for developing mental illness. Thankfully, strabismus is a treatable condition. The range of treatment options include wearing glasses, doing exercises to strengthen eye muscles, medication (botox injections into eye muscles), and surgery. An ophthalmologist can examine your eyes and offer the best plan of treatment for your case specifically. It’s especially important to promptly seek medical assistance when children have this condition, because the more quickly the problem is addressed, the more likely it is that treatments will be successful. I hope this 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.

SUBSCRIBE TO THE MEDICALEXAMINER +

Why read the Medical Examiner: Reason #22

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

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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

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THE MYSTERY SOLVED The Mystery Word in our last issue was: STERNUM

! Y R A U N A J N I G N I N R U T E R

...cleverly hidden on the roof in p. 9 ad for OVERHEAD DOOR COMPANY OF AUGUSTA THE WINNER: ANDREW FELAK 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 A R C H

R O S E

T O R A

C O D A

I T E M

D I M E

M A J O R

I M A G O

S P I E S

S S M C A A R T B T R I Y E C S O S N C O N A P E R S L E L F E I Y T

T H R E E S C O R E U L N A

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.

1. TOE 2. LEG 3. FOOT 4. BONE 5. NECK

H U N A M O U R

L L O E S E T C G A P E R E M A T T E R R E M S T E B I L U R R E G E

H E P A T I T I S R I V E R

6. VEIN 7. BLOOD 8. SCALP 9. THROAT 10. AORTA

A B A S H

M O N T E

S N E E R

I B I S

S I D E

M A S T

C A D E

A L E E

L E N D

TheSUDOKUsolution 8 1 6 5 3 9 7 4 2

7 9 5 2 4 8 6 3 1

4 2 3 6 1 7 5 9 8

3 5 4 9 2 6 1 8 7

2 8 7 1 5 3 9 6 4

1 6 9 7 8 4 2 5 3

5 3 1 8 9 2 4 7 6

9 7 8 4 6 1 3 2 5

6 4 2 3 7 5 8 1 9

QUOTATION QUOTATION PUZZLE SOLUTION “There will be a rain dance Friday night, weather permitting.” — George Carlin

The new scrambled Mystery Word is found on page 12

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

I L I A D

SEE PAGE 12

The Celebrated TEXT ME ! N O O S K C MYSTERY WORD CONTEST A B MING

...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!

DECEMBER 21, 2018

AUGUSTAMEDICALEXAMiNER

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DECEMBER 21, 2018

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AUGUSTAMEDICALEXAMiNER

THE MONEY DOCTOR

THE VALUE OF A ROAD NOT TAKEN The holiday season is full of excitement and anticipation as we plan and participate in the holiday events and festivities. This is also a time for reflection on 2018 and preparation for 2019. As you are doing this, I would encourage you to revisit the poem by Robert Frost, “The Road Not

Taken.” The final three lines in the poem say, “Two roads diverged in a wood, and I – I took the one less traveled by, and that has made all the difference.” The poem and those famous final lines hold many lessons and insights that can be applied to your personal financial situation. Let’s start with things to consider as you are reflecting on 2018. As you reflect back on 2018 or other years, you can probably identify some major life decisions that you have made. These decisions resulted in roads not taken. The poem is very accurate as it describes what happens to those road not taken, “Oh, I kept the first for another day! Yet knowing how way leads on to way, I doubted if I should ever come back”. We typically do not go back and revisit that road not taken. However, we have found that revisiting decisions or roads not taken is often a valuable exercise. When reflecting on your decisions, one of two different

feelings or conclusions are normally reached. The first is a feeling of satisfaction or job well done. People have said to us, we are so thankful we decided to downsize the house before retirement, or taking that extra vacation with the kids before they all went to college meant so much. The other feeling you may experience is regret or a decision not turning out as well as you expected. It is important to reflect on those and not beat ourselves up, but use those feelings to try and make better decisions going forward. One example is a couple that recently purchased a home. The next month they had six large trees fall down near their house from a large storm. During our conversation, they noted that they had an exclusion on their home insurance that would not have covered the damage if the trees had fallen on their house. The exclusion reduced the cost of the policy, but they realized that the risk of the road they took was not

BINGEREAD

worth the short-term savings. They decided to go back and update the policy. So, how do you measure the value from expertise and guidance that helps you navigate the forks in the road? That is probably one of the hardest concepts to explain to people as they are considering working with a financial planner. The natural way to perceive value is by looking at things that are easy to measure and see such as investment returns and account balances. As part of the financial planning and risk management discussions you should be having across your entire financial plan, a good financial planner may recommend that you purchase additional insurance or spend money for estate planning documents. Tax planning is another good example, in low income years creating taxable income with Roth conversions or IRA withdrawals (if over 59.5 years old) to fill up the lowest tax brackets can help

you pay less tax over your lifetime although it seems counterintuitive. Our natural tendency is to avoid doing things that feel counterintuitive, which often times puts us on the road that is most traveled. We end up following the herd or missing opportunities unique to our situation. It is hard because you may not know the right questions to ask or consider when you are at the fork in the road. We have found that reflecting on the roads taken (or not taken) and seeking guidance from qualified experts will help you find the road less traveled or even find a road you did not see, and to paraphrase Robert Frost – that can make all the difference. + by Clayton Quamme, a Certified Financial Planner (CFP®) with Calvary Wealth, LLC (www.calvarywealth. com). Calvary Wealth is a feeonly financial planning and investment advisory firm with offices in Augusta, GA and Columbia, SC.

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