Medical Examiner 6-19-20

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JUNE 19, 2020

AIKEN-AUGUSTA’S MOST SALUBRIOUS NEWSPAPER • FOUNDED IN 2006

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oxygen because people are breathing in the same air they just exhaled?

There are more: the virus is a deadly attack orchestrated by the Chinese to harm the United States. Others believe it’s all a fiendish plot by Democrats to undermine Trump’s presidency and steal victory from the Republicans. Some proponents of this theory throw in killer hornets and George Floyd as other key components in this elaborate plot. Subplots include governmental agencies using these events as a pretext to control the masses and curtail basic freedoms.

These ideas might seem ridiculous to some, but believers will debate any and all comers on places like Facebook to try to prove their contentions. What’s significant about that is that Facebook is not a setting that offers anonymity, so people are ready to repeat and promote all kinds of theories in full public view. And some of them are pretty hard to believe.

For example, do you know why the coronavirus test requires such a long swab?

People who have had the test say it goes so far up their nose that it feels like it’s in their brain. That’s because it is! According to one rumor making the rounds, the “test” is actually the means they are using to implant chips in our brains. And “they” isn’t plural; it’s singular: Bill Gates.

We can’t make this stuff up, folks.

Another belief that has gotten a tremendous amount of traction is the allegation that COVID-19 is spread by 5G cell towers, or that some kind of invisible rays emanating from the towers, while having no direct connection to coronavirus, weaken the immunity of everyone living nearby.

Evidence said to support this contention includes detailed maps in many locations showing that wherever there are multiple 5G towers there are also serious outbreaks of COVID-19. Non-believers in this conspiracy theory say the maps are true for one reason: there are more cell towers in populated areas, and naturally there are more cases of coronavirus in populated areas too. That is the only connection. There are more streetlights and traffic lights in urban areas too (and dogs and bakeries and lawn furniture and gas stations); why are they not the cause of virus hot spots?

No appeals to fact or logic prevented nearly two dozen arson attacks on 5G towers across the U.K. over Easter weekend. ou know all those people who have been saying the economic fallout from Sometimes the theories that spread like wildfire in the year 2020 seem remithe virus will kill more people that the virus? We have an alternate scenario: niscent of medieval superstitions. The 5G tower rumor, for example, is a highthe information overload connected to this pandemic is more dangerous than the tech resurrection of the old miasma theory of the spread of disease, but in this pandemic itself, and is actually making the situation worse. incarnation disease is spread wirelessly. If true, that represents a huge leap in About 90% of the conversations we’ve had in the past two or three months mankind’s technological capabilities. have at some point included either, “They’re saying now that...” or, “Well, I heard But as always, clear thinking is a good thing. Ditto for good manners. It’s not that...” Sometimes you hear both in the same conversation. considered polite to spread unsubstantiated rumors about a friend, neighbor or It’s not that people are sharing crucially important information (although they co-worker. The same is true of deadly diseases. Maybe more so. might believe it to be so); they are often sharing false and unsubstantiated ru As for clear and logical thinking, new doctors are often taught to remember that, mors. Considering that accurate information could be live-saving and inaccurate “When you hear hoofbeats, think horses, not zebras.” The meaning is simple: odds information could prove fatal, this is not a subject to take lightly. are the patient has the more common disease, not the exotic, rare, improbable one.

Have you heard the one about wearing masks causing the immune system to The truth, more often than not, lies in the simple explanations, not the complex, be compromised? How about the “fact” that wearing a mask deprives the body of complicated, convoluted quagmires of conspiracy. +

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THE FIRST 40 YEARS ARE ALWAYS THE HARDEST

JUNE 19, 2020

The path I have chosen

by Kimberly Savage

PARENTHOOD

by David W. Proefrock, PhD

Dr. Proefrock is a retired clinical and forensic child psychologist.

“In fight-or-flight, flight is simply not an option.”

they did not! But during this time, they were different for several reasons that I want to share and give you a glimpse inside.

First, every patient that came into the hospital for admission was screened and tested for COVID. This meant that if a car accident victim came into emergency department, they were tested for COVID (once they were stabilized in the ED).

This increased the amount of time patients were in the emergency department, and that they were alone, which

— Kimberly Savage is a respiratory therapist who works at two Augusta-area hospitals

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In the hospitals where I work, COVID-positive patients are quarantined to specific areas of the hospital. Have car accidents, traumas, strokes, and the like just stopped happening?

I can tell you emphatically

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If you answered: A. You need help. If this is not abuse, it is close to it and is never acceptable. It also may be a sign that something is going on with you that needs to be addressed. Contact a mental health professional and ask for anger management.

B. Unfortunately, it is common for parents to lose control occasionally. However, this kind of punishment is never acceptable. You need to get help.

C. There’s nothing wrong with telling your child you are sorry when you make a mistake, but this is a serious mistake that needs more than just saying you are sorry.

D. It is never okay to punish a child this severely. It will not help him as he grows older and it is very unlikely that he will thank you for it. You need to get help with your temper.

Discipline is important for children. However, discipline should never include beatings. Losing control to this extent, even once, is not okay. +

As we slowly try to establish a new normal, both in the healthcare environment and in our daily lives, it gives me an opportunity to reflect on some of the things I observed during the “surge” in our area but maybe didn’t take the time to process. You see, as a respiratory therapist I take care of critically ill patients every time I work, and the fight in my fight-or-flight drive is alive and well.

What do I mean by that?

Every time there is a “Code Blue” called in the hospital there is always a respiratory therapist at the head of the bed either bagging the patient, preparing for intubation, assisting in intubating or intubating the patient.

The respiratory therapist is fighting for the patient’s life.

In fight-or-flight, flight is not an option.

Despite the recent crush of patients, it is important to reflect from time to time in order to learn, grow, and improve. It can also be a good time to decompress. All of that said, I am reflecting on my experience during this pandemic.

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You were tired and stressed and your 4-year-old son had been difficult all day. When he broke a glass, you lost control and spanked him much more severely than you intended to.

Marks were still present the next day. You’ve never done anything like that before and you are frightened you might do it again. What do you do?

A. Get help now. You need anger management training.

There is something wrong when you lose control to this extent.

B. It’s normal for parents to lose control now and then. As long as it’s not your usual way to deal with your child, don’t worry too much about it.

C. Make sure he knows that you were wrong to spank him that hard. Tell him you are sorry and that it won’t happen again.

D. In the long run, a good hard spanking doesn’t hurt a child. It instills discipline. He will thank you for that discipline someday in the future.

brings me to my next observation.

“No visitors” has meant no visitors. There was no gray area about this rule. Could you imagine being a patient during this time? Patients were afraid of going to the hospital because of the pandemic, and if they did come to the hospital, what were they exposing themselves and worse yet their family to? If a patient was intubated, they were alone. Family members could not come to see their loved one under any circumstances. I don’t know how well I would manage over an extended hospital stay if my only human interaction was limited to talking to a nurse a couple times a day and never being able to see my family.

If a patient passed away, they were alone. That was one of the hardest things for me. It makes me incredibly sad to think that people died without a loved one holding their hand. It happens more often than you would think under normal circumstances, but under these circumstances they did not have a choice.

Finally, the patients were looking to me and my colleagues to calm their fears about this virus and their condition, as well as other issues. I realized I had to take the time to reassure each patient who needed it because, well, there was no one else.

I am sure there are many other observations that will surface over time. The impact felt by non-COVID patients was just as great if not greater than the impact on COVID positive patients. +

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JUNE 19, 2020

Let’s spend a few calm, quiet and rational minutes talking about everyone’s favorite subject, the coronavirus. (Part 6 of a feature of unknown duration.)

To amplify and enlarge upon the brief Dear Readers article on this page, the Medical Examiner is eager to resume printing at the earliest possible date. There are no plans here to permanently transition to an online-only publication.

Print is not dead, and anyone who says otherwise is uninformed.

But here’s the problem: we deliver to literally hundreds of places, most of them connected in some way to medicine and wellness: pharmacies, doctors offices, nursing facilities, fitness centers and more. It could be said that such places are more likely to be sources of possible COVID infection than, say, a car dealership or a barber shop (we deliver to several of both

barbers and car sellers, too).

After all, if someone is not feeling well, they’re likely to visit the very places to which we deliver most Examiners.

Are we just being paranoid? Isn’t this thing starting to wind down?

We wish.

In the past week (dating back to June 12), the 7-day rolling average for new COVID cases in Georgia has increased from 737 per day to 848 new cases daily. On June 1, the daily average of new cases in Georgia was 643, and now it’s 848. The second highest single day for new cases in Georgia since the pandemic began happened this month. (All figures courtesy of the Atlanta Journal-Constitution) Across the river in South

Carolina, new cases are surging, higher each day than the day before. The Palmetto State’s daily average for new cases stood at 340 on June 1.

Two weeks later it had more than doubled to 736. Its highest-ever daily peak of new cases since the pandemic erupted was within the past week (last Saturday, June 13).

No, this virus is not going away, but many people in the CSRA and around the country seem to be acting like it has.

From where we’re sitting, it looks like a lot of people have interpreted the easing of economic restrictions as evidence that COVID-19 is on the way out the door.

They are two completely different issues that, in practice, are unrelated. They probably should not be unrelated, but they seem to be. How do you restart an economy without compromising health guidelines? How do you enforce health guidelines without affecting the economy?

So as all this relates to the Medical Examiner, we’re eager to start printing again, but we’re waiting for a clear signal from the numbers that says it’s safe to do so.

In the meantime, we hope you’re enjoying the online version. We haven’t missed an issue yet. Hope you can say the same. +

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Why are doctors called doctors?

People haven’t always called their healers doctors. The word has been around for centuries, but not in any way connected to medicine.

In the first century, an episode is recorded in the Bible about Joseph and Mary searching in vain for their son Jesus.

Luke 2:46 in the King James Bible (KJV) says, “And it came to pass, that after three days they found him in the temple, sitting in the midst of the doctors, both hearing them, and asking them questions.”

More modern translations, reflecting the changing meaning of the word, say teachers instead of doctors. But around the time of the KJV’s publication, doctor meant church father, religious teacher, adviser, scholar. Gradually, any exceptionally learned person who had received every university degree offered ­could be called a doctor, a teacher, instructor, learned man; one skilled in a learned profession.

Doctor in that meaning has its roots in classical Latin, the noun docere: “to show, teach, cause to know.”

By the 1400s, the use of doctor as a medical practitioner began to appear, replacing — believe it or not — leech, a word that borrowed one of the medical profession’s cutting edge tools of the time. Doctor as a medical practitioner was not in common use until the 1600s.

See also this spot in our previous issue: “Why are physicians physicians?” +

DEARREADERS Many of you have contacted us to ask when the print edition of the Medical Examiner will return. We are as eager for that day as you are, but when it happens will be dictated by conditions largely beyond our control. It will happen as soon as it is practical and safe to do so, you may be sure. For now, COVID cases in the two-state region are still on the rise (see Reality Check). We hope they will plateau soon and begin a steady decline. In the meantime, thank you for continuing to support this online version and the loyal advertiers who make it possible. +

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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.

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The appearance of advertisements in this publication does not constitute an endorsement of the products or services advertised. © 2020 PEARSON GRAPHIC 365 INC.

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JUNE 19, 2020

AUGUSTAMEDICALEXAMiNER

#117 IN A SERIES

Who is this?

ON THE ROAD TO BETTER HEALTH A PATIENT’S PERSPECTIVE

S

ometimes major advancements in medicine defy logic, and at times they can come at great personal risk.

Such was the case with this doctor’s claim to fame, although we use the word fame loosely. His name is Thomas Dimsdale. Have you ever heard of him?

As everyone knows, Edward Jenner discovered inoculations in 1796, treating an 8-year-old boy against smallpox using the contents of lesions on the hand of a young dairymaid, Sarah Nelmes.

But how often is “what everyone knows” correct? Not always. Not in this case specifically.

Rewind the time machine nearly three decades, to 1768.

In that year we find Dr. Dimsdale, a thoroughly British doctor, in St. Petersburg, Russia, and about to do something that from the standpoint of logic made very little sense: deliberately infect a perfectly healthy person with disease.

The disease was the dreaded smallpox, and the perfectly healthy person was Catherine the Great, Empress of Russia.

This could go wrong in any number of ways, and Dimsdale actually had secretly arranged for a coach to be on standby to whisk him to safety if things went awry. But they did not. Catherine the Great was successfully vaccinated against smallpox (although “vaccine” was Jenner’s word and would thus come later), and was happy enough with the results that she awarded Dimsdale £10,000 plus an annual stipend for life, and she made Dimsdale a baron of the Russian Empire. He was invited back to Russia later for a second round of inoculations involving even more members of the royal household. She was so incensed at people who rejected the medical advancement, the anti-vaxxers of her day, that she said they were “truly blockheads, ignorant or just wicked.”

Should Dimsdale, who lived until 1800, have been jealous of Jenner’s fame for something he, Dimsdale, invented?

In truth, inoculations (or variolations) were not discovered by either man, and no one knows exactly who did, just that they were first practiced in China centuries earlier, perhaps even before the days of Columbus.

In one respect, it’s easy to see the potential path this discovery originally took. Perhaps a village healer noticed a child who had a mild sickness, and the same doctor expected all the children in contact with that child would also get sick. When none of them did, it could have started the thought process that mild infections can create immunity. As an article in Wired recently noted, to intentionally infect someone with one of humanity’s deadliest diseases was so outrageously dangerous that variolation could only have been conceived and popularized by someone outside the medical mainstream.

It had to be a tricky business in the beginning: introduce too much viral material and you could kill the person you’re trying to protect; too little and they don’t produce antibodies or gain any immunity. The process must have progressed through many trials and many errors. But billions of people have escaped the clutches of mankind’s deadliest enemies thanks to Dimsdale, Jenner, and others before them. +

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 I need to clean off my dining room table.

It has become a repository for lots of “stuff” of which little has any socially or otherwise redeeming value. Why do I need to do that? Well, because I need some flat space in which to do jigsaw puzzles. Puzzles not only require flat surfaces, they also require a place where they can sit, undisturbed, for as long as the puzzle takes to complete.

I haven’t done puzzles in many years, but our Columbia County meals on wheels is providing them with meals for those of us who are housebound and alone. When I was asked if I’d be interested in doing puzzles, at first, I thought it was referring to puzzle books, which I already like and have written about. But she was referring to 300-piece jigsaw puzzles. This is going to require me to stretch my skill levels to another type of mental exercise, and to test my arthritic hands to see if I can perform fairly exacting maneuvers with little bitty pieces.

Fun for an old lady living in a vacuum of solitude! My life doesn’t provide me with much entertainment which means just like in my youth, we had to provide ourselves with fun. So my fun has to come from my own imagination, my own willingness to try new things like puzzles.

Although fully healed now, my hip still hurts, especially on rainy or cold days. It limits what I can do, even with the help of both physical and occupational therapists who come to the house and ask me to do what is close to impossible for me. Doesn’t

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matter. They can be very insistent. Their latest big effort is to help me learn how to graduate from my slow-moving plain old walker to my fancier and much faster rollator.

The surgery to repair my hip took two inches of length off my right leg, so walking is challenging enough without using the rollator. They aren’t being mean, though.

Using the rollator will give me the ability to do much more standing up.

The old walker wasn’t something I could easily use to do laundry with, although Justin helped me to figure it out. The rollator, with its seat, gives me a platform for carrying things from place to place. It also takes me from sitting in my wheelchair to standing up more of the time. I remember being able to walk around the grocery store for long enough to shop for my own groceries, and then using the rollator to bring in the groceries. It’s been nearly a year since I could do that. I believe I can do it again if I work hard enough and become strong enough. I am determined enough to master the fear which puts the brakes on relearning what used to be easy skills.

Breaking my hip caused enormous and long-lasting pain from which today’s fear arises. I had more confidence about walking when I was a toddler, when I was an awkward teenager, even when my knees were riddled with such severe arthritis that I had two knee replacements. I believe I can regain that confidence, so my later years are less confined to my home, as lovely as it might be. +

JUNE 19, 2020

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AUGUSTAMEDICALEXAMiNER

ADVENTURES IN

Middle Age

BY J.B. COLLUM

Since my introduction to middle age, I have become aware of the growing role medicine plays in my life. I start my days with several pills and end them with a few more. I have to make sure to get my refills, and I must check to see if I even have a refill available. When I don’t, I call the doctor’s office and hope they will send in a refill without me paying for another expensive visit.

If a visit is required, it might be a while, so I may have to wait on my meds. I hate to be that dependent on something or someone, but what can you do?

Last fall, I went to buy my usual supply of Zantac only to find it stripped from the shelves. It turns out that some lawsuits are saying it might be cancer-causing.

Either way, the lawyers don’t care as long as they get paid.

The facts don’t matter. It’s just what they can make a jury believe, or what they can frighten a drug company into believing they can convince a jury of. The problem in this case is that nothing else worked as well for me as Zantac. Similar scenarios have played out for other medications. I have friends and family who can’t get the drugs that were the most effective for them because those drugs are now off the market based more on wellrun propaganda or smear campaigns than on science, in my opinion.

For some people with chronic pain, the best medicines that were available are either tightly controlled to the point where many who need them can’t get them, or they are not available at all. And why is this? Because there were some bad actors that abused these drugs, or wrongly prescribed them. Is that enough reason to refuse a better life to people who desperately need them? I think not. In some cases the

replacement drugs they must use have bad side-effects, but since they have been around a long time, are cheap, and haven’t been made a cause célèbre by the press, there is no public outcry against them and there’s no money in suing them, so they stay.

While it is true that we all love our lawyer when we need him or her and they can and do provide an important service in our society, lawyers have seemed to run amok on our healthcare system in the last few decades.

In this article, I just want to focus on their effect on the availability of medicine because to discuss all the ways that they have hindered good healthcare would take volumes. Not to say they are the only culprits, but they bear a sizeable portion of the blame both as individuals and in their roles in government and business.

You can’t watch TV without seeing an ad about a drug that some lawyers are trying to sue out of existence.

Sometimes this might be a good thing, but usually, the side-effects they talk about in those ads are the same ones the drug company warned you about when they advertised their medicine. Right?

So, if they warned us, how is it that we can now sue them for it? It doesn’t seem fair.

Some of their ads make the lawyer’s antics on Better Call Saul look tame by comparison.

The law of unintended consequences comes into play here in a large way.

Ask yourself: If you were the head of a large pharmaceutical company, would you risk hundreds of millions of dollars to make a drug that has great benefits, but some side-effects for a small percentage of the people who take it? It is a sobering thought. The fact is that pharmaceutical companies make these kinds of decisions

all the time. I am not saying they are saints, but it is only reasonable that they should try to protect their company from bankruptcy. When they are forced to stop making a drug because of side effects that typically affect perhaps 2% of users, some people will not be getting medicine that could prolong their lives or at least help them have a better life. This becomes especially acute as we age.

It is because of considerations like this that very few companies make vaccines. It is why many promising drugs and treatments never make it to market. These companies have to compensate for millions and sometimes even hundreds of millions of dollars in research, legal costs, testing and approval processes before they can even begin to make money on the medicine, and then in a few years the generic version comes out.

You might think there would be no worries if they made drugs safer, but you’d be wrong. There are many cases where lawyers have won big settlements and then research later established that the drug company’s product did not cause the issue. Do the lawyers then give the money back? I’ve never heard of that happening. All the lawyer must do is convince 12 people, whom they have helped select, that the big bad drug company made something that hurt someone, whether it is true or not.

Drug companies have deep pockets, so why not make them pay? The lawyers for the plaintiffs do their best to make sure that the jury has people who can be swayed to their side of the story.

These are people who have no knowledge of medicine or science in most cases, and in others, just enough knowledge to make them dangerous.

So, here is my idea to

WHEN ONE DOOR CLOSES, JUST OPEN IT AGAIN. THAT’S HOW DOORS WORK.

solve it. All legal cases involving drugs or medical treatments must first pass through an unbiased double-blind scientific process to determine the merits of the case. The lawyers bringing the suit must pay for this testing out of their own pockets and not charge the client unless the tests show proof for their case and the subsequent court case in front of a jury also finds in their favor. I think this would virtually do away with frivolous medical lawsuits and leave only clear cases of wrongdoing. It would free up drug companies to invest in some less lucrative medicines because they wouldn’t have to fear lawsuits nearly as much.

Most importantly, we could get the medicine we need, but the side benefit is that It would likely reduce or eliminate those annoying

ads. I understand that this would impact the legal profession in a big way, because we would have an excess of lawyers, but maybe we could export the excess lawyers to other countries where they could hurt their economies and even the playing field.

People are always talking about the United States not exporting enough stuff, right?

If you have a story about how the legal profession has adversely impacted your access to medications or treatments, please share by sending me an email to the address listed below.

Until next time, stay safe dear readers. + J.B. Collum is a local novelist, humorist and columnist who wants to be Mark Twain when he grows up. He may be reached at johnbcollum@ gmail.com

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JUNE 19, 2020

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nies who already supp ort us ns of compa ! the te Join

Summer is in full swing, which makes it a great time to learn how to create the perfect charcuterie board to serve your family and friends. The boards are a quick and easy way to serve healthy snacks or a light meal. The word charcuterie originated in France, and it translates to “pork-butcher shop.” While the original French translation refers to pork, American charcuterie boards tend to include other types of food, such as fruits, vegetables, a variety of cured meats, nuts, spreads, crackers, dips, and bread.

A good charcuterie board has a balance of flavors and textures with items that contrast and complement each other. For example, you could contrast a chewy cured meat to a smooth dip such as hummus.

Add something spicy and contrast it with sweet. You could also add hard and crips crackers with soft, chewy bread.

A charcuterie serving board can be made out of a wood board, a metal tray, a stone cutting board, or a large flat ceramic platter. I like using a wooden tray, as you can see in my picture.

Just let your imagination go, look around your home to find an interesting serving item to start creating your charcuterie on.

Be sure and head over to my blog for a printable charcuterie shopping list.

You will also be able to

IS YOUR GARAGE DOOR CAUSING HEARING LOSS?

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AUGUSTAMEDICALEXAMiNER

JUNE 19, 2020

COVID AND THE UNDERCOVER ADDICT

by Ken Wilson Steppingstones to Recovery

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Last week I needed to move an old black fiberglass truck bed cover that had been laying on the ground for awhile and naively asked a buddy to help me lift it up. He warned me, saying “there’s probably a snake under it so let’s be careful.” At that point I put some gloves on and we heaved up and sure enough, he was right! We had interrupted the longest black snake I’ve ever seen taking a nap, and I think it was as surprised as I was! It relocated quickly and we were all thankful and relieved.

COVID-19, however, is not going to leave as quickly and willingly as that snake. And none of us will be relieved very soon. It’s a hidden demon much of the time and will bite and hurt if it gets too close.

And if addiction isn’t enough, add COVID to the equation and the disease is magnified exponentially. Hearing the admonition to “shelter in place” is great news to the introverted addict who is hearing “isolate at home.” On the other hand, it is terrible news to the extroverted addict. The first says “Whoopee – I get to be with me!” And the other one says “Oh no, I have to be with me!”

At any rate, either addict quite likely is at greater risk of contracting COVID-19 compared to the non-addict “earth person,” as addicts sometimes call “normal” people. And just why would that be?

I do not have statistics (if there are any) to prove my point, but in my 33 years of working with addiction I have

noticed that addicts smoke, and they smoke a lot. And many vape their drug nowadays, placing their suppressed immune system and lungs at greater risk of contracting diseases. Not to mention the ones who share their THC vape with a friend or two. Say what?

Yes, drug use impairs the frontal lobe where rational thinking occurs. Just look around and see. You don’t have to be the proverbial rocket scientist to figure this one out. And there is also the increased rate of heart disease among addicts, which in turn spells out still greater risks of severe consequences if COVID hits.

A great risk factor for addicts right now is access to health care. In North Carolina, for example, 30% of all addiction treatment personnel were laid off in March and April. As a result, over the past 2 months more than half of the treatment programs there (57%) have discontinued at least one of the services they provide. Many treatment centers operate on a hand-to-mouth basis as far as income is concerned, and COVID has hit the treatment industry hard. Just think: many businesses can only have one-third to one-half of their former customer base due to social distancing. I suspect many more will go under. Many treatment centers are only doing tele-counseling these days as well.

An addict must have three things to get well: desire, support, and accountability. COVID has damaged two of the three criteria addicts need to recover! (I’m leaving it to you to figure out which two.) Self-help groups have entirely disbanded their group format and gone to online meetings. They are

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

certainly much better than no support or accountability, but those in early recovery especially miss the hugs and group energy they rely on. Connectedness with others is a powerful positive influence for their mental health – and ours too.

Many addicts do not have good jobs for a number of reasons, and with unemployment approaching 20%, jobs are scarce. This financial disaster of course affects access to health care, food, rent, and transportation, what Maslow would call “basic human needs.” And the longer “shelter in place” lasts, the more acute these problems become.

This is what’s going on, undercover, with the addict right now. Do be understanding. Not all of the snakes we can’t see are as cooperative as that black snake I saw last week. +

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JUNE 19, 2020

AUGUSTAMEDICALEXAMiNER

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

TIGER NUTS - THE SUPERFOOD

by Jiajun Lin, MS-Dietetic Intern Tiger nuts, one of the hottest “superfoods” on the market, are not exactly nuts. They are actually edible tubers also known as chufa or yellow nutsedge. They are the size of a chickpea, but wrinkly in appearance with a chewy texture and a sweet nutty taste similar to coconut. Tiger nuts were one of the first plants to be cultivated in Egypt and commonly used as food and medicine.

They are popular in Spanish and Mexican cuisine to make the drink called horchata. You can eat tiger nuts raw, roasted, boiled, or juiced. They are also used in plant-based beverages, spreads, flours, oils and more.

Tiger nuts are rich in a range of nutrients and have been linked to a number of health benefits, ranging from improved digestion to decreased risk of heart disease. On average, one ounce (28 grams) of raw tiger nuts contains 120 calories, 19 grams of carbohydrates, 10 grams of dietary fiber, 7 grams of fat, and 2 grams of protein.

The “nuts” are rich in vitamins and minerals including vitamin C, vitamin E, iron, phosphorus, magnesium, zinc, potassium and calcium. Their antioxidants protect your body against aging, cancer and heart

disease. In addition, tiger nuts may promote a healthy digestive system.

Tiger nuts are abundant in insoluble fiber, which passes through your intestine without being digested. Insoluble fiber helps food pass through in the intestines quickly, decreasing the risk of constipation. Tiger nuts also contain resistant starch, which is a carbohydrate that resists digestion in the small intestine and ferments in the large intestine. It benefits the gut by acting as a prebiotic, feeding the good bacteria in the gut. Animal studies have shown positive results with tiger nuts reducing blood sugar levels. This may be because their high fiber content slows down the absorption of sugar in the digestive tract. Moreover, tiger nuts are rich in the amino acid arginine, which

promotes heart health and is essential for controlling blood sugar by increasing insulin production and sensitivity. The body can convert arginine to nitric oxide, which is a vasodilator that supports relaxation of the blood vessels and lower blood pressure.

The fat in tiger nuts is mostly monounsaturated fat known as oleic acid. Similar to olive oil, it is associated with lowering LDL and raising HDL cholesterols resulting in lower risk of heart attack, stroke, and many other heart diseases.

Adding tiger nuts into the diet should be done with care.

The high fiber content may be an irritant in people with inflammatory bowel disease and for such people tiger nuts should be avoided. Also, the fiber may cause unpleasant gas and bloating, so it’s prudent to gradually increase portions. Tiger nuts also contain bioactive compounds, such as phytates, oxalates, saponins and tannins, which may reduce nutrient absorption in the digestive system. Roasting them can decrease these compounds and increase nutrient absorption rate. Though tiger nuts are described as super, it is important to remember that there is no single food that holds the secret to good health or disease prevention. A balanced diet containing a variety of foods is the key to maintaining good health.

Additional information on food, diet and health, can be found at www.eatright.org.

The website is owned and managed by the Academy of Nutrition and Dietetics.

They are the largest body of nutrition experts (Registered Dietitian Nutritionist) that are trained and certified in the field of nutrition and dietetics.

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CRASH

COURSE

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

S

One of the reasons that speeding matters peed kills. is because of something we have written Yeah, yeah, you say. Tell me someabout previously in this space: we are thing I don’t already know. currently living in the (possibly temporary) To which the Crash Course instructor golden age of non-motorized transport. says, “No, really.”

Courtesy of a deadly pandemic, people Speeding is not something to ignore have been, and in many cases still are, or view as inconsequential, yet that is working from home and avoiding exactly what we do. And when we say non-essential trips of every kind. You we, we mean pretty much everybody. have probably noticed the results Plus, how often can you write a of all this in your own neighborsentence where 3 out of 4 consechood: the streets are filled with utive words are “we,” oui? kids on bikes, dog walkers, We are, collectively, addicted neighbors standing in the to speed, so much so that the street chatting, moms pushmost commonly broken law ing strollers, older retired on the planet, it is said, is couples, joggers and speeding. (Cheating on fitness walkers. taxes is said to come In 2014 New York in second.) There is City lowered the not a single one of us citywide speed limit who hasn’t been guilty Speeding is often much more about safety for in the Big Apple to 25 pedestrians, bicyclists, joggers, children, walk- mph. It made sense: of speeding at some ers and so on than it is about other motorists. point (or multiple can you think of any points, maybe even earlier today). city in this country with more pedestrians There are people — traffic engineers and bicyclists than New York? among them — who say that speeding is Along with their speed reduction, the not inherently dangerous, and to a certain New York City Department of Transportadegree they have a point. To illustrate, let’s tion released research showing that a pesay on a certain road the posted speed limit destrian struck by a vehicle traveling at 30 is 40 mph, but the actual speed of traffic on mph is twice as likely to die as a pedestrian that road averages 55 mph day in, day out. struck at 25 mph.

That would not be an unusual situation. If That is an amazing statistic for a differa driver decides to scrupulously observe the ence in speed of just 5 mph, and it shows posted speed limit, he will create a hazardexactly how dangerous speed can be, not ous traffic situation — and will probably to other drivers encased inside steel cages get plenty of angry stares and honks to equipped with seat belts, airbags, and enreward him for his law abiding ways. gineered crumple zones designed to absorb Statistically speaking, the biggest facimpact. No, speed is most lethal to people tor in speed and the danger it presents is minding their business walking down the driving significantly faster or slower than street or sidewalk, pedaling along the curb the main flow of traffic. Either scenario in their own neighborhood, pushing a can create accidents or increase the risk of stroller or riding a skateboard. impatient actions by other drivers, actions A driver could be a speed demon for which sometimes lead to that other highdecades and never get more than the ocway danger, road rage. cassional ticket. Or the very next time he Having said all of that, the first sentence gets behind the wheel could be the time he of this article still stands; it is still a fact. strikes a child or some other unfortunate Speeding still matters, and the fact that pedestrian. nearly everyone is doing it makes it even Is saving a minute (possibly just secmore concerning. onds) really worth the risk? +

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JUNE 19, 2020

HUMAN BEHAVIOR When a palmetto bug dives at you in the bathroom, you scream so loudly your spouse thinks someone is breaking in through the window. You have that dream

by Jeremy Hertza, Psy.D. again of being abandoned or alone and wake up with your heart racing. You just can’t face going up on that rollercoaster with your child. And hey, is that a clown hiding in your bushes?!?

Most of our fears revolve around the unknown and things we can’t control. But here’s what’s really going on when we get scared.

HOW TO OVERCOME OUR FEARS

Here’s What’s Happening The part of the brain that handles fear and negative emotions is only about the size of an almond. But the amygdala can cause powerful responses to negative emotions, memories and fears—and it’s also the part of the brain that’s impacted if we have post traumatic stress disorder or depression.

This tiny organ basically creates a pathway for fears directly to the front of the brain, which then activates our fear response. Fears can be both conscious (like running screaming away from a palmetto bug) or unconscious (that prickly uncomfortable feeling in the pit of your stomach that someone—like that clown—is watching you).

But these fears aren’t all bad. Think about it: What else keeps you from walking down the street with a wad of cash in your hand at 3 in the morning? Sometimes you need negative emotions to help drive good behavior. The right amount of fear and anxiety is healthy and can keep you from doing stupid things or getting into unsafe situations.

The problem comes when those fears are no longer driving us to make the right choices but are consuming us.

Here’s What You Can Do Fear, anxiety, pain—all of these activate our sympathetic nervous system, which controls our “fight or flight” response.

So for example, if you put your hand on a hot stove, your brain isn’t processing, “Oh, look, my skin is melting.” Your sympathetic nervous system kicks in to protect you so that you move your hand away as quickly as possible.

But if your anxiety or fear are causing your sympathetic nervous system to be on alert all the time, that’s when you can’t control your thoughts, your muscles tense up and your blood pressure spikes to pump more blood to your legs so that you can get away from whatever it is that’s scaring you.

But that doesn’t help you when you’re scared of your nightmare boss or you have to be the one to present on stage at the next conference or when you have to take the kids trick or treating and you hate crowds.

But here’s what you can do: You can start changing the situation instead of worrying about what you can’t change. There’s always something you can change; at the very least, it’s your attitude.

• For the nightmare boss, maybe it’s talking to coworkers that he or she gets along with about how to interact more positively.

• For the presentation, maybe it’s practicing every day for a week, alone at first, then in front of people you trust.

• For trick or treating, maybe it’s starting early and leaving early to avoid crowds.

Also understand that the biologic reactions—the tight muscles, the sweaty palms and the fast heartbeat—typically come first. So they should be the first things you deal with. Focus on your body, breathe, maybe go for a walk if you can. Work on slowing down your heart rate to help stop your body’s reaction to what it thinks is an acute situation but isn’t.

By doing this, you can help make sure your emotions don’t come into play, you can pay attention to what’s going on, you can have a thoughtful response and you can control your fear, instead of having it control you. + Jeremy Hertza, Psy.D., is a neuropsychologist and the executive director of NeuroBehavioral Associates, LLC, in Augusta, on the web at http://nbageorgia.com. Contact him at 706-823-5250 or info@nbageorgia.com.

JUNE 19, 2020

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AUGUSTAMEDICALEXAMiNER

The blog spot From the Bookshelf — posted by Christopher Bennett, MD, MBA on July 4, 2017

THESE PHYSICIANS ARE CRYING. HERE’S WHY. I cried this morning. It wasn’t because of the patient who coded with a wide-complex tachycardia and died in front of me, and it wasn’t because of the patient who tried to spit on me for not giving her a prescription for narcotics. Nor was it my intoxicated 2 a.m. bar fight patient yelling at my other patients, including one whom I’d recently diagnosed with metastatic cancer.

It was because I was tired and defeated. Sitting quietly at my desk in the back corner of this emergency room with the third cup of coffee since my shift started at 7 p.m., I spent this night like the countless others preceding it, churning through notes and seeing patients with the goal of trying to provide the best patient care I can while being reminded by the sounds of the waiting room that many more need to be seen.

But I didn’t cry as bad as the surgery resident behind me did last night. She had made a mistake. Somewhere midway into her shift, well beyond what any other industry would consider “safe,” let alone a field where each moment could involve life-or-death decisions, she had clicked the wrong button. She made a human error that anyone, even with a good night’s rest, could have made. There was a theoretical harm to the patient. And upon immediately recognizing this, she owned it and called her attending. It was impossible not to hear his voice screaming through the phone. Almost as impossible as it was for her to hide her already bloodshot eyes, now tearing, as his words ripped deeper and deeper into her, her literal cries of “I’m sorry” met by deaf ears and bitter words.

And I didn’t cry as bad as the psychiatry resident last week, the one who thought he was alone in the supply closet when I fumbled in looking for a suture removal kit.

On the other side of the ER, a patient had apparently said all the wrong things, and one of them had hit home. It was the kind of conversation that was too loud for you to not hear and too angry not to notice. I had seen the resident walking quietly away with his clipboard under his arm to the closet several minutes before. Minutes after when I’d walked in, he coughed, made eye-contact and looked for a quick exit. Hastily wiping tears onto his sleeve in the process; leaving the room to go back to the patient and finish.

And so it seems so much easier with each passing day to understand why our profession suffers from such alarming rates of burnout and depression. We staff busier and busier hospitals with patients who have increasingly complex health care needs. We are asked to do more and more.

And we do it through hours that are unsafe for both our patients and ourselves. But we residents don’t talk about that, because when we do, those before us are quick to remind that “we worked longer.” We don’t acknowledge the difficulties and vast differences in health care systems of then versus now.

But when we hear about her, the young doctor who rammed her car into a guardrail after falling asleep at the wheel, or him, the young doctor who jumped to his death, we get uneasy. We offer counseling sessions and ice cream socials. But we don’t fix the problem. We put Band-Aids on cracks to an already breached dam. We simply say, just keep working.

Burnout and depression and suicide don’t signify an issue with the clinician; it signifies a failure of the system. +

It’s the failure of the entire system

Christopher Bennett is an emergency physician

From an online Amazon.com review: Over the years, I have had a number of people confide in me that either they or their spouses were considering divorce. My advice has always been to read Wallerstein’s series to learn the variety of outcomes that can arise post-divorce.

Those considering divorce are all well advised to “do their homework.”

These books are also a must read for anyone involved in family and/or divorce counseling - religious or secular counselors.

In “Unexpected Legacy of Divorce,” the authors address the myth that the children will do fine if the parents are happy - divorced.

Children, no matter how amicable and settled the parents are after divorce, suffer greatly. They lose their family, they lose control of their life (to the whims of parents and rules of courts), and they lose their childhood. All of these combine to provide a series of struggles as they move into adulthood and beyond.

Important subject areas covered in this book include: * The ghosts of childhood the bottomline after 25 years * The exploitation of children by divorcing parents * The path to adulthood being thrown out of sync * Children dealing with the loss of THEIR nuclear family; the family that created them just vanishing - a loss that will be quietly or openly mourned throughout their lives * Children living with and coping with chaos * The missing father or mother after divorce * Children growing up lonely

* Relationships with the “steps” (step-parents) * The loss of mom - whether or not she is physically available * Court ordered visitation and its disruption of a “real” life for the children to make mom and dad complete * Children of divorce taking the leap in relationships and marriages - the return of the relationship ghost * The role of an intact family for modeling and shaping children whether their parents marriage is good or bad * Other residues of divorce for children - fear of loss, fear of change, fear that disaster will strike, especially when things are going well * And the need for all involved in divorce, directly or indirectly, to be educated on all the issues that emanate from the divorce for children over their life as well as in the short term.

This will not be an easy read for many. It was not intended to be. + The Unexpected Legacy of Divorce

by Judith Wallerstein, 400 pages, published in 2001 by Hyperion

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AUGUSTAMEDICALEXAMiNER

The Examiners

JUNE 19, 2020

THE MYSTERY WORD O

+

by Dan Pearson

What’s this I hear about For selling my herbal Why? And what do you supplement called This has happened to Yes. In 1988, 1932, you getting in some kind It’s true. you before? mean “again”? of trouble?

Never Ever Die. 1873, 1841 and 1754.

I was arrested again.

The Mystery Word for this issue: ELLBIRA

© 2020 Daniel Pearson All rights reserved.

N ACAthen begin exploring Simply unscramble theVletters, TIONspelled word our ads. When you find the correctly hidden in one of our ads — enter at AugustaRx.com

EXAMINER CROSSWORD

PUZZLE

A B B S C E

N E R E I D

T I G E R S

A N N A

D E E R

ACROSS 1. Picnic pests 5. Studies before a test 10. Crusted wound-site blood 14. Trim 15. _________ County 16. Keep ____ on someone 17. Like some rains 19. Upon intro, sometimes 20. Type of surgery 21. Drunkard 22. Parter of Wynken and Blynken 23. Temporary fracture care 26. Straighten 29. Squander 32. Wreath of flowers 33. David Bowie hit 34. Late Augusta historian Ed 35. Unit of energy 36. Employee benefit prog.

37. Peach companion?

38. Churchill sign 39. Gone by 40. LA team 41. Inheritor 42. Gun 43. 03 44. _______ off; deflects or avoids 45. Lower canal or riverbed 47. ____-invasive 48. Mr. Floyd 49. Lower class 55. Leave out 57. Prepared, cooked, or served with spinach 58. Medicinal amount 59. Finished 60. High school woe 61. Exclamations of content 62. Relaxes 63. First or second ______

BY

2

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E X A M I N E R

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22 27

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35 38 41 44

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We’ll announce the winner in our next issue!

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4 9 8 3 2 6 9 9 1 7 3 7

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by Daniel R. Pearson © 2020 All rights reserved.

S U D O K U

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

by Daniel R. Pearson © 2020 All rights reserved.

DOWN 1. Oxidant beginning 2. _____ sign 3. Waterproof canvas 4. Odd 5. Member of the dog family 6. Religious practice 7. Related by blood 8. Flesh 9. Long-running NBC show 10. Sample lead-in 11. Projecting construction 12. Primary survey letters 13. Breast cancer check (abbrev.)

18. English public school 21. Consume 23. Agitates 24. Satellite of Neptune 25. Detroit team 26. Fear in country slang?

27. Encampment encircled by wagons or armored vehicles

5

QUOTATIONPUZZLE

28. Make poor 29. Crazy 30. Gray 31. Type of holder?

34. Fad 37. Study suffix 41. Merchandise label 44. Damaged by much use 46. Palm fruits 47. Must have 49. Arm bone 50. Starts to drift off 51. Endure, suffer (poetic) 52. Augusta painter Ed 53. ______ Karenina 54. ______ Crossing (road sign) 55. Room within a harem 56. Extinct flightless bird 57. Sum charged

O E E I C Y T E N N W B F O A N W O O O Y Y A V V R A T U R E G R H I

by Daniel R. Pearson © 2020 All rights reserved

3 2 8 6 9 1 5 8 I R N6 4 O R K1 7 O S 2 9 A U 7 5 4 3 — Morris Fishbein

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.

Solution p. 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.

1

2

E 3

1

2

1

O 1 2 3 4 H 2 3 1 2

T 1 2 3 4 5 6 7 8 9 L 3 1 2 3 4 5 6 7 8

1 1

2 2

3

G 5

4

1 2 3 4

F 1 1 2 3 4 5 6 1 2 3 M 1 2 3 4 5 6 1 2 3 4 5

1.FFCLTTTMMDIHACI 2.SOOOOOHIMHHAAH 3.RSTNEVIPSIET 4.LEHHINOT 5.DRGEER 6.RRRT 7.AE 8.NN 9.T

SAMPLE:

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

L 1

O 2

V 3

E 4

I 1

S 2

B 1

L 2

I 3

N 4

D 5

by Daniel R. Pearson © 2020 All rights reserved

WORDS NUMBER

1

Click on “MYSTERY WORD” • DEADLINE TO ENTER: NOON, June 1, 2020

5 7 4 2 3 9 8 6 1

1 3 5 7 2 8 6 4 9

9 2 6 1 5 4 3 8 7

8 4 7 6 9 3 5 1 2

JUNE 19, 2020

13 +

AUGUSTAMEDICALEXAMiNER

THEBESTMEDICINE ha... ha...

W

hile grocery shopping, two nuns walked past the beer cooler. One nun said to the other, “Wouldn’t an ice cold beer or two taste great on a hot summer day?”

“Indeed it would, sister,’ said the second nun, “but I wouldn’t feel comfortable buying beer. It would cause a scene at the checkout counter.”

“I can handle that,” replied the first nun as she picked up a six-pack and headed for the checkout.

The cashier had a surprised look on his face when the two nuns arrived with their beer.

Noticing his expression the first nun said, “We use beer for rinsing our hair. It makes it very shiny.”

The cashier reached under the counter, pulled out a package of pretzel sticks, handed them to the nun and said, “The curlers are on the house.”

A nun stood outside a tavern, scolding patrons about the evils of alcohol as they entered. Most ignored her, but one gentleman stopped to discuss the matter.

“Do you really think it’s fair for you to stand

here and scold people on a subject with which you have no personal experience?

Have you ever tried alcohol? Even once?”

“Most certainly not!” the nun said, blushing.

“Be reasonable,” said the man. “Wouldn’t it make a little sense if you at least tried some before you criticized it?”

The nun thinks about it for a moment, then says, “Perhaps you’re right.”

“Great! What would you like to try?”

“I’ve heard something about a... a fuzzy navel with a twist of lemon.”

“Comin’ right up, sister!”

The guy walks in and orders a fuzzy navel with a twist of lemon. The bartender says, “A fuzzy navel with a twist of le—? Is that nun outside again???”

Moe: Do you know what body part takes the longest to die?

Joe: I’ve always heard that hair keeps growing after we die.

Moe: Nope. It’s the eyes. Well, the pupils.

Joe: For reals?

Moe: You’ve never heard pupils dilate?

Moe: I bet hand sanitizer manufacturers are making a killing this year.

Joe: Yeah, they must really be rubbing their hands together right about now.

NFL NEWS: The Washington Redskins have decided to change their name to get rid of the association with racism.

They’ll now be known as the Arlington Redskins. +

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

Advice Doctor ©

Dear Advice Doctor, I guess this is a love life question if you answer those. I was dating this great girl for almost two years, but a couple weeks ago we broke up over a little argument. I was 100% sure we would get back together, but I had a rude awakening today: I found out she’s already seeing someone else! Do you think she’s just trying to make me jealous, or should I move on?

— Torn at the moment Dear Torn, I’m so glad you took the time to write in about this. It’s an important subject that affects more people than most of us would realize. Of course, everyone likes to be awakened gently, but rude awakenings can be especially problematic for people who are sleepwalkers.

There are all kinds of old wives tales about what happens when sleepwalkers are awakened, but the simple truth is that sleep walking — technically known as somnambulism — takes place during the deepest phases of sleep. Obviously someone walking around the house or even driving a car is not sleeping lightly. As a result, if they are awakened they can be extremely confused and disoriented, even violent, aggressive and combative.

Because of this, experts with organizations like the National Sleep Foundation recommend the best course of action is to try to gently guide the person back to bed without waking them up, and with minimal physical contact, since that might awaken them. If efforts to return the person to bed are not successful, the next best option is to stay close by to make sure they don’t do anything to endanger themself. Although the common misconception is that you shouldn’t wake a sleepwalker, it can actually be very dangerous not to. The person could fall down a flight of stairs, for example.

If you do have to wake up a somnambulist, don’t shake the person. You’re too close to them, and you could be injured by their confused and combative response. Instead, make a loud noise from a safe distance, then gently explain what happened and try to get them back to bed.

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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Money Doctor NOW IS THE TIME FOR FINANCIAL PLANNING! Wow, what a crazy last few months. The roller coaster of current events and market swings has been unprecedented. It will be interesting to see what the history books say about 2020. No doubt, it will be the year of COVID-19. The long-term changes businesses and individuals will make because of this pandemic are slowly starting to unfold. As the dust settles, one of the best things you can do as a family is to take an inventory of your financial situation and reflect on the changes. Then come up with a list of actions you can consider taking to improve your financial situation.

That process is actually what financial planners help people with. Consider engaging a financial planner to help you with this process. Often times, we hear that the reason people never do financial planning is that they do not know what the financial planning process

is or covers.

The good news is that the CFP Board has established standards that all Certified Financial Planner™ professionals are expected to follow. These standards outline what financial planning is and covers.

The CFP board defines financial planning as “the process of determining whether and how an individual can meet life goals through the proper management of financial resources”. Plans are customized to address the areas of importance for your family. The CFP board does not identify a minimum number of subject areas required for financial plans, so a financial plan may cover one or multiple subject areas.

The following subject areas are typically included in financial plans: • Financial statement preparation and analysis • Insurance planning and risk management

• Employee benefits planning • Investment planning • Income tax planning • Retirement planning • Estate planning Once you identify the subject areas for your financial plan, a Certified Financial Planner™ can help you work through the planning process.

The steps in the planning process are also outlined by the CFP Board. It involves six steps: 1. Establishing and defining the client-planner relationship 2. Gathering client data including goals 3. Analyzing and evaluating the client’s current financial status 4. Developing and presenting recommendations and/or alternatives 5. Implementing the recommendations 6. Monitoring the recommendations

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JUNE 19, 2020 The hardest steps are often 5 and 6, the implementing and monitoring. A good financial planner will check in with you on a regular basis and hold you accountable to make sure you stay on track. The planning process is ongoing and life events will change the inputs or assumptions that you make in the original plan. When that happens, it is important to re-visit the steps in the planning process and update your plan.

This ongoing planning process is the reason most families look to form a long-term relationship with their financial planner. A good planner will clearly explain how they’re paid and why their help is worth the cost to you. Almost anyone can call themselves a financial planner, so be sure to do your homework and make sure they know what they’re talking about. A good starting place is looking for a Certified Financial Planner™ that is held to the CFP Board code of ethics & standards of conduct found on www.cfp.net. +

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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

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