Medical Examiner 12-16-22

PLAY ON!

More than two full weeks of Christmas vacation is about to begin for students all across the River Region (or depending upon when you’re reading these words, has already started). Once upon a time, that meant hours of outdoor play every day, no matter what the weather. Kids up north were having snowball fights, ice skating, and building igloos. In the South, kids were climbing trees, skipping rope, riding bikes, and building forts.

Chances are, the children and grandchildren of the children described above won’t be climbing trees, skipping rope, riding bikes, or building forts during this vacation. As a sweeping generalization, most kids these days don’t play outside like their parents used to. They are more likely to be indoors looking at a screen: playing a video game or watching TV.

This is what many parents want. Back in the day they used to disappear into their childhood neighborhoods for hours at a time, coming home only for meals and when the streetlights came on, but as adults and parents, they want their children in sight at all times. Someone might snatch them away if they stray too far.

There are more healthcare organizations than can be counted that are very concerned with the activity levels — actually the inactivity levels — of kids today. Children are suddenly being diagnosed with health conditions once reserved for middle age and beyond. The most obvious is obesity and all the attendant health risks it elevates. Back in ancient times (the late 1960s) CDC stats say that just 4.2% of kids ages 6-11 were obese. The 2007-2008 numbers for that same age group: 19.6%. Obesity in all age groups from 2 to 19 is dramatically up and continuing to trend higher. What can be done? See headline above. Most parents have jobs; play is the job of childhood. One of the jobs parents have is to make sure their kids are doing their job: playing. Some families have a rule: sun’s out, kids out. They can only sit around inside if it’s raining. Otherwise it’s out the door. Sure, they need to be safe. Each family needs to establish its own ground rules for safety depending on their neighborhood and their kids. But when it comes to protecting kids, consider this question:

THE IMPORTANCE OF

CONTEXT

by guest columnist Dr. Rob Lamberts Augusta, Georgia

Sigh. These conversations are far too common, and they make me wonder: what are they thinking? Do they really think I prescribed a drug with the intention of destroying their liver? Do they think I am ignorant of the risks of the drugs I prescribe? Or do they think I’ve been duped by the pharmaceutical industry and am somehow not seeing the other side? I can’t imagine someone would choose me as their doctor if any of these are true, so I’ve concluded that they just haven’t thought it out. I’m not the kind of doctor who minds being questioned; in fact, I actually prefer patients that don’t accept things without question. I don’t take it personally when a person brings up issues of side effects, risk versus benefit, or expresses their fears about a treatment. It’s my job to explain these issues and address these fears whenever I advise a treatment. When folks make statements like this, they are usually just telling me that they are scared to take medications. They feel the risk is too high, given what they’ve read or heard about the treatment I’m suggesting.

Doctor’s weren’t questioned like this in the past, largely because we had information that others didn’t have access to. We were keepers of the “secret knowledge” of the body, of drugs, of disease. Sure, they could go to the library and do research, but that was too much work for most people to do, and so we’d just dispense our judgment based on this secret knowledge and tell them what they needed. Patients were often given a prescription without an explanation (other than “doctor’s orders”).

This all changed with the advent of the internet. Suddenly, all of our secret knowledge was no longer secret. Suddenly, patients had access to all medical knowledge and information. If someone had a symptom, they didn’t need to wait at the doctor’s office to see if it was a concern, they just googled it.

The desire to do so is compounded by the increasing inefficiency of and frustra-

“Doc, I didn’t take the medication you gave me. I read somewhere that it would destroy my liver.”

year happens during the winter holiday season.

According to an APPC analysis of suicide stats for one recent year (2021), here are the numbers for the entire year: MONTH RANK

MEDICAL MYTHOLOGY

PARENTHOOD

by David W. Proefrock, PhD

Your older children have been dropping hints to your 4-year-old son that there isn’t really a Santa Claus. You have told them not to tell him, but they are still dropping veiled references. You’re afraid that they will tell him directly or that he will figure it out from their hints. What do you do?

A. When you hear the older kids dropping hints, punish them severely.

B. Go ahead and tell him yourself so he will hear it from you in a more appropriate way.

C. You can ask the older kids not to tell him, but you can’t control all of their interactions with him, so don’t even try. If he asks you about Santa, tell him that some people believe in Santa and some do not. He will have to decide for himself what to believe.

D. Tell him that the older kids don’t know what they are talking about and that they are just being mean. Of course Santa is real.

If you answered:

SUICIDES

PEAK DURING THE HOLIDAYS

Once a myth becomes entrenched in popular culture it can endure for decades, even centuries.

Exhibit #1 this time of year is the myth that suicide rates are highest around the Christmas holidays. Did you just say to yourself, “Hold on. That is no myth. It’s true. I’ve read about it dozens of times.”

wonder people are doing themselves in during the holidays. Except that statistics prove it isn’t true.

The chart below, created by the Annenberg Public Policy Center (APPC) based on CDC statistics, illustrates daily suicide rates throughout the year. The grey vertical bars show November, December and January of each year dating back to 1999. The inset offers a close-up of the upper right corner of the chart, the most recent years. As you can see, the lowest rate of daily suicides each and every

January 10 February 9 March 8 April 11 May 6 June 4 July 5 August 1 September 2 October 3 November 7 December 12 December and January are two of the lowest months all year, while summer and early fall months (Aug., Sept., Oct., June and July) see the highest numbers of suicides.

Of course, all 12 months present unacceptable numbers. If you or someone you know is having an emotional crisis, call 9-8-8 for free and confidential assistance 24 hours a day.

But the next time you hear this is the worst time of the year for suicides, speak up and help put this particular myth to rest once and for all.

A

. You are not going to be able to control everything they say to their little bother. Punishing them will very likely make them more apt to tell him rather than less.

B

. There is no real reason to do this if he’s not ready to give up on believing. It would be better to cast doubt on what the older kids are saying to him.

C. This is the best way to go. You don’t have to lie to him, and you don’t have to tell him the older kids are lying to him.

D. He’s too close to the age when children figure Santa out for themselves to lie to him.

Belief in Santa is going to stop by itself. While it is not best for the older children to tell him, it’s going to happen one way or another soon enough. It is better to tell him that he has to think about it and decide for himself. He’s going to have to do that about many other things as he gets older anyway.

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

We all have. And as long as those pesky things called facts aren’t required, the case for the myth is quite compelling. It’s easy to list all the reasons why the myth is true, or at least should be: we’re inundated with images of Hallmark moments of joy and family get-togethers that leave the lonely and forlorn feeling particularly left out. Commercials depict surprise gifts like his-and-hers luxury vehicles (seriously?), while the teeming masses buy more ordinary gifts that still leave them under mountains of holiday debt. Toxic family situations, over-indulgence in alcohol, cold, dark, dreary weather...no

CRITERIA

BENEFITS OF PARTICIPATION

WHY CAN’T I GET TAMIFLU?

It is more than a little frustrating when flu season after flu season one of the best tools doctors have in their little black bags is in short supply or downright unavailable precisely when it’s needed most.

Do the makers of Tamiflu not know that flu season erupts every year about this time? It’s like not having firecrackers and sparklers around July 4th, or if not a turkey was to be found in the weeks before Thanksgiving.

Unfortunately, despite the vast power wielded by the press — the Medical Examiner in particular — this is a matter beyond even our ability to fix in time for this flu season.

But we have something to offer that is available right now.

It’s called elderberry.

Before you roll your eyes at this natural medicine and the crackpot science behind it (if it can even be called science) and demand honest-to-goodness pharmaceuticals made from chemicals, at least take the time to finish reading this article.

What is the verdict on elderberry from legitimate scientific studies?

The findings are good. Both lab tests (in vitro) and numerous double-blind, placebo-controlled, randomized real-life (in vivo) studies showed “significant” beneficial effects; one showed elderberry to be an “efficient, safe and cost-effective treatment for influenza,” relieving sufferer’s symptoms on average 4 days earlier compared to placebo. Other research found elderberry blocked the ability of H1N1 influenza viruses to infect host cells in vitro, comparing elderberry’s anti-influenza effectiveness with Tamiflu. Yet another study carefully assembled a pool of more than 300 long-distance air travelers with upcoming flights of 7 hrs or longer on their itineraries, and tracked the respiratory health of them all from 10 days before flying to 5 days after. Some of the 300 took elderberry capsules, others a placebo. The results: “a significant effect of elderberry on cold duration and cold associated symptoms was detected.” And when they say “significant effect,” they mean “significant positive effect.”

This is already shaping up to be a very active flu season, and reports from around Aiken and Augusta say there just isn’t enough Tamiflu to go around. If that happens to you, elderberry is available, it’s over-the-counter, it’s inexpensive, it comes in many forms, and best of all, it gets a thumbs-up for effectiveness against the flu in clinical studies.

Who is this?

Thi s man is credited for the discovery of one of the most unlikely drugs in the history of medicine.

If you read “Who is this?” in our previous issue, you will recall that it was about Alfred Nobel, who built a huge fortune based on dynamite and nitroglycerin and used that fortune to create and fund the Nobel Prize in Medicine and half a dozen other fields. The article ended with the promise that this issue would contain the amazing story of nitroglycerin’s important medical applications.

As is often true in many fields of endeavor, a fortuitous accident led to this discovery that has benefited so many. Sometimes the significance of these various accidents isn’t recognized. In fact, it would have been very easy for our subject, William Murrell, MD (pictured above), to ignore what he experienced as of no medical value, but he was perceptive enough to investigate further, and many heart patients to this day still benefit.

Born in 1853, William Murrell received his medical training at London’s University College Hospital. At the time, it was home to several of Great Britain’s leading medical scientists, and Murrell worked closely with John Burdon Sanderson (who preceded Alexander Fleming in recognizing the value of penicillin) and Sydney Ringer (the inventor of Ringer’s solution and Ringer’s lactate).

There had been scattered reports of experiments into the medicinal use of nitroglycerin for twenty years, most of which concluded that it was bad news, suspected of causing everything from tachycardia (rapid pulse) to paralysis. No one suggested deliberately taking it until Murrell came along in 1879.

One day at his medical practice, just before the arrival of his first patient of the day, he had touched his tongue to the cork stopper of a bottle of nitroglycerin. As quoted in a 1971 article in the British Medical Journal, Murrell said within minutes he “experienced a violent pulsation in my head” that “soon became so severe that each beat of the heart seemed to shake my whole body...The pen I was holding was violently jerked with every beat of the heart.”

For most people, and indeed, everyone who had preceded Murrell, an experience like that would be all the proof needed to realize that nitro was to be avoided. But Murrell was perceptive enough to recognize the possibilities: at the proper dosage, nitroglycerine could be an effective treatment for angina pectoris, the term that describes chest pains usually caused by insufficient blood flow to the heart muscle. (The word comes from Latin angere, “to strangle,” and pectus, “chest.”) He perfected the dosage through experiments on himself and a few willing patients and thanks to his perceptiveness, a completely non-explosive drug is still in use today (more than 3 million prescriptions in 2020) exactly as Murrell would have prescribed it in 1879.

A few months before his death in 1896, Alfred Nobel was prescribed nitroglycerin for this heart condition, a circumstance he descibed as “the irony of fate.” +

ON THE ROAD 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

My g reat-granddaughter Luna has just lost her first front tooth. She showed me the big hole where a tooth used to be and grinned broadly. It reminded me of that old song, “All I Want For Christmas is My Two Front Teeth….” I recently read her the Christmas story that was my children’s favorite, “The Christmas Cookie Sprinkle Snitcher.” Like them, she loves the pictures, charming depictions of families making and decorating Christmas cookies despite the predations of the Snitcher who snitched up all their sprinkles, and of plucky little Nat, who got the sprinkles back.

It’s funny how even my grown children, some of them grandparents themselves now, remember and treasure the family activity of making cutout Christmas cookies, regardless of how messy it could be. We never quite managed the kind of cookies they show on the Food Channel. You know, those finely decorated treasures made to resemble the angels, trees, Santas, and stars. I still have a big container full of those cookie cutters. They were not limited to the standard few. We had playing cards cutters, lots of animal cutters, gingerbread girls, boys, and angels of various sizes. But, to tell you the truth our glazed and sprinkled cookies tasted a whole lot better than those made with the hard cardboard taste of royal icing.

Today some of the kids and grands prefer their cutout cookies naked. Some prefer chocolate chip cookies. To me that’s a positive reminder that it’s the act of baking together that’s important, like the townsfolks in the story who made cookies en masse, it’s a communal affair.

Much of Christmas is like that for me. When the kids were little, we went together as a family to pick out and cut our tree. We worked together to decorate it. We sang carols together. We went to church together. We watched Christmas movies together. We marveled at Grandma and Grandpa’s

color TV together, and were thrilled when we finally got one. We ate big family meals together.

I loved those times. To me they are and will remain what Christmas means to me. I was as excited as the kids for Christmas morning to finally arrive. I was often up most of the night making Christmas happen and then waiting for them to wake up and come down the stairs to feel the magic.

I loved the controlled chaos of present opening, of a family breakfast, of the afternoon rides to visit the grandparents. All of it, even when it wasn’t the same, was always wonderful.

One year, Christmas was extra special because our Lee was born on December 9th. Even that tiny, his eyes registered wonder when we showed him the Christmas tree. You know, it’s funny, because with a few rare exceptions, I can’t remember presents given or presents received, but I can remember the times spent as a family making Christmas happen together.

I can remember at five being given a real desk to be a writer and teacher with. I also remember outgrowing it way too fast. I can remember when I was eight and Pam was given a toy train, and I happened to wake up and come down when Mom and Dad were setting it up and getting to play with it first. It was kind of boring because all it did was go around and around. I remember the year the Sister Aunties brought us a nun doll with a habit just like theirs. I remember my bride doll and the year my mom sewed a red corduroy pant set to go with it, many years before women wore pant sets. And I remember the year mom stayed up late at night sewing black velvet jumpers for me and my sisters, even though sewing black on black at night was hurting her eyes. And I remember Dad giving us very cheap copies of classic books, what he could afford, which we treasured and fought over. I kept mine for many, many years and mourned losing them.

Such happy memories.

BY J.B. COLLUM

One of the saddest facts of life is that we don’t usually fully understand how to raise children until they’re all grown up and gone. Then we get to watch our children struggle with raising their children, our grandchildren, and we try to offer help and advice when they need it, whether they want it or not. We get to watch them make some of the same mistakes we made, and it reminds us of the regrets we have of how maybe we could have done better when we had our chance. Of course, we get the kids sometimes over a school holiday or the summer and get to put in our time as reservists in the army of people it takes to help raise children. But then we get to give them back and then go about our lives until the next visit.

with some other medical challenges and is non-verbal, so it is difficult to know what she needs at times, but we love her so much that we will patiently work with her to figure it out. She is also very loving and the cutest little girl alive. Even cuter than Shirly Temple was. I might not be objective about this, but that doesn’t mean it isn’t true. We’re working to potty-train her now and to get her to feed herself in ways other than with her hands (without utensils). Both of those may be the death of us, as they currently seem impossible.

I’D LIKE TO HEAR FROM YOU.

Another sad fact of life is that because of circumstances beyond our control, sometimes we may get called back into active duty as parents, when our children are going through a rough time, like a divorce, a financial hardship, or some other unforeseen tragedy. We are currently experiencing just such a thing. My wife and I, with help from one of our daughters, have temporarily taken on the task of raising our three young grandchildren, ranging from 5 to 13 years old. It isn’t permanent, but will last at least until the end of the school year. I don’t think we could do it without our daughter (the children’s aunt) stepping in to help, and we are extremely proud about the way she has stepped up and taken on this responsibility. To make it easier, she has also moved in with us so we can take care of them as a 3-person tag team. This is a daunting task, even with help. Just because you feel like you know how to raise and deal with children better than you once did doesn’t mean you still have the energy for it once you’re past the half-century mark, or especially if you are well past it. Sure, you have more patience now and you know more, but you are also an extra generation removed, so that generation gap is more like a yawning chasm at times. We have only had the kids for about two weeks now, and I will admit that they are cramping our style. Oh, sure, you say, “what style?” and of course you are right, but what I really mean is the freedom we had to head off for a quick weekend trip with no concerns. But now, with kids in school, we are somewhat boxed in on when we can travel and for how long. Our youngest child is over 30, so we have had many years to get used to that freedom and it will take a while to get used to being without it. If we ever do.

Our youngest grandchild has autism, along

There are so many joys to raising children though, and we are hopeful that the good will outweigh the bad, and the sacrifices. Things like seeing understanding dawn and happiness brighten their little faces once they finally learn how to do something like tie their shoes, ride a bike, use the potty, understand long division, or some other milestone.

There are also the “joys” of them bringing every known disease home to you from school. Especially the little ones. Just this past week, I had the littlest one coughing in my face and then yesterday morning I awoke to a sore throat and other symptoms that has turned out to be the flu.

Yes, raising children, especially in middle age, is a monumental challenge, but we can do it. As the Beatles song puts it, “we’ll get by with a little help from our friends.” We know that we aren’t alone as grandparents in taking on grandchildren though. There is a crisis everywhere in our families, and increasingly the children are paying the price even though some grandparents, aunts, and uncles are trying hard to compensate when and where they can. I am actually grateful and proud that my daughter, the mother of these three children, and her husband are putting the kids first by agreeing to us taking temporary custody while they get things sorted out. It gives me hope.

If you are currently helping raise your grandchildren, or nieces, nephews, etc. please reach out to me using the email address at the end of this article if you’d like to share some of the challenges unique to raising children in middle age. Until next time, take care of yourselves and whomever else needs taking care of. After all, as they say, it takes a village.

J.B.

PLAY ON

from page 1

If you have kept your children mostly indoors or restricted them to the confines of your own small yard to protect them from the dangers of being hit by cars or being kidnapped by strangers, have you gained anything at all if their inactivity results in them being diagnosed with diabetes, sleep apnea, asthma, high cholesterol and/or high blood pressure? All those things and more have proven links among children to obesity. Have you really protected them if their weight results in anxiety, depression, low self esteem, and being bullied? These are all very common and growing ways the 12.7 million children in the US who are obese are being affected, while events like stranger abductions of children are extremely rare (less than one per day nationwide, on average) and kids getting hit by cars results in about 400 fatalities annually nationwide. Meanwhile, over a million US kids have diabetes, a disease once considered extremely rare among the young; more than 5 million children have asthma; 1.3 million have high blood pressure; statistically, 43% of overweight kids have high cholesterol compared to only 14% of kids who are not obese. And on and on the list of risk factors and complications goes.

Lack of exercise is far from the sole cause of obesity, but it’s definitely on the short list of top culprits. Kids, get outside and play! And take your parents with you as often as possible.

Dan@AugustaRX.com

www.Facebook.com/AugustaRX

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

In the haunted lateness of night, when even vampires fear to venture forth, I comb the ancient labyrinth of YouTube seeking semi-lost treasures.

One such gem from decades ago sprang forth. It is near perfect for teaching our young ladies the pain and irresponsibility of indiscriminate sexuality. Clearly it points out the pains of premarital sex and subsequent illegitimate birth. How quaintly prophetic is wisdom from half a century gone.

In case you don’t know, I love Delta blues. The music and cadence stirs realness in my heart and soul. The primordial slow beat is soothing and inspiring. The lyrics frequent memorialize true feelings: some good, some bad, some delightful, some hurtful. They delineate social trends. Point out faults of our social morays.

I give you Odetta’s lyrics of “Careless Love.” (To fully appreciate it, go on YouTube and search for Odetta, “Care-

BASED ON A TRUE STORY

(most of the time)

Drag my man around this town by her aprons strings

donor must be a man and marry her and rear the child as a family, voluntarily or out of respect (or fear) of the girl’s father and his trusty shotgun. (Therefore, the quaint term, shotgun wedding.) Or she had to leave town to have the child and put him up for adoption.

A

series by Bad Billy Laveau

less Love.”)

Love, oh love, Careless Love See what love has done to me.

Once I wore my apron strings low

Could not keep that man away from my door

Now my apron string won’t tie (Got knocked up, what you think about that?)

He walks down the street Passes my door right on by Hate to see that evenin’ sun go down That’s about the time

My man left this town.

If I’m feeling tomorrow like I’m feeling today

Gonna pack up all of my clothes and make my get away. If it wasn’t for her diamond rings

If it wasn’t for that powder and that store-bought hair (Everybody knows that’s a wig) That man of mine would not have gone nowhere Got the St Louis Blues Blue as I can be My man got a heart like a rock in Tennessee Or else he wouldn’t have gone so far from me Take me back to St. Louis Where I belong If you don’t believe I’m leaving Count the days I’m gone.

Odetta laments a man who took advantage of her youthful sexuality and as soon as she was pregnant, he walked on by. She is hurt by the other woman’s store-bought sexual amenities and the betrayal of whom she thought was her man.

Odetta documents the now seemingly forgotten rule that if an unmarried girl gets pregnant, it is a shameful and hurtful situation for her and her family. The sperm

But nowadays, political correctness burdens the public with her medical bills, a place for her to live, food stamps, WIC, etc. She is almost idolized as a brave single mother. The sperm donor is ignored and devoid of responsibility. I once saw a very pregnant student and mother-to-be giving a speech at a high school graduation. Is that setting a dreadful example or what? (When I was in school, a married teacher who become obviously pregnant was not allowed to teach until after the delivery.)

But back to Odetta. Her highly skilled and hauntingly delivered lyrical style holds audiences captive. She need not strut around the stage like Mick Jagger (who by the way, covered Odetta’s Careless Love). Nor twerking a near

naked butt before a national audience like Miley Cyrus. Nor set off piles of pyrotechnics like Great White (who set the night club on fire and killed several people). Nor does she need the backup of numerous tractor-trailer loads of ear-splitting amps and speakers like Lead Zeppelin. Nor make sexual gestures or stroke private parts like Michael Jackson.

No, Odetta and Ed Alstrom, Director of Music in a Presbyterian church playing on a lone piano, can thoroughly entertain while telling us good morals and self-respect needs to be reinvented in our society. Her Careless Love video should be played every day in every high school in the county and maybe, just maybe, we could rear a new generation of self-respecting and responsible adults.

Odetta, rest in peace.

Once you have watched Odetta perform “Careless Love” on YouTube and you are not moved by her, then shame on you. You must write a letter to the Governor explaining why your moral fiber is in question.

TRYTHISDISH

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

CHRISTMAS SALSA WITH CINNAMON CHIPS

You could really focus on the holiday theme by using colored sugar on the chips if you wanted to be extra festive.

Chips

• 8 corn tortillas

• Vegetable oil cooking spray

• 5 Tbsp. sugar

• ¾ tsp. cinnamon

Preheat the oven to 350°. Combine sugar and cinnamon in a small bowl. Place 2-3 tortillas on a foil lined baking sheet and spray with cooking spray, bake for 4 minutes. Turn the tortillas over, spray lightly again and sprinkle with sugar mixture. Using a pizza cutter, slice each tortilla into 8 “chips” bake an additional 6 minutes or until crisp (watch them closely as they burn in an instant). Repeat procedure with remaining tortillas and sugar mixture. Note: there should be about 1 tsp. of cinnamon sugar left over (use this in the salsa).

Christmas salsa

• 3-4 kiwis

• ½ cup pomegranate seeds

• 1 tsp. cinnamon sugar

• 1 Tablespoon fresh cilantro

• 2 tsp. finely chopped red onion

Peel the skin off the kiwi fruit,

and coarsely chop. Mix with pomegranate seeds, sugar mixture, cilantro and onion. Refrigerate until ready to serve.

Yield: 8 servings (serving size: 8 chips, ¼ cup fruit salsa) Nutrition Breakdown: Calories 100, Fat 0g, Cholesterol 0mg, Sodium 10mg, Carbohydrate 24g, Fiber 3g, Protein 2g. Percent Daily Value: 35% Vitamin C, 4% Calcium, 4% Iron, 0% Vitamin A Carbohydrate Choices: 1½ Carbohydrate Diabetes Exchanges: 1 Starch, ½ Fruit

Kim’s Note: The red onion and cilantro add the perfect balance to the sweet fruit. However if you wish to make this ahead of time do not add the onion until you are ready to serve it, otherwise the fruit can absorb too much onion flavor.

+

ROTH IRAS - THE FRONT AND BACK DOOR

The Roth IRA was established by the Taxpayer Relief Act of 1997 and is named for its chief legislative sponsor, Senator William Roth of Delaware. Since 1997, the popularity of Roth accounts has exploded because of the tax advantages. The Roth IRA does not give you a tax deduction when you put contributions into the account, however the account allows your money to grow tax-free for life. That is very powerful, but putting money into a Roth IRA can be tricky depending on your income situation.

In 2022, the Roth IRA contribution limit is $6,000 per person or $7,000 if you are over 50 years of age. A Roth IRA does have income limits which is where the front and back door come into play. If you make under the modified AGI limit of $204,000 for joint filers or $129,000 for single filers in 2022, you can use the front door. Just put the money directly into your Roth IRA each year. You have until April 15, 2023 to make your 2022 contributions.

If you make over the income limits, you can still put money into your Roth IRAs, but you will have to use the backdoor. The backdoor lets you put money into a Roth IRA with an extra administrative step. Below are the steps;

• Put money in a traditional IRA account. Since you are over the income limits the contribution will be considered non-deductible for taxes.

• Convert the account to a Roth IRA. This will move the money from your traditional IRA to your Roth IRA.

• Make sure your tax preparer reports the transactions properly on your tax return. It is best if you work with a CPA when doing this.

There are a few rules Roth IRAs must follow. The most important rule to understand for this strategy is the IRS pro-rata rule. To avoid complications, make sure you do not have any other traditional, SIMPLE, or SEP IRAs accounts with balances. If you do, the IRS will make you pay taxes on the percentage of pre-tax money you have in the other open accounts when you do the Roth conversion in step number two.

The pro-rata rule is one of the reasons we recommend you discuss this with a financial planner before doing it. If you do have other IRA accounts with balances, there are strategies you can consider that will consolidate the accounts and allow you to use the backdoor Roth IRA option. However, for some people the extra complexity may not make sense.

Jefferson Davis Hwy

We help our clients navigate the backdoor Roth strategy every year. It is amazing to watch couples use this strategy. Using a 6% average return, a couple can save almost $200,000 in Roth IRAs over 10 years. We find that couples in retirement with Roth accounts have increased flexibility with the withdrawal strategy which helps minimize taxes in retirement. Not to mention, Roth IRA accounts are great for legacy planning.

by Clayton Quamme, CFP® a financial planner with AP Wealth Management, LLC (www.apwealth.com). AP Wealth is a financial planning and investment advisory firm with offices in Augusta, GA.

by Ken Wilson Steppingstones to Recovery

When I was a church pastor I planned a rare weeklong vacation, and a member of my congregation apparently didn’t think I should be gone that long. He said “The devil doesn’t take a vacation!” and I curtly replied, “Correct – and I’d be just like him if I don’t!”

As a counselor, sometimes I think my job security stems from what people do on vacation! In my line of work

The January Effect is an influx of new clients due to excesses during the holidays. I mean, people do crazy things while celebrating on vacation. So for this month I’ll digress from the series on how to find a treatment program due to the timeliness of addressing the holidays and addiction.

The holidays are hard enough as they are, not-

withstanding adding in addiction. One thing is for sure – addiction doesn’t take a vacation! It’s a sleeping tiger, always ready to pounce and consume everything good in its reach, even after resting up with sobriety. The addict, whether in recovery or not, undergoes a plethora of emotions which run the gamut from overwhelming feelings of sadness to the heights of elation – just like the affected family. They are like those old-fashioned jumping beans which appear out of control. And the holiday season seems to be getting longer and longer, right?!! Remember when holiday music wouldn’t start ‘til after Thanksgiving? And Christmas trees weren’t available ’til then either?

I was in a local big-box building supply store in September and employees were putting up lighted Christmas trees already! Go figure. I

was just getting past Labor Day!

For the addict/alcoholic, if you want to have a memorable holiday in a positive way, go ahead and play the tape forward to January 2 and think of how good you’ll feel then if you don’t relapse during the holiday. It’s like someone in Weight Watchers visualizing themselves in pants that are 6” less in circumference. Everything such a guy puts in his mouth is then carefully calculated. This works. We gravitate towards our fantasies, upside or down.

Remember The Vacuum Principle: wherever there’s a vacuum, something will rush in to fill it up. If you have lots of holiday downtime, have a plan to be engaged in something positive so you won’t be “sucking wind” when the sleeping tiger wakes up. If you fail to plan, plan to fail.

If you go to a party where there is alcohol, go with a friend and agree ahead of time that you’ll be accountable to each other. Perhaps you can have a signal to leave and - no questions asked - leave when you or they signal.

For families of the addicted one, know that it is normal to feel a variety of emotions this season. Perhaps there is still active addiction going on, or perhaps you haven’t had closure on past negative events such as theft or other actions resulting in loss of trust. Here come those emotional jumping beans again.

Get a support system. Write it all out and maybe share with the loved one who is in recovery or needs to be. Exercise your power by doing so and not practicing co-dependent behavior of weakly waiting, watching, and hoping.

If company is coming who

A monthly series by an Augusta drug treatment professional

enjoy alcohol, decide how you’ll control the flow of it – maybe talk about it before a cork is popped, or decide how you’ll cut it off the second a single person begins to get crazy. If the flow merely slows down, things won’t get better. Always worse. Guaranteed.

Like the addict/alcoholic, think about attending selfhelp group functions such as sober dances and bringa-dish dinners. I promise you, there’s no more fun in the whole wide world than a social occasion with people in recovery!

Take - and enjoy without guilt - a good, planned vacation or you might just join the devil in his misery.

by Samantha Bowick, MPH, Board Certified Patient Advocate

SELF-CARE AND BOUNDARIES

Self-care and boundaries are extremely important for everyone, including those who have a chronic illness. Self-care and setting boundaries

Self-care allows you to relax, blow off steam, and take care of yourself. Self-care should be part of everyone’s toolkit to stay healthy. Selfcare can help with physical, mental, spiritual, social, and emotional health.

Examples of self-care: • Reading a book • Journaling • Meditating • Swimming • Walking • Sitting outside • Listening to music • Dancing • Visiting a favorite place

• Turning do not disturb on your phone

• Taking a warm bath Find something you enjoy

and carve out time to do it regularly (weekly, monthly, etc.).

For me, self-care looks like reading, writing, going to the beach when I can, sitting outside, swimming in the summer, and using do not disturb on my phone when I need a break. It’s also helpful for me to go to my room around 9 pm to get some time to myself. I use a journal to write in when I need to process things that are happening in my life and around me and listen to music. I’ve been to therapy to help with dealing with things like my hysterectomy at 23 years old and setting boundaries.

Setting boundaries with people isn’t negative or selfish. It’s a way of protecting yourself. There may be some pushback from the people you set boundaries with, but it’s important you set bound-

aries so you don’t deplete yourself. Keep the boundaries strict because if you wavier, people will continue trying to break the boundaries. An example of setting a boundary is saying no when you don’t feel up to doing something. Don’t say yes out of guilt because of what you think they might think or how you think they might react to your no. You have to put yourself first. You can’t take care of everyone else without taking care of yourself first.

Having a therapist/counselor can be extremely helpful and beneficial. A therapist can help come up with a plan for practicing self-care and setting boundaries with everyone in our lives. Talking with someone outside of your circle can help you process feelings in a healthy way without feeling judged.

If you have a chronic illness, going to doctor appointments, having surgeries, researching, and everything else that comes along with it is exhausting. People may think that you’re already practicing self-care when you’re sleeping and laying in bed because you’re fatigued and in pain. However, those aren’t things you enjoy and those are things you’re doing to survive. You still should find things you enjoy and your body can tolerate to practice self-care. If people don’t believe what you’re going through, that’s where setting boundaries with these people is crucial.

Here are some books that may be helpful if you would like to learn more about setting boundaries:

• Boundaries by Dr. Henry Cloud and Dr. John Townsend

• Beyond Boundaries by Dr. John Townsend and Dr. Henry Cloud

• Set Boundaries, Find Peace: A Guide to Reclaiming Yourself by Nedra Glover Tawwab

“I perform in court, not in TV commercials.”

CRASH COURSE

ventually, many families reach the point where they need to have the painful discussion about whether or not the oldest drivers in the family tree should still be driving.

It’s a big moment, as big as the first time Junior drives off on his own at age 16 behind the wheel of a two-ton vehicle. Except this event feels like a big moment for completely different reasons.

In the best case scenario, dear old mom has seen the handwriting on the wall herself and is realistic enough to know it’s time to voluntarily hang up the driving gloves. That certainly makes things easier.

In many families, though, this moment is extremely stressful because mom (we say mom because female life expectancies are generally longer than men’s, but everything in this article applies equally to aging drivers of either gender) fights tooth and nail for the right to keep driving and is highly offended that anyone would suggest otherwise.

AARP is one of a number of organizations that offer guidance to help determine whether or not it’s time to have “the talk.” Among the warning signs they (and others) say to look for:

• being easily distracted while driving

• driving too fast or too slow

• having difficulty maintaining their lane

• dings, dents and scrapes showing up on the car, the garage, the mailbox

• having frequent close calls

• running stop signs and red lights

• getting traffic tickets from police

It doesn’t help one bit when people in their 20s and 30s are frequently observed doing everything on that list. So let’s add a few additional symptoms to look out for that are even more worrisome (and conclusive):

• getting lost, even when going to familiar local destinations

• stopping at green lights or at intersections where there is no stop sign

• having collisions

Those last three are huge red flags that strongly suggest immediate steps need to be taken for everyone’s safety. When issues like that are on the table, mom’s insistence on continuing to drive is just one more very troubling sign that it is definitely time for her driving days to come to their end.

As a professional and impartial person, her doctor can help bolster and fortify the family’s arguments in favor of parking the car for good, and in fact might be someone to involve as early in the process as possible.

People who are losing their driving privileges — willingly or unwillingly — often see it as the beginning of the end. No wonder they sometimes fight so hard to keep driving. It’s the family’s job to make sure those fears don’t become self-fulfilling prophecies.

We have never before seen a time like now when personal cars are such a potentially unnecessary luxury. You can order literally anything online and have it delivered right to your door, and free shipping is very often part of the sales pitch. Even a few years ago, nobody had ever heard of such a miraculous thing as same-day delivery — sometimes even within an hour of ordering.

We too can be delivered: gone are the days when carless people needed to walk or live on the bus line to get anywhere. Taxi and rideshare services are ready when you are, and are massively less expensive than owning a car.

There are many eldercare organizations, church groups, and senior health agencies that offer free or very low-cost transportation.

First and foremost, close friends and family members — immediate and extended — should take the lead in making sure mom’s transportation and shopping needs are cared for.

As difficult as “the talk” might be when it takes place, within a short time everyone involved should be glad it happened. +

They’re here!

The world’s most salubrious mugs, created for us by the artists at Augusta’s Tire City Potters, are here! Win a chance to get one by entering our celebrated Mystery Word Contest!

More Americans have died on US roads since 2006 than in World Wars I & II combined +

The Advice Doctor

Probably not.

Questions. And answers. On page 13.

Will he ever get one right?

the blog spot

posted by Humeira Badsha, MD, on Nov. 30, 2022

A DOCTOR’S GRIEF

Last evening I crumbled in the arms of my patient and wept. This was unknown territory to me, an unexpected role reversal. For three weeks after my Mom’s death, I maintained a stoic distance as patients offered their condolences, as they asked about my mother, and empathized. We doctors have been trained to do this, to face death, to keep our emotions at arm’s length. But this patient, who has faced so many tragedies herself, recognized the emptiness and loss I was experiencing. She held me and let my tears flow. I was embarrassed. Never in 30 years have I lost my composure before a patient. But I, too, need to grieve, and grief creeps up on you unexpectedly when looking at an X-ray or glancing at a sunset.

In the last month, I’ve been traumatized by the violence of the ICU. As doctors, we move in the intensive care unit from task to task, with numbers on charts, small gains, and defeats every day. But here was my beloved mother in the ICU.

A strong independent woman, stylish, an icon for so many, was reduced to a tangle of wires and tubes, beeping monitors, and shrill alarms. Shorn of her lipstick, we tried to hang on to her dignity. Ultimately she passed away, not slipping into the night, but in an agonizing, ferocious upheaval.

Two months ago, Queen Elizabeth peacefully passed away at her Scotland castle. Many scoffed at her death certificate, which stated merely old age. Old age could be a diagnosis against which we can battle with all our sophisticated equipment and medications, but old age still robs our organs and ability to fight a minor ailment. In my mother’s case, she had a perfectly functioning heart, lungs, kidneys, and liver. She came into the hospital with a fractured arm; one by one, old age stripped her of her organs, vitality, and life.

She went not the way she would have wanted.

Doctors and nurses were battling to save a patient in a nearby cubicle. Cardiac compressions, electric shocks, shouted instructions, noise, clamor.

We gathered around our mother and whispered our tearful goodbyes, telling her not to be afraid and that what was to come was beautiful. But how did we know any of that?

It calmed me, the platitudes I am trained to say, helping me ease my mother’s journey.

And now I sit in my white coat. At my desk. Grieving. Patients wait outside. But I am taking a few moments for myself when it feels like my heart will overflow and the pain is endless.

+

From the Bookshelf

T his is the harrowing story, says Kirkus Reviews, of two brilliant immunologists, one Christian, one Jewish, who were separated during World War II yet found heroic ways to turn their typhus vaccine research against the Nazis.

In a twist of irony not lost on the book’s author, Arthur Allen (who also wrote, Ripe: The Search for the Perfect Tomato in 2010), the Nazis were deathly afraid of lice. The little insects were known to carry typhus, a dreadful contagious disease that could cause hallucinations, terrible headaches, raging fever, and often death. Typhus ravaged communities forced to live in subhuman conditions, including soldiers on the war front, as well as inmates in concentration camps and ghettos. It therefore became a wartime imperative to eradicate lice and the disease.

In Poland, scientist Rudolf Weigl (1883-1957) and his assistant, Ludwig Fleck (1896-1961)—who would later write the seminal text The Genesis and Development of a

Scientific Fact—were both enlisted to develop a typhus vaccine: Weigl in the service of the German army and Fleck under SS guard at Buchenwald. Weigl, after all, had created the first typhus vaccine in th 1920s. The dual stories of Weigl and Fleck, beautifully told within the devastating tumult of Poland’s unfolding history, describe the war from a vivid perspective: that of the laboratory saboteur.

Weigl secretly used his lab to smuggle vaccines to the Polish ghettos and recruited many intellectuals as lab workers, saving their lives. (Frequently, these respected

thinkers would be hired as louse-feeders, letting the creatures feed on their own blood—a surreal scene.)

Meanwhile, Fleck’s lab was also a center of conspiracy, and his sabotage was even more dangerous and cunning: He produced a fake typhus vaccine for German troops and Nazi experimenters while sneaking real doses to desperate inmates. Both scientists risked terrible deaths to defend the idea of moral good despite the corruption, bloodshed and evil surrounding them.

Allen is unflinching in his retelling of this monstrous era, but he manages to avoid writing a depressing narrative. Instead, Weigl, Fleck, and their vaccines illuminate the inherent social complexities of science and truth and reinforce the overriding good of man.

An unforgettable book, concludes Kirkus.

+

Humeira Badsha is a rheumatologist

She was denied the death she would have wanted.

cold snap of the year.

THE MYSTERY WORD

The Mystery Word for this issue: PETTIANNI 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

M I

QUOTATIONPUZZLE

DIRECTIONS: Recreate a timeless nugget of wisdom by using the letters in each vertical column to fill the boxes above them. Once any letter is used, cross it out in the lower half of the puzzle. Letters may be used only once. Black squares indicate spaces between words, and words may extend onto a second line.

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

EXAMINER CROSSWORD

EXAMINER CROSSWORD

THEBESTMEDICINE

A college student got a weekend job delivering pizzas to make extra money. One of his first deliveries was to an address that no one else wanted. “That guy is a notoriously bad tipper,” the other drivers warned him.

When he got to the house and delivered the pizza, the man asked, “What’s the usual tip?”

“Well,” said the student, “this is my first time here, but the other drivers told me if I got 25 cents out of you it would be a miracle.”

Aphilosophy professor enters a lecture hall to administer the final exam to the assembled class.

He picks up a chair and places it on the desk before him and tells the class, “Using every point of reasoning you’ve learned in this class, write an essay proving that this chair does not exist. You have 30 minutes.”

Dozens of heads bent to their test papers and as many pens began writing the essays that flowed from the students’ minds, embodying the highest principles of philosophical thought to establish the chair’s non-existence.

Within less than a minute, however, one student got up, walked down the steps to the professor’s desk, handed in his paper, and left the lecture hall. As it turned out, he received the highest grade in the class.

On his paper were written two words: “What chair?”

Moe: I was voted “Least Likely to Succeed” by my high school class.

Joe: Wow. Tough crowd.

Moe: Yeah...I hated being a teacher.

“Is that so?” said the man. “Well just to show you how wrong they are, here’s five dollars.”

“Thank you very much, sir,” said the young man. “I’ll put this in my school fund.”

“Happy to help you,” said the man. “What are you studying?”

”Applied psychology,” said the student.

Shortly after a group of strolling carolers went through a poor neighborhood in London just before Christmas, a major crime wave erupted. Police soon apprehended the street urchins responsible for the string of petty thefts and discovered the motive. When the poor children learned that Santa brings a lump of coal to the homes of all the bad children, they finally knew there was a way to keep warm.

Moe: I just heard that Dollar Tree is going to have to change its name due to inflation.

Joe: What’s the new name going to be?

Moe: Tree Dolla.

Moe: I think my cholesterol might be too high, Joe: What makes you say that?

Moe: The other day a mosquito bit me, grabbed its little chest and keeled over.

Dear Advice Doctor,

My son has been depressed for almost a month now because his girlfriend broke up with him. He doesn’t seem to realize that this happens to everyone at his age. He’s just a high school student and someday he’ll realize this was just puppy love. But how can I help him in the meantime?

Dear Trying,

— Trying To Be A Healer

One of the proven strategies for getting through life’s ups and downs is exactly what you suggest: owning a pet (although it doesn’t always have to be puppy love; it could be guppy love or kitty love or a dozen other loves).

It isn’t for everyone, though, and there are special considerations during this COVID era that just won’t seem to go away.

First, people need to fully accept that owning a pet is a serious responsibility. You are taking on the role of parent and protector for a life that will be largely dependent upon you, most likely for many years. Someone who works out of town for stretches of days at a time shouldn’t choose a pet that needs everyday care. If a person is going to chain a dog to a tree in their yard and ignore it 23.9 hours a day, why do they have the dog in the first place? It’s cruel and inhumane. That person does not deserve the privilege of pet ownership, and really should be prosecuted (in the opinion of The Advice Doctor, at least).

Pets like dogs and cats are domestic animals, meaning that they enjoy and perhaps need human interaction. They need our attention, and not just to pet and feed them. True puppy love (and other animals too) also requires medical care for acute situations and in preventive medicine (such as vaccines). Pets have schedules for such things just like kids do.

Believe it or not, pets can get COVID-19. It’s not at all likely for people to get COVID from their pets, but we can definitely give it to them. If a pet is sick and suspected of possibly having COVID, contact your veterinarian, but try to keep contact with your pet to a minimum. No cuddling, kissing, petting, or sleeping in the same bed. You could consider the situation as very similar to having a human in your home with COVID; you would practice some isolation protocols. For example, the CDC says if your cat has COVID, they should not go outside.

In summary, for the right person, puppy (and other) loves can be great for all parties involved. Best wishes to your son.

I hope this answered 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 only be provided in the Examiner.

from page 1

tion with the healthcare system. Doctors won’t answer most questions over the phone, and office visits take lots of time and cost lots of money, so why not ask “Dr. Google?” I can’t blame people for doing this; I do the same thing when my car acts funny, or my dishwasher stops working.

But anyone who’s gone to Dr. Google for advice quickly is presented with a key question: why does it so often point to scary diagnoses?

The reason is that, while the information on the internet may be entirely true, it lacks something that is extremely important: context. Dr. Google knows facts, but it doesn’t know your past history, your demographics, your family history, your previous problems. It doesn’t know if you are in the midst of a pandemic, doesn’t know what your overall risk is, and doesn’t know what previous blood testing has shown.

Let me explain by using a commonly questioned treatment: statin drugs for lowering cholesterol. I’m often asked, “What do you think about statin drugs?” Also, “I’ve heard that those drugs are dangerous.” My answer is simple: I feel about statin drugs the same way I feel about appendectomies: they are good when you need them, but bad when you don’t. I give them to people who should take them, and stop them for people who shouldn’t be taking them. How do I decide?

Context.

I don’t approach high cholesterol as a problem, but rather as risk factor. A high LDL cholesterol is associated with an increased risk of heart disease. A statin drug can lower that risk by as much as 35%. A 65-year-old

diabetic smoker with high cholesterol may have a 50% chance of serious heart problems in the next 10 years, so taking a statin can lower that risk to 32.5%. In that case, taking a medication with a 3% risk of serious problems to get that risk reduction is a very good deal. On the other hand, a 35-year-old who is in good shape, has no significant heart risk factors, but has the same cholesterol as the previous patient may have only a 1% chance of having a heart attack in the next 10-years. Taking a cholesterol medication lowers his risk to 0.65%.

Clearly this is a bad trade-off, and I’d stop any statin the person was on. (There are a number of scientifically verified tools that give an estimated cardiac risk based on risk factors. It’s available...on the internet.)

Another example: testing for strep throat. One would assume a positive strep test means you have strep, and a negative one means you don’t. But consider these situations: first is a person who’s had close contact with someone with strep. They have a bright red throat with 102° fever, and have a fine red bumpy “scarletina” rash on their torso (seen in people with streptococcal infections). But their strep test comes back negative. The second person is totally asymptomatic with no exposure at all, but has a positive strep test. How do you interpret these? The first I call a false-negative test and opt to treat, despite the negative test. The second is a bit harder (why did I do the stupid test in the first place?), but I would at best say they might be an asymptomatic carrier, but probably not treat them without symptoms. This is the same test, but I interpret the test results entirely based on, you guessed it, context.

Should people stay away from medical information on the internet? Heck no. But they should read it with caution, understanding that the information is given as general advice that may not apply to their situation. Do not trust medical blanket statements (except for this one, I say with no irony). Cousin Joe with strong opinions about back surgery doesn’t know the anatomy of your intervertebral discs, nor does he know the risk of long-term neurological damage versus the risk of the surgery itself in your situation. The YouTuber who is anti-antibiotics doesn’t know the type of infection you have, and the risk of non-treatment.

Let me end by acknowledging that the healthcare system has been a huge reason this problem exists. Most docs don’t have time to take a detailed history, nor is there time to explain the nuance of the medical decision-making to the patient. It’s easier just to give the prescription, order the test, or send the person to a specialist. Context is impossible to know if the doctor doesn’t take time to figure out the context in the first place. That’s why antibiotics are given when they could be avoided. That’s why statin drugs are given unnecessarily. Medicine is often too hard to be done in a 15 minute visit (with 10 of those minutes spent dealing with the medical record). So people are left to fend for themselves, which is also unacceptable.

The doctor may know more about medicine than you do, but you know more about yourself than they do. The best care means having good communication both ways. Ask questions. If your doc doesn’t let you do so, then find someone who will listen and explain.

TIRED OF WAITING?

IS DIFFERENT

THE DOCTOR WILL SEE YOU NOW. you are welcome

Jamie Steinsapir, MD, PhD Endocrinology Khalil Al Soutary, MD Endocrinology

Janaki Nadarajah,