Medical Examiner 10-15-21

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OCTOBER 15, 2021

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

The blog spot — posted by Heather E. Schultz, MD, MPH, on October 5, 2021

PINK RIBBONS AND MURDER BOOBS I woke up this morning to a flood of ballerina pink emails for Breast Cancer Awareness Month. The irony was not lost on me as I rolled over in bed, protecting my body from the healing scars where my breasts used to be.

“I don’t even like pink,” I muttered to myself, while swallowing feelings of guilt. I shifted my mind to focus on gratitude … for awareness of breast cancer, encouragement of women to get screening mammograms, and fundraising for research. And yet, as a 41-yearold physician, I am often struck by how little I knew about breast cancer until my own boob tried to murder me.

Sure, I understood the importance of screening mammograms and breast self-exams. But I also knew that I, a Peloton-addicted vegetarian who had breastfed three children, must be immune from breast cancer. In medicine, we often think in terms of risk and family history, and there just weren’t boxes to check that would have prepared me for what was to come.

First, there was the unexplained nipple discharge a few days after I turned 41. I tried not to panic, but I also knew I needed answers quickly. Four days later, at my first mammogram, I was haunted by the cold machine that took images for hours. I still shiver thinking about how vulnerable and frightened I felt. My radiology report included a new term to me: “BI-RADS 5,” which a few Google searches revealed meant “definitely cancer.”

When I was diagnosed with breast cancer, it felt as though everything I knew was turned on its head. My perceived perception of perfect health vanished in an instant. After my biopsy, I stuffed an ice pack in my bra and went back to work, seeing patients. Maybe if I continued as

My own boob tried to murder me.

Please see PINK RIBBONS page 9

AUGUSTARX.COM

FALL FORWARD In just a few weeks (November 7 to be exact), we will be turning our clocks back an hour. The old adage about the beginning and end of Daylight Saving Time is “spring forward, fall back.”

So why is our headline fall forward?

For many of us in this part of the world, summer is not our favorite time to exercise. When you can get sweaty just walking to the mailbox at 9 a.m., you know it’s summertime in the South.

But the brutal heat of summer is behind us, making right now the perfect time to start (or restart) an exercise program. (Please read the next paragraph.)

Plenty of people stop reading when they see the e-word. We know that. But please give us a few moments to plead our case.

Exercise is not just a way to be fit. Exercise itself is a fit word, as in one-size-fits-all.

For the twenty-something people among us, exercise might mean playing tennis a few times a week, or running a mile or two before work most mornings.

But what about forty- or fifty-somethings? Or even seventy- or eighty-somethings? With a few noteworthy exceptions (and congratulations to them), this demographic isn’t going to be literally running anywhere.

This is where the definition of the word “exercise” reveals

its flexibility. Each one of us gets to define it for ourselves.

For instance, at an assisted living facility their most popular exercise program might be called Sitercize. Participants never leave their chairs, but they definitely enjoy an age-appropriate workout.

That well illustrates that each of us can and should design the exercise program that perfectly fits our own situation.

As that applies to the illustration below, exercise can involve anything, even raking leaves.

And as the picture also suggests, it might be a little more like exercise if you use a rake rather than a blower. It’s quiet, carbon-neutral and all those other ecological factors.

Raking as exercise also makes another important point: exercise can be different every season, every week, even every day. The important thing is regularity.

And the many options — going for a walk, riding a bike or a thousand other choices — are so pleasant this time of year.

When it comes to stirring around for our health, remember: fall forward! +

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AUGUSTAMEDICALEXAMiNER

THE FIRST 40 YEARS ARE ALWAYS THE HARDEST

PART I OF A 26-PART SERIES

PARENTHOOD

by David W. Proefrock, PhD

Your 14 year-old son is a freshman in high school. He has become preoccupied with violence. He has been playing video games with violent themes for some time, but lately he has been talking about guns and bombs almost constantly.

He recently asked for a rifle for his birthday and said that he wants to get involved in target shooting. What do you do?

A. Buy him a rifle and get him into certified shooting lessons at a target range. It will channel his interests more appropriately.

B. Buy him a rifle and get involved with him in target shooting.

C. These are normal interests for an adolescent boy. Buy him the rifle.

D. Let him know that you are worried about his preoccupation with violence and weapons. Don’t buy him a rifle.

If you answered: A. Shooting lessons are more likely to increase his interest in violence than to channel it. This is not the time for a rifle for this child.

B. It is always good to become involved in activities with your child. Choose an activity which doesn’t have violent overtones.

C. These are normal interests, but they shouldn’t be indulged. It’s normal for adolescent boys to be interested in sex, but you wouldn’t hire him a prostitute (we hope).

D. This level of preoccupation with violence is not normal.

In fact, it is a warning sign you should pay attention to. Definitely do not buy him a rifle. Encourage him to get involved with other activities.

One of your jobs as a parent is to encourage your children to engage in appropriate activities. This level of preoccupation with inappropriate activities must be addressed. There is nothing wrong with an adolescent having a gun if it is used appropriately. This adolescent, however, should not have any access to weapons. + Dr. Proefrock is a retired clinical and forensic child psychologist.

OCTOBER 15, 2021

IS FOR INSULIN The human body doesn’t like big changes. As was discussed last issue here in “H is for Heat,” temperature regulation is an excellent example of homeostasis, the body’s attempt to maintain constancy.

Take someone’s temperature at rest in an air conditioned environment and again after they’ve been toiling in the sun for an hour on a hot day and the variation might only be two or three degrees.

Insulin is another example, part of a sophisticated chemical system that regulates the fuel body cells need to function effectively.

If we back away for a moment to take in the bigger picture, the most noteworthy component in this particular system is the pancreas, a most unusual gland.

About six inches long and located behind the stomach, the pancreas is composed of both endocrine and exocrine gland cells. Simply put, endocrine glands secrete hormones directly into the

bloodstream, while exocrine glands secrete their products through ducts into nearby tissues.

The pancreas not only includes both types of cells, its compact real estate produces two completely different chemicals that create opposite reactions.

The first is insulin, of course, and the second is glucagon.

Their composition and functions could not be more different, but they are born and raised and sent out into the world from the very same house (the pancreas, that is).

The factory within the pancreas where production takes place — or should we say factories — are the islets of Langerhans, named for the German physician Paul Langerhans, who first described them in 1869. Within the limited space of a normal human pancreas are about one million islets. In each of these million or so islets are alpha cells, which synthesize glucagon, and beta cells, which produce insulin.

When blood sugar rises, after we eat a meal, for example, insulin is automatically released (at least in a healthy person). It lowers blood sugar by enhancing the transport of glucose and other simple sugars into body cells. Its action is considered hypoglycemic.

Low blood sugar, on the other hand, triggers the release of glucagon, an extremely powerful hyperglycemic agent, a blood sugar raiser. How potent? One single molecule of glucagon can trigger the release of 100,000,000 molecules of glucose into the bloodstream.

During the course of a

normal day, blood sugar levels will naturally rise and fall, and the pancreas does its level best (get it?) to constantly lower the highs and raise the lows to maintain equilibrium using glucagon and insulin.

It all works great until it doesn’t, and the most common reason it doesn’t is a disease called diabetes. There are two forms, Type I, the more serious variety, and Type II, the one that has all kinds of heavily advertised drugs to help manage it.

True, the sentence above makes no sense. But it’s reality.

One would think the more life-threatening version, also known as insulin-dependent diabetes, would get the pharmaceutical attention, but part of the reason Type I is more serious is that it’s more complex in every aspect: cause, remedies, management, you name it.

To back up just a bit, someone with Type I diabetes has little to no insulin activity; their pancreas has failed in that respect (although it still functions in other jobs).

Without insulin, blood sugar levels can rise to dangerous levels, and if left untreated, an ultimately fatal cascade of problems results that shuts down the heart, oxygen delivery and all physiological processes.

Type II diabetics, by contrast, have a pancreas that produces insulin, but it may be at inadequate levels, or their body does not utilize the insulin, a condition known as insulin resistance. About 90% of people with Type II are overweight, and in many cases their symptoms can be managed solely by exercise Please see INSULIN page 6

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AUGUSTAMEDICALEXAMiNER

OCTOBER 15, 2021

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Very simply, really. Anyone can go online and check the price offered by GoodRx for a prescription they have. If they like the price, they can print out a free coupon or download it to their phone, take it to their participating pharmacy and reap the savings. How big can the savings be?

The antifungal drug voriconazole has an average retail price of $1,510.58 for 60 200mg tablets. The lowest GoodRx price for the most common version of voriconazole is around $102.58, 93%off average retail. Another example: 30 20mg tablets of Viagra, used to treat erection problems in men as well as pulmonary arterial hypertension, a serious heart and lung condition, have an average retail price of just under $196. The GoodRx price is about $8.00, 95% savings.

Believe it or not, GoodRx offers more 150 billion different prescription pricing data points (for differing dosage and quantity combinations) at its online comparison platform, up from only 1 million when the company launched. Its coupon codes are accepted at more than 70,000 pharmacies across the United States, including Walmart, Kroger, CVS Pharmacy, Walgreens, and many more.

Something is working right: 18 million people access the GoodRx app and website every month, and since its opening day in 2011, GoodRx has saved its customers over $20 billion on prescription costs.

But another aspect of this QA is: how does such a company make any money?

Don’t worry; they’re doing just fine.

The company is worth more than $21 billion and has made an annual profit for the past 3 years (2018-2020).

Where does all their revenue come from? Some income is generated by advertising on its website, and it has launched a few side ventures, like a telemedicine service. But more than 90 percent of its income is generated by the coupons people like you and I use. If we redeem a GoodRx coupon at our drug store, the store says thank you to GoodRx for bringing them that business. It may be just pennies, but all those pennies add up: GoodRx generated $550.7 million in revenue for the fiscal year 2020. +

MEDICALEXAMINER AIKEN-AUGUSTA’S MOST SALUBRIOUS NEWSPAPER

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OCTOBER 15, 2021

AUGUSTAMEDICALEXAMiNER

#149 IN A SERIES

Who is this?

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

by Marcia Ribble

A

s careful readers of this column may recall, in this space in our previous issue we profiled the ancient medical pioneer Herophilos, born circa 335 BC in what is now Istanbul.

In this issue we’re profiling the man above, Erasistratus, who was Herophilos’ partner in founding a school of anatomy in Alexandria, the world capitol of higher learning at the time.

The two were noted for the systematic, thorough, and accurate explorations of the then uncharted territory of human anatomy. This was possible because, unlike most of the world at that time, dissection of human cadavers for medical study was legal in Alexandria. It made possible the many pioneering discoveries made by Erasistratus and Herophilos.

But perhaps the most interesting chapter in the life of Erasistratus came before he moved to Alexandria. While practicing medicine in the royal court of Seleucus I Nicator of Syria, Erasistratus received what is probably the highest fee ever paid to a physician, and the story behind it was verified by a number of ancient writers, including Galen and Hippocrates.

Although elderly, Seleucus had taken a wife in his old age.

Stratonice was said to be every bit as beautiful as the wife of a king should be. In the months after the wedding, Seleucus’ son, Antiochus, fell ill with symptoms that today would be called clinical depression. Nothing his father or friends could do helped Antiochus; court physicians were baffled by the cause and therefore unable to prescribe a cure.

When Erasistratus came on the scene, he too was unable to discover any physical cause. He did note that whenever Stratonice was nearby, Antiochus’ melancholy mood disappeared; his pulse quickened and his skin was flushed.

Erasistratus told Seleucus that he had discovered his son’s disease and it was incurable: he was in love, but the object of his desire was unattainable.

“Who is the woman?” the king wanted to know.

“My wife,” replied Erasistratus.

Seleucus did everything in his power to persuade Erasistratus to give his wife to his son. Erasistratus asked the king if he would do the same if he, the king, were in Erasistratus’ shoes.

Seleucus assured Erasistratus that he would do so without hesitation. At that point Erasistratus revealed the truth, that the woman in question was the king’s wife, Stratonice.

Seleucus was as good as his promise: he gave Stratonice to his son, as well as a number of provinces over which to rule.

For his part, Erasistratus was said to have been paid 100 talents for discovering the cause of Antiochus’ sadness. If those were talents of silver, their value would exceed $1.5 million in today’s dollars. If they were talents of gold, however, Erasistratus was paid well over $115 million in today’s dollars.

According to legend, an incurable ulcer on his foot caused him to commit suicide by drinking hemlock in 250 BC. +

One of the absolute craziest things we face as seniors is proving who we are. I’ve been Marcia Ribble since I was 21. I’m 78 now.

But do you think anyone will just accept my word for who I am? If you do, you would be wrong. After moving and hence changing my address, suddenly my identity has come into question.

New address? At least 10 different places where I have done business in the past, often for ten or more years, no longer believe me when I say that I need to change my address.

They want proof that I am still Marcia Ribble.

It feels as though now that I’m 78, suddenly I am no longer me. Understand too that what they want as proof can be more than slightly bizarre. For example, my one bank wanted the amount and person to whom I sent a check three months ago. This when all my stuff had been packed away to move and I had no idea which box might contain that information. And it seems as though every account in the land comes with a pin number I cannot for the life of me recall. If I ever had one! Fortunately, my other bank had no problem, changed the address, and even ordered free new checks for me.

I carefully examined my skin. Yup. Still the same old wrinkled skin I had the day before. Same blue eyes? Check! Same scars from knee replacements? Check! Same two different length legs from my broken hip?

Check! Same old gray hair that I wish would turn all the way white? Check!

Then I had to open a new bank account at my new location. Listen to this. Those folks had not one single problem accepting the

check from the sale of my home. I signed the check and they put it into my account.

But hold on a minute. I received my new checks from them, and they had my daughter’s name and address on them with me as the secondary person of record on the account. Secondary? What in the name of all that’s good and holy was going on?

“We couldn’t put you on as primary because you don’t have a current Michigan driver’s license. We can change it as soon as you have a valid picture ID from Michigan.”

I did not swear at them. I did not curse and call them names. I do admit to raising my voice.

I was, to put it mildly, furious, incensed, outraged, cantankerous, livid, inflamed, and perhaps a small bit obnoxious. My skin still creeps and my blood still boils thinking about it. I had my Georgia driver’s license, with the required picture ID! But that didn’t count! It had to be a Michigan license.

Today my daughter is taking me to get my Michigan ID, which will take several weeks to arrive. I just received a check with my name and current address on it from the escrow account at the bank where my home loan was.

If I deposit that check, they will be only too happy to put it into my account. They will happily cash my check and even hand me cash for it because they will trust that I am the person named on the check who lives at the address on the check.

But remember, I am not me yet because I do not have the correct ID. I have lots of hair, but I refuse to pull a single strand of it out in frustration about how insane it is to deal with people so bereft of sanity. +

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OCTOBER 15, 2021

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AUGUSTAMEDICALEXAMiNER

Middle Age

EVERYBODY LOVES A GOOD STORY

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AND EVERYBODY HAS A STORY. WE’D LOVE TO HEAR YOURS.

ADVENTURES IN

BY J.B. COLLUM

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We’re nearly halfway through the college or life, the players have gained experience but football season as I write this, and it struck me are suffering the aches and pains that come how college football is a metaphor for life. If it with that experience. By the latter part of the seems like I’m always looking for illustrations season, some have had to rest up and miss a and metaphors, it is probably because I am. It few games, and hope they can be healed up in helps me understand things and communicate time for the post-season. By then, nearly evmy thoughts better. And I’m in good company. eryone is hurting, but they want to go out on a It is said that The Great Teacher, Jesus Christ high note by winning their bowl game or their himself, did not speak without the use of an playoff game, and for a couple of teams, to illustration (and by the way, John Lennon meet in the national championship. The team was wrong; The Beatles were not bigger than doctors have patched them up and given them Jesus). But I digress. pain killers and injections to help them perform Life begins with so much promwell despite their injuries and to ise, just like the beginning of footextend their playing time.

If life is like ball season. Everyone is undefeat As we approach retirement ed. For the most part, everyone (the post season), perhaps we football, I’m is fresh and healthy and ready to have lots of medicine to take too. go. The college bluebloods, teams approaching the Some of it is to help stave off like Notre Dame, Alabama, Oklapain, some of it is to extend our postseason. homa, Ohio State, Georgia, Clemlife. We have to be more careful son and others, have a head start about what we eat and make on life since they have money, sure to exercise to stay in shape tradition, the best players, and inertia on their so we can enjoy our latter years. Like practice side. Others are starting life behind the proverin football, it isn’t our favorite part of life, but if bial 8-ball. Still, until that first game is played we want to stay in the game we must do it. they all have a chance, even if the Las Vegas Just like in life, sometimes a player can do prognosticators say it’s slim to none. That said, everything right and still not win the game. we’ve seen six teams who were unranked to Namely he can study life’s playbook, do all the start the season end it by winning the national exercise, eat right, get enough rest, and stay on championship. So anything is possible. the straight and narrow in respect to the law.

We’ve also seen teams that started out high But one freak injury or illness can take him out. in the rankings only to fall completely out. This Life isn’t fair, but neither is football. So, as long year that has already happened to the Clemson as you are still in the game, enjoy it.

Tigers, so I am sure this will be a sore point Like football teams, we don’t all aspire to with some readers. Fear not, Tiger fans. The win the national championship of life. A good season isn’t over. They can claw their way back winning or even break-even season (life) is to, if not the top, near the top. They do play in good enough. We want our post-season (also the ACC after all. And Clemson may still be the known as retirement) to be fun and filled with best team in that conference this year. new beautiful and warm places. We want to Life is the same. The children of the rich have a good time. have plenty of advantages, and if they want Some are never satisfied unless they win it to they can get the best college education and all, while others are happy and content with perhaps even a nice nest egg from their parents what they have. I think these latter are truly the to get started in business and life. Unfortunatehappiest people. Less accomplished? Sure. Less ly, there are too many examples of rich kids famous? Also, true. who blew the family fortune for that scenario Me? I’m content with being able to write a to be an anomaly. So starting out well-off is no column that a few people enjoy reading, enjoyguarantee for your future. ing new places and experiences with my family On the other side of the coin, we have those and friends, eating good food and drinking who started with nothing. Single parent chilwell (but in moderation), and enjoying this dren or even orphans who later excelled in life, big, beautiful globe we call home. not just in riches measured in dollars, but in Well, that and maybe writing a amazing talent in art, literature, law, and other few more novels. + endeavors.

Truly, nothing in life is guaranteed except J.B. Collum is a local novelist, hudeath and taxes, as attributed to Benjamin morist and columnist who wants to be Mark Twain Franklin and Daniel Defoe, among others. when he grows up. He may be reached at johnbcol As the season progresses, whether in football lum@gmail.com

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MEDICINE IN THE FIRST PERSON Send your interesting (or even semi-interesting) stories to the Medical Examiner, PO Box 397, Augusta, GA 30903 or e-mail to Dan@AugustaRx. com. Tell us if you want it “by you” or if it needs to be anonymous. Thanks!

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AUGUSTAMEDICALEXAMiNER

OCTOBER 15, 2021

INSULIN… from page 2

and weight loss. For Type I patients, those lifestyle factors are important too, but nothing can replace insulin except insulin.

Some advances in recent years include insulin pumps and CGMs (continuous glucose monitors), but those are basically just automated versions of the same old-same old: test and inject.

Pumps and CGMs are in effect an artificial pancreas, but researchers dream of the day today’s hardware will seem primitive. It could be a while. Pancreas transplants are becoming more common, although many still view the procedure as experimental, but they come with a list of serious side effects, including infection, bleeding, tissue rejection, and more.

One aspect of insulin that is both inspiring and maddening dates back to its discovery and isolation 100 years ago, the autumn of 1921. Canadian researchers finally refined and perfected their methods enough to be able to produce large quantities of insulin.

Since insulin is to a Type I about as vital as air is to the rest of us, they thought it only right and proper to make it available to everyone at the lowest possible cost. They sold the patent to the University of Toronto for $1.

As a 2019 Vox article put it, the original discoverers must be spinning in their graves: “Their drug, which many of the 30 million Americans with diabetes rely on, has become the poster child for pharmaceutical price gouging.”

Why has this happened? Two major reasons: one is a free market approach in the US, versus other countries who strictly regulate drug prices. As Vox said, drug companies raise prices to sometimes astronomical levels “because they can.”

The other reason has to do with what are described as “incremental” improvements to the original insulin formula. These newer versions are covered by additional patents, driving up their costs. Critics say the tiny improvements don’t justify the huge price jumps, but it’s a free market economy, even when it comes to life-and-death medications. +

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AUGUSTAMEDICALEXAMiNER

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

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Instructions Slice banana and freeze for 30 minutes. Combine milk, yogurt, banana, cocoa powder and ice cubes in blender. Blend until smooth and frothy. Top with chocolate sprinkles, if desired.

Yield: 4 Servings (serving size: 8 ounces) Nutrition Breakdown: Calories 140, Fat 2g (1g saturated fat), Cholesterol 5mg, Sodium 100mg, Carbohydrate 20g, Fiber 1g, Protein 12g.

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OURNEXTISSUE

NOVEMBER

A NEW PAIR OF GLASSES

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AUGUSTAMEDICALEXAMiNER

A NEW PAIR OF GLASSES

by Ken Wilson Steppingstones to Recovery

A few months ago I had cataract surgery in both eyes, two weeks apart. Modern technology makes it almost a non-event!

After one eye was corrected, I looked up to the sky one evening using just my “old” eye and saw one star. One! Then I closed that still cataracted eye and opened my newly corrected eye and saw hundreds of stars.

Hundreds. Maybe thousands!

I did get new glasses, though, to correct astigmatism (ok, look that up) and for close-up vision, and now it seems like I have new eyes!

It’s amazing what these paradigm shifts can do for your mental health. I’m gratified to hear news for the first time in my 70 years about the importance of mental health for our well-being. Suicides,

alcoholism, and addiction have sharply increased over the past year and a half largely due to the isolation and sadness that Covid 19 has caused. It’s tragic, but if anything good thing has come out of it all it is the new emphasis on achieving and maintaining good emotional and mental health – from kindergarten on up. Curriculums are changing, counselors are listening, and people are talking more openly than ever before. It’s a good thing.

Alcoholism is one of the least understood illnesses in the field of mental health. Many people look at the alcoholic and curse the demon alcohol — “yeah, alcohol’s got him” — focusing on the chemical itself. But that thinking is old stars. One star.

Bummer.

You see, alcohol is only the symptom, not the problem. Say what, Ken? Here’s what I say:

Reach for some new glasses right about now, ok? Look past the alcoholic for a minute, look past the clouds in his brain, look for even the dimmest stars.

Alcoholism is a feelings illness. People drink or drug for one reason only. One lowest common denominator. And that is, people drink to change the way they feel. Only. It’s not rocket science to deduce that if they need to change the way they feel with alcohol, they don’t like the way they feel without alcohol. Ben Franklin is credited with saying “Beer makes you feel like you should feel without beer.” Not everybody has that luxury, however.

Maybe alcoholics drink to be merry, to loosen up, to drown negative feelings, or to cope with depression (good luck with that). One definition of intoxication is, “the absence of feeling.” Recovery, then, is

not about stopping drinking alone. It’s about learning how to change the way you feel when you need to, but without demon alcohol. Earth people (non-alcoholics!) do that all the time…they walk, run, exercise, play music, meditate, talk, ad infinitum.

In treatment we have a saying, “Deal with your feelings or your feelings will deal with you.” I once knew of an intoxicated driver who repeatedly bashed a bus with his sub-compact car at a stop light! His car was totaled; the bus was unscathed. I asked why he did such a thing and he replied, “the bus driver came into my lane and I wasn’t going to let him get away with that.”

In treatment I heard his whole story. When he was a little boy his alcoholic dad used to beat his mom’s head

OCTOBER 15, 2021

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

on the kitchen table while he was hiding under it, and he decided, “when I grow up, nobody’s going to push me around like that.”

He was finally able to see that he wasn’t really mad with the bus driver but with his dad. He hadn’t dealt with his feelings, and as a result his feelings had dealt with him.

When I talk to family members about their affected loved one these days, I ask them to reach for a new pair of glasses. They help them see so much better. +

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OCTOBER 15, 2021

PINK RIBBONS… from page 1 if everything were the same, it would be. But alas, the cancer was all too real, and the old healthy me was seemingly gone in an instant.

I remember being so confused when friends called me a “warrior” and told me to “kick cancer’s ass.” I knew they loved me and were being encouraging. But I was very scared and certainly had no clue how to become a warrior. I just felt immense pressure as my calendar was quickly filling up with medical appointments and heavy decisions. After my biopsy, there was genetic counseling, meetings with breast and plastic surgeons, and the decision to have a bilateral mastectomy followed by reconstruction. “Your new boobs will be even more amazing,” friends said. When they ask if I’m happy with the results, I’m not sure how to tell them that my numb chest now feels like someone else’s body.

Early detection absolutely saves lives. For

9 +

AUGUSTAMEDICALEXAMiNER

WE EMPLOY ALL REASONABLE COVID SAFETY MEASURES me, it also led to a summer of chemotherapy (not fun), monthly injections to suppress my ovaries (hello, instant menopause), and daily medications to prevent the cancer from recurring (also not fun). I can’t wear a pink tutu and proudly announce that I beat cancer, because the truth is more complex and somewhat gritty. I will be fighting for years to come and hoping that the scary dark shadow of cancer recurrence isn’t lurking over my shoulder.

This month, I will celebrate the lives of breast cancer survivors like myself. But instead of tying up their narrative with a pink bow, I acknowledge the complex tapestry of ups and downs that accompany cancer treatment.

And if I must wear a tutu, please make mine black. +

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CRASH

COURSE

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

Remember about 16 months ago or so? We were in the golden age of pedestrians. The world was on lockdown mode and neighborhood streets were seeing more kids, parents and grandparents taking walks than any time in recent memory. Vehicular traffic was at an all-time low. Every day was like Sunday morning.

Combine the two and it seemed like the perfect recipe for greatly improved road safety. Then again, sometimes looks can be deceiving. We’re a lot more vigilant when traffic is heavy, but we might let our guard down when traffic is as light as it has been lately. And sure enough, 2020 accident statistics were among the worst in recent memory.

Back in pre-pandemic days, a disturbing trend was steadily building: pedestrian deaths were increasing nationally year after year.

More pedestrians and cyclists were killed in 2018 than in any year since 1990. Deaths of pedestrians have jumped by 42% in the last decade even as the combined number of all other traffic deaths has fallen by 8%.

Locally, pedestrian fatalities in Georgia have increased every year except one (2014) since 2011. In the 8-year period between 2011 and 2018, pedestrian deaths have more than doubled, from 130 in 2011 to 261 in 2018.

In South Carolina, an SC DOT annual report in 2018 showed a 60 percent increase in pedestrian fatalities between 2013 and 2017, jumping from 100 deaths to 160 during that 5-year span.

Most agencies studying this trend have identified distracted driving as the #1 culprit. Translation: using cell phones while driving. Fortunately, Georgia law prohibits even touching a device while driving. Unfortunately, many drivers seem to completely and openly ignore the law.

In South Carolina, it is illegal to text while driving, but talking on a cell phone, hands-free or otherwise, is not prohibited.

While there are a number of circumstances where the law gives pedestrians the right of way, as a general rule it’s of little benefit to be 100 percent in the right but 100 percent dead.

Because of that, pedestrians need to take responsibility for their own safety. Unlike drivers, people on foot are not protected by a seatbelt and airbags and surrounded by a steel cage.

How can pedestrians protect themselves?

For starters, see and be seen. How many times have you been sitting at a red light and watched a pedestrian cross in front of your stopped car while they’re texting or otherwise staring at a screen? That is not seeing. It’s essentially walking blind. Being engaged enough to make eye contact with motorists is a great idea while driving, and it’s an even better idea when walking. See with your own two eyes that they’ve seen you.

Another way to make sure you see is to walk against traffic.

Even on quiet neighborhood streets, you don’t want to turn your back to oncoming cars. Facing traffic is much safer. (Obviously the best option is to walk on sidewalks, but most neighborhoods don’t have them.)

To be seen might seem like a given, particularly if you’re walking in broad daylight. But law or no law, plenty of drivers are not giving their full attention to the task at hand. They might be taking a selfie for all you know. In fact, some drivers who would never post to Facebook or Instagram while speeding down I-20 at 70 mph might think nothing of it on the quite streets of their subdivision, the very place where you and your family are walking. So never assume you’ve been seen. Be alert. Wear bright clothes. If you’re walking at night or in the evening or any other time when there is poor visibility, carry a flashlight and use it to alert drivers to your presence.

This is a great time of year to get out and walk, and it will be an even greater thing if we collectively carry over the habit into the post-pandemic period when it comes.

Let’s just do it safely. +

THANKS FOR READING THE EXAMINER

OCTOBER 15, 2021

HUMAN BEHAVIOR TIRED OF COVID?

Me too. We are all tired.

We’re tired of hearing about

by Jeremy Hertza, Psy.D. COVID-19, and tired of it being all we’re talking about. We’re tired of worrying about masking up but worry more when we go out without one.

Our hearts are heavy thinking about friends and family who are choosing to ignore the pandemic and its new Delta variant, even while we wish we could do the same.

“The problem is that most of us are incapable of processing the reality of a new pandemic. Not because we don’t understand math or have thrown caution entirely to the wind, but because our capacity to comprehend information with nuance, particularly information about health, is gone. That capacity has not yet recuperated from the total exhaustion of the pre-vaccination months. Workers are burned out at their jobs, parents are burned out at parenting, and pretty much everyone is burned out on hearing about the coronavirus,” wrote Anne Helen Peterson in The Washington Post in August.

Burnout is easy enough to diagnose. That tiredness—both mental and physical—is one sign. Disinterest is another—in reading news about COVID or talking about it. Burnout can also lead to less attention to the details, like forgetting to send a mask to school with your child. It can also cause us to sleep less, be more irritable and less patient, and, ironically, more susceptible to being sick. Burned-out people swing from one side of the spectrum to another; on the one hand, they may choose to pretend everything is back to normal, or on the other, they may become hyper-vigilant and fearful of being near anyone who’s unvaccinated.

What’s harder is what to do about burnout. In a way, we’ve become too used to the stress and strain we’ve all been under for the past 18 months, and burnout feels almost normal.

So first, we need to say that out loud, since it’s clear that many of us share that feeling. Next, it bears repeating that selfcare should be at the top of our lists. Every single day, in some small way, we need to be checking in with ourselves, our families, and our friends. Maybe today it looks like having a 15-minute Disney dance party with your child or scheduling a meetup with vaccinated friends. Maybe it’s bringing groceries to your mother or FaceTiming a cousin who lives across the country. It should also definitely include exercising as you can and eating well but healthily. Every day, do that one small thing to help remind you that life is good and still normal in so many ways.

The trick is balance—in being safe but not afraid. Not overor underreacting to the current situation. In other words, can we try to strike a balance between partying like it’s 2019 versus hiding at home with a blanket over our heads?

We can’t pretend that life is what it used to be. But there’s still plenty of good and joyous life to be had. As tired as we all are, we should all take that first step to hold on to those moments. + 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.

OCTOBER 15, 2021

11 +

AUGUSTAMEDICALEXAMiNER

bonus blog spot From the Bookshelf WAKE UP, SAILORS! SCURVY IS A HOAX

by Kathryn Baecht, from McSweeney’s Internet Tendency

I’m just a lowly seventeenth-century British sailor, not some fancy-pants seventeenth-century British sawbones, but there’s one thing I know for sure: I would rather walk the plank than suck on a single stinking lime. In fact, I will be giving a wide berth to any and all citrus fruits the Captain brings aboard during this long and arduous voyage, because scurvy is a hoax, and I don’t trust foreign fruit.

You know what I do trust? My own body to protect me. I’m young and fit, and my childhood rickets has almost entirely cleared up. And as far as I can tell, nothing bad has ever happened to a young and fit sailor with just a touch of rickets who heads recklessly off to fight pirates and ghost ships for months on end with nothing for nourishment except barrels of stale, rat-infested biscuits.

So no, I’m not “afraid” of scurvy.

What’s the worst that could happen?

My teeth will fall out? My bowels will bleed? I’ll die at sea, and my body will be cast into the murky depths by my equally moribund shipmates, who won’t even have the energy to say a blessing as octopuses and sea monsters feast upon my corpse? That doesn’t sound any worse than a little seasickness, and it definitely sounds better than occasionally sucking on a lime.

Yes, I know there are a thousand stories from old salts who say, “Oh, scurvy is so bad! Believe me, young man, you don’t want scurvy! Oh, the rats swarmed out of the biscuit barrels and dragged off my mate’s body before we could cast it into the sea!” To that, I say: Whatever. Sailing to the edge of the flat earth must have muddled your mind, old man. I’ll be fine.

And while I may be fine, what I am not fine with is the Captain’s mandate that we must all take this so-called citrus cure. He claims that it’s necessary in order to hang onto our already extremely low chance of surviving this harrowing journey through uncharted waters. He says we must do it for our fellow seaman who truly are our brothers. He says we must do it for the common good. He says it is our noble duty. And to that, I say: Screw. Everybody. I’m in it for me and me only.

Listen, if you want to hide below deck licking limes and then later come above deck to enjoy the sunshine and your lack of jaundice and intact teeth and gums that aren’t leaking putrid black blood, then be my guest. But not even the Captain has the right to make me eat a nutritious and lifesaving fruit if I don’t want to.

But there’s more to this story, my friend, and if you are ready, I will open your eyes to the writing on the wall (literally—I read this on the wall of the ship’s head while I was taking a pee this morning; that’s where I get all my medical information). Consider this: Why would the powers that be insist that the only cure for this supposed dreadful disease is to eat these unknown, untested, and totally experimental fruits? We know that limes, lemons, and even oranges are filled with acid, and is acid not caustic? Is acid not, in fact, deadly when it becomes too strong? Could it be that the acid of these devil fruits is the true cause of scurvy? Does “scurvy” even exist? Or is it all just an elaborate hoax designed to take away our God-given right to needlessly suffer a totally preventable malady?

You see it now, don’t you? Scurvy is nothing more than a made-up, foreign-fruit-induced plague, and I, for one, will not be silent! I will not be a sheep, er, I mean, I will not be a fish! I am a man! A very, very painfully misguided man, and I swear to you that the juice of a lime will never pass my lips—at least until the internal bleeding starts, and then I’m sure I will go along with whatever old sawbones says.

And I definitely want access to that new experimental leech treatment. +

I’m not buying the captain’s citrus mandate.

What is a coffee table book? To some, it conjures up thoughts of an oversized volume, filled perhaps with images of great art or stunning photography, too big to fit on a bookshelf.

For others, a coffee table book is all that, but it’s also a book you don’t want to read once and then consign to the bookcase; it’s a book you want to leave out so when you have even just a few spare moments, you can open it to any page and find something to engage both your mind and your eyes.

This book is all that and then some — with one exception: it’s slim, and at 7” x 9” no one will ever call it oversized, but it fits the definition for coffee table placement in all other respects.

It’s a book that contains too much information to be absorbed in a single reading, packed as it is with fifty pionering profiles of legendary ladies — and a visual feast of delightful and enlightening illustrations.

Even the glosssary is illustrated, every last word.

The book is arranged chronologically, beginning

with noted Egyptian astronomer, mathematician and philosopher Hypatia of 3rd and 4th century fame and concluding with Maryam Mirzakhani, the brilliant Iranian mathemetician who was born in 1977.

As you’ve gathered then, these women are not all in the medical field (even though you might expect that from a book reviewed in the Medical Examiner).

Several are though, and their presence is a reminder that we need to profile more women in future installments of “Who is this?” on page 4 of every issue.

One of the underlying

themes of this book is how challenging it often was to be a woman scientist down through the centuries, right up to and including our day.

Hidden Figures, the movie of a couple years ago, tells yet another chapter in the lengthy saga of prejudice and discrimination faced by so many gifted people, just because they happened to be women.

Girl power, it turns out, is more than just a catch phrase; it was and is the two-word survival strategy for strong women from ancient times down to our day.

This book would be an inspiring gift for any young girl who loves science and learning, but it’s hard to imagine boys not liking it too.

Both may have to hunt for the book: instead of being on the coffee table where it belongs, mom and dad will surely be reading it from cover to cover too. + Women in Science — 50 Fearless Pioneers Who Changed the World by Rachel Ignotofsky; 128 pages, published in July 2016 by Ten Speed Press.

BINGEREAD VISIT ISSUU.COM/MEDICALEXAMINER, WHERE OVER 230 ISSUES OF THE EXAMINER ARE ARCHIVED FOR YOUR READING PLEASURE.

MEDICALEXAMINER

+ 12

AUGUSTAMEDICALEXAMiNER

The Examiners

OCTOBER 15, 2021

+

I had cops banging on at 5 o’clock You look tired today. my door this morning!

by Dan Pearson

All I know is they wanted to know where What? How come? I was between 3 and 4.

I told them daycare.

But really, who can What did you say? remember that far back?

The Mystery Word for this issue: BLOMMSAITE

© 2021 Daniel Pearson All rights reserved.

EXAMINER CROSSWORD

PUZZLE

1

2

3

4

13

14

16

17

19

5

6

7

8

11

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

We’ll announce the winner in our next issue!

EXAMINER SUDOKU

12

7 6

18

20

21 27

28

29

4

30

9

8 1 2 6 3 9 4

32

9

37 41

42 46

6

50 53

54

55

3 8 9 6 5 4

58 63

64

8 5 1

47

65

66 69 72

5

7

1

3 9

by Daniel R. Pearson © 2021 All rights reserved.

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

33. Georgia county whose seat is Cordele 34. Sano start 35. Lowest point 37. Started 39. Citizen army 41. Desert in East Asia 44. Political power or influence 46. Will Farrell holiday film of 2003 49. It lies east of the Bay of Biscay 50. Popular ISP 53. _____ Mountains 54. Aromatic spice 55. Arm joint 57. Criticize severely 59. _____ smear 60. Exploit 61. Pharmaceutical sales agt.

62. Sick 63. Edible brown mushroom 64. Where the Wild Things ___ 65. Young boy

QUOTATIONPUZZLE U C A H B P A S U I M M S M H A A S E B S C P I I T N Y Y B E O I T T N Y O N

by Daniel R. Pearson © 2021 All rights reserved

7 9 G T R 4 E M O8 I3 S 6 I 1 — Robert G. Allen 2 5

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.

I 1 2

G 1

1 2

L 1 2 3 4 5

2

3

1

2

3

4

5

1 2 3 4

6

1

2

1

2

1 2 3 4 5

1

2

S 1 2

Y 3 1 2 3 4 5 6 7

1.HHTTFIGGWWUU 2.LOOOSSAAIIFE 3.CVVUNDY 4.KLEET 5.NEED 6.TD 7.S

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

6 1 8 5 4 2 3 9 7

by Daniel R. Pearson © 2021 All rights reserved

BY

10

N O I Simply unscramble the letters, then begin exploring T A C our ads. When you find the correctly spelled word A V hidden in oneNof our ads — enter at AugustaRx.com O

15

ACROSS 22 23 24 25 26 1. Take-home 4. Cardiac add-on sometimes 31 10. Jr. commissioned naval 33 34 35 36 officer 13. South American tuber 38 39 40 14. Venice bridge 43 44 45 15. Hip bones 48 49 16. Rocky peak 17. In view of 51 52 19. Thrombus 56 57 21. County in Ireland 59 60 61 62 22. Woods of local note 27. Broad silk necktie 67 68 31. Like Phinizy Swamp 70 71 32. Echolocation 33. CHOG charity partner

by Daniel R. Pearson © 2021 All rights reserved.

36. Money of Western Samoa 37. Stain with mud DOWN 38. Wander 1. Jugular ________ 40. Blacksmith’s workshop 2. Common intestinal bacteria 42. Hebrew for “delight” 3. Fortune-telling cards 43. Formally charge with a 4. Russell St. school crime 5. Past Olympic site, in brief 45. Private box in a theater 6. Operated 47. Major CSRA employer 7. Ernie of the PGA 48. Noted local burn doctor 8. Like summer weather in 49. Smaller shin bone Augusta 51. Dental prefix 9. List variety 52. Strengthen 10. Peyton’s little brother 56. Brass wind instrument 11. 30-D group, for short 58. Lounge lazily 12. Bend downward 59. Rigidly moralistic 15. Annoying 66. Male swan 18. Delete 67. On the ocean 20. Classic movie station 68. White of the eye 23. Top ____ 69. Minimalist IV (abbrev.)

24. Skill 70. Liveliness 25. Christiania today 71. Came to the aid of 26. Mr. Chaplain 72. Evergreen tree 28. Nematocyst 29. Paddled 30. Mr. Reznor of 11-D

WORDS NUMBER

9

THE MYSTERY! WORD

5 3 2 9 7 1 8 6 4

3 4 1 6 8 7 9 5 2

9 8 7 2 5 4 6 3 1

OCTOBER 15, 2021

AUGUSTAMEDICALEXAMiNER

THEBESTMEDICINE ha... ha...

The

13 +

Advice Doctor

“are you telling me you managed to count them all in that brief moment of passage?”

“Don’t be silly, Watson. I counted the legs and divided by four.”

©

Pierre Curie walks into his lab and remarks to his wife, “Marie darling, I swear you look more radiant with each passing day.”

A

man who just moved to Augusta wants to get a COVID vaccination. As he’s walking down Broad Street he asks a stranger on the sidewalk, “Excuse sir, I’m new in town. Where are they giving the vaccination around here?”

“Well, for me,” said the stranger, “it was in my left arm.”

Moe: Ever notice that British people on TV shows seem like they’re wealthy?

Joe: Well, at least well off, yeah definitely.

Moe: You know why that is?

Joe: No, why?

Moe: The camera adds ten pounds.

Sherlock Holmes and Dr. Watson were aboard a train one day when a huge flock of sheep in a field passed by their window.

The train was traveling at full speed, so the field and its many grazers were quickly gone.

“So many sheep!” Watson exclaimed. “I wonder how many there were?”

“Elementary, Watson,” Holmes calmly stated. “There were 167 sheep.”

“My good man,” said Watson in disbelief,

At a party a chameleon says, “Hey everybody, watch this!” and he changes color to match the walls. Everyone is amazed. Not to be outdone, an octopus comes up to him and says “Hold my beer, hold my beer, hold my beer, hold my beer, hold my beer, hold my beer, hold my beer, hold my beer.”

Moe: How many magicians does it take to change a lighbulb?

Joe: Into what?

Moe: Has your tooth stopped hurting yet?

Joe: I don’t know. The dentist kept it.

Moe: How was the blind carpenter cured?

Joe: He picked up his hammer and saw.

Moe: If an apple a day keeps the doctor away, what will an onion do?

Joe: Keep everyone away.

Moe: Why do Native Americans hate snow?

Joe: I didn’t know they did.

Moe: They do.

Joe: Ok then, why?

Moe: Because it’s white and settles on their land. +

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.

Dear Advice Doctor, My best friend is in the middle of a fight with someone at her job. I don’t even know what it’s about and I don’t want to know, but she has cooked up this scheme to get even with this other person involving ME. Supposedly this will allow her to deny whatever it is without having to lie about it. As if I have nothing better to do than engage in her petty squabbles. Believe me, I have bigger fish to fry! I’m actually questioning whether she should even be my friend anymore. What do you think?

— Can’t We All Just Get Along?

Dear Can’t We, I’m glad you brought up this important topic.

According to the US Food & Drug Administration (FDA), fish are a great element in a healthy diet, and they recommend eating fish two or three times a week.

The reasons: fish have great nutritional and health benefits. Fish are a great source of protein, iron, salubrious omega-3 fats, and more vitamin D and B12 than any other kind of food. Plus they are good sources of important minerals like zinc, iodine, and selenium.

Those nutritional benefits when fish are regularly in the diet translate into benefits for the heart and brain, and a lower risk of obesity. In addition, the FDA’s 2015-2020 Dietary Guidelines for Americans recommends that women who are pregnant or breastfeeding consume between 8 and 12 ounces of various seafoods each week from its extensive “Best Choices” list. These options, great for everyone, male or female, pregnant or not, range from anchovies to whiting, and include salmon, sardines, crab, shrimp, perch, tilapia, Atlantic mackerel, clams, oysters, flounder, freshwater trout and many more, including even catfish. Being on the “best” list denotes seafood that’s safe to eat, as opposed to the “Choices to Avoid” list, where it’s likely to find higher levels of mercury. You can find the complete list of good, not as good, and not good seafood at fda.gov.

My primary concern about your situation is that you said you’re frying fish. Look for recipes that involve broiling or grilling, and keep the cooking time to the shortest time possible to thoroughly cook your seafood.

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.

SUBSCRIBE TO THE MEDICALEXAMINER +

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If you live beyond the Aiken-Augusta area, or miss issues between doctor’s appointments — don’t you hate it when that happens? — we’ll command your mail carrier to bring every issue to your house!

NAME ADDRESS CITY STATE ZIP Choose six months for $20 ____ or one year for $36 ____. Mail this completed form with payment to Augusta Medical Examiner, PO Box 397, Augusta GA 30903-0397

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

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N O I in the p. 15 ad for T ...cleverly hidden in the woman’s hair A READ US ON YOUR SMARTPHONE OR TABLET AC V ON

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

OCTOBER 15, 2021

AUGUSTAMEDICALEXAMiNER THE PUZZLE SOLVED N O T C H

E C O L I

C R I S P

M O N T E

P U A S P E

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

R R E S I A L T O N S I C C O C K R S H Y A L A F O R G T L O F I B R E I B A A N I C S C L E H E L P

T O I D E R O R K A S S O B E M E E G E U L A N F O L A L R A E D

E N S L I A I N G C N I D A

O A R E D

T R E N T

R O C K Y

C L O V E

E L B O W

SEE PAGE 12

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

...wherein we hide (with fiendish cleverness) a simple word. All you have to do is unscramble the word (found on page 12), then find it concealed within one of our ads. Click in to the contest link at www.AugustaRx.com and enter. If we pick you in our random drawing of correct entries, you’ll score our goodie package!

SEVEN SIMPLE RULES: 1. Unscramble and find the designated word hidden within one of the ads in this issue. 2. Visit the Reader Contests page at www.AugustaRx.com. 3. Tell us what you found and where you found it. 4. If you’re right and you’re the one we pick at random, you win. (Winners within the past six months are ineligible.) 5. Prizes awarded to winners may vary from issue to issue. Limited sizes are available for shirt prize. 6. A photo ID may be required to claim some prizes. 7. Other entrants may win a lesser prize at the sole discretion of the publisher. 8. Deadline to enter is shown on page 12.

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QuotatioN QUOTATION PUZZLE SOLUTION Many an optimist has become rich by buying out a pessimist.

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AUGUSTAMEDICALEXAMiNER

The

Money Doctor THE “TABOO” MONEY TOPICS WE SHOULD BE When asked what we do, my wife (a marriage and family therapist) and I (a financial planner) tell folks that we play a unique role in people’s lives. We spend many hours helping individuals and couples with topics that are traditionally taboo: marriage and money. For many people, their financial advisor is part of their very close circle of trust that includes only a handful of other people. And, it can be hard to know when to expand that circle of trust.

Each family is different, and we haven’t found two families exactly the same when it comes to how, when, and with whom they discuss money. We encourage people to use the “sleep at night” test. If you have a

concern and it keeps you up at night, you need to consider talking with someone.

The hard part is identifying who to talk with.

If you come from a family that does not openly discuss money, it can be tough to get the conversation going, or even know the right way to start it. There are a few key areas that discussing with family and friends.

Estate Planning Estate Planning is a very common area that we find open discussion among family members can be really helpful. For growing families, we encourage discussion between parents and the guardians and trustees listed in the will. The goal of these discussions is to avoid

OCTOBER 15, 2021

life planning, expressing your feelings and desires before you become incapacitated is very important.

These discussions should supplement your durable health care power of attorOPENLY DISCUSSING ney form. Sometimes it is easier to start this discussion by talking about long-term surprises if an unexpected care planning. We often get event happens. We have found these discussions can asked, do we need longbring families closer togeth- term care insurance? Our response is always, you er when done right. absolutely need a long-term care plan which may or may Guardians It is a big deal to be asked not include long-term care insurance. Your long-term to be a guardian. It means someone has a tremendous care plan should include disamount of respect and trust cussions with your potential caretakers. for you as a person. Discussing this also gives the potential guardian a chance Initiating the discussion to provide feedback or bring We tell young adults that if their parents are not initiup any concerns they have ating the discussions, they about the role. should absolutely initiate them. The best way to start Long-Term Care Planning these conversations is by For aging family memtelling your parents you bers, we encourage discuslove and care about them, sion between the elderly which is why you want and their caretakers - often to better understand their their children or siblings. future plans. You don’t need When it comes to end-of-

to know the details about every account or insurance policy. The goal should be to gain a basic understanding of their plan.

If they don’t have a plan, gently encourage them to start thinking about it and set a date and time to have a follow-up discussion. If they are still struggling to plan, consider getting a financial professional involved.

Some of my favorite moments in our office happen when multiple generations are together in one room.

Getting multiple generations on the same page allows families to focus on making memories together. You can also avoid a lot of family drama when the plan gives everyone a feeling of transparency. +

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.

SAY IT AIN’T SO, JOE! WHAT ABOUT THOSE JOE NAMATH COMMERCIALS? Are you paying too much in Medicare premiums?

Are you missing out on additional benefits available at no cost to you?

IT’S POSSIBLE.

BUT HERE’S A BETTER QUESTION:

WOULD YOU PREFER TO GET THE ANSWERS FROM A TELEMARKETER AT A CALL CENTER, OR FROM A LOCAL AGENT? “I have all the answers they do, but I have the advantage of being right here in Augusta.”

— Susan Renea Soos

Soos Benefits Group

Your Local Independent Medicare Professional

706-399-1989

I can answer your questions in the way you’re most comfortable with: in person, over the phone, or by video conference.