This issue contains several provocative articles. The health article should expand your knowledge and ability to support your family and friends medically, plus several wealth articles to help you find your true “investor self.

 
This issue has 4 articles:

1. Health Article  - HWR Medical Editor, Steven Mandel MD, introduces the Sjogren Syndrome to extend our body of knowledge and ability to support family and friends
2. Wealth Article 1: When Not to Buy a Stock, by HWR Wealth Editor and investing enthusiast Gary Smith
3. Wealth Article 2: Washington's Gridlock Will Set the Stage for Big Market Gains. Public insights from brotherhood member Larry Glazer
4. Wealth Article 3: A professional response to stock picking and stock timing from brotherhood member Frederick (Fred) Taylor

Please do not miss the overt and underlying messages of all these articles that FJMC continues to be a place that we need to be participating in with our financial support as well as our time.

Be sure to be in touch with Richard Gray, Editor, at rgray@fjmc.org with your articles, comments, appreciation and critiques. Each issue is brought to you by your editorial staff that includes:

• Richard Gray (Editor in Chief)
• Steven Mandel MD (Medical Editor)
• Gary Smith (Wealth Editor)
• Mark Druy (Publisher)

This HWR was sent out on , at approximately 9:30 PM (Eastern and prior to Shabbat).

Sjogren’s syndrome was first described by the Swedish ophthalmologist, Dr. Henrik Sjogren, in 1933. He identified a group of dry eye patients who also had dry mouth and arthritis.
 
Sjogren’s (pronounced “SHOW-grin’s) is an autoimmune disorder where the immune system attacks your body’s own cells and tissues and can affect the entire body. Along with symptoms of extensive dryness, other potential serious complications include profound fatigue, chronic pain, major organ involvement, neuropathies and lymphomas.Prevalence estimates range from 1.2% to 4.8% of the population, and Sjogren’s affects women almost 10 times more frequently than men and traditionally has been diagnosed in middle age. However, Sjogren’s can develop at any age. Four million Americans are estimated to have Sjogren’s with less than 2.5 million diagnosed.
 
Symptoms may include dry itchy skin, chronic burning mouth syndrome, cough, numbness in the arms and legs, fatigue, muscle and joint pain, vaginal dryness, dry nose and sinus, cognitive issues, and gastrointestinal, pulmonary, kidney and liver problems.  Visual symptoms include blurring of vision, intolerance to bright light, and eyes that itch, burn and are prone to infection.   Additional oral symptoms include dry mouth, rampant cavities, loss of teeth, choking upon swallowing, difficulty speaking, dry peeling lips, and problems with taste and smell. Sjogren’s patients have a 6.5%–16% increased risk of developing non-Hodgkin’s lymphoma and a 1000-fold increased risk of developing parotid gland marginal zone lymphoma.
 
The etiology is believed to involve both genetics and the environment, triggered by viral or bacterial infections or a toxic exposure in a genetically susceptible individual.   It may be associated with other autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosus.  Sjogren’s is associated with the production of autoantibodies, increased B cell activity and immune abnormalities affecting exocrine glands and extra-glandular tissue. The histological hallmark is focal lymphocytic infiltration of normal appearing glandular acini.
 
Neurological symptoms can include difficulty concentrating, poor memory, dysautonomia, inattention, reduced perceptual speed, verbal fluency, and a picture similar to subcortical dementia. Parkinson’s disease and other movement disorders such as dystonia have been described. Individuals can develop aseptic meningitis where MRI and spinal fluid may reveal abnormalities.  Central nervous system problems can include encephalitis, seizures, stroke, transient ischemic attack, and migraine. Individuals can develop numbness, coldness, burning, lancinating as if the feet are on fire, weakness, and clumsiness. Autonomic symptoms can affect the heartbeat, respiration, body temperature control and gastric motility causing abdominal distention. Facial pain occurs in the form of trigeminal neuralgia and throat pain with glossopharyngeal neuralgia.
 
The spinal cord can be affected with numbness, weakness, urinary problems, defecating, and sexual disorders. Peripheral nerve findings include fatigue, numbness, burning, and paresthesias. There can be selective involvement of dorsal root ganglions to include ataxia and dysesthesia and difficulty walking which may result in a painful sensory neuropathy. Hypokalemic and respiratory failure associated with renal tubular acidosis can be the first manifestation of Sjogren’s.
 
Sjogren’s can affect the GI system including biliary, cirrhosis, stomach upset, gastroparesis, pancreatitis, and irritable bowels.  Lung involvement can include bronchiectasis, interstitial lung disease, pneumonia. Uro-gynolcological problems can occur, including interstitial cystitis, vaginal dryness, and vulvodynia.  Blood vessels can be affected leading to vasculitis and Raynaud’s phenomenon (in which blood flow to fingers and toes is affected leading to digits turning white or blue and feeling numb and cold). Difficulty with blood pressure, cardiac rhythm disturbances, and sweating abnormalities may occur.  One can suffer from hearing loss due to sensorineural hearing loss. Sleep disturbances are not infrequent as well. 
 
Diagnosis can be delayed for many reasons. Healthcare providers might not link a wide variety of symptoms as part of one disease. In addition, many symptoms can mimic other disorders or diseases, complicating the diagnosis. Symptoms of Sjogren’s also can be confused with side effects of various drugs including antidepressants, allergy, and blood pressure medications. Proving a diagnosis of Sjogren’s may be difficult as systemic and/or neurological involvement can occur prior to sicca (dryness) symptoms. Diagnostic testing includes looking at blood for Rheumatoid Factor, inflammatory markers, and the autoantibodies SSA and SSB; a lip biopsy to see if lymphocytic infiltrates are present; ophthalmology tests measuring tear production; and oral tests to measure salivary flow. With peripheral nerve involvement, EMG studies can measure motor and sensory response. Autonomic testing can be performed.
 
Treatment can include disease modifying drugs as well as symptomatic treatment for those with dry eyes and dry mouth.  Drugs to be considered when needed include hydroxychloroquine, steroids, biologicals including rituximab, TNF-alpha inhibitors, exercise, and antiepileptics and anticholinergic drugs.  For oral dryness, one can use topical fluoride to help preserve teeth, over-the-counter salivary stimulants, and prescription sialogogues are used.  For ocular symptoms, artificial tears and ointments and prescriptions such as Restasis and Xiidra can help. One should suspect Sjogren’s when symptoms are greater than three months without other explanations.
 
Individuals can find education and support locally and nationally through the Sjogren’s Syndrome Foundation (SSF). The SSF offers educational materials and conferences, support groups, and numerous online support venues. The SSF also works hard to advocate for patients, whether for increased medical and scientific research, new and better therapies, and increased insurance coverage, public awareness, and professional education. More information on the SSF can be found at www.sjogrens.org or by calling 1-800-475-6473.
 
Steven Mandel MD FAAN
Clinical Professor of Neurology, Donald and Barbara Zucker School of Medicine at Hofstra/ Northwell 

The other day a good friend of mine told me he put in a bid for a stock named Amarin Corp. ARMN.   He asked me what I thought. He was very excited about the stock because he read some great things about it and heard this was a hot stock.   
 
There was a study out by one company in Australia showing that Fish Oil diminishes the possibility of stroke. Amarin Corporation plc is a biopharmaceutical company with operations in lipid science focused on the commercialization and development of therapeutics for cardiovascular health. The Company operates through the development and commercialization of Vascepa segment. The Company's lead product, Vascepa (icosapent ethyl) capsule, is approved by the United States Food and Drug Administration (FDA) for use as an adjunct to diet to reduce triglyceride levels in adult patients with severe hypertriglyceridemia. This indication for Vascepa, known as the MARINE indication, is based primarily on the results from the MARINE study of Vascepa in this approved patient population.
 
The stock price went from 2.35 a share to 22.75 per share.  It was hot, every day it was going up.  People were almost panic buying.  We will see this happen in the months ahead with many companies.  People will not want to lose out on apparent large potential gains.
 
The cocktail party effect is when people are so euphoric about making money on stocks that it is all they can talk about at parties. We are not there yet.
 
Well I researched this company for my friend. Here is what I found.

1. Insiders have been selling this company since it was at 10 to the tune of over 2,000,000 shares
2. Analysts were all over the place one said strong buy one said strong sell.  Other then that other were saying hold or sell.
3. Earnings were poor and erratic.
4. Basically this was Amarin’s only product.
5. EPS was -0.34 cents
6. ROA was -$52.90 there is much more
7. Return on investment capital was -1.42
8. Institutions owned only 38% of the outstanding shares.

I believe there was panic buying of this stock and it artificially ran up on speculation and manipulation.  Really it was a disaster waiting to happen.  This is very common.  Further, I suggested if he heard about this company in a public setting or on TV or on News that he was probably too late for the game. He canceled his order and the next 4 days the stock went down to 15.47 or lost 42 % before moving back up to 16.
 
The take away here is to never buy these kinds of stocks when someone recommends them. Most of the time you are going to lose money and lose money fast. Do your due diligence and watch these stocks for a while before buying them.  If you miss it then there will always be another stock to buy. You rarely get rich from high risk investments.  You get rich from great companies that offer products that people need and pay a nice dividend.
 
I hope you enjoyed this little stock tip.  It is our joy to bring this to you and hope that is some small way it makes a difference in your life.   The information provided in this article surely can be more complete but I wanted to keep it fairly simple and give you some tools to not make rash decisions. As Warren Buffet says do not follow the crowd. Also Buffet says the number one most important factor of investing is never loose money and the number two most important factor is never forget number one.  This article was born out of some of my own experiences and learning the hard way. Let me, Gary R. Smith DVM, know your thoughts and email me at gsmith@fjmc.org

Larry Glazer believes a bullish scenario is unfolding on Wall Street, just in time for the holidays.  The $3 billion money manager points to impending Washington gridlock as a major factor in his optimism. The polarized result of the midterm election, which saw the House swing to Democratic control but preserved the GOP's hold on the Senate, might help spur market gains, Glazer said.
 
"Investors' worst case fears were not materialized during midterms," Mayflower Advisors' managing director told CNBC's "Futures Now" last week. "A split government may not be what everybody wants, but it may be what investors want."
 
According to Glazer, a split Congress should prevent President Donald Trump from getting additional stimulus passed. As a result, Glazer contends it'll put less pressure on the Federal Reserve to get more aggressive with its interest rate hikes. "Had the Republicans really swept, you'd have more likely more stimulus coming into the market. [That] was the fear — whether it's accurate or not. That fear means the potential for higher rates," he said.
But now, that risk is subsiding. With uncertainty fading, Glazer is calling for stocks to rally 5 to 10 percent by year-end.
 
"You do have the backdrop of maybe this is the best of both worlds for investors going into the end of the year, and the beginning of next year," Glazer added. "They can ride through this rally here."  It's not just the midterm results driving Glazer's optimism. He believes lower energy prices will give consumer spending a boost in the key holiday shopping season. WTI crude is trading at low levels not seen since March.
 
"You really have to consider the fact that the precipitous decline in energy prices caught everybody by surprise. It's really going to be a tailwind to keep this market afloat," said Glazer.  Dow 30,000?  And, the story may get even sweeter on Wall Street next year.  Glazer said he's keeping an open mind about the prospect of the Dow Jones Industrial Average resuming its record run, and rising another 15 percent next year.
 
"We know that we get double-digit returns following gridlock a year out and potential for significantly above that two years out," Glazer said. "A 15 percent rally puts you in spitting distance of Dow 30,000 by Labor Day. Hard to imagine for those of us who are a bit cautious. But it's conceivable here."

This is written in response to the article by Gary Smith in the previous issue of HWR.  Gary Smith's article is well written, motivated and interesting. That's the end of my "positive" comment.  I will provide a very short response to Mr. Smith's article.

If there was ever any reliable consistency to the "technical tools" Mr. Smith references, he and all of those who follow this philosophy of investing would be quite wealthy in very short order and have no need for any further investment considerations.

The reality is that it is not! If it were true, all anyone following this methodology of investing would have to do is to go out and mortgage their house, all their property and borrow as much as they could from any lender and put their chips down on this bet (market going up or down) -- for that is what it really is, not investing, but betting on an outcome.
 
There are all sorts of "technical" tools used on an ongoing basis as well as research into historical events in order to divine the future movements of the stock market. Decades of independent academic research has shown them to be essentially worthless. What Mr. Smith's research into this area is offered to accomplish for us is to provide some sort of rational way to time the market -- for all this is, is just another market timing methodology.

Since Mr. Smith references a couple of investment icons (indirectly): Warren Buffet and John Bogle (both of whom I admire), let me provide some insight from them:

1. Buffet does not ever attempt to market time. He finds what he likes and he buys it when available. Moreover, he has not been an investor in individual stocks for years (he leaves that to the investment committee of his insurance subsidiary). His advice (offered in numerous places including his annual shareholder letters) is to simply buy index funds and leave it alone. This is not only offered to the public but advice he has given to his heirs as to how they should invest when they inherit upon his passing. In terms of what he buys, as exhibited by his actions over the last many years, it is whole companies (both public and private) that fit in the Berkshire Hathaway family of companies. Individuals and most institutions cannot invest in this way.

2. John Bogle's comment on market timing is more succinct: "I have never met anyone who was able to do it nor have I ever met anyone who knew anyone who was able to do it -- market time!".
 
Simply, what causes market to go up or down is the input of all the global players participating in the market, processing all of the known information and acting upon it. What can change their market behavior is what is basically unknown -- tomorrow's news and/or any new inputs! This is the basic of the "Efficient Market Hypothesis" postulated by Nobel Laureate Eugene Fama. The overall results, over decades by professional money manager/investors has pretty much proven him right.  Res Ipsa Loquitur!

Fred Taylor, a wealth coach in Marietta, Ga

This issue is prepared by a bunch of guys who are continuing to GIVE BACK to FJMC.  We invite you to also give back to FJMC through your participation and most importantly through donations supporting FJMC as Friends of FJMC.  Participate by clicking on “Become a Friend of FJMC” on www.FJMC.org or contact Gary Smith at gsmith@fjmc.org.

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