A Publication of August 2011 News from the Front in the War on Cancer

By Yaakov Kornreich The decline in the overall cancer melanoma (a form of skin cancer) not compatible death rate is also due, to a less- and cancer of the liver, pancreas The nation’s war on cancer er extent, to recent advances and uterus are on the increase, Pair 1 declared by President Nixon 40 in the diagnosis and treatment and the reduction in the rate of compatible years ago is still being fought. of breast cancer and colorectal lung cancer in woman has been While medical science has recent- cancer. smaller than expected. The in- ly won some small battles over These fi ndings were report- crease in melanoma is attribut- Donor 1 Recipient 1 the disease, overall progress con- ed in the latest annual survey ed to an increase in sun expo- tinues to be painfully slow. In par- conducted jointly by the Ameri- sure, while obesity and hepatitis ticular, the results from some of can Cancer Society, and the Cen- are believed to be factors in the compatible the newest treatments and diag- ters for Disease Control and pub- rising incidence of liver cancer. nostic techniques for which there lished in the Journal of the Na- Samuel Epstein of the Uni- had been high hopes have not tional Cancer Institute. For the versity of Illinois School of Pub- Pair 2 not compatible been as good as expected. period between 2003 and 2007, lic Health, expressed disappoint- The total death rate for all the latest for which statistics are ment at the slow rate of progress forms of cancer among Ameri- available, deaths fell from 10 in the war against cancer. He sug- cans has been falling in recent of the top 15 forms of cancers, gested that better results might Donor 2 Recipient 2 years, but mostly due to pre- which also include ovarian, pros- be obtained if more resources ventive factors. Specifi cally, the tate, kidney, stomach and brain were allocated to cancer preven- incidence of lung cancer has cancers. The most progress was tion, such as anti-smoking cam- dropped due to the sharp reduc- seen with those cancers which paigns, which reduce known risk The Greatest Act of tion in the number of Americans can now be detected and treat- factors, rather than concentrating who smoke. The fall in the inci- ed at an earlier stage, when they on developing new forms of diag- Tzedaka - A Lifesaving dence of lung cancer was first are easier to cure. nosis and treatment. But Donald seen several years ago among But the report also contained Berry, a professor of biostatistics Kidney Donation men, and is now beginning to some discouraging news. The By Yaakov Kornreich appear among women as well. number of cases and deaths from Continued on p.34

What was the biggest single donation to Tzeda- ka (charity) or greatest act of Chesed (personal kind- ness) in your life? How much of a diff erence did it re- Extent of Gabby Giffords’ ally make? Did it change a life? Did it save a life? How do you know for sure? Contributions to the most noble of causes do not Recovery Still Uncertain usually go entirely to the advertised purpose. Even when By Joel Mandel time to working towards we give Tzedaka to poor people face to face, whom we her recovery through a encounter in the street, or who come knocking at our Despite Gabrielle Giff ords’ tri- vigorous course of physi- door, we cannot be sure what they will spend it on. umphant, surprise return to Con- cal and occupational reha- Even if we invited them into our home and gave gress to cast a vote in favor of the bilitation, as well as speech them something to eat, we know that after eating from debt ceiling compromise on Au- and cognitive therapy. our table, they were no longer hungry, but what will gust 1st, it remains unclear when According to medical happen the next day, when they will be hungry again, or even whether she will be able experts, an injury to the and we will not be there to feed them? to resume her regular duties, or left side of the brain, such But there is a way to give a gift of Tzedaka that whether she will run for re-elec- as the bullet wound that keeps on giving for many years. We can give some- tion to her House seat in Novem- Giffords suffered, often one in end-stage renal failure one of our healthy kid- ber 2012. Giff ords is still recuperat- Giff ords’ doctors say that she has results in motor control problems neys to carry out the vital functions that his own kid- ing from a near-fatal bullet wound made a remarkable recovery so far with the right side of the body. neys can no longer perform. to the head suff ered in an attack from a wound which is often fatal, Although the uninjured portions during an event with her constit- and which usually results in lasting of a brain will begin to take over Continued on p.20 uents in Tucson, Arizona on Jan- disability. Nevertheless, during her functions from the damaged por- uary 8. Her dramatic appearance brief appearance on the House fl oor, tions, most people recuperating to participate in the crucial debt she seemed to be unsteady on her from such brain injuries do not ceiling vote was an emotional mo- feet and did not appear to have full see a full restoration of their for- ment that cheered her congressio- use of her right arm. Also, she did mer capacities. nal colleagues from both sides of not make a public statement, indi- Giff ords’ spokesman said that the political aisle and uplifted the cating that her verbal skills are prob- she had until Arizona’s fi ling dead- entire country. Yet her spokesman, ably still compromised. Her higher line in May 2012 to decide wheth- C.J. Karamargin, said that “she still intellectual functions, though, are er to run for re-election to her has work to do on her recovery” reported to have survived the injury. House seat. During her recuper- before she can return to her job According to her staff , Giff ords on a full time basis. will continue to devote most of her Continued on p.23 2 | August 2011 HEALTH LIVING HEALTH LIVING August 2011 | 3 Table of Contents At a Glance Medical and Health News 4-5 L’Chayim to Life Issues - Op Eds Kidney Donation ...... 20 Heart Stents ...... 21 Prenatal Testing ...... 6 Community Tragedy: What Have We Learned? ...... 7 Raising Our Children Insect Bites: Why Do Insects Bite? Most of the time, insect bites from non-ven- omous species, such as mosquitoes, tics or chig- gers are more of a nuisance than harmful, as op- Smoothies For Your Health ...... 22 posed to bees, wasps hornets and yellow jack- ets, whose venomous bite is a defense mech- Water Aerobics ...... 23 anism to a perceived threat. Non-venomous in- Grocery Shelf-Esteem ...... 24 sect bites are usually due to the female seeking Respecting Babysitters ...... 8 to feed off human blood. Most ants and cock- Science of Comfort Foods ...... 25 roaches do not bite. When they do, their bite is New Crib Safety ...... 9 usually harmless. Mind, Body & Soul The typical non-venomous bite results in itch- Infant GERD ...... 10 ing, slight swelling and a red color in the area im- Recovery from Mental Illness……..26 Tips for Child Development ...... 11 mediately surrounding the site of the bite, which Raising a Boundary will usually begin to subside within 24 hours. It also Controlling Parental Anger ...... 12 common for lymph nodes near the site of the bite Conscious Child ...... 27 to become swollen Anxious Children ...... 13 Peace of Mind with Faith ...... 28 The greatest danger from all bites is a strong, individualized allergic reaction by your body to Golden Years Decluttering Your Marriage ...... 29 the insect proteins or hormones which are inject- ed by the bite. A dangerous reaction will usually Showing Affection ...... 30 start appearing within 20 minutes and aff ect the entire body. More serious symptoms include hives, Psych Ward Diary ...... 30 shortness of breath, swelling of the throat, nausea, Pulling and Eating Hair ...... 31 vomiting, dizziness or fainting. Any of these may indicate a potentially life threatening reaction, and Help for OCD ...... 32 requires immediate medical attention.

Stopping Negativity ...... 33 TYPES OF INSECT: At a Glance ...... 3-38 Mosquitoes: Mostly seen between late Alzheimer’s Cure ...... 14 spring and early fall. They are most active at Directory Advertising . . . . .33-37 dusk and dawn and prefer humid, warm cli- Long Term Senior Care ...... 15 mates. They live and breed in pools of stagnant Health Provider Bulletin . . 36-37 water. Certain species of mosquitoes are carri- Secrets of Longevity ...... 16 Health & Living Checklists38 ers of potentially fatal diseases, such as malaria Caring for Caregivers ...... 17 and West Nile virus. From the Doctor’s Desk . .39 Ticks: Tick bites are the means of transmis- Private Pay Home Care ...... 18 sion for Lyme disease and Rocky Mountain spot- ted fever, both of which are caused by bacteria. Chiggers: Also known as redbugs, only the Supplement Publisher Moshe Klass [email protected] larvae of this species is capable of biting, caus- Senior Editor ing intense itching. Yaakov Kornreich [email protected] Flies: The common housefl y and fruit fl y do Associate Editor not bite at all, however; other species can infl ict a Ita Yankovich painful bite that can transmit infectious diseases. Mental Health Consultant Chaim Sender Bees, wasps, hornets, and yellow jack- Editorial Staff ets: The bites of all of these species are ven- Dana Ledereich and Tova Ross omous. When a bee stings, its stinger is de- Contributing Writers tached from its body, which ultimately causes Sheryl Mayer, Esther Hornstein Sales the bee to die. David Hoppenwasser at [email protected] Shaindy Urman at [email protected] Continued on page 38 4 | August 2011 HEALTH LIVING Medical and Health News COMPILED BY TOVA ROSS, ITA YANKOVICH AND STAFF Exercise May Not Be Enough for Those with Desk Jobs Government recommendations of exercise. A 2010 review of sever- First Successful suggest at least 30 minutes of moder- al studies from the past decade, con- ate intensity exercise every day. How- ducted by American and Australian Synthetic Windpipe ever, the American College of Sports researchers, found that 60 percent of Transplant Saves Medicine says that people who lead adults spend 60 percent or more of sedentary lifestyles – for instance, their waking hours sitting. Man’s Life those with desk jobs – are at health Sitting still for prolonged periods For the fi rst time, scientists have risks such as heart disease and dia- causes the muscles which are criti- successfully transplanted a synthet- betes, regardless of whether they get cal in regulating carbohydrate and ic windpipe, grown from the patient’s in that half hour of exercise before or fat metabolism, to burn fewer calo- own stem cells. afterwards. ries than if they were engaged in ac- es. Instead of phoning your co-work- Sedentary behavior, defi ned here tivity. Ways to combat this eff ect in- er down the hall or e-mailing her to as sitting for long periods of time, is clude taking frequent breaks to walk ask a question, just get up and walk seen as a health risk despite periods around an offi ce or do some stretch- over to her offi ce. New Weapon in Fighting Malaria In the history of dis- who die from malar- mated 20 percent in areas Andemariam Teklesenbet Beyene, ease-fi ghting ideas and ia, many of whom are where malaria is rampant. a 36-year old man from Eritrea, was techniques, few are as children. Lab tests have suff ering from tracheal cancer. A sur- odd-sounding as the Researchers be- proven that geon suggested a transplant using a one currently being hind the smelly ‘sock- smelly socks do synthetic trachea made from a spongy tested in Tanzania: us- as-trap’ idea are attract mosqui- polymer. Stem cells were taken from ing smelly socks to lure hopeful that if their toes, who bite in plan works, it could order to feed off the blood of their vic- Beyene’s hip to grow living cells on insects into traps con- taining lethal chemi- serve as a low-tech tims. In this case, they do not realize the windpipe, which helped prevent cal poisons. way to prevent ma- that the sock is empty until it is too late. his body from rejecting the transplant. Many people in Tanzanian villages laria, in addition to another simple pre- Researchers are hard at work to de- The 14-hour surgery, performed in get bitten by malaria-infected mosqui- ventative measure, insecticide-treat- termine how many traps per village early June, gave hope that other syn- toes each year, and are among the near- ed bed nets. The use of bed-nets has are needed, and the optimal place to thetic organs can be grown to help chil- ly 1 million people a year worldwide reduced childhood deaths by an esti- put them. dren, who do not generally have access to as many donated organs as adults. A girl who was born without a tra- People with Pre-existing Conditions chea is set to become the next patient to receive this type of transplant. Get Good Insurance News The federal government recently Until recently, PCIPs required that peo- ter from another insurer denying them at the time of application – whether announced that it would reduce pre- ple with pre-existing conditions be unin- coverage before they could enroll in they will be accepted or not. Though miums for uninsured sick people by sured for six months prior to signing up PCIPs to prove their pre-existing con- the money is eventually returned if an up to 40 percent in high-risk pre-exist- for these new plans. Their high premiums dition. Now, people can simply bring applicant is denied coverage, the delay ing condition insurance plans, or PCIP also discouraged many from applying. a letter from their doctor, physician in the reimbursement can be a hardship – in 17 states, as well as the District of Now, with the reduced premiums, more assistance, or nurse practitioner, from on struggling families and individuals. Columbia. people who would otherwise be unable the past 12 months, stating they have Stephen Finan, senior director of Government offi cials, as well as con- to find affordable coverage for them- a qualifying medical condition or dis- policy and the American Cancer Soci- sumer advocates, hope that the new selves are signing up for the new plans. ability. This makes the paperwork eas- ety’s Cancer Action Network, told The rules and lower premiums will encour- These new federal guidelines also ier, and removes the fi rst-month pre- Washington Post that the change in the age more people to sign up for the sub- make the application process easier. mium payment many insurance com- federal rules, “is a very positive step for- sidized insurance coverage. Previously, people had to produce a let- panies require all applicants to submit ward.” Easily Quitting Smoking May Be a Symptom of Lung Cancer A study by researchers at Thom- ing easily may have been a telltale of their lung cancer patients had quit so with relative ease, even though oth- as Jefferson University in Philadel- sign that they had already developed smoking before they were diagnosed, er tests indicated that they had been phia of 115 lung cancer patients at a lung cancer. and often without having consciously thoroughly addicted to nicotine. local VA hospital suggests that some The researchers asked the patients decided to. The researchers speculate that the of them may actually have been able whether they had quit smoking be- The study found that 49 of the 115 developing lung-cancer tumor itself to quit smoking on their own be- fore or after their diagnosis, and how patients had quit smoking before be- may secrete a chemical which some- cause of the eff ects of the disease on diffi cult it had been for them to quit. ing diagnosed or noticing any of the how blocks the body’s nicotine addic- their body, before it was diagnosed. The researchers undertook the study more common cancer symptoms. Of tion. They urge further research to try to In eff ect, their ability to quit smok- on a hunch after observing that many those who quit, 31% were able to do confi rm and explain their fi ndings. HEALTH LIVING August 2011 | 5 Medical and Health News continued IBM Developing Nanoparticles to Treat Drug Resistant Infections IBM engineers are developing a sometimes leave behind cells that technology that provides a new an- can launch a new infection that is re- swer to an increasingly serious pub- sistant to the antibiotic. According to lic health problem - how to seek out the CDC, such drug resistant microbes and destroy drug-resistant germs in are responsible for the death of more the body. than 70,000 hospital patients in the The engineers have created mi- US each year. croscopic plastic nanoparticles Tests showed the drug to be harm- that can find and penetrate the less on mice, and scientists in Singa- cell walls of drug-resistant bacte- pore are now testing the eff ects of ria. After killing the bacteria, the the nanoparticles on larger animals, particles harmlessly degrade, leav- as IBM talks to pharmaceutical com- ing no residue. panies about testing the effective- When antibiotic drugs are used ness and safety of the nanoparticles to attack a bacterial infection, they for use on human beings. Palliative Care Focuses on Reducing Pain who ultimately recover. a routine part of hospice care. tients. However, private health insurance The goal of palliative care is to improve That was proven by a study published policies still do not generally cover the the quality of life for people with serious last year by the New England Journal of full cost of a palliative-care team’s services chronic or life-threatening problems such Medicine showing that lung cancer pa- outside of a hospice environment. as cancer, congestive heart failure, and tients who received palliative care had a Diane Meier, who directs the pallia- kidney failure who must deal with prob- better quality of life, were less depressed tive-care program at Mount Sinai Hos- lems such as pain, shortness of breath, fa- and survived longer than those receiving pital in New York City, says that because tigue and nausea. standard hospital care. most people with serious illnesses aren’t Such patients are treated with special- A more study published in March in the hospital, she expects to see pallia- ly trained palliative-care teams, which in- found that palliative care for Medicaid pa- tive care emerge in individual physician clude a doctor, a nurse, a social worker tients in New York state hospitals reduced offi ces, clinics and other community set- and a spiritual counselor, to help relieve the average cost of their hospital stay by tings over the next decade. “That’s where The use of palliative care to relieve the their pain and manage their symptoms. nearly $7,000, confi rming the results of a most of the patients are, and that’s where suff ering of seriously ill patients is being Hospitals realized that seriously ill pa- 2008 study of non-Medicaid hospital pa- the need is,” she said. adopted at many US hospitals because it tients who are expected to recover could is both cost-eff ective and may improve also benefi t from the pain and symptom the health outcomes of those patients management techniques which today are Blood Thinning Drugs Raise the Question, “Is Newer Necessarily Better?” The FDA has just approved the drug make sure that it is working as intended, Xarelto for use by people who have a and to allow their doctors to make any Exercising to Music Helps heart condition that puts them at high necessary adjustment in their dosages. risk for blood clots that can lead to While about as eff ective at prevent- strokes. The new drug, and others like ing blood clots as warfarin, Xarelto has the Elderly Avoid Falls it, appear to be as eff ective as the stan- a much more specifi c biological action. dard treatment of a drug called warfarin, It therefore does not have as many dan- A study of 134 elderly Swiss adults, People who exercised to music which can be very diffi cult to manage. gerous interactions, with foods and oth- most of whom were women, found that showed greater improvement in their Xarelto was approved by the FDA spe- er drugs, and requires much less patient when they exercised to music they were balance and suffered falls at a rate of cifi cally to prevent dangerous blood clots monitoring than warfarin. less likely to suff er falls than when they 0.7 per person per year, compared to in patients who have undergone hip and However Xarelto, and another new exercised without music. The partici- a rate of 1.6 falls per person per year knee replacement surgery. The new drug drug, Pradaxa, which was approved by pants in the study had an average age in the group which did not exercise is also being considered as a treatment for the FDA last year for atrial fi brillation, of 75.5 years. to music. atrial fi brillation, which can also lead to are much more expensive than gener- Injuries due to falls are one of the Among the other benefits of ex- the formation of blood clots, which trav- ic warfarin, which is readily available at most serious risks for people in that age ercising to music were an increase in el to the brain, causing a stroke. from several large pharmacy and retail group. All of the subjects in the study walking speed and stride length, and Warfarin, which is also sold under chains for as little as $4 a month, where- participated in an instructor-led one- an improved overall gait (manner or the names Coumadin and Jantoven, is as the newer drugs cost between $6 and hour weekly exercise program that in- style of walking). These were in ad- a blood-thinning drug that has been in $9 a day. cluded movements that were designed dition to the improved balance that use for more than 50 years, but which Another advantage of warfarin is that to improve balance and which became reduced the risk of falls, researchers has unpredictable interactions with cer- doctors are well aware of how to control increasingly diffi cult over time, includ- from a university hospital in Geneva tain foods, like dark leafy greens, as well its most dangerous side eff ect, uncon- ing walking in time to piano music and found. Their results have been pub- as some antibiotics and painkillers. trolled bleeding, whereas the side ef- responding to changes in the music’s lished by the journal Archives of Inter- That is why patients on warfarin are fects of the newer drugs are not so well rhythm. nal Medicine. required to get monthly blood tests to understood. 6 | August 2011 HEALTH LIVING Issues - Op Eds Benefi ts and Challenges of Prenatal Testing By Yaakov Kornreich ings published in the AMA journal will organizations and planned parenthood era when prenatal gender determination lead many American doctors to start groups provided fi nancial incentives and was carried out with more expensive pro- A new study published in the Jour- offering the prenatal maternal genet- information that encouraged the practice cedures, mostly done later in pregnancy. nal of the American Medical Association ic blood test to their patients. Current- of gender-selection abortion, and turned Ethicists fear that the availability of cheap suggests that analysis of fragments of ly, the blood test on fetal cells in a moth- a blind eye to the ethical problems inher- gender tests so early in a pregnancy that fetal DNA found in an expectant moth- er’s blood is available in the United States ent in the practice. These included the it is not yet outwardly apparent would er’s blood could reliably determine the only through a number of direct-to-the- United Nations Population Fund, the In- encourage even more expectant moth- gender of the unborn baby as early as 7 consumer websites, which have been ternational Planned Parenthood Federa- ers to submit to the cultural pressure to weeks into the pregnancy. That is much operating since 2005 without govern- tion and the World Bank women. abort their female fetus without anyone earlier than ultrasound exams that are ment supervision. These on-line servic- This surplus of male babies will lead to else knowing. commonly done at around 20 weeks of es charge consumers $179 for which they signifi cant social and criminal problems Currently, the genetic screening capa- pregnancy and which can be used to de- provide a home fetus gender testing kit as they grow into adulthood. In these so- bilities of early prenatal testing are very termine fetal gender. and require a blood sample to be mailed cieties, millions of men will never fi nd a limited, but as the technique is improved, The gender test checks the stray frag- to the lab. it is reasonable to expect that ments of fetal DNA in the mother’s blood Some medical ethicists they will be able to detect the for markers unique to the Y chromosome, worry that the availability of presence of non-life threat- which genetically diff erentiates males a safe, reliable and inexpen- This surplus of male babies ening genetic defects, such from females. The conclusions were sive fetal gender test early in leads to signifi cant social and as Down Syndrome. based on an analysis of 57 studies in Eu- a pregnancy could result in Babies born with Down rope, where such tests have been widely an increase in a phenome- criminal problems as they syndrome usually grow up used for several years, involving a total of non which is already distress- grow into adulthood. In these experiencing a mild to mod- 6,500 pregnancies. It found that the tests ingly common in some asian societies, millions of men will erate disability in intellect were more than 95 percent accurate at countries – parental gender and everyday living skills. determining gender at seven weeks of selection through abortions, never fi nd a woman to marry. Physically, they are also at pregnancy, which is more accurate than resulting in a surplus of male heightened risk for heart the current ultrasound determinations babies. defects and hearing prob- much later in pregnancy. That practice has been lems, but their life expectan- Historically, the standard bearer for particularly common in China as the re- woman to marry. The societies have also cy is near normal – about 60 years. Ac- prenatal testing has been amniocente- sult of its long-standing one child per experienced a sharp increase in interna- cording to Dr. Brian Skotko, a Down syn- sis, which can detect fetal gender with family policy intended to limit the growth tional bride traffi cking, involuntary fami- drome specialist at Children’s Hospital in accuracy that approaches 100%. This of its population, but it is present to a less- ly-arranged marriages and outright white Boston, “the vast majority of people with test involves the testing of amniotic fl u- er extent in other Asian countries as well, slavery. Hvistendahl also suggests a clear Down syndrome and families affi rm that id withdrawn from the expectant moth- where there is a strong cultural bias pre- historic correlation between the propor- their contributions to their communities er’s womb. However, the procedure pos- ferring boys to carry on family lines. tion of surplus males in a society and its are signifi cant, and their lives are very es a small risk of miscarriage, and is usu- The natural human birth rate is about incidence of violence and criminality. valuable.” ally performed at the 16th week of preg- 105 boys born for every 100 girls, which According to Hvistendahl, gender se- Today, most Down Syndrome cases nancy. Chorionic villus sampling can also compensates for a slightly higher natural lection is usually introduced by a coun- are diagnosed after birth, but if a prena- be done for this purpose. This procedure male mortality rate. By contrast, in China, try’s “urban, well-educated stratum of tal blood test for it is developed, parents involves testing a small piece of the ear- the ratio is 121 baby boys to every 100 society.” These people have the knowl- of a fetus with Down Syndrome will be ly placenta and is typically done at 12 girls. In India, where only a culture gen- edge and fi nancial resources to take ad- able to learn of the condition at a very ear- weeks, also with a small risk of miscar- der bias favoring boys is at work, the ra- vantage of the latest prenatal gender de- ly stage of the pregnancy, increasing the riage. The development of a test for fe- tio is 112 to 100. termination technology. Once they begin likelihood that they would choose to ter- tal gender that can be done dramatical- However, those who support making performing gender selective abortions minate the pregnancy. According to Dr. ly earlier in pregnancy may herald the early fetal gender tests available in the based upon the test results, the practice Skotko, even with today’s much less ef- beginning of a new era in prenatal di- U.S. claim that such strong gender bias- becomes accepted as part of the broad- fective level of prenatal screening, it ap- agnosis. es in favor of male babies do not exist in er culture. pears that the frequency of Down Syn- Dr. Diana Bianchi, a reproductive ge- this country. Even in societies which do not have drome births in the US has fallen by 11 neticist at the Mother Infant Research In- According to a recently published active population control policies, a percent over the past 25 years. stitute at Tufts Medical Center who partic- book by Mara Hvistendahl, a Beijing- strong cultural bias for baby boys in a To be fair, the decision by a couple to ipated in the new study, says that gender based reporter for Science magazine, the family can skew the normal male-fe- continue such a pregnancy is not an easy determination by blood test could be of population control measures imposed male birth ratios over time. For example, one. Raising a baby with Down Syndrome real benefi t to pregnant women known in Asian countries since the 1960’s, com- in South Korea, the ratio for fi rst births is challenging, and there is the question to be carriers of genetic diseases like he- bined with advances in prenatal gender was 104 boys for every 100 girls, which about how the parents would arrange mophilia, which aff ect only boys. She said determination since that time, has result- is within the normal range. But couples to care for the child as it grows into an that, “in Britain, researchers have shown ed in more than 160 million female ba- whose fi rst babies were female apparent- older adult. that using the Y-DNA test led to a reduc- bies who were never born. ly came under increasing family pressure Assuming that certain restrictions tion in amniocentesis and other invasive In China, these female fetuses were to have a boy. For second births, the ratio may have to be put on new forms of ge- testing,” which can endanger the fetus. deliberately aborted because their par- climbed to 113 boys for every 100 girls; netic testing to avoid the kind of gender Bianchi added that “the technique ents and families felt that if the couple for the third baby, to 185, and for fourth- selection abuses we are now seeing in could be implemented in U.S. labs pret- could only have one child, they wanted it born children, the ratio is an astounding Asia, the next question is how to enforce ty easily without high fees.” to be a boy. In addition, Hvistendahl says, 209-100 male to female births. Medical experts believe that the fi nd- over the past 40 years international aid These patterns emerged during an Continued on p.7 HEALTH LIVING August 2011 | 7 Issues Lessons to Learn from a Community Tragedy By Dr. Norman Blumenthal not have to know. How many of us looked selves in familiar and predictable ways. tend that message to include the threats at our children and said to ourselves “they The alleged perpetrator of this heinous of kidnapping and murder. Last July 13th the world changed. As have their whole adult life to know of the crime is just such a familiar fi gure, who is the heart wrenching news of the abduc- depths of depravity that even one of our externally recognizable as a member of the WHAT NOT TO LOSE SIGHT OF: tion and murder of Leiby Kletzky, z”l, pen- own can descend to. Why do we have to fold. Nevertheless, he is accused of abduct- In our frantic eff orts to preserve our etrated our homes and psyche, none of us expose them to this while they are still so ing his innocent young victim off the street own safety and that of our family, we and have been the same. young? Shouldn’t their childhood mem- in broad daylight, in the middle of one of our children must not lose sight of the un- During the fi rst few hours and days ories be of a time of carefree innocence our most concentrated Orthodox com- deniable reality that the frum world is still following this catastrophe, the Chai Life- and a universal belief in the kindness and munities. This jarring realization once and predominately a safe one populated by line crisis team and professionals through- good intentions of others?” for all alters our perception of the safety of inherently kind and caring people. Many out the country were besieged by calls. The painful truth is that we had no our environment, as well as the personal of us have been moved by the impres- Initially, most inquiries cen- security lessons we teach our sive unity displayed within our commu- tered on how best to inform children. nity during those bleak days of search- our children. As time went on, One way to understand how One way to understand ing and mourning for Leiby Kletzky. We many of the adults calling ex- this could have happened is to how this could have hap- should also be comforted by the outpour- pressed concerns about their pened is to recognize that as ing of support and sympathy we received own equanimity and abili- recognize that as our numbers our numbers increase, the from nearly every corner of the globe. ty to cope with the tragedy. increase, the marginalized element marginalized element in our Taking a broader view, our lives as Several weeks have midst grows comparably. The Jews have never been better. We live in passed and, hopefully, those in our midst grows comparably. minute percent of our com- a country that assures our safety and se- initial concerns have been munity who are misguided, curity and guarantees our right to freely addressed. At this juncture, deranged or vicious grows, practice our religion with no government much of the shock has worn off , and we choice but to share all the known details even though the percentage of our pop- restraints or persecution. Thanks to the are left to grapple with the lasting chang- of this unthinkable crime. If we didn’t, our ulation they represent remains very small. advances in medical care, we are healthi- es the Kletzky tragedy has made in our un- children would have inevitably learned The regrettable lesson we must take er and live longer than ever before. derstanding of the safety of our own world. about them from other, less reliable from this tragedy is the need to incorpo- Our new awareness of danger and les- sources that would have made it more dif- rate into our psyche and instructions to chil- sons of safety to our children must be con- THE DEMISE OF CHILDHOOD fi cult for them to process and manage the dren that ostensibly orthodox individuals veyed in the context of our overall safety INNOCENCE: disturbing implications of this event. The with all of the ritualistic garb and appear- and well-being. Exaggerating the extent The culture and realities of childhood bigger and sad implication is that we can ance, can still be dangerous and must be of the danger can be counterproductive, have changed radically since even our no longer protect our children from expo- treated with a suitable amount of caution. breeding excessive fear and hesitation. youngest parents were children. With the sure to the atrocities and harsher realities Our children must be made aware that they While we must teach our children that increased penetration of the Internet and of our world. In these times, the best we cannot automatically trust someone who a carefree disregard of potential danger the media into our daily lives, our chil- can do for our children is to provide them looks like one of our own, because of that can put them at risk, we have to calibrate dren are exposed to detailed information with the means to manage that informa- depraved and potentially harmful fringe of that message in the context of an over- about events from which, in the past, they tion and keep it in its proper perspective. our community. This is particularly relevant all sense of safety and gratitude for the would have been insulated. Not only has when our children are in are most vulnera- blessed times we live in. this exposure led to their increased aware- IS THERE SAFETY IN NUMBERS? ble, when they are lost or scared, and when ness of events, but also to a fundamental The Orthodox community’s astronom- they feel threatened or frightened; Tthat Dr. Blumenthal is the Director of the change in their attitudes as well. Today’s ical growth over the last few decades has is when we all welcome the presence of Bereavement and Crisis Intervention children feel entitled to know it all. When resulted in the creation of homogeneous seemingly well-intended and familiar fi g- Department of Chai Lifeline (Project we were children, we understood that communities populated by seemingly like- ures. Unfortunately, it is those very situa- Chai) whose team was at the fore- there are events and situations that were minded neighbors with familiar garb and tions that disturbed or depraved individu- front in serving individuals, schools relegated to the purview of adulthood, appearance. These are semi-closed en- als nefariously exploit. and the community during the Leiby about which children do not inquire and claves, densely populated with shuls, yeshi- Even before the Leiby Kletzky trage- Kletzky crisis. He is also the Educa- had no wish to know. Today, our children vas, kosher restaurants, and the like which dy, we were just beginning to create this tional Director of the Harry and Bel- demand to know everything, and make it fosters an illusion of safety within these very awareness in relation to the problem la Wexner Kollel Elyon and Semikha their business to fi nd out. confi ned settings. Indeed, psychological of molestation. We have fi nally begun to Honors Program at the Rabbi Isaac This change struck home when we research has similarly demonstrated that realize that pedophiles or sexual preda- Elchonon Theological Seminary of had to explain aspects of this horrifi c mur- we automatically tend to trust people who tors can be in our midst, disguised in frum Yeshiva University, and in private der that we wished our children would look familiar and ostensibly conduct them- garb and appearance. Now we have to ex- practice in Cedarhurst, New York.

Benefi ts and Challenges ital adrenal hyperplasia and begin treat- tions. We can expect that further advanc- SUBMISSION of Prenatal Testing ment for this condition even before the es in genetic screening technology will baby is born. soon make much more information avail- INFORMATION Continued from Page 6 Dr. Grazi suggests that, just as profes- able about our unborn children, both Health & Living invites readers to sional medical societies currently issue good and bad. That will then force us to submit Letters to the Editor. Letters such restrictions. ethical guidelines within which most phy- confront some very diffi cult moral and re- According to Dr. Richard Grazi, direc- sicians practice, guidelines for using this ligious choices about the future of some will be selected for publication at tor of the Genesis fertility clinic in Brook- new technology would no doubt be sim- of those children that we have never be- the sole discretion of the editor, and lyn, passing legislation to make such ge- ilarly issued and adhered to. Thus, instead fore had to consider. netic testing illegal is not the best answer. of making these tests illegal, they would may be edited for size and content. That is because there are circumstances be put under the control of licensed med- Yaakov Kornreich is a veteran Anglo- Submissions become the proper- in which such testing can be medically ical professionals, in much the same way Jewish journalist. He is the Senior ty of The Jewish Press. Please e-mail useful. For example, the new early pre- that they are now trusted to write pre- Editor of Building Blocks, published natal gender determination test can be scriptions for powerful drugs, which also by the Jewish Press, and this Health your Letter to the Editor to used to identify a female fetus whose par- have the potential for abuse. & Living supplement. He can be con- [email protected] ents carry a condition known as congen- These are no longer theoretical ques- tacted at [email protected]. 8 | August 2011 HEALTH LIVING Raising Our Children Respecting our Babysitters One who honors his fellow.” (4:1) “Be- loved is man, for he was created in the image of G-d”. (3:14) “Let the honor of your fellow be as precious to you as By Shaindy Urman your own…” (Avot 2:10) These lessons about respect are The word “respect” has several dif- defi nitely applicable to parents when ferent connotations and applications. they hire a teenager to babysit their There is, of course, respecting our par- children. The fact that we are paying ents, which is a lesson taught and re- them for a service does not reduce our inforced from birth. In later stages in responsibility to provide for their needs our lives, we are taught to respect our while carrying out their assigned du- elders, teachers, and spouse; but for ties, or to give them the same respect whatever reason, respect is a concept that we are required by the Torah to that is not generally applied to those give to any other person we employ. who are younger than us. This may be There is no excuse for parents to mis- due to a natural attitude that as their treat or take unfair advantage of teen- elders, we are generally more experi- agers who babysit for their children. We enced or mature. However, the Torah must also remember that these bab- clearly mandates that we also must ysitters are also children who are im- tive experiences, but I certainly en- drinks so that she doesn’t have to rum- respect those who are younger than pressionable and need our care and re- countered some unpleasant and un- mage through your kitchen. we are. spect, and for whose welfare we are re- comfortable scenarios during that pe- Agree on an hourly or a set payment Pirkei Avot (4:12) teaches us that, sponsible while they are caring for our riod of time. There were times when rate beforehand, making it clear exact- “The dignity of your student should children in our homes. the parents came home hours later ly what kind of additional services are be as precious to you as your own…” Throughout my teenage years, than indicated, forcing me to make expected, above and beyond babysit- Other sections of Pirkei Avot teach us I babysat a lot for relatives, family last minute rearrangements to my ting for your children. This can spare to respect all human beings, regard- friends, and even complete strangers. schedule. Even when that wasn’t nec- misunderstandings and hurt feeling less of their ages: “Who is honorable? Luckily, I didn’t have too many nega- essary, I would still feel upset and frus- at both ends. trated at being forced to stay later than If you are coming home really late, intended. off er the babysitter a ride home, or ar- Other upsetting behaviors includ- range for another way for her to get ed: paying me much less than I expect- back to her home safely and conve- HUGE SALE GOING ON NOW! ed and deserved, being forced to care niently. for additional children, who just hap- Come to an agreement with the pened to be there at the time, and who babysitter on phone usage. If you don’t were not part of the original job de- want her talking on your home phone scription. I was also expected to com- for personal use, be clear about it be- plete other tasks in addition to the bab- forehand. If you are fi ne with it, let her ysitting, such as clean and fold laundry, know that too. and this was expected to be done with- Let the babysitter know exactly out extra payment. what is expected from her. If you want With a little thought and consider- her to change diapers, feed the chil- ation, parents can turn these poten- dren or put them to bed, be specifi c; tially frustrating situations into pos- don’t expect her to guess what it is you itive ones for both the parents and want her to do. the babysitter. I still fondly remem- Don’t take advantage of a babysitter ber those families who welcomed me by insisting that she clean the house warmly, off ered me open access to the or do the dishes. If you want her to do fridge and telephone, and who did ev- these things in addition to watching erything they could to make me feel the kids, be prepared to pay extra and comfortable in their home. make that expectation clear before you The following are some guidelines hire her. Again, communication is key. to keep in mind when hiring a baby- Above all, remember that although sitter which can avoid misunderstand- they are younger and less experienced, ings, aggravation, disappointment and babysitters deserve our respect and hurt feelings. appreciation just as much as any oth- Come home on time. If you are run- er employee. Remember, we are hiring ning late, make sure to call and to veri- them to protect what is most valuable fy that this is okay with the babysitter. to us on this earth- our precious chil- Try to plan your schedule to give your- dren. We must treat them with the re- self plenty of time to get home by the spect that is commensurate with such promised hour. an important task. Off er the babysitter some light re- freshments and/or access to the re- Shaindy Urman is a freelance writ- frigerator. If you are not comfortable er living in Brooklyn, NY. She can be with this then set out some snacks and reached at [email protected]. HEALTH LIVING August 2011 | 9 Raising Our Children continued New Crib Safety Regulations By Dana Ledereich other year and half to change all their these problems raised by parents. For not, then use this procedure to check rental cribs to fi xed-sided models. those parents who are short, or who its hardware on a regular basis, to make In an ongoing eff ort to protect the According to the CPSC, the preferred suff er from bad backs, it has been sug- sure that all screws, nuts ,bolts and most vulnerable of citizens, the CPSC crib is one that has four fi xed sides. While gested that they use a stepstool when wood are tight. Remove the mattress issued new safety regulations for baby this eliminates the risk of suff ocation from removing or placing their child in the and shake the crib back and forth to cribs. The new regulations went into ef- faulty hardware, it comes with addition- crib to ease their plight. However, par- see if any of the sides rattle. If you dis- fect on June 28th 2011. They eff ective- al challenges for parents. As mentioned ents should be aware that stepping cover that some of the hardware has ly ban the sale, resale or donation of all above, drop-sided cribs make it easier for up on a stepstool while holding an loosened, stop using the crib immedi- drop-side cribs, and instead infant, poses its own risks. ately until it is fi xed. The CPSC also ad- requires that they be replaced Parents should also follow vises against attempting to fi x the crib with fi xed-sided cribs. the generally recommend- yourself unless you are sure you can do According to CPSC re- ed procedures for lifting it correctly in order to eliminate the suf- search, faulty hardware on heavy objects by keeping focation risk for the baby. the more traditional drop-side your back straight and using cribs is responsible for over 30 your knees more than your Dana Ledereich, MA, OT/L is a pe- infant deaths in the span of back muscles. While the lim- diatric occupational therapist who three years. Drop-side cribs itations posed by fi xed-sid- works in Yeshiva of Flatbush and have one side of the crib that ed cribs can be annoying, also maintains a private practice. can be lowered and raised as it’s important for parents to She evaluates and treats children needed. This allows for easier remember that these regu- age birth-13 years with sensory pro- access to the baby. It also eas- lations were put in place to cessing issues, poor handwriting, es placing an already sleep- protect babies, and that any developmental concerns and neuro- ing baby into the crib with- resulting inconvenience is logical issues. She has lectured to out waking him. However, mil- surely outweighed by the both parents and professionals on lions of these cribs were subject to re- parents to reach their babies. Fixed-sided dreadful alternative. various topics in sensory processing calls over the past few years when it was cribs pose diffi culty for parents of shorter For those who choose to continue and handwriting development. She discovered that the hardware was loos- stature who may have diffi culty reaching using their drop-sided crib, the CPSC is available for lectures as well as to ening which was then creating a gap over the top of a fi xed-sided crib to get recommends to first check whether mentor new therapists. She can be between the mattress and that side of to their infant. Similarly, parents with dis- the crib model has been recalled. If reached at 718-252-2939. the crib. Unfortunately, babies became abilities are inconvenienced by these new stuck in this gap and suff ocated. regulations. Parents have also been com- Because of the scope of the recalls plaining that reaching into a fi xed-sided and the number of infant deaths result- crib to reach their infant puts too much *UDFLRXV5HWLUHPHQW/LYLQJ ing from the use of drop-side cribs, the strain on their back. CPSC issued the recall. The ban extends So far, there have been few ef- RQWKH$WODQWLF%HDFK%RDUGZDON to hotels as well and allows them an- fective suggestions off ered to solve

New Hope on Horizon for Children with Rare Aging Disorder Children who suff er from Hutchin- Hutchinson-Gildford by clearing out a son-Gilford progeria syndrome, a rare toxic protein called progerin. Progerin disease that rapidly ages children and causes people with Hutchinson-Gilford typically kills victims of it before they to develop skin and joint problems, and reach adolescence, have new hope in advanced cardiovascular disease that 2FHDQ%RXOHYDUG an anti-rejection drug given to recip- eventually kills them. A small amount $WODQWLF%HDFK1< ients of organ transplants. The fi nd- of progerin is found in healthy people,   ings are reported in a study that was and accumulates as they age. published in Science Translational Researchers into the eff ects of this Medicine. drug may also reveal clues about slow- Rapamycin, a drug typically given to ing down the natural aging process, transplant patients to help their bodies said National Institutes of Health Direc- accept their new organs, may also re- tor, Dr. Francis Collins, who was a co-au- verse DNA cell damage in children with thor of the study. Children’s Food Allergies More Common than Previously Thought A new study, funded by Food Aller- Signs of a food allergy include diffi - gy Initiative and published in Pediat- culty breathing, tightening in the throat, rics, estimates that one in 13 children skin rashes, and wheezing. While chil- have a food allergy in the United States, dren are likely to outgrow some aller- which is double the previous estimate gies, like eggs and wheat, they are less from the Centers for Disease Control likely to grow out of allergies to nuts. and Prevention. About 40 percent of Food Allergy Initiative, a non-profi t those children have severe reactions; advocacy group, is at work with the CDC peanuts and milk were the most com- to help craft national guidelines about mon culprits of food allergies. how to treat food allergies in schools. 10 | August 2011 HEALTH LIVING Raising Our Children continued Infant GERD and Tummy Time

By Dana Ledereich extend this time. The result is that the baby with GERD spends most of Infants who suffer from Gastroeso- the day either being held or support phogeal Reflux Disease (GERD) may upright in an infant seat or swing. As experience great discomfort both a result, the baby with GERD often during and after feedings. They can protests when she is placed on the be quite irritable and exhibit behav- floor to play. It can be uncomfortable ior similar to infants with colic. Fortu- for her to be on her stomach on the nately, symptoms typically resolve by floor. As a result, she does not get one year of age. However, even after enough of the exercise she needs to the symptoms do subside, their ef- build her upper body and abdomi- fects on motor development can lin- nal muscles. ger longer into the future. The important of tummy time for Most infants spit up during the all babies cannot be overstated. It is day. Sometimes it’s a result of over- the time the baby spends playing on feeding, but often it’s a result of an her belly on the floor that stimulates immature digestive system. Mild spit- her to prop up on her arms and devel- ting-up is not a cause for concern. op her upper body strength in prep- However, the infant who spits up con- aration for future fine motor skills. It stantly may be suffering from GERD. also encourages her to roll over and Other symptoms include frequent to eventually transition to sit up, all vomiting, frequent cough, refusing the while exercising and strengthen- to eat or difficulty eating (possibly ing her abdominal muscles in prepa- demonstrated by gagging with feed- A baby who spits up frequent- medical intervention. As the diges- ration for sitting, crawling and even- ing), crying with feeding and heart- ly but is otherwise happy and gain- tive system matures, the symptoms tually walking. A baby who does not burn, gas or abdominal pain. ing weight will usually not require should subside, but a baby who pres- get enough tummy time is likely to ents with several of these symptoms present with delayed gross and fine should receive medical attention. motor skills when she gets older. Trying to have There are a variety of medications It is important for parents of an on the market today which treat the infant suffering with GERD to be a baby? discomfort of GERD that are safe for aware of this developmental risk and infants. In addition to pharmacologi- to have a plan in place to combat it. cal intervention, doctors recommend Once a baby is on a feeding sched- several home remedies. It may be as ule, the hours between feedings are simple as changing the feeding times typically spent playing and sleep- WEWE CANCAN HHELP!ELP! and schedule. Sometimes doctors ing, in that order. A baby with GERD recommend thickening bottle feed- must be upright for thirty minutes ings with baby cereal or trying solid after a feeding. While some babies food. Neither of these suggestions do require more time to digest their should be implemented without a meal, there should be some time left doctor’s approval. over for playing before the baby falls Other methods to alleviate feed- asleep again. During that play time, At GENESIS our mission is to help patients realize the dream of parenthood. ing discomfort include elevating the the baby should be placed on her bel- We deliver high quality, cutting-edge and comprehensive care for infertility in an environment that addresses the personal needs and privacy of every head of the baby’s crib to keep the ly, at least for a brief period of time. patient. Under the leadership of Dr. Richard Grazi, Dr. Jennifer Makarov baby upright and maintaining the Then the amount of time that she and Dr. David Seifer, specialists in reproductive endocrinology, the GENESIS baby upright for thirty minutes af- spends on her belly should be incre- program has earned recognition as one of the nation’s top Centers of ter a feeding. Both of these sugges- mentally increased every day to build Excellence for Infertility by Contemporary ObGyn, one of the most widely tions utilize gravity to help the food her tolerance for tummy time. read journals among women’s health professionals...and now conveniently reach the stomach and to stay there. Like stated earlier, most babies located in the Park Slope community! They also minimize the possibility of will outgrow GERD by one year of In recognition of the needs of Torah-observant couples, GENESIS offers on-site food entering the lungs should re- age, but the impact on motor devel- rabbinical supervision that meets the most stringent criteria of contemporary flux cause the child to regurgitate opment can linger into the toddler poskim. In an effort to reduce the risk of transmitting common genetic disorders, Preimplantation Genetic Diagnosis is offered in conjunction with her food. years and beyond. By respecting the in vitro fertilization. A possible side effect of infant physical discomfort of GERD but yet GERD is delayed gross motor and fine facilitating tummy time as the ba- 808-8th Avenue, Brooklyn, NY 11215 U 1355-84th Street, Brooklyn, NY 11228 1571 Broadway, Hewlett, NY 11557 U 1855 Richmond Avenue, Staten Island, NY 10314 motor skill development, due to the by’s tolerance permits, parents can (718) 283-8600 U www.genesisfertility.com treatment to alleviate the symptoms. be the best personal trainers for their Most Major Insurances Accepted While doctors recommend maintain- babies, putting them on the road for ing the baby upright for thirty min- good gross and fine motor skills well NEW YORKYORK STATSTATEE sart DepartmentDepartment of Health Society for AssisteAssistedd ReproReproductiveductive TechnoTechnologylogy utes after a feeding, parents often into the future. HEALTH LIVING August 2011 | 11 Raising Our Children continued Development Tips for Your Child

By Chaya Ilean Klass 3. CHOOSE AGE 8. GET PHYSICAL: 10. TALK TO YOUR BABY: APPROPRIATE TOYS: Give your child a lot of opportuni- Babbling to your child will help There are two major factors that Toys have skill building attributes ties to engage in, and practice physical them learn to listen to people around play a pivotal role in development: Ge- and help children learn and develop activities that help them develop the them. In the beginning it is important netics, known as “Nature” and Environ- skills through play, thus their “work” is large muscle groups of the body. Phys- to slow down and exaggerate your ment, known as “Nurture.” It’s the age- playing with objects, people and toys. ical activity is not only important for speech, vary the pitch and use a lot of old question of whether it’s our biolog- Watch age guidelines and safety pre- their overall health and physical well- intonations. Make eye contact as often ical makeup or how we are raised that cautions noted on the box. Check for being but also for building gross mo- as possible. Singing is an entertaining makes us who we are. Scientists have de- product recalls frequently. tor skills as well. For example, when di- way to encourage listening and expos- bated which of these elements is more apering your child, use this opportunity ing your child to more language. instrumental. Today most believe that it 4. CHECK HEARING to do bicycling motion with their legs. Parents always feel guilty for either is a combination of both that defi nes us. AND VISION EARLY: not spending enough time with their Here are ten crucial steps that can Recurrent ear infections should be 9. READ TO YOUR CHILD: children, or they feel unsure on what improve the “nurture” aspect and fos- monitored to ensure that they do not Research has shown that children is considered productive activities, but ter child development: cause hearing loss. Even a mild or tem- who are read to, develop a larger vo- it is not the quantity of the time rather porary hearing loss can impact how a cabulary than children who are not ex- the quality that can have a major role 1. MAKE SURE BABY GETS child understands language or the clar- posed to books early on. Begin with in their development. A few minutes ADEQUATE TUMMY TIME: ity of speech. Undiagnosed vision def- easy board books with only pictures, rolling around on the carpet or nar- Ever since the American Academy icit can aff ect their ability to perform then increase to books with one or two rating your daily tasks may seem trivi- of Pediatrics began urging parents to reading, writing, visual motor skills, as words on a page, and gradually chose al, to you, but you have just fostered a put their babies to sleep on their backs well as visual perceptual skills such as more complex books as your child major key in your baby’s development (to reduce the incidence of sudden in- puzzles, mazes and more. grows. Books with rhymes and repeat- that will have an impact years to come. fant death syndrome) and with all the ed phrases are great in enabling your new and convenient baby gear (car seat 5. EXPOSE YOUR CHILD TO child to anticipate the next word and Chaya (Ilene) Klass, MS, OTR/L, is an carriers, bouncers, and reclining high VARIOUS TYPES OF SENSORY help you “read” the book by memoriz- occupational therapist who works for chairs), babies are spending less time INPUT EARLY: ing the phrases. Ask your child to point the NYC Department of Education and on their tummies and pediatricians have Sensory integration involves the to objects in the book, and help them treats children in the community. She noted a sharp increase in misshapen brain’s ability to organize and process point using their index fi nger. can be reached at [email protected]. heads. Tummy time helps babies de- the various sensations that enter the velop the neck, shoulders, back and arm brain through the body’s sensory re- muscles needed for rolling, crawling, sit- ceptors; the fi ve senses as well as the ting and standing, and decreases the in- joint receptors and inner ear recep- cidence of cranial asymmetries. Tummy tors. Infant swings and rocking your time should be done when the baby is child provides vestibular input, while happy and alert; begin slowly and grad- swaddling and holding off ers proprio- ually increase the time amount. Tummy ceptive input. Brightly colored or con- time can be practiced from the day the trasting toys are great for visual input, baby is born, but can be really begin by while music, mobiles, and sound toys 4-6 weeks of age. Tummy time should provide auditory input. Textured toys, always be supervised and should be clothes and blankets off er tactile input provided for at least 30 minutes a day, and feeding your child a large variety which can be broken down into smaller of foods (age appropriate of course) of- increments throughout the day. It also fers gustatory input. off ers a diff erent head position there- by providing input to the inner ear re- 6. PROPER NUTRITION: ceptors, which provides sensory input Birth to age three is a period of rap- as well and decreases the incidence of id brain growth. If the child does not get cranial asymmetries. adequate nutrition, the damage may be permanent and irreversible, and can 2. SURROUND YOUR limit performance in later years. Malnu- CHILD WITH TOYS: trition can result in diffi culties with at- Offer toys on both sides of your tention and activity levels, decreased child as well as in midline. This encour- cognitive functioning, and a poor im- ages your child to turn their heads to mune system, which cannot fi ght off both sides, look in both directions, and infections. Consult your pediatrician reach for objects on both sides as well on when to introduce cow’s milk and as in front of them. Alternate hang- solid foods. ing toys or mobiles on infant car seats, strollers, and cribs. When your child is 7. ENGAGE IN PLAY: sitting in your lap or on the fl oor, have Get down on your child’s level and them reach for toys on both sides and talk, sing and play with them. Time in midline. Doing so encourages swat- spent playing with your child is the ting and reaching for toys with both best investment into the future of hands, which activate both sides of the your child. Don’t underestimate the brain, thereby developing coordination impact your playing has on their de- of both sides of the body. velopment. 12 | August 2011 HEALTH LIVING Raising Our Children continued Controlling Anger in Front of Our Children

By Shoshana Lewin, Psy.D. Here is a fi ctional example, Mrs. Co- options, and the consequences from • Case f, in which Mrs. Cohen ignores hen comes home from the grocery each one: the mess when she first arrives In Pirkei Avos, Rabbi Eliezer instructs, store, to fi nd that her young children • In case a, if Mrs. Cohen realizes home, is also a desirable approach. “…be not quick to anger” (Avos 2:10). have scattered clothes and toys on the that their behaviors are appropri- It gives her a chance to calm down Chazal liken someone who is angry to fl oor, while under the supervision of a ate for her children’s level of devel- and address the situation after re- an idol worshipper since he is not in babysitter. What could she do? opment, she can accept the situa- viewing all of her options, instead control of his rage and is acting in a She might: tion as something that should be of letting her emotions take over. By self-serving way. He relinquishes his a) Smile, and say, “Well, kids will be expected and keep herself from be- doing so, she also shows her chil- opportunity for free choice to the emo- kids.” coming angry in the fi rst place. She dren that sometimes it is appropri- tion of anger and follows its dictates. b) Raise her voice at the babysitter, then has the option to take advan- ate for a mother to take care of her The Yetzer Hara presents us with and say, “I’m paying you to watch my tage of the positive potential in the own needs fi rst, especially when it multiple opportunities that challenge children - why have you let them wreck situation, by keeping herself from make her better equipped to deal our middos (character) development, the living room?” anger and letting this be a “teach- with a potentially stressful situation. especially in the area of our greatest c) Storm out of the house, mutter- able moment” for her children. We all have a natural inclination to weaknesses. In this sense, the diff er- ing, “I can’t take this anymore.” • In case b, blaming the babysitter slip into our learned or practiced pat- ent challenges and tests we are giv- d) Raise her voice at the children, in front of the children is likely to terns to address stressful situations, en in our lives ultimately enable us to yelling, “Kids, don’t you know how to teach her children that she doesn’t even when they may not be the most refi ne ourselves. Our children are our put your toys away?” respect the babysitter and that they constructively available options. How- greatest blessings, but they too can e) Pay the babysitter, and join the do not need to show the babysitter ever, if we can manage our own anger, challenge us. kids in cleaning up the room. respect, either. The children may that will enable us to rationally consid- Under stress, each person reacts f) Take a deep breath, have some- even learn to extend this attitude of er all the options available, and to ac- diff erently. Before responding to a sit- thing to eat and drink, and then calmly disrespect to other adults as well. By tively choose one that is most appro- uation, we should think about the goal address the cleanup with the children. berating the babysitter, the moth- priate, promoting our goals for the sit- of the interaction, rather than just re- In this situation, which of these al- er could also be teaching the chil- uation and the interaction. acting out of habit. When something ternatives would you choose? Some dren another unfortunate lesson, May we have success in that wor- that “triggers” our anger comes our of them would promote a healthy en- that one has the right to verbally thy pursuit! way, we can use this reflective pro- gagement with her children, while abuse someone when they have cess to decide how to address it rath- others will both distance her from her been paid money for a service. Shoshana Lewin, Psy.D., is a NYS er than letting our anger make the children and make them sad, upset, • In case c, by storming out of the licensed clinical psychologist spe- choice for us. or afraid. Let’s take a closer look at her house, Mrs. Cohen is teaching her cializing in individual and group children by example how adults psychotherapy. She works at Ja- can handle stress. They also learn maica Hospital Medical Center in that their Mommy may abandon Queens, NY serving the inpatient them (even briefl y) if they have done and outpatient populations. She can something she feels is unaccept- be reached at (718) 206-5891. able. As a result, on some level, they M must be “bad,” since they have “made MEADOW PARK Mommy go away.” On a deeper level, EMOTIONAL REHABILITATION & HEALTH CARE CENTER this level teaches the children to be CHECKLIST FEATURING afraid, because they no longer trust that Mommy will be completely reli- • Develop a support network The Chai Traditions Program™ able, understanding or predictable. (friends, a formal support group, Created in 2004, our extensive experience servicing the Jewish • Mrs. Cohen had a choice of many or therapy) resident has allowed us to build an exclusive community resource possible ways to address her chil- • Remember to take care of your im- dren in this situation. In example d, mediate physiological needs fi rst • Short-Term Rehab & Long-Term Care by asking them “Don’t you know (adequate sleep, food, etc.) how to put your toys away?” she is in- • Become aware of your “triggers” Watch our Video • Under Frum Ownership & Operation sulting their intelligence. This is likely including physiological, environ- & Virtual Tour at • Judaic Library for Study and Leisure to hurt their self esteem and will not mental, and historical experiences. www.mprcare.com • Tehilim Groups motivate them in the long run. • Try to avoid or prevent anger-in- • Clearly, case e is a preferable op- ducing situations whenever real- • Weekly Bikur Cholim Visits tion. Mrs. Cohen meets her immedi- istically possible. Planning helps! • Special Shiurim Delivered ate responsibility to the babysitter, • Choose your battles by Inspiring Guest Speakers while leaving the option open for a • Figure out the goal of your inter- discussion of the situation with the action • Special Monthly and Holiday Events babysitter at a more appropriate • Reserve yelling for situations of dena.graphix 718.701.1125 • NEW! Torah Conferencing Network time. Then, instead of verbally pun- actual danger Shiurim for Residents and the Community ishing the children, she sets a posi- • Monitor yourself for physi- • Shabbos Programming tive example for them by helping in cal signs of tension, including cleaning up the toys. This motivates tensed muscles, pressured or loud Dr. Zeitlin, Medical Director the children to join their mother speech, increased breathing or in the desired cleanup activity. It heart rate. When you are feeling also gives her the opportunity to tense, be more cautious about Under the VAAD Horabanim of Queens (VHQ) make it more fun by turning it into how you react to your children’s 78-10 164th Street, Fresh Meadows, New York a game, and a positive learning ex- behavior. For further information please contact perience, without hurting anyone’s • Do not be afraid to ask for help in Akiva Goldstein 718.591.8300 Ext. 248 feelings as in some of the previous managing your children or your examples. emotions whenever needed. HEALTH LIVING August 2011 | 13 Raising Our Children continued How to Help My Anxious Child By Leanne Matlow, BA, OTC, MA the child, he or she is perceiving the sit- feelings of others. When children are giv- ular exercise. Whenever you feel that uation as dangerous or scary when it is en the opportunity to discuss their con- you are under stress when dealing with Current research shows that anxiety not. If a child repeatedly (for more than cerns, they are often relieved to know that your child, take a break in order to con- aff ects one in eight children and most a month) avoids a certain non-threaten- they are not alone in their thinking. Chil- trol your anger and impatience. Helping of those children are not receiving treat- ing activity or situation, parents should dren can often feel reassured and empow- an anxious child is a lot of work but there ment. Children suff ering from anxiety consider seeking professional assistance ered through the use of techniques such is help and hope. Involve other fami- are at high risk of performing poorly in to determine if the child is suff ering from as rehearsing “stressful” situations, prac- ly members and trusted adults in the school, missing out on important social an anxiety disorder. ticing conversation starters, and breaking child’s life. A consistent approach helps experiences, and falling prey to sub- There is no blame or fault in having daunting tasks into smaller pieces. the child to develop better coping skills. stance abuse. These children must be an anxious child. While research indi- 3. No parent likes to see their child 5. Applaud any eff ort made by the identifi ed and helped to navigate the cates that genetics may be one factor suff er in any way. However, if a parent child to do something that was once pitfalls that come with avoidance and that gives rise to anxiety, life experienc- swoops in and “saves” the child, this can too “scary” and focus on even the mini- other poor coping skills. es, temperament and environmental lead to a bigger problem: the child never steps toward success in freeing them- All children, and for that matter factors are also important factors. That gets to prove their own ability to problem- selves from their anxiety disorder. most adults, will experience periods of explains why two children born to the solve or handle a situation without paren- time that are fi lled with stress and wor- same parents can be raised in the same tal intervention. By over re-assuring, giv- Leanne Matlow, BA (Hons.), OTC, ry, which manifest themselves in dis- house, with only one of them suff ering ing all the answers, and encouraging or MA, is a counselor who holds a turbed sleep patterns or reports of ill from anxiety. enabling avoidance behaviors, parents certificate in Cognitive Behavior health. These experiences are a normal Parents can help their children to are actually reinforcing their child’s anx- Therapy. She is the author of, part of child development. overcome the physical, mental and so- iety. Parents should instead encourage Thinking About Thoughts, a child- There is a diff erence between worry cial strain that anxiety can place on the their child to think of possible outcomes friendly resource to help children and anxiety. A person can be stressed, child, by doing a variety of things: or situations before they occur, and to en- who suffer from anxiety. Leanne worried or fearful when faced with real 1. Learn about the type of anxiety courage their child to look at the process facilitates interactive workshops danger; this is an in-born, natural re- disorder that your child suffers from. of trying to deal with their anxiety as a that focus on recognizing and sponse. An anxious child, on the other The more you understand about how necessary learning experience. By teach- building coping skills for anxious hand, is one who is hypersensitive or “on your child thinks, the better able you will ing their child problem solving skills, par- children and adults, and are suit- alert” for danger most of the time. That be to empathize with them and to help ents can promote the growth in their child able for parent groups, teachers’ heightened sense of “this is not safe” or them to fi ght their anxious thoughts. of a more positive self-image. professional development as well “something bad is going to happen” pre- 2. Children need to develop an emo- 4. Be a positive role model. Teach, as student groups. For informa- vents the child from participating in age tional vocabulary and learn not only to model and practice relaxation tech- tion, email matlow@sympatico. appropriate activities. Inside the mind of recognize their own feelings, but also the niques including a proper diet and reg- ca or phone 416-702-7605 14 | August 2011 HEALTH LIVING Golden Years Early Detection of Alzheimer’s May Lead to a Cure cently, such concentrations of amyloid sible for the killing the brain cells which form of the disease, it may be possible One of the main focuses in Alzheim- plaques and tau tangles in the brain trigger the symptoms of dementia. to detect Alzheimer’s patients as long as er’s research is fi nding a way to detect could only be identified in autopsies, Alzheimer’s drugs on the market to- 10 or even 20 years before the fi rst onset the “silent phase” of the disease, which but newer brain imaging techniques al- day, such as Aricept and Namenda, have of visible symptoms. starts to damage the brain of its victims low their detection while Alzheimer’s pa- been disappointing because they have According to Cliff ord Jack, a profes- years or even decades before the symp- tients are still alive, years before they re- proven eff ective in delaying the onset sor or radiology at the Mayo Clinic, who toms are prominent enough to be diag- sult in detectable memory loss and oth- of Alzheimer’s symptoms for only a few specializes in brain imaging techniques, nosed using conventional means. er symptoms of Alzheimer’s. months. The new research indicates that “If your therapeutic intervention is target- A recent medical conference in Paris Recently, scientists have concentrat- the problem may be that the drugs are ing the very front end of [the disease pro- of Alzheimer’s researchers discussed new ed on studying the progression of a rela- being applied years too late, after the cess], it makes sense. But imagine you’re procedures and techniques for identify- tively rare form of Alzheimer which is al- amyloid plaque has broken down the tau enrolling people in the clinical trials at the ing proteins and other chemicals in the ways transmitted genetically, and whose proteins but before the dementia symp- very end of the disease…it’s just too late.” brain and spinal fl uid of Alzheimer’s pa- victims can be defi nitively identifi ed by toms become apparent. The problem now is to fi nd a way to tients, using new brain scanning tech- genetic scans, years or even decades be- The companies making these drugs identify which of the many people who nologies, which can spot telltale signs fore the fi rst onset of symptoms. have responded by trying to identi- have amyloid plaques in their brains, but of the disease. By closely following such patients, sci- fy people showing the earliest signs are symptom-free, are at greatest risk of Scientists have long used the pres- entists have uncovered new clues as to of the disease, whom they call pre-de- developing full blown Alzheimer’s, and ence of a sticky substance known amy- the role of amyloid proteins and tau tan- mentia patients, and who are likely to to start their treatments as soon as pos- loid-beta42 in the brain, and a shortage gles in the course of the disease. The new get greater benefi ts from the available sible, before their brains have suff ered of the same substance in the spinal fl u- research indicates that the fi rst stage is drug treatments. much damage. id, as a defi nitive sign of Alzheimer’s. An- a buildup in the amyloid proteins, which There is also a greater emphasis in Researchers need to identify that other physical indicator of Alzheimer’s is trigger a reaction in the brain that causes research on early diagnosis using new population in order to carry out scien- an increase in what are known as tau pro- the tau protein which is normally found brain scan techniques to detect the tifi cally valid human trials of new drugs tein tangles which, like amyloid plaque, in healthy brain cells to break down and buildup in amyloid plaque. Based upon designed treat the earliest stages of Al- contributes to brain cell death. Until re- form tangles which are directly respon- brain scans of those with the genetic zheimer’s. Deep Brain Stimulation Reduces Parkinson’s Symptoms Canadian researchers have con- sor of neurology at the University of fi rmed that surgical brain implanta- Toronto, “this surgery does not stop tion of electrodes are effective for the slow progression of the disease more than a decade in controlling over time.” The alternative treatment tremors (a symptom of the disease) for Parkinson’s is a combination of the and in improving the general motor drugs levodopa and carbidopa, but function of Parkinson’s disease pa- they to lose their eff ectiveness over tients by blocking the cause of abnor- the course of time. mal nerve signals. The implantation surgery carries Parkinson’s disease is one of several some risks, including device-caused motor system disorders caused by the infection, bleeding in the brain, stroke, loss of dopamine-producing brain cells. seizures, speech and breathing com- Its symptoms include quivering in the plications, and heart problems, ac- extremities, jaw and face, as well as ri- cording to Mayo Clinic. Two of the gidity or stiff ness of the limbs, slowed eighteen patients in the study who movement, and impaired balance and received implants between 1996 and coordination. In the disease’s later stag- 2000 ultimately developed serious es, patients have diffi culty walking, talk- device-related infection within a de- ing and doing other simple tasks. There cade after the surgery. The study’s re- is no cure for Parkinson’s disease; treat- sults were published in the Archives ment focuses only on relieving the of Neurology. symptoms. Other Parkinson’s experts, while ex- Deep brain stimulation requires pressing interest in the study’s results, a surgeon to implant a small device warned against placing too much reli- called a neurostimulator under the ance on the fi ndings of the study, not- skin near the collar bone, and to po- ing its small size and the lack of a con- sition electrodes at the end of wires trol group. In addition, the patients in from the device in the motor control this study were diagnosed with Par- areas of the brain. kinson’s while in their 40’s, whereas But according to the study’s lead most Parkinson’s patients do not show researcher, Dr. Elena Moro, a profes- symptoms until their 60’s. HEALTH LIVING August 2011 | 15 Golden Years continued The Crises in Long Term Senior Care: With Long Life Comes Long Term Planning

By Aaron Neiger, Financial WHO NEEDS Services Professional LONG TERM CARE? Most of us strive to live active, healthy You probably know someone who lives well into our later years. Indeed, as a needs long term care. Maybe you have society, Americans are living longer than witnessed a family member, friend or ever before. This extended longevity is colleague struggle with the emotional one of the things that drives the grow- and fi nancial issues that can come with ing need for long term care. The longer a long term care experience. The truth we live, the greater the odds are that we is, no matter when the need arises, be- may need long term services. It is pre- cause of age, disability, or because of dicted that in 2020 some 12 million old- an unexpected illness or accident, long er Americans will need long term care. term care can aff ect any age, group, so- cial strata, or geographic location. Here WHO PAYS FOR are some of the most important things LONG TERM CARE? you need to know about long term Long term care can be expensive care, and how to plan for it: fi nancially and emotionally. An unex- pected need for long term care can PRESERVE YOU AND YOUR have a signifi cant impact on a family’s FAMILY’S CHOICES assets and lifestyle. Close to one fourth Long-term care is very expensive, of all nursing home costs are paid by in- but insurance can protect and pre- dividuals and their families. serve the income and assets you have Many people mistakenly believe worked so hard to accumulate, and give at home, with or near their families and al, and physical toll of providing care for that their health insurance will cover you the ability to purchase the needed still get the professional care they need. you. Whether at home, in an adult day the cost of long term care. Others be- care. With the advances in home health Long-term care insurance allows your care center, or an assisted living facility, lieve that Medicaid or Medicare will care services, many people needing family to be there to love you, instead of you and your family can maintain con- long term care are actually able to stay worrying about the fi nancial, emotion- trol of your options and your lifestyle. Continued on p.16

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For more information:713-936-2248 www.gtisanes.com 16 | August 2011 HEALTH LIVING Golden Years continued Longevity: For Some It’s In The Genes By Chaya Lieba Berger tween the ages of 95 and 112 who were tion and asked him a series of ques- living independently. They compared tions, such as how he feels about his Old age is terrifying. When peo- the data collected, including how of- health, what his diet is, and how long ple grow old they frequently lose their ten they exercise, drink and smoke, to his parents lived (his mother lived till memories, their ability to move, to take 3,164 people who had undergone sim- 99; his father 93). care of themselves, and then they die. ilar interviews and examinations in the Klass also said that when he was Some people are lucky and do not fi t 1970s as part of a federal health survey asked to what he attributes his long this mold; they will live a very long time, but have since died. life, he answered, “The Ribbono Shel not getting sick, living independently, What they found is that the long- Olam (G-d).” and die peacefully in their 100’s. This is timers, by and large, were not veg- The study’s results would seem to all determined by their genes. etarians or overly health conscious. leave the rest of us with two options: People who age better and live lon- One 107-year-old woman had been either kick back and enjoy the good ger have not necessarily earned it by smoking for 90 years. Only 43 per- genes, or kick back and enjoy the going to the gym more often or stay- cent of the men exercised regularly, bad genes if we are cursed anyway. ing away from alcohol, according to a compared with the 57 percent from Barzilai warns that there is still study released August 3rd in the Jour- the larger study. Thirty percent of the more than enough evidence to prove nal of the American Geriatrics Society. women smoked over 100 cigarettes that a healthy lifestyle can be benefi- Actually, the study suggests that these in their lifetime, while 26.2 percent cial in combating the aging process centenarians have worse habits than of the general population did. Dr. especially since we have no way of the rest of us. Barzilai and his team of researchers determining who inherits the lon- As part of the Longevity Genes Proj- suggest that they may be “protect- gevity genes. ect, Nir Barzilai and fellow researchers As part of the Longevity Genes Project, ed” from the negative effects of bad The long-term goal of the Lon- Nir Barzilai, lead researcher of the at the Albert Einstein College of Medi- Longevity Genes Project, at the Albert habits simply by their genes. gevity Genes Project is to create a cine of Yeshiva University interviewed Einstein College of Medicine of Yeshiva “I think that because their body drug to imitate the effect of these and examined 477 Ashkenazi Jews be- University and mind have not aged at a regu- genes. Fighting old age one disease lar rate they can continue to lead ac- at a time is not working because as tive lifestyles,” Barzilai told The Jew- soon as one disease has been fought ish Press. On the other hand, he said off, another one goes in for the kill. he knew “many, very active people But the researchers hope that with who died ‘youngish’ from diseases.” this study, and more like it, they will One study participant, Albert be one step closer to developing a Klass of Brooklyn, a senior execu- drug to slow the aging process and tive of the Jewish Press, is 100 years ward off age-related diseases such old. He said that a researcher con- as Alzheimer’s, cardiovascular dis- ducted a brief physical examina- ease and Type 2 diabetes.

The Crises in Long Term BEGIN YOUR PLAN NOW Senior Care The sooner you begin the planning for long term care, the better. Wait- Continued from Page 15 ing can be expensive in several ways. The younger you are when you pur- cover long term care expenses. While chase long term care insurance, the Medicare does provide health care cov- lower the premiums will be. As you erage for seniors, it is limited in the cov- age, the premiums will get higher for erage it provides for long term care. the purchase of an equivalent policy Medicaid will pay for long term care, and changes in your health may al- but fi rst you must qualify by meeting ter the kind of policy that you qualify Post-Acute Care/Sub-Acute Care • Short Term Rehabilitation Nursing Home • Medical Model Adult Day Health Care strict income and assets eligibility re- for. Waiting a few years to purchase it Social Model Alzheimer Center • Long Term Home Health Care quirements. could cost you thousands more in pre- Community/Inpatient Hospice miums over the life of the policy. Or LONGTERM CARE INSURANCE you may not be able to qualify for cov- COULD BE THE SOLUTION erage at all. But the greatest cost of Parker Jewish Institute for HEALTH CARE AND REHABILITATION Long term care insurance can be a waiting is that it may result in you not very smart way to address challenges having any coverage in place when 271-11 76th Avenue, New Hyde Park, New York 11040-1433 (516) 322-6223 • www.parkerinstitute.org from a long term care need. Long-term you need it most. care insurance can help pay for nursing With long life comes long term plan- home care as well as a variety of home ning. Make a plan for you and your fam- Medical transportation provided by: On-site dialysis provided by: and community-based services. Long- ily today. term care insurance may not be for ev- erybody, so if you are considering a pol- For more information on long term icy, read it carefully and be sure to work care insurance please contact Aaron Strictly Glatt Kosher kitchen on premises, with insurance agent who understands Neiger at cell (347) 782-4457 or of- now under the supervision of Rabbi Avrohom Friedlander. long-term care issues. fi ce (646) 227-8088. HEALTH LIVING August 2011 | 17 Golden Years continued Caring for the Care Givers By Mutty Burstein they require. In addition, many “sand- wich” caregivers may have to deal Providing care for a family mem- with their own health and fi nancial ber in need is a centuries-old act of worries. Other challenges caregivers kindness, love, and loyalty. Back in might face include the demands of the old days, when multi-generation- a work schedule, as well as relation- al families lived together, it was ex- ships with a spouse or signifi cant oth- pected that the younger would care er, siblings and close friends. Any of for the older, the healthy would care these conditions may easily interfere for the sick. Bubby and Zaidy raised with a person’s ability to be an eff ec- their children and then their children tive caregiver. As the stress piles up, took care of them. In the modern age, frustration and despair may take hold, extended families no longer live un- making burnout a very real danger. der one roof; there is increased inde- Finding time for positive, nurturing pendence and distance. However, the interactions with others might seem needs of the elderly and infi rm have impossible, but is crucial. not disappeared, and if anything, they Warning signs of caregiver burnout: have increased. As life expectancies • excessive stress and tension increase and medical treatments ad- • debilitating depression vance, more of us will participate in • persistent anxiety, anger or guilt the care giving process. • extreme irritability or anger with It is a tremendous zechus and priv- the patient ilege when we are called upon to pro- often be daunting and at times even Being a caregiver is a demanding • decreased overall life satisfaction vide care for a loved one. Hashem has stressful. Being aware of the challeng- job. There is usually very little op- • relationship confl icts and social given us the opportunity to perform es and managing the stress while cele- portunity to prepare for a new care- isolation pure chesed for those we hold dear. Al- brating the enormous benefi ts and ad- giving situation. Those who are in • lower immunity and greater need though we recognize the opportunity vantages of being a caregiver is a deli- the “sandwich generation” are often for healthcare services we are given and welcome the chance to cate balance. Having a successful expe- faced with the demands of care need- • excessive use of medications, show our love and caring in immeasur- rience can be achieved through prepa- ed by their parents or older relatives drugs or alcohol able ways, it comes with a huge amount ration, education, communication and while also being responsible for rais- of responsibility. The responsibility can having a realistic but positive attitude. ing their own children and the caring Continued on p.19 18 | August 2011 HEALTH LIVING Golden Years continued Private–Pay Home Care By Allen Hymowitz aide only when they are awake? How well do they sleep at night; how many Recent government budget cuts will times do they get up? result in changes in the way that seniors Since Medicare typically doesn’t pay in our community receive home health for long term care, there are several pos- care services. While an assisted living fa- sible ways to obtain private pay home cility or a nursing home may be the best care, even when the cost seems out of option for some seniors, statistics show reach. Private duty services can be paid that when professional health care is directly by the patient, family, conserva- provided in the home, health, nutri- tors, and by long-term care insurance or tional awareness and the relationship combinations of them all. between family members all improve. Organizations which deal specifi cal- Care which allows seniors to remain ly with diseases such as Alzheimer’s, in their own homes, enables them to MS and cancer off er programs to as- retain an important sense of indepen- sist individuals with that particular ill- dence. It is also psychologically benefi - ness. Many religious organizations have cial for older adults to remain in famil- some funds available for its members iar surroundings. There is a signifi cant for this purpose. For those who don’t diff erence between a senior who sim- have savings available to pay for private ply needs help with personal care and to remain safely in their homes. Decid- needs have been met. In those cases, pay home care, Long Term Care (LTC) In- one who requires medical assistance. ing which option is best for your family their family might choose to close the surance is an option. The Veterans Ad- A relatively healthy older adult who is requires you to know what to look for. gap by purchasing the additional ser- ministration has established a pension placed in a facility with those who are Medicare, and most insurance policies, vices their loved one needs. program whereby the purchase of per- much sicker or infi rm will feel out of cover only short-term clinical home care Paying privately for home health ser- sonal care and attendant home servic- place. Remaining at home is far prefer- aide services for limited increments of vices is often necessary for seniors who es are paid for through a Veteran’s ac- able (as well as less costly) than reloca- time. Often, the amount of care pro- want to remain living independently in quired pension title VA Aid and Atten- tion to a facility. vided through insurance and other their homes. Private pay services in any dant Pension Benefi t. Fortunately, there are many options programs is insuffi cient to keep a per- combination can be tailored to meet When receiving personalized ser- today for those who need assistance son safely at home once their medical individual needs, where the client and vice in your home environment, you family members have a voice. Home or a loved one can live with dignity and health care private pay services are ex- ease. This includes the selection of high- cellent for clients who: ly skilled personal care assistants, home • Were discharged from a hospital health aides, homemakers, compan- or skilled nursing facility. ions, nurses, physical therapists and so- glatt kosher assisted • Require additional assistance with cial workers. & independent personal care. It is important to understand that living community • Need physical or occupation ther- the rules and regulations that govern apy. what a certifi ed home health aide can • Desire general homemaking or or can’t do protect both the patient companionship. and the family. Hiring a non-certi- With great pride • Are concerned about safety issues fi ed, untrained individual for these in the home. services greatly increases the risk that The type of private pay home care the use of wrong medication or the The Lakewood Courtyard services available varies greatly depend- wrong lifting procedure will result in announces that we have received ing on the needs of the individual re- harm or pain to the patient. That is ceiving service. Nonmedical homemak- why using only a New York State li- er services includes assisting with activ- censed Home Care Agency is neces- Excellent Survey Results ities of daily living (ADLs) and providing sary in order to protect you and your on our 2011 NJ State Survey companionship and supervision to pa- loved one. tients who are lonely or need on-site su- pervision because of dementia or other Allen Hymowitz is the Administra- cognitive disease. Services may include: tor at Preferred Home Care of New • Home Health Aide York, a Licensed Home Health Care • Homemakers Agency located in Brooklyn, N.Y. • Companions This well known and trusted agen- • Medication reminders cy provides caring, compassionate, • Nursing Services experienced and licensed caregiv- Private-pay home care assistance ers through-out the 5 boroughs of can range from a few hours a week to New York and Westchester Coun- 24-hour care that supplements Medi- ty. Preferred Home Care’s multilin- care Home Care, or which begins when gual staff of registered nurses, home Medicare coverage ends. health aides, PT’s, OT’s, and speech The fi rst thing you have to do is de- therapists is always available to as- fi ne exactly what level of care is need- sist you with all of your home care ed. Does your loved one need a home needs and concerns. Allen can be 52 Madison Ave. Lakewood, NJ 08701 Chana Daina : 732.865.8127 Fax: 732.905.4030 Direrctor of Marketing health aide to monitor them all day and reached at 718-841-8000 or allen@ www.lakewoodcourtyard.com 732.865.8127 Ext.2130 all night, or do they need a home health preferredhcny.com. HEALTH LIVING August 2011 | 19 Golden Years continued

Caring for the Care Givers 2. Take respite time. Caregiving is a these services may be free, paid for by as it has been said, it still cannot be job and you need to take a break. Re- insurance, subsidized by government said enough - the best way to take Continued from Page 17 member to be good to yourself, love grants, or done by volunteers. care of others is to also take care of and value yourself. You are doing a 8. Seek support from other care- yourself. Regardless of their age, there are very hard job and you deserve some givers and support groups. There many instances where the main care- quality time for you. is strength in knowing you are not Mutty Burstein is the Education giver in the family refuses to acknowl- 3. Accept assistance. When people alone. Support groups can be help- Outreach Manager of the Patient edge that they cannot handle the off er help, accept the off er and sug- ful to validate feelings as well as pro- Relations Department at Ameri- load. They are too caught up in the gest specifi c things that they can do. viding encouragement and network- care CSS, a Certifi ed Home Health daily grind that they do not recognize 4. Be aware of signs of depression, ing opportunities. They off er a safe Agency. The Americare Companies, the warning signals, and will not ad- and don’t delay in getting help when place to share, seek, give and get ad- founded in 1982, provide high qual- mit that they are overwhelmed. It is you need it. Confi de in others. Talk vice regarding practical information ity home care services in the N.Y. imperative for a caregiver to recog- to people about what you feel; don’t and emotional guidance. Local sup- metro area, including the 5 bor- nize that they need help and be able keep your emotions bottled up. Care- port groups are often listed on the oughs, Long Island, and Westches- to ask for it. As a caregiver, informal giver support groups are invaluable, Internet, or ask your doctor or social ter, Rockland, Orange, Dutchess, networks and peer groups become a but trusted friends and family mem- worker for leads. Putnam, Sullivan, and Ulster coun- lifeline to your strength, and taking bers can help too. Being a caregiver can often be ties, in the Hudson Valley. Ameri- care of yourself is a primary concern. 5. Educate yourself about your an extraordinarily rewarding and care integrates compassionate pa- One can prevent caregiver burnout by loved one’s condition and how to positive experience, as it should be. tient care with family needs and is following a few essential guidelines: communicate eff ectively with their There is great fulfi llment in knowing ready to serve with registered nurs- 1. Know your limits. Be realistic doctors. Knowledge is power. Learn that you are capable of giving back es, home health aides, PT’s, OT’s, about how much of your time and as much as you can about your fami- in some way to those who gave you speech therapists, and social work- yourself you can give. Set clear limits, ly member’s illness and how to be an so much. ers. In addition to all the regular as- and communicate those limits to doc- eff ective caregiver. However, the long term emotion- pects of home care, Americare has a tors, family members, and other peo- 6. Encourage your loved one’s in- al and physical demands involved in special license to work with patients ple involved. Share responsibilities dependence as much as possible. nurturing another person can strain with mental health issues and pa- with other family members as a team There is a diff erence between caring even the most capable person. That tients with dementia, Alzheimer’s, and delegate specifi c tasks to each and doing. is why it is so important to seek out and/or depression, as well as the relative on a regular basis. For exam- 7. Research services available in and take advantage of available help developmentally disabled. Mutty ple, one can deal with the prescrip- your community, such as adult day and support. Understanding the po- can be reached at 917-287-1636 or tion refi lls and scheduling appoint- care centers, home health aides, tential for burnout and accessing [email protected] for any ments with the doctors and psychi- home-delivered meals, respite care, the proper assistance is essential to questions regarding health care or atrists, while another meets with the transportation services, volunteer making caregiving the most posi- eligibility for Medicare, Medicaid, doctor and the OT/PT professionals. visitors, and skilled nursing. Some of tive experience possible. As much and managed care. 20 | August 2011 HEALTH LIVING L’Chayim to Life

nors or taken from the bodies of individ- Live donor kidney transplants have both Reuven and Shimon to premature uals declared to be dead. However, the been carried out since 1954. There have death due to renal failure. However, if Shi- overwhelming majority of deaths are in- been many advances since then, includ- mon’s family member gives his kidney to eligible for donation, resulting in a se- ing the use of laprascopic surgical tech- Reuven, and the donor in Reuven’s family vere shortage of kidneys available for niques, signifi cantly reducing recovery gives his kidney to Shimon, both Reuven transplant. time and scarring. and Shimon can be saved. The kidney transplant process begins The concept of a swap was fi rst sug- Kidney Donation TAKE A NUMBER AND WAIT with a compatibility test followed by a full gested in 1986, but did not start gaining Since 1984, kidneys have been allo- medical screening. After all the test results wide acceptance until the 1997 publi- Continued from Page 1 cated by the Organ Procurement and are back, which takes several weeks, the cation of an article in the New England Transplantation Network (OPTN), which procedure is scheduled. The actual opera- Journal of Medicine by Dr. L. F. Ross, ex- Medical science has made major was created at that time by an act of Con- tion usually takes 4-hours, and the donor ploring its ethical considerations. The fi rst strides in treating people with end stage gress to assure that available transplant usually stays in the hospital for about two transplant exchange in the U.S. was con- renal disease (ESRD). Periodic dialysis can organs are distributed impartially. The days. Renewal recommends two weeks of ducted at Johns Hopkins Hospital in Bal- fi lter the poisons and waste products out same legislation made it illegal to sell an recuperation before returning to a desk timore in 2001. of their blood, prolonging their lives. But organ for transplant in the United States. job, or a few weeks longer for those with The logistics required for successful ultimately, the only eff ective replacement In the case of kidneys, the main criterion physically active jobs. At times the pro- swap arrangements can be diffi cult to for two failed human kidneys is another for selection is the length of time that a cedures have to be delayed for months set up. To minimize the element of mutu- healthy human kidney. potential recipient has spent on a central- in order to meet the scheduling require- al trust required, kidney swap operations Fortunately, our marvelous bodies ly maintained waiting list. ments of donors imposed by their work are generally scheduled to be performed can survive quite nicely with just one nor- One option for those who need a kid- or family commitments. After recovering simultaneously, to prevent any of the par- mally functioning kidney, while each one ney transplant, but are unwilling to wait from the immediate eff ects of the opera- ticipants from backing out at the last min- of us was born with two of them, includ- until their name is on the top of the list, tion, kidney donors go on to live normal, ute. This requires both donors and the ing a built-in spare. Healthy people never is medical tourism. Some travel to China healthy lives. necessary medical facilities and person- really need their second kidney, while for where organs are taken involuntarily from Kidney recipients are required to re- nel all to be available at the same time. someone with ESRD, its donation literal- executed prisoners. Others go to coun- main on immunosuppressant drugs to ly means the diff erence between life and tries like Pakistan and India where organ guard against rejection for the remain- COMPLICATIONS AND death. On average, a patient in end-stage sales are legal. In those countries, organ der of their life. They are also closely mon- REWARDS renal failure will live 10 to 15 years longer transplant has become a big business, itored to make sure that their new kidney In recent years, there have been com- with a kidney transplant than if they re- but the practices there have also been is functioning as intended. plex swaps involving more than two pairs main on dialysis. Younger transplant re- criticized as an immoral exploitation of Medicare or other health insurance of donors and recipients. The fi rst multi- cipients enjoy an even longer extension the poor and disenfranchised. covers the direct cost of the transplant hospital kidney exchange involving 12 of their life expectancy. Two U.S. teenag- A living kidney donor in the U.S. may operation itself for both the donor and patients was performed in February 2009 ers who were among the earliest kidney legally specify the recipient of their kid- the recipient. Renewal covers the ancil- by Johns Hopkins, Barnes-Jewish Hospi- transplant recipients in 1966 and 1967 ney, as long as there is no direct fi nancial lary costs of the procedure for donors, tal in St. Louis and Integris Baptist Medi- are both alive and well today. quid pro quo. It may be a family member such as compensation for loss of wag- cal Center in Oklahoma City. Live donor kidney transplantation is or friend, or a complete stranger in what es, convalescence and transportation The great advantage of these swaps often (but not always) an exception to is known as an “altruistic” donation. Liv- expenses, which can amount to $5,000- is that they permit the lifesaving utiliza- the rule in Halacha which forbids muti- ing donors account for about one-third $10,000 per transplant. tion of kidneys from more willing donors lation of our bodies because of their in- kidney transplant operations performed Renewal does not solicit donations who are of the wrong blood type for a di- herent holiness, having been created in the U.S. today. from the family members of prospective rect donation to the specifi c family mem- “b’tzelem elokim,” in the image of G-d. In A Jewish communal organization recipients. It does not receive any govern- ber or friend whose life they want to save. cases of ESRD, we are dealing with “pi- called Renewal, which was formed in ment funding, and relies on donations This gives these donors another way to kuach nefesh,” saving a life, which, in Jew- 2006, specializes in fi nding living kidney from members of the community. save that particular life, by giving a life- ish law, is often considered to be a com- donors for patients suff ering from ESRD. saving kidney to a complete stranger, in pelling reason to permit a normally for- Renewal works in cooperation with hos- LIFESAVING KIDNEY SWAPS what could be seen as the ultimate win- bidden act. pitals and medical teams across the U.S. The organization arranges for an av- win situation for all involved. specializing in transplants, and with the erage of two kidney transplants a month. These complex chains of kidney DYING FOR A KIDNEY National Kidney Registry, which main- However, there are still patients in the swaps can present signifi cant addition- Kidney transplantation is a life-saving tains the kidney waiting list in the U.S., community who are dying because no al logistical and timing challenges, and procedure. Today, nearly 90,000 Amer- and assures that the established medi- suitable kidney donors are available. To much work is being done to streamline icans await kidney transplants, accord- cal and ethical guidelines are followed. accommodate their needs, Renewal has the process and make it as smooth as ing to UNOS or United Network of Or- become involved in the newest trend in possible. Renewal is working closely with gan Sharing. Each year, 8% of U.S. patients ONLY 1 IN 10 COMPLETE THE kidney donation, “swaps,” also known as the National Kidney Registry in this area, with ESRD die while awaiting the dona- DONATION PROCESS “paired exchanges” involving multiple si- and hopes to make the fi rst internation- tion of a kidney from a compatible donor. According to Menachem Friedman, multaneous donors and recipients. al swap with Israel. On average, another person is added to the Program Director of Renewal, only Often times a recipient has an eligible Becoming a kidney transplant do- the kidney list every 11 minutes, and 18 about 1 in 10 people who volunteer to family member who can donate, howev- nor is not an undertaking to be entered people die every day suff ering from kid- donate a kidney actually do so. Some are er the blood types of the donor and re- into lightly. But for most donors, it is well ney failure. not deemed healthy enough to safely do- cipient are incompatible. When anoth- worth the inconvenience. Given the tre- The primary requirements for live kid- nate one of their kidneys. Others cannot er family with a similar situation comes mendous satisfaction they get from ney donors today is that they be in ex- arrange to take off from work or other ob- along, Renewal arranges for a swap. For knowing that they have given someone cellent health and share the same blood ligations for the procedure and recovery. example, suppose Reuven needs a kid- suff ering from ESRD a new lease on life. and tissue type as the recipient. While an Some prospective donors cannot donate ney donor with type A blood, and Shi- identical twin makes for the best live kid- due to objections from their own fami- mon needs a kidney donor with type B For further information about kid- ney donor, advances in the use of immu- ly members. Renewal also recommends blood. However, the only potential donor ney donation, contact Renewal at its nosuppressive drugs has reduced the risk that donors seek clearance from their Hal- in Reuven’s family has type B blood, and web site, www.renewal.org; email: that the recipient’s body will reject a kid- achic authority, who generally has a bet- the only willing donor in Shimon’s family [email protected]; write: 5904 13 Av- ney from any person as a foreign body. ter understanding of their situation and has type A. Looked at individually, neither enue, Brooklyn, NY 11219, or call: Kidneys can be donated by live do- how the donation will impact the home. transplant is viable, potentially dooming (718) 431-9831. HEALTH LIVING August 2011 | 21 L’Chayim to Life continued The Art Of Medicine: “To Stent Or Not To Stent?”

By Jason Esses though the studies may suggest oth- erwise. There is also a concern that Over the last few months, there sometimes stents are used aggres- have been high-profile reports of sively because of financial motiva- incidents in which several interven- tion. Stents can cost anywhere be- tional cardiologists and their affili- tween hundreds of dollars to thou- ated institutions were accused and sands, and net the doctor and insti- convicted of the serious charge of tution thousands of dollars. placing cardiac stents in patients The New York Times reported who do not meet the recognized cri- how Dr. Mark Midei, a “prominent” teria for receiving stents. and “top” interventional cardiolo- Cardiac stents, which are, in fact, gist in Maryland, “may have implant- small metal tubes, revolutionized car- ed 585 stents which were medical- diology over the last two decades. ly unnecessary from 2007 to 2009.” Prior to the mid-1990’s, the accept- (Dec 2010). Although this isn’t the ed way to “open-up” or “unblock” an rule and most physicians are prac- atherosclerotic, coronary blockage, ticing in good faith, Midei’s case is was to perform balloon angioplas- not the only exception.) ty. This involved inflating a tiny bal- In general, stents are beneficial in loon at the obstruction to increase patients who present with a heart at- the area of the lumen (opening). Bal- tack due to coronary artery disease. loon angioplasty was susceptible to a Additionally, individuals with coro- phenomenon known as restenosis or nary artery disease treated with ap- “re-blockage” of the artery. To combat propriate medications, who contin- this problem, cardiac stents were de- ue to suffeg symptoms of chest pain, veloped to maintain the open lumen, or angina, may benefit from stents. serving as scaffolding for the open ar- However, asymptomatic patients tery. Initially they were introduced in with stable, or non-obstructive arter- an un-medicated form, or the “bare- ies should not receive a stent. metal stent”, and subsequently as the Does this mean that patients should medicated, or “drug-eluting” variety, be afraid of cardiac stents? Of course which is the current the standard of not! What should someone do when care in interventional cardiology. told that a stent is necessary? First of In the properly selected patient, all, trust your doctor, but be informed, these procedures can be life saving, ask the interventionalist “why?” Make especially in the setting of an acute sure he or she explains the degree of heart attack, where the benefi ts clear- blockage and why a stent is required, ly outweigh the risks. However, in and to show images of the blockage. many patients with coronary artery (A seventy percent blockage is usually disease, studies have shown that med- the minimum requirement.) Ask what To learn how you can save a ical therapy is as good or even supe- are the other options? In fact, stents rior to invasive procedures used to are good for most cases of signifi cant life or for more information about “open” arteries. Proceeding to an inter- blockage, but not all cases. kidney donation contact: vention in these patients could be del- Some patient, need and even- eterious, requiring unnecessary med- tually go on to open-heart surgery, ications, and possibly lead to down- and would be wrongly treated with right life-threatening complications. a stent. Speak to the non-invasive Stenting is not a risk free procedure. cardiologist for a second opinion 718.431.9831 The question that needs to be to confirm that a stent is required. [email protected] considered carefully in each individ- Also, don’t assume, that just because ual case is whether or not stenting is a particular interventional cardiolo- www.RENEWAL.org likely to be beneficial in this particu- gist is the “busiest”, he or she is the 5904 13th Avenue, Brooklyn, NY 11219 lar patient and circumstance. Tragi- best one to see. cally, many patients believe that the When it comes to stenting, know- “more the doctor does, the better.” ing when not to do, is as important, Unfortunately, this is far from the if not more important, as when to truth, and is often not supported by do, and that is the art of medicine. medical research. Cardiologists’ motivation to place Jason Esses is an attending cardi- stents may be related to their pro- ologist affiliated with Maimonides fessional opinion that opening an Medical Center, and practices in artery is, in fact, beneficial- even Brooklyn. 22 | August 2011 HEALTH LIVING L’Chayim to Life continued Get Healthy The “Smoothie” Way By Sheryl Mayer SSTRAWBERRYTRAWBERRY As a registered dietitian, BBANANAANANA one of my all-time favorite 1 frozen banana kitchen tools is my blender. 1 cup frozen strawberries Smoothie making is a sim- 1/2 cup vanilla yogurt ple way to attain your 5-a- 1/2 cup milk, 2 tsp honey day goal of fruit and veg- 1 cup ice etable intake and is great for getting nutrition into kids who are picky eat- CCHERRYHERRY AALMONDLMOND ers. Kids will drink it be- 1/2 cup frozen pitted cherries cause of the “cold factor” 1 1/4 cup milk and are often not aware 2 tsp sugar that the drink is chock full 1/4 tsp pure almond extract of healthy ingredients. (or vanilla extract) Making a smoothie as part 1 cup ice of your morning routine is one of the best things you can do for yourself and KKIWIIWI SSTRAWBERRYTRAWBERRY your family. Because you SSWIRLWIRL are using the whole fruit, 2 peeled and cubed kiwis a smoothie gives you far 1 cup hulled strawberries more fiber and nutrients 2 tsp sugar than juice does (fi ber con- 1 1/2 cups ice tent is not aff ected by pu- ½ cup water reeing). Because it’s nat- ural, it is a more effi cient source of vitamins than pills or supplements. Fur- WWATERMELONATERMELON SLUSHSLUSH thermore, the high wa- Blend 3 cups frozen watermelon ter content of a smoothie cubes (cube watermelon and freeze helps keep you hydrated in fl at tray or container) with 2 cups and the fructose content Here are ten fresh watermelon cubes and the BBLUEBERRYLUEBERRY DDREAMREAM of the fruit provides slow- smoothie com- juice of 1 lime. (There is no need for 1/2 cup frozen blueberries releasing energy that will binations. Use additional water or sugar, the fruit 1/2 cup low-fat vanilla yogurt keep you going all morning. these as inspirations for other itself supplies both). 1/2 cup milk One secret to making flavorful, smoothies; add your own favorite 2 tsp honey creamy smoothies is to use frozen fruits and see which combo works 2-3 ice cubes (optional) fruit rather than just ice. Purchase a best for you. Liquid amounts may SSTRAWBERRYTRAWBERRY lot of fruit when they are in season vary depending on water content of MMANGOANGO and peel, chop and store in freez- ingredients, so adjust liquid as need- TTRIPLERIPLE BERRYBERRY BLASTBLAST 4 leaves basil er bags. Frozen fruit can last in the ed until the smoothie is a slushy con- 1 1/2 cup frozen raspberries 1 cup frozen mango cubes freezer approximately fi ve months if sistency. When blending smoothies, strawberries and blackberries 5 hulled strawberries packaged well. You can then stretch wait until the contents are circulat- (or blueberries) 1 cup water the use of summer peaches and ber- ing freely in the blender and then 1 cup milk 2 tsp sugar ries into the fall season. Commercial blend for 1-2 minutes more to ensure 1 tsp sugar 3 ice cubes bags of frozen fruit are also an excel- that all the ice is blended evenly. It is 1 cup ice lent option if you want to save time worth this extra minute of patience and not go through the hassle of slic- to get it perfectly smooth. Ice cold GGLASSLASS OFOF “FRESH“FRESH ing and dicing. The nutritional value smoothies served in a pretty glass PPEANUTEANUT BBUTTERUTTER of store bought frozen fruit is quite have an appealing presentation; it 2 Peeled and chopped apples BBANANAANANA SURPRISESURPRISE high (if not higher than fresh fruit) as is a great way to extend the boun- 2 cups fresh baby spinach 1 banana the fruit is fl ash frozen right after the ty of sweet summer fruits. Drink to 1 medium cucumber 2 T peanut butter fruit is picked. So either way, it is great your good health! 2 celery sticks 3/4 cup milk to have frozen fruit on hand to make 1/2 inch or 1 tsp peeled ginger root 1 tsp honey (this is not for those a healthy snack. 1 bunch parsley juice from 1 lime Sheryl Mayer MS RD CDN is a reg- watching their weight, as peanut A smart idea would be to make a istered dietitian with an M.S. in with some pulp butter has a high fat content). double batch of any smoothie reci- Health and Nutrition. She is the Juice from 1/2 lemon pe and pour the leftovers into freeze owner of Nutritionista, a nutrition 1/2 mango (This was featured on pop makers (think FrozFruit). One that the Oprah Show, featuring anti-ag- consulting service. Children and PPEACHEACH MMANGOANGO I absolutely love is the Zoku Quick teens are welcome. To make an ap- ing drinks by Dr Oz. I modifi ed the SSUPREMEUPREME Pop maker (Williams-Sonoma.com). pointment or to suggest ideas for recipe to include a mango for added 1 cup frozen peache In roughly 8 minutes, it freezes any future articles, please call 347-850- sweetness. Don’t get scared of the 1 cup frozen mango mixture into what seems like an in- 3438 or email at SherylMayer@Nu- ingredients in this recipe, it actual- 1/2 cup vanilla soy milk stant ice pop. It works excellently and tritionistainc.com. Please visit her ly turns out to be a pretty color and 1/2 cup orange juice is a great activity and snack for kids. website www.nutritionistainc.com has an interesting taste). HEALTH LIVING August 2011 | 23 L’Chayim to Life continued Water Aerobics - The Exercise for People Who Hate Exercise

By Malka (Redlich) Kornreich feel lighter more fl exi- then have the option of ble. At the same time, involving their baby safe- Water aerobics, which has long been the natural resistance ly into their aqua fi tness associated with the senior population, of water to body move- workout, or just splash is now becoming a popular form of ex- ments makes them around with their child ercise for people of all ages, including many times more ef- and have fun together. expecting and new mothers and their fective than when they The experience can cre- babies. It is ideal for anyone looking for are performed outside ates deeper bonds be- an easy and eff ective fi tness program the water. tween mother and baby for health, weight-loss, or just an im- Aqua fitness exer- in addition to minimiz- proved sense of well-being. cises are recommend- ing the child’s natural fear Because of the buoyancy of the wa- ed from people suff er- of the water at a very ear- ter, low-impact aqua fitness exercis- ing from osteoporosis, ly age. es are far more comfortable and less lower back pain syn- Aqua fi tness programs stressful on the body than mainstream drome, arthritis, and offer people who have exercise workouts. Water fi tness classes neuro-muscular diseas- shied away from tradi- are also suitable for people who were es. Many participants tional forms of exercise a never comfortable in the water before report that the sessions lead to signif- After giving birth, aqua fi tness can variety of new, safe and enjoyable op- since you don’t even need to know how icant reductions in their knee or back help mothers to overcome post-par- tions that present many of the same to swim in order to participate. pains. The increases in self-confi dence tum depression. Aside from the phys- health benefi ts, with the bonus of be- Aqua fi tness classes are designed and self-awareness stemming from a ical and psychological benefi ts of the ing much less stressful and more fun. to make participants feel comfortable regular aqua exercise routine yield ben- exercises, aqua fitness sessions pro- and secure in the water. Individuals can efi ts in all kinds of everyday situations, vide women with a pleasant social ex- Malka (Redlich) Kornreich, BA, workout at their own level, and typical- and may also help to relieve feelings of perience with their peers, giving them is a fi tness professional certifi ed by ly emerge from each session feeling depression and anxiety. a chance to network while having some the Aquatic Exercise Association. more relaxed, agile and accomplished. While water exercise is suitable for safe and non-stressful fun in the water. She teaches prenatal/postnatal and The social framework is both stimulat- all age groups, it provides addition- Many aqua fitness programs are other water fi tness groups in Jeru- ing and motivating, but not compet- al benefi ts for prenatal and postnatal now off ering “Mommy and Baby” class- salem. She can be reached at fkm@ itive. The water also helps to cover up women who may be suff ering from var- es, in which the women bring their ba- actcom.net.il. Her direct US phone areas of the body about which partici- icose veins, hemorrhoids and swelling bies into the water with them. They number in Israel is (718) 506-0265. pants might feel self-conscious. in the extremities. The sessions off er all of the medi- Aqua fi tness is also one of the safest cal benefi ts of a regular exercise pro- forms of exercise for women in the third gram- they can improve circulation, trimester, and may also have benefi ts strengthen the heart and lungs, in- for the fetus. One enthusiastic mother crease stamina and lower blood pres- in my Jerusalem class reported, “I was in sure and pulse. The natural buoyan- the water until the day before my baby cy of our bodies in the water makes us was born, I felt incredible!”

Extent of Gabby Giffords’ up and vote regardless, because she felt Recovery Still Uncertain that the debt ceiling compromise was probably “the most important bill” the Continued from Page 1 House would address all year. “It was the congresswoman who de- ation, local Democrats have run sev- cided that she couldn’t miss this vote,” eral campaign fundraising programs her spokesman confi rmed. “During one on her behalf, bringing the amount in of the many [congressional] impasses, her congressional campaign account she shook her head and said to [her hus- to $800,000 by late June. If she decides band, NASA astronaut] Mark Kelly, ‘They to run for re-election, Giff ords would should just get it done.’ ” be a tremendous sentimental favorite. Her unexpected appearance on the Republicans have yet to choose a chal- House fl oor to cast her vote was a rare lenger for her seat in next year’s election. unifying moment at the end of a divi- Before she was shot, there was spec- sive partisan debate, moving Republi- ulation that Giff ords might mount a bid cans and Democrats alike to stand and TRUST US. WE CARE in 2012 for the open seat of retiring Re- cheer in salute to her courage. publican Senator Jon Kyl, but that now Her friend, Wasserman Schultz, who seems increasingly unlikely. was in the middle of the political cross- According to her friend, Democrat fi re over the debt ceiling, said that dur- Congresswoman Debbie Wasserman ing the often bitter debate, “the most Schultz, Giff ords had been following the grizzled hardened hearts harden[ed] 15% OFF LOSE 3-7 INCHES IN TO JUMPSTART YOUR DIET acrimonious debate over the debt ceil- even further, but they all melted when RESTRICTIONS APPLY ing extension and was always prepared she walked in the chamber…. ONLY 2 WEEKS to come to Washington to cast her vote “It was such a moment that the Con- ZERONA FDA APPROVED Clinically proven body slimming on it, if needed. After it appeared that gress needed, that the country needed. Lose stubbon fat off your waist, 718.972.1500 her vote would not be needed to pass Everyone’s been praying for this mo- hips and thighs 4918 Ft. Hamilton Pkwy. Brooklyn, NY 11219 ZERO pain, ZERO downtime, the measure, Giff ords decided to show ment,” Wasserman Schultz said. www.inchknocker.com 10 Min. from Belt Pkwy; ZERO Surgery 5 Min. from Ocean Pkwy 24 | August 2011 HEALTH LIVING L’Chayim to Life continued Grocery Shelf Esteem

By Ita Yankovich the familiar 64-ounce container of Tropi- cana brand orange juice was downsized “Lights, camera action!” This may in early 2010 to 59 ounces, but the retail sound like a director on a movie set, but price remained the same, thereby hiding it can also be your local store manager an eff ective 7.8% price increase. Similarly, talking to his staff . Supermarkets have be- national brands of ice cream have grad- come wise these days in tracking, all your ually reduced the traditional half-gallon purchases so they can entice you to buy container to 1.75 or 1.5 quarts, without re- even more next time. That is often the ducing their prices proportionately. reason why, after you come home from If you are not good at math, or didn’t a shopping trip, you are left wondering bring along a calculator, when you are what possessed you to buy 10 packs of in the supermarket aisle, comparing the gum or coconut fl avored toothpaste? prices of competing items in different sized containers, pay attention to the “unit LIGHTS AND SCENERY: price” listed alongside the selling price. TIPS: The layout and displays in every major Manufacturers have even been cheat- y Make a list prior to shopping and stick to it! supermarket have been staged. The fi rst y Try buying with cash only since then you will certainly only buy what you ing on the size of the sheets of toilet pa- items displayed at the entrance are usual- can aff ord. It is easy to go crazy when buying with credit card or check per on a roll. Traditionally, they were sized ly fl owers, fresh baked goods or produce since you don’t feel the pinch until you get your monthly statement. to fi t the average man’s hand, 4.5 inches in order to stimulate your sights, scents y If you can, use a hand basket instead of a shopping wagon, or better yet square, but in recent years, the national and tastes. Some stores use spotlighting carry your food to the register. brands have reduced the length of the av- to make the food look shiner and more y Purchase high markup non-food items, like toiletries and hardware items erage sheet by as much as a half an inch appetizing. Some food displays which at discount stores where they tend to be cheaper. (the width has been kept the same to look seem to be overfl owing with radiantly y Don’t be fooled by fancy packaging, especially when purchasing stan- right in most dispensers). dardized products where competing products are essentially the same. colored and shiny produce are just opti- y Prepared foods are often a waste of money. Items like bagged salads spice There is also a vigorous competition cal illusions. Typically the bottom of the and rice mixes are often much more expensive than simply putting to- played out on the store shelves between display is just cardboard fi ller, with the gether their ingredients from your kitchen. Food companies selling these the salesmen for various name brands of overabundance at the top being just an- items at huge markups by appealing to your laziness. Take the spice mix- such popular items as soda, snack foods other tactic to tempt to buy. Similarly, es for example, if you read the label, you’ll fi nd salt to be the main ingre- or baked goods. Some will pay the store the odors of baked goods still fresh from dient and then a bunch of other common spices that you probably al- owner for prime shelf placement of their the over, or fresh fl owers are intended to ready have in your spice rack. brand, and will send their own employees stimulate your olfactory nerves to make y Buy generic or store brands for commodity products which are essential- into the stores to stock the shelves with ly the same as the name brand at a fraction of the price. you feel hungrier when you are selecting their products to make them look as at- the foods to buy. takes more purchases to fi ll them up. As teries, candy and magazines are usual- tractive as possible. There is a behind-the- Even the colors of the supermarkets long as it seems half-empty, you are less ly placed near the cash register. They are scenes battle going on for shelf space in displays have been scientifi cally tested aware that you are overbuying. intended to catch your eye when you are most supermarkets, and your food pur- and chosen to make you spend more. bored standing on line to check out, hop- chasing dollar is the ultimate prize. Red is the color of choice since it stimu- PLACEMENT: ing that you will suddenly decide to pick A fl oor managers at a major kosher lates the production of adrenaline and has Location, location, location is the up that issue of Yarn Magazine Weekly, to supermarket in Brooklyn was gracious also been shown to be appetite inducing. name of the game. Every box, bottle and read to pass the time, and maybe fi nish enough to speak with us about the more bag has been placed in a specifi c aisle when you get home. Or maybe you will subtle strategies that his store uses to in- CAMERA: and on a specifi c shelf for a reason- to in- decide that you might need that pack of crease the volume of purchases. “It’s not ‘Big Brother’ is watching your every fl uence your buying decisions. ten double AA batteries in case we have so much of a ‘Gotcha Ya’ scheme that we move in the store, and it’s not just to pre- Most grocery stores have the same a blackout tomorrow. After all, it’s always are aiming for”, he explains. “We are simply vent shoplifting. Store managers install basic fl oor plan - they keep the most fre- good to be prepared. trying to make the shopping experience surveillance cameras in every aisle to see quently purchased foods, dairy, bread and Sometimes store managers will stick as pleasant as possible by keeping the how well the psychological triggers in meat products at the far side of the store very expensive items near regular priced aisle large, clean and having food stocked their product displays are working. or up against the back walls. This forces items to make you feel better about the on the shelves by categories. If that makes Loyalty cards may reward you with dis- customers to walk through aisles fi lled purchase at regular price. This is called customers buy more, so much the better.” counts, credits and coupons, but they also with less essential items in the hope of “The compromise eff ect.” At other times, This store deliberately groups all prod- track your shopping habits and purchas- stimulating an impulse purchase. Stores they will put up a display of items at the ucts with a particular brand name in a ing patterns. Taken together, this infor- have even fi gured out that most people corner of the aisle with a big sign as if it general category of food together so as mation helps stores to determine which are wired to look fi rst to their right side, so were on sale, when it is, in fact, the regu- to avoid the ‘shelf battle.’ items to put on sale at a deep discount. they place items that they most want you lar everyday price, and hoping their cus- Of course, this store is like any other Their goal is to lure you back into the to buy on the right hand side of the aisle tomers won’t realize it. business. They are here to make a profi t, store, knowing that once you are there, The most expensive brands with Don’t be lazy. Do the math. You may and do not apologize for pushing their own you will usually buy some of their items the highest profi t margins are typically discover that buying items in bulk quan- brands above others, because they say that at regular price, in addition to the bargain placed at eye level, while bulk options or tities or in larger sizes may not always be their own brands are superior in taste. “Lis- you came for. lower margin generic brands are gener- the most economical choice. The Journal ten, any store that tells you they don’t use ally at the bottom. Once again, this is to of Marketing Research reports that peo- these tricks is lying,” he says, “whether you’re ACTION: maximize the profi t from impulse pur- ple will spend more money and buy more selling electronics, clothes or food, all stores Every show has music and so do your chasers, or from shoppers who are in too of any given item when a high number is do this to make sales and survive.” grocery stores. They often will play upbeat much of a hurry to stop to compare pric- placed in front of them. When you see but soft music to make you linger longer es. Stores also place children’s foods on signs that read “Buy 2 for $5” or “Buying lim- Ita Yankovich is a freelance writer/re- pondering which items to purchase. kid’s eye level so your child will spot it and it 10”, you are being lured into buying more porter and teaches English literature Shopping carts are another sales tool. throw a temper tantrum until you buy it. of any one item than you want or need. at Kingsborough and Touro College. They were invented in 1938 and seem This also explains why items that are fre- Packaging can also be used deceptive- She can be reached at itayankovich@ya- to be growing larger each year, so that it quently bought on impulse, such as bat- ly to disguise price increases. For example, hoo.com HEALTH LIVING August 2011 | 25 L’Chayim to Life continued ‘Comfort Food’ Shown To Affect Mood

By Ita Yankovich to sad and neutral music, and sad and acetylcholine, a component found in neutral facial expressions. eggs. Eating eggs and other foods rich Ice cream, brownies, and french fries Eff orts to induce sadness through in choline may help to ensure the avail- are typically the foods we consume music and images of frowns caused ability of acetylcholine to your brain. when feeling, stressed, nervous or sad, people’s moods to fall by 2.5 points out Eating protein increases alertness. and new research suggests that fat- of 10, but the fatty acids helped reduce During digestion, proteins are bro- ty foods such as these actually aff ect the dip to about 1 point, according to ken down into their amino acid con- our brain activity making us feel hap- Van Oudenhove. stituents. One of these amino acids is py once again. One possible hypothesis on why tyrosine which increases the produc- This is not news; we have always comfort foods make us feel good is be- tion of the neurotransmitters norepi- known that there is a relationship be- cause often they are associated with nepherine, dopamine and epinephrine. tween food and mood, but the latest our childhood or people that are close These neurotransmitters are responsi- research shows that eating fatty foods to us. When eating those warm choco- ble for making us feel alert and ener- “seems to make us less vulnerable to late chip cookies, or plate of baked ziti, getic. Healthy protein choices include sad emotions, even if we don’t know we are transported back in our minds fi sh, poultry, and lean meat. we’re eating fat,” says psychiatrist Dr. to our childhood kitchen table and all Nuts, tuna, sunflower seeds and Lukas Van Oudenhove. He is a co-au- the positive memories we have of it. whole-grain cereals are all good sourc- thor of a study at the University of Bel- It’s unclear if other ingredients in tially a cold-induced pain tolerance test es of selenium. Studies have shown that gium that tracked people’s responses to food would have a similar eff ect. More involving sticking your hand in ice-water. people who have low levels of seleni- sad and neutral experiences while fatty research is needed to determine wheth- Researchers discovered that the people um are more anxious. Increasing levels acids were inserted into their stomach, er the fi ndings may have any value in who ingested the high-fat, low carbohy- of selenium helps to normalize mood. bypassing sensory stimulation, so the treatment of obesity, depression or eat- drate pancake meals 1.5 hour before the Eat fatty fi sh such as salmon, mackerel subjects were unaware that they were ing disorders. CPT experienced a greater reduction in and herring as well as omega-3 eggs. getting fat or saline. Fatty foods have even been shown pain reception compared to those who The fatty acids found in these foods are For the study, researchers recruit- to reduce pain. In a UK study conduct- had the low-fat (high-carbohydrate) important to the health of nerve and ed 12 healthy volunteers who received ed by Sue Zmarzty and colleagues, 16 meals of the equal calorie content. brain cell membranes. Lack of these fatty acids or a saline solution through volunteers (8 male and 8 female) were Foods can have signifi cant impact fats in your diet may put you at higher a feeding tube. Using functional MRI, treated to pancake meals with varying on the body. Eggs have been linked to risk for depression. the researchers also scanned the volun- fat content before being subjected to a strong memory. Alzheimer’s patients (some info obtained from Health- teers’ brain waves as they were exposed Cold Pressor Test (CPT), which is essen- have been shown to have low levels of DayNews) 26 | August 2011 HEALTH LIVING Mind, Body & Soul Recovery From Mental Illness: Myth Or Fact? Leah Rokeach, LCSW and is not an end result. It is a trans- to avoid stress. CRASH! His dreams and ” The focus of the therapy with my formation of the self, wherein one hopes were destroyed. new therapist was on my wishes, my What does recovery from mental both accepts ones’ limitations and ” I was suspicious of people and dreams and my goals. At first I was illness mean? When we look at the also discovers a new world of possi- overwhelmed with sadness and very skeptical about the whole con- recovery literature, we see that it has bility. Patricia Deegan Ph.D., who re- hopelessness. I didn’t see a future for cept of recovery, of learning strate- been variously used to mean an ap- covered from schizophrenia writes, myself and it was very hard to face gies to cope with my delusions and proach, a model, a philosophy, a par- “this is the paradox of recovery, that daily challenges and make it through voices. I was also fearful of disclosing adigm, a movement, a vision, and in accepting what we cannot do or be, the day. Although my families, espe- to my therapist that I still harbored skeptically, a myth. This understand- we begin to discover who we can be cially my parents, were supportive, the dream of going back to school. I ably creates ambiguity and confusion. and what we can do.Thus, recovery is I could see the sadness in their fac- love writing, but I haven’t picked up a William Anthony M.D. Director of the a process, and a way of life. It is an at- es and I would often see my mother pencil and paper since I was forced to Boston Center for Psychiatric Reha- titude and a way of approaching the crying when she thought I was not leave school. However once I start- bilitation, states that in the last sev- day’s challenges. It is not a perfectly watching. The end of my dreams was ed to feel safe, and to trust her, I told eral decades, several sources demon- linear process.” also the end of her dream to see me her that my dream is to go back to strate that people with severe men- school, her answer to me was,”great, tal illness are achieving higher roles this is a wonderful goal to work on. of functioning, subjective well-being, “I was treated by a number of psychiatrists, I believe you can do it”. For the first and adjustment than had previously, but their focus was always on my symptoms. time I felt hopeful, like a light bulb and that severe mental illnesses are going on, I felt that my therapist be- not universally deteriorative. One The diagnosis assigned to me became my lieved in my potential and I began to source has been the writing of peo- identity, I felt that I lost myself, I the human develop confidence in myself. ple with severe mental illnesses. An- This was the first step on my jour- other source is long term- outcome being.” ney to recovery. I am learning cop- studies, which suggested that a sig- ing strategies for my symptoms. My nifi cant percentage of people with voices are bothering me, but I am severe mental illnesses were dramat- learning strategies to manage them, ically improving over time. According Concepts or factors that are com- settled in my profession with a wife to challenge them and how to be in to Courtney Harding, Ph.D., director of mon to all forms of recovery include: and children. control of them. I learned the impor- the Center for Rehabilitation and Re- hope, believing in the person, self- I was treated by a number of psy- tance of medication in my life, and I covery, at the Coalition of Behavioral confidence, self-help, education/ chiatrists, but their focus was always always take them. Agencies in New York City, there are knowledge about the illness and the on my symptoms. The diagnosis as- My therapist gives me reading ma- 10 national and international studies symptoms, empowerment, medi- signed to me became my identity, I terial about men and women who are which have investigated the recovery cation/treatment, support, employ- felt that I lost myself, I, the human be- on their journey of recovery.These sto- and community integration of people ment/meaningful activities, and cop- ing, did not exist. For close to 8 years, ries are very inspiring, and nurtures with schizophrenia and other severe ing strategies. Most important, recov- I attended many different day pro- my hope to reclaim my life. At the mental illnesses. ery is gaining social success and per- grams. Whenever I felt overwhelmed present time, I attend a few groups at Dr. Anthony argues that the per- sonal accomplishment in those areas and the voices became loud and un- a day program, but most important I son with a mental illness can recover that the person defi nes as important bearable, I became frightened, and I am doing volunteer work in a nurs- even when the illness is not cured, and for him or herself. admitted myself to the hospital. ing home three afternoons per week, the process of recovery can proceed The following is the recovery story About two years ago, after my dis- and I write an article in their weekly in the presence of continuing symp- of J., a 31 year old man, who was di- charge from my fifth hospitalization, bulletin. Helping others is giving me toms and disabilities. From this view agnosed with schizophrenia. He was I was referred to a new psychiatrist meaning in my life, but even more im- point, the focus is ”wellness” and not” valedictorian in high school, but after and a new therapist. portant, for the fi rst time in ten years I illness.” Thus, Dr. Anthony says: his graduation he became paranoid. The first step on the journey to am doing what I love, writing. I know “Recovery is a deeply personal, While in college pursuing his dream recovery starts with the relationship that I have a long and diffi cult journey unique process of changing one’s at- of becoming a journalist, he became with the professional helpers, espe- ahead of me. I continue to experience titude, values, feelings, goals, skills suspicious of his roommates, believ- cially the therapist. Being met with days that are, scary and diffi cult I use and or roles. It is a way of living a sat- ing that they were talking about him. hope, optimism and a sincere be- self-help techniques I learned to feel isfying, hopeful and contributing life He started to hear voices that told him lief that the person with mental ill- better. If it doesn’t work I reach out even with limitations caused by the ill- he was no good, will never graduate ness has the potential and ability to for help. Most important, I am deter- ness. Recovery involves the develop- college, and will never amount to any- get a life, to take responsibility and mined, to do whatever it takes to re- ment of new meaning and purpose in thing. He did not feel safe anywhere, to change despite their disability, build my life.” one’s life beyond the catastrophic ef- so he stayed in his room. His parents is a common feature in many peo- J’s experience meets Dr. Antho- fects of mental illness.” picked him up from the university and ple’s accounts of recovery. Another ny’s definition of recovery. It is a Because recovery is a personal and took him directly to a hospital where important factor in recovery is the unique personal process of changing unique process, an intimate journey, he was admitted to the psychiatric therapist showing the client that he/ one’s attitude, values, feelings, goals, everyone attaches his/her own per- unit. The psychiatrist told him that he she never gives up, no matter how and learning how to live a meaning- sonal meaning to recovery. It denotes had paranoid schizophrenia, a disease many “bumps” are encountered on ful and satisfying life within the lim- a severely mentally ill person’s poten- of the brain, and that he must to take the journey. Failures and setbacks itations caused by the illness. J. still tial for growth, healing and commu- medications for the rest of his life. He must be accepted as part of the re- has a long road to travel. However nity integration. We also see from this also told him that he cannot go back covery journey and as educational defi nition, that recovery is not a cure, to college, or work because he needs experiences. Continued on p.27 HEALTH LIVING August 2011 | 27 Mind, Body & Soul continued Raising a Boundary-Conscious, Empowered Child

By Aviva Rizel vate areas is to make sure that the child ents must mold their children into If, G-d forbid, your child does come is healthy and growing, and that ex- strong kids who are not easy victims. to you with a report about such an in- I recently overheard some pre- amination is allowed to take cident, your fi rst responsibility is school aged girls having a conversa- place only when the child’s to show your child that you trust tion about their favorite animated char- parent is in the room. “Predators are less likely to and believe him or her, and that acters. As kids start telling se- you will not blame or punish “I like Princess Cinderella.” crets to each other, parents abuse a child who maintains your child for any involvement in “I like her too, but I hate Princess Jas- should tell them, “You are strong boundaries and resists the incident. The highest prior- mine because she shows her belly but- allowed to keep a secret as ity is to protect your child. Then ton and that’s disgusting!” long as it is tznius and not inappropriate contact.” you can proceed to find out The therapist in me was about to in- dangerous.” Children should more information. Therapy for tervene when the other girl voiced the also be taught at an early that the whole family is often neces- response I had in mind. “Really?” she they should not keep secrets about any A child should be able to give the sary after such an incident, and there is asked. “Belly buttons are disgusting? physical contact with others, no mat- appropriate answer to each of the fol- no shame in asking for that help. I think belly buttons are soooo cute! ter who they may be, which makes lowing questions: A child whose parents has given the I just think that it’s not nice to show it them feel uncomfortable or guilty for “Is anybody allowed to touch your proper messages, that the child himself all the time.” any reason. private parts?” owns his body, and that it is a precious The 5 year-old paused for a moment When a parent is assisting a 6 year- “Is anybody allowed to show you gift, is a child whose inner strength and reconsidered her original opinion. old in the bathroom, it is good to re- theirs?” will spill over into other areas of life. “Yeah, belly buttons are cute, but she mind the child that the only reason that “What should you do if that hap- A confi dent, proud child is more like- really shouldn’t be walking around the parent is there is because he or she pens?” ly to engage in healthy relationships showing it.” needs their help, and that their marvel- “Would it be your fault?” in the future. “That’s right,” her friend agreed. “Her ous body is really private and special. “What if it feels nice? Is it then ok?” belly button belongs to her and she As a child grows to elementary “Whom should you tell? Is it Lashon Aviva Rizel is a Marriage and Fam- should keep it private.” school age, these lessons should be- Hara to tell?” ily Therapist in private practice in This is the attitude to adopt when come more explicit, even though such “What if the person tells you that Cedarhurst, NY. She lectures in the teaching about modesty and bound- conversations can be confusing or em- you will get in trouble if you tell? Is New York City area on dating, rela- aries. The reason a person covers his barrassing for the child and embar- that true?” tionships and marriage. Aviva Rizel or her body is because it is an intimate rassing and awkward for the parent “What if the person tells you that no can be reached at 347-292-8482 or possession. The body is something as well. But it would be far worse and one will believe you? Is that true?” [email protected]. precious that warrants protecting, potentially harmful to fail to empower rather than something negative or our children with the tools they need disgusting. to protect themselves. One way to empower our children is Predators are less likely to abuse to teach them proper boundaries. This a child who maintains strong bound- $725$+3$7+727:(/9(67(3 can be started at a very young age. A aries and resists inappropriate con- parent can tickle an 18-month old, and tact. Most of the time, the predator is 5(&29(5<)520$'',&7,21 then stop. Once the baby stops laugh- someone whom the child knows and ing, the parent should ask, “More?” trusts, perhaps even a family member. And then, and this part is key, respect Even though in these situations it is the )5207+($'',&7,2162) what the child answered. This is a valu- child who is being victimized, the child -RXIVRIX able lesson that teaches the child, “I may enjoy the attention from an adult, %PGSLSP alone have control of what is done to or even derive some physical plea- my body.” sure from the abuse. That can gener- (VYKW As a child grows, the lessons grow ate strong feelings of guilt on the part +EQFPMRK MRGPYHMRKWXSGOHE]XVEHMRK as well. of the victim. If the perpetrator is real- *SSH At a child’s annual check-up, the ly skilled, he might trick the child into ;SVO child should be told that the only rea- thinking that the child started or pro- 7LSTTMRK son the doctor is allowed to see the pri- voked the encounter. Therefore, par-

&21),'(17,$/$121<0286 Recovery to afford them all that is available to 3+21($332,170(176 help them move on with their lives, 'PMIRXWEVIKMZIREGSHIRYQFIV 8LIVIMWRS'EPPIV-(2EQIWGERRIZIVFIORS[R Continued from Page 26 and help them to recover. As Patricia Deegan, one of the most eloquent he is hopeful, optimistic and feels spokesperson on recovery states, capable of making the changes to ”The concept of recovery is rooted *6))*-678'327908%8-32 achieve more satisfaction and suc- in the simple yet profound realiza- cess in his life. tion that people who have been di- 

Why are some people not get- agnosed with a mental illness are hu- +DVNDPDIURPOHDGLQJ ting better? Dr. Harding tells us that man beings.” 2UWKRGR[5DEELVRI/RV$QJHOHV “we need to take a second, third and fourth look. We need to do whatev- Leah Rokeach is psychotherapist in er it takes to discover what is hinder- private practice with a specialty in ing their progress.” Psychiatric Rehabilitation and Re- 6)'3:)6=8,639+,836%, 5(&29(5< People with mental illness have covery. She can be reached at leah- 4EGM½G%ZI7YMXI:IRMGI'EPMJSVRME the same wishes, dreams, hopes and 6IGSZIV]8LVSYKL8SVELGSQVIGSZIV]XLVSYKLXSVEL$]ELSSGSQ 7+528*+ [email protected] , or by phone: 725$+ aspirations as the rest of us. We need (917) 670 – 7148. 6IGSZIV]8LVSYKL8SVELMWEG  GLEVMXEFPISVKERM^EXMSR 28 | August 2011 HEALTH LIVING Mind, Body & Soul continued Peace of Mind with Faith and Trust

By Rachael B. (Goldberg) sion, and even physical illness. Over 20,000 In one study, researchers used a recent- These findings encourage integrative Rothstein and Devora (Greer) scientifi c articles have been published on ly launched Torah-based treatment proto- methods of building gratitude and other Shabtai religion and mental health. However, little col designed to encourage individuals to spiritual concepts into treatment proto- research has been designed to address the tap into their own relationship with God cols for the clinician and into the individ- In the shuffl e of communal celebra- unique needs of the Orthodox Jewish com- as a source of psychological strength and ual’s use in everyday life. tions and activities, the Jewish community munity. Recent empirical research, howev- support. In a randomized controlled trial Try the following “gratitude building” radiates joy and stability. For some howev- er, is pointing to what our Torah sages have with over 125 Jewish individuals, partici- exercises throughout the day: er, on the back burner lies a more complex been telling us for 3,300 years, namely, that pants who completed these exercises ex- - Constantly try to view yourself as the web of emotional turmoil. Many individ- working on one’s relationship with God is perienced dramatic reductions in anxiety benefi ciary of God’s kindness (i.e. try keep- uals within the Jewish community strug- important for mental health. In addition, re- in just two weeks. ing a list of specifi c things in your life that gle with a range of psychological confl icts search now shows how some of our own Sit in a comfortable, relaxed position. you feel grateful for). that go clinically untreated and/or unno- mussar principles can be utilized as tools in Take several slow, deep breaths in and out. - Verbally express your gratitude to God ticed due to fear of stigma and public em- the treatment of anxiety, depression and - Think of someone you trust. Think of in your own words. barrassment. other mental health disorders. what makes them trustworthy in your eyes. - Think of something that you value very Individuals struggling may see them- Several empirical studies have recently Now try to see how it feels to think of this per- dearly in your life (e.g your hands, your sense selves as victims without the means to uncovered that working on specifi c com- son as God’s messenger. Try to picture that of sight, a family member). achieve appropriate treatment. Well- ponents of one’s spirituality could have God sent them to you, to help you in some Now take a moment to picture your life meaning religious mentors may use a profound benefi ts for emotional well-be- way in your life, out of deep caring for your without the person/item you chose. Try to combination of intuition and insight in ing. The following principles capture two personal happiness and well-being. think about how your life might be diff er- the course of their counsel without con- of the most important fi ndings of the re- - Think about a stressful past event when ent without it. Also, think about how the sidering established, evidence-based ap- search thus far. things turned out better than expected. “item” has made your life more convenient proaches. On the other hand, psychol- Principle 1: Increasing one’s emunah Think about how God controlled the fact and happy. Now, take another moment to ogists may leave their religious patients (faith) and bitachon (trust) in God has that the situation turned out okay in the think of the item as a gift from God. Imagine feeling a sense of fragmentation between been scientifi cally proven to improve end. Contemplate God’s role in the situation. God giving you the item with the full knowl- their religious beliefs and the therapeu- one’s mental health (i.e. less anxiety What did God do to make it turn out okay? edge of what it does for you in your life and tic process. and depression, and “greater person- What might have happened had some ran- how diffi cult life would be without the item Psychologists have long tried to deter- al happiness”). Trust and mistrust in dom force been in charge and not God? or person. mine whether religious beliefs can aid in God were, in fact, predictors of mental - Try to feel increased trust in God when While these exercises are straightfor- the battle against stress, anxiety, depres- health and well-being. engaging in daily activities. For example, ward, they require focus and constant try to practice feeling this trust the next time practice. By implementing these methods, you stand up. Trust that God will enable your one can begin to tackle the overwhelming muscles, ligaments, and bones to accom- and sometimes debilitating nature of anx- plish the task of getting out of your chair. Re- iety, fear and panic. alize that God is the One keeping things run- These fi ndings bring hope and confi rm Find a Therapist ning, and will continue to do so. the relevance of spiritually to individuals - Try meditating on the following ideas: seeking to boost psychological well-being. Trusting in God involves believing that Two entities which are often left unasso- success and failure are not related to hu- ciated--one’s relationship with the Creator man eff orts. and aspects of one’s mental health--- are Trusting in God means believing that now proven to be closely linked. Spiritu- the outcome of any situation is ultimately ally-integrated cognitive behavioral tech- in God’s hands. niques like those mentioned above, can Trusting in God involves believing that help one to fi nd peace of mind with emu- God is always in complete control because nah and bitachon. no power is greater than God. Therefore, for those who trust in God, help is close by even Rachael B. (Goldberg) Rothstein when things seem really bad. graduated from Stern College for These meditative exercises can help Women where she studied psychol- to illuminate the balance between hu- ogy and journalism. She current- man eff ort and Divine assistance, allevi- ly works for Yeshiva University’s ating the anxiety-ridden person of need- Center for the Jewish Future in the less worry, particularly for things that are Leadership Training Department. out of their control. Devora Shabtai is a psychology stu-

om Principle 2: Higher levels of grati- dent at Stern College for Women and c . l tude toward God have been associat- a Research Assistant in the JPSYCH

ed with higher levels of psychological Laboratory (www.jpsych.com). well-being. The research cited and the cognitive ex- 6952 . .design@gmai l In another study, researchers found an ercises included in this article were cre- 416 . association between people with higher ated by Dr. David H. Rosmarin, an In- sfranke 917 levels of spirituality and gratitude and de- structor in the Department of Psychia- a free service provided by creased levels of anxiety and depression. try at Harvard Medical School and As- Explanations have been off ered that grate- sistant in Psychology at McLean Hos- Nefesh International ful people experience even more positiv- pital (Belmont, MA). Dr. Rosmarin the organization for Orthodox Mental Health Professionals ity and emotional well-being in response has received extensive training in evi- to positive things in their lives, and dur- dence-based treatment for anxiety, de- PO Box 3027 Teaneck NJ 07666 T:201-384-0084 F:201-384-0018 ing times of distress are more likely to see pression, bipolar and psychotic symp- E:[email protected] www.nefesh.org themselves as the benefi ciaries of kindness. toms (see www.centerforanxiety.org). HEALTH LIVING August 2011 | 29 Mind, Body & Soul continued “Decluttering” Your Marital Relationship By Tova Katz LMFT the clutter that is hampering your vision, In this state, the relationship is so laden lationship that world renowned relation- you can bring a more satisfying and ful- with built-up frustration and resentment ship expert Dr. John M. Gottman calls them These days home organization is an fi lling marriage into view! that everything gets interpreted nega- the “Four Horsemen of the Apocalypse” extremely popular fad. If you Google the tively. Small off enses become magnifi ed (*See sidebar for more information). Usu- term “declutter” you will get 3,230,000 RELINQUISH THE PAST and miscommunications swirl out of con- ally these four horsemen develop in the fol- hits in just .06 seconds. Everyone is trying To begin the process of decluttering, trol - due to unresolved issues in the past. lowing order: criticism, contempt, defen- to pick up the latest tips on how to relin- it is crucial to begin sorting through what The good news is, once you have identi- siveness, and then stonewalling. quish what they don’t need, reorganize you have accumulated from your back- fi ed some of these memories and off ens- what they do have, and reprioritize how ground, prior to your marriage. This re- es, you can begin to work through them REPRIORITIZE THE FUTURE things should be. “Clutter” is the key word quires taking stock of what you brought in a healthy fashion and heal the pain or To review, the fi rst stage required sort- and it is essentially the enemy. It consists in with you from your past that may infl u- damage that they may be causing. ing through your piles of old habits and of the ‘stuff ’ we pick up along the pathway ence the way you operate in your mari- patterns, exploring your background and of life; day in and day out. It can be an over- tal relationship. This is especially critical REORGANIZE THE PRESENT uncovering buried issues and old hurts whelming and seemingly endless job to in the early stage of marriage as a new Sifting through the patterns and fea- from under the layers. Then there’s delv- declutter our homes- being that it is a by- couple establishes their foundation for tures that have been established in your ing through the collection of unhealthy product of the past, present and future… their marital relationship. It is helpful to marriage is the next step in this process. interactions, insecurities, and toxic styles There is another type of ‘home organi- explore your template for what you as- Couples tend to get stuck interacting with of communication to see which ones we zation’ which also requires consistent per- sume marriage ought to look like. What each other in fi xed patterns that may not may have gotten comfortable with that severance and eff ort- that of “declutter- are some of your expectations you have be healthy or eff ective. For example, peo- need to be addressed. What comes next? ing” your marriage. This most important for marriage? Where did these expecta- ple often slip into roles of over-function- The maintenance plan. If we truly relationship has a way of picking up ‘stuff ’ tions come from- your family of origin? ing or under-functioning with their part- want to aff ect long-term change in the that can be similarly overwhelming. Much Your parents’ own marital style? Do you ners, in which one of the spouses has future, the key is to set small, realistic of the strain in marriage is due either to: and your spouse have a similar template taken on too much responsibility-and goals and chip away at them consistently. • some unmet expectation or unre- for marital expectations? Notice the diff er- the other, not enough. This discrepancy Changing the nature of a marital relation- solved issue generated in the past; ences and similarities from your individual may be apparent in any realm: emotion- ship is not something that happens over- • insecurity, confl ict and poor commu- backgrounds. Identifying various expec- al, physical, practical and/or fi nancial. The night. It requires much eff ort and dedi- nication occurring in the present; or tations and preconceived notions about couple can become locked in a ‘seesaw’ cation, and in many cases, may require • worry and anxiety over unsatisfi ed marriage can be helpful in enabling cou- type of inversely proportional relationship the assistance of a professional marriage needs and unfulfi lled dreams in the ples to get “on the same page” and merge where the more one holds down their side, counselor or therapist. future. their vision of what marriage entails. the less the other one contributes from Any professional organizer will tell you Decluttering your marriage is high- Sorting through your past also can their end. This unhealthy pattern can re- that fi ghting the accumulation of clutter is ly worthwhile since it enables you to see include digging up those old arguments sult in problematic relationship dynam- an ongoing endeavor. The more you keep more clearly all the good that lies right be- and painful exchanges between you and ics such as enmeshment, co-dependen- on top of it, the less unwanted build-up fore you. Much like fi nding a favorite your spouse which took place at some cy and resentment. will accrue. The same is true for marriage! shirt tucked under a pile of clothes that earlier point in your marriage, which you While searching through the nooks If you make your marriage a priority by are rarely worn, the joy and positive op- haven’t quite let go of. Harboring ill-will and crannies of your marriage, anoth- putting eff ort into meeting each other’s portunities of marriage can sometimes or deep hurt over time can build the level er cluster of things to clean out are un- needs and actualizing your potential as be obscured by the common challeng- of negativity, eventually leading to a state healthy interactions which can be rooted a couple, then you will surely see results. es of marital life. By eliminating some of known as negative sentiment over-ride. in individual insecurity or low self-esteem. This includes building yourself individual- This is highly benefi cial since individuals ly while simultaneously working on your * TOXIC COMMUNICATION STYLES  “GOTTMAN’S FOUR HORSEMEN”: who become more secure with them- marital relationship i.e. creating positive Criticism: as opposed to a complaint- which addresses a specifi c action or selves, including both their strengths and lines of communication, nipping nega- situation where your spouse disappointed you, criticism is more global, includ- their weaknesses, tend to have more ef- tivity in the bud before it multiplies, and ing blame and general character assassination. “I’m really angry that you didn’t fective and constructive communication. spending quality time together creating sweep the fl oor last night” is a complaint. “You’re so selfi sh. How could you leave In a healthy marriage, the couple happy memories. By following these or- the fl oor like that?” is a criticism. should be able to communicate both ganizational tips, you will be on your way Contempt: sarcasm, cynicism, mud-slinging, name-calling, eye-rolling, sneer- positive and negative aspects of their re- to building the type of home that the two ing, mockery, and hostile humor are all forms of contempt. These are toxic to lationship in constructive ways. Construc- of you can enjoy and feel perfectly com- the relationship since they convey disgust. They lead to more confl ict than rec- tive communication builds the marital rela- fortable living in! onciliation. Comments such as: “what’s wrong with you?” or “you’re not normal!” tionship, as opposed to destructive com- are expressions of contempt. munication which breaks down the mari- Mrs. Tova R. Katz is a Licensed Mar- Defensiveness: A state of defending your position rather than listening to tal relationship. When a husband and wife riage and Family Therapist (LMFT) what the other person is saying. It is rarely eff ective since it is actually a way of are able to exchange genuine input about who specializes in marital and pre-mar- blaming your partner. In eff ect you are saying “The problem isn’t me, it’s you.” their feelings, needs or preferences, the ital counseling, as well as treatment of Stonewalling: In marriages where discussions begin with harsh start-ups, overall capacity for working through is- anxiety, depression, and other individ- where criticism and contempt lead to defensiveness, eventually one partner sues in the marriage increases dramatically. ual and family issues. Her clinical prac- tunes out and shuts down. This is what we refer to as stone-walling. Think of the Sift Through your Collection of Com- tice is Long Island Couples and Family husband who comes home from yeshiva and is met with a barrage of criticism munication styles Counseling (LICFC) in the Five Towns from his wife, so he buries his head in a sefer or busies himself on his comput- Sarcasm, laundry lists, untimely venting, and Far Rockaway areas. She has lec- er… which causes her to yell even more until he eventually gets up and leaves harsh start-ups, criticizing, labeling, over- tured in the NEFESH Conference for the room. This husband is stonewalling. He disengages rather than confront- generalizing and blaming are all examples Orthodox Mental Health professionals ing her. He may be avoiding a fi ght, but he’s also avoiding his marriage. This is of unhealthy communication styles which on pre-marital counseling and she lec- far more common among men than women (though women do this at times may have been collected over the years. tures on Marriage Enhancement in var- too). It is a result of feeling overwhelmed or fl ooded by all the negativity com- Couples get so used to speaking in these ious settings. She is trained as a J.M.E. ing his way. This may seem passive and indiff erent, like a “stone-wall”- but inside ways that they barely notice how much (Jewish Marriage Education) Kallah there’s intense anger and turmoil which needs to be addressed. negativity and distance they generate. In- Teacher and treats women and kallahs Gottman, John M., Ph.D., The Seven Principles for Making Marriages Work. spect your relationship for certain kinds of with intimacy issues. She can be reached Published by Three Rivers Press, (May 16, 2000). negativity, which can be so lethal to the re- at [email protected]. 30 | August 2011 HEALTH LIVING Mind, Body & Soul continued Showing Affection: Communicating Bonds in Relationships

Michael J. Salamon, Ph.D. thought the conversation was about re- Warmth, attentive nurturing, true feel closer to one another. Interesting- pairing a refrigerator. The third broth- dialogue communication and expres- ly, the same four steps for increasing In general individuals do not listen er stood there with his mouth open. sions of aff ection form the essence of aff ection in marriages apply to all rela- well to one another. If you watch peo- “I thought we were speaking of Dad,” what keeps people bonded to one an- tionships, including parents and chil- ple carefully, you will fi nd that there is he said. other. Separateness, even unintention- dren, between siblings, even among a lack of focus and attention in almost I have often heard people complain al, divides people. We often feel that we friends. The steps are: all conversations between people, even that the most stressful time for an Or- do give of ourselves to others, but most 1) Focusing on what you are feeling in the seemingly deep or heated con- thodox family is at the Friday night research into social interaction shows so that you can identify what your true versations that often take place at fam- Shabbat table. This is no doubt in part that not to be the case. What we do give emotion is to the other person. ily or social gatherings. That can be charitable, important 2) Ask open ended questions in is because there is no consis- and even, at times, signifi- all of your conversations to allow the tent attempt by many people cant, but until we give true other person to express themselves in to ask questions or follow a Everyone has something undivided attention and an more depth clear line of thought or emo- expression of love that can 3) Try to probe for a more complete tion in their communications to say and wants the be felt by the recipient, we understanding of what the other per- with others. It almost seems are missing the deeper link son is saying to you. like people, even caring peo- attention to be focused that we would truly want. Re- 4) Express true compassion of the ple, talk too fast or past one entirely on them. search also shows that with- person’s feelings and ideas. another. out this level of bonding, re- There is a famous quotation that Listen to politicians as lationship problems, rang- says “out of order comes chaos.” This is they exemplify this when ing from subtle to extreme, hardly the case in relationships. To have they are asked a question – the answer due to the expectations for certain be- inevitably develop. These diffi culties a loving warm and bonded relation- is often meandering and never seems haviors and actions at the table. Fri- are most often observed in marriages ship, you need to develop an ordered to directly address the original query. day night is frequently one of the few and in parenting confl icts. It is for this way of showing aff ection – by attend- It is not just elected offi cials who com- times during the course of a week that reason that the most common fami- ing completely to what is said and en- municate this way. All of us are too in- the entire family spends time togeth- ly complaint is, “You just don’t under- couraging intimate conversation. With volved in our own thoughts and expec- er at a meal. Everyone has something stand me!” some thought and eff ort, deeper bonds tations for how a conversation should to say and wants the attention to be Several experts suggest ways to can form in all of your important rela- develop, which causes us to fail to en- focused entirely on them. The natural overcome this shortcoming in commu- tionships. gage suffi ciently to properly focus on rivalries surface and some of the chil- nicating attention and aff ection. Most the true meaning of the exchange. This dren want more attention than their include a touch on the shoulder or star- Dr. Michael Salamon, a fellow of the type of verbal ADHD occurs among al- siblings. Adults expect certain behav- ing into the other person’s eyes as signs American Psychological Association, most everyone. iors, and frustration is often rampant. that you are focused on what they are is the founder and director of ADC I was listening to a conversation be- Inevitably there is misunderstanding saying. While these techniques are usu- Psychological Services in Hewlett, tween three brothers recently at a gath- and this confusion can lead to emo- ally helpful, they are more ancillary. The New York and a board member of ering at one of their homes. To one an- tional pain. real fi x happens when the actual meth- P’TACH. He is the author of numer- other they seemed to be having a co- What lies at the heart of this is a nat- od of communication is enhanced. ous articles and several psycholog- herent discussion, but frankly I had no ural tendency to focus a little too much Dr. John Gottman, an expert in the ical tests and books including “The idea what they were speaking about. on oneself causing a disconnect that area of research into successful mar- Shidduch Crisis: Causes and Cures” As they fi nished their talk, I asked what undermines the true meaning of a re- riages, has found that there are four (Urim Publications) and “Every Pot it was that they were discussing. One lationship with someone else. Again, steps to creating what he calls “intimate Has a Cover” (University Press of brother said they were talking about it’s the same issue of not listening com- conversations.” These types of conver- America). His newest book is called his new car while another said that he pletely. sations help make marriage partners Abuse in the Jewish Community. Psych Ward Diary I have been diagnosed with Bipolar take a good look around and whis- understand. My family was fear- Admitting myself was very diffi- Disorder. This is a personal account of per “I slept?” ful about the stigma, but I had no cult. I could care less about giving my feelings and experiences after vol- I made the tough, but necessary choice. I was scared of losing control up my cell phone and all my pos- untarily admitting myself to a psychi- decision to admit myself. The previ- and hurting myself, or worse, some- sessions, changing into a hospital atric hospital due to a severe episode ous month had been very difficult, one whom I loved. gown and removing all my personal of mania. with the visits and late calls to my Mood swings are not new to me, accessories. What hurt most was the I awake to find myself in bed psychiatrist, going back and forth so why was I so surprised when I wait. Patience and mania do not go surrounded by doctors and nurs- to adjust my meds. The tears and found myself swinging manic. I was well together. I wanted to start feel- es. I forget where I am. Dr Sacks, frustration, followed by the silence talking, but never finishing a thought; ing stable already. I was not compli- in his loud voice, booms, “How are were an unspoken cry for help. I was writing a paragraph without any sen- ant. I wanted this nightmare to stop. you feeling Rochel?” I shake my ill and needed treatment. tences; buying clothes to pass the Let the magic start – let this pain be head. I blink several times and an- I packed a small night bag and time; thinking deeply and not eat- over! Sedated, I remembered noth- swer in disbelief. “I feel as if I have told my family I was admitting my- ing. I was charming, funny, thought- ing more, which was a blessing. been run over by a car,” I respond. A self to the psychiatric ward in the ful, and loving, but also quick to an- chuckle ensues. Startled, I sit up to hospital downtown. They didn’t ger, teary, fearful, and very confused. Continued on p.31 HEALTH LIVING August 2011 | 31 Mind, Body & Soul continued Trichotillomania: A Tricky Problem

Benyamin Wolfson, M.ED. I was dumbfounded. When I got in the digestive tract that can be fatal if A study by Dr. Jon Grant at the Uni- home that day, I immediately “Googled” misdiagnosed. versity of Minnesota’s Medical School Hair styles for boys changed radical- that funny sounding name to begin a What could possibly cause one to has shown promising results from the ly in 1964. That was the year the Beatles long search on that topic in books, ar- start such an unusual behavior? There use of an over the counter dietary sup- appeared on The Ed Sullivan Show. In- ticles, research papers, etc. Here’s what is no clear answer. Theories about the plement called N Acetyl Cysteine or NAC. stantly, every kid in America wanted to I found. driving force behind the compulsive be- In a double blind, clinical study with 50 drop the ubiquitous “crewcut” and grow Trich (short for trichotillomania, also havior range from anxiety to depression people, 56% of people on the supple- long hair. At that time I was 11 years old referred to as “TTM”) is a “self-induced to stress to a neurocognitive model fo- ment reported drastically reducing their and living in a small town in northern and recurrent loss of hair.” It aff ects up cusing on the frontal lobes of the brain pulling after nine weeks. However, be- Wisconsin - and I had a terrible secret. to 4% of the population and is, report- which are believed to control habit for- fore trying this supplement, it is high- One fateful day, while we were playing edly, more common in women. ly recommended to consult dodge ball in gym class, my terrible se- It is classified in the DSM- with your doctor. A review cret, was exposed. My teacher had spot- IV as an impulse control disor- When they mentioned the word: of the study can be found at ted a massive bald spot on top of my der on the obsessive-compul- www.trich.org. This website is head. I had always meticulously covered sive spectrum with other disor- “trichotillomania,” I jumped the most important source of it over with hair from the sides so no one ders such as nail and cheek bit- off the couch and said, “What? information on TTM available would know, even my parents. I would ing, skin picking and eating dis- on the Internet. The website die of embarrassment if any of the oth- orders. There are three distinct There’s a name for this? Other is sponsored by an organiza- er kids knew that I was bald, and even subgroups by age: preschool people do it too?” tion, called TLC or, Tichotrillo- worse, that I was bald from pulling the age children, pre-adolescents mania Learning Center, and hair out, one by one, and then eating it. to young adults and adults. It was started by a woman with Once my horrible secret was discov- is also subdivided into “automatic” ver- mation. A recent study at the Center for the disorder. The organization publishes ered, my mother took me to the barber sus “focused” hair pulling. Children usu- Human Genetics at Duke University led a newsletter, runs conventions and re- shop and had my head shaved. That was ally fall into the automatic, or subcon- by Dr. Allison Ashley-Koch has identifi ed treats, and provides expert panel mem- her solution to the problem. Many other scious subtype, while older people may a gene (SLITKR1) that is common in 5% bers and current updates on research. people with trich have tried this. It never have focused, conscious ritual associat- of those with the disorder. She says that I also highly recommend the book: works. Once the hair grows back, one sim- ed with it. Some people pull only spe- this small fi nding may reveal the under- The Hair Pulling Problem by Fred Penzel. ply begins pulling it out again. In 1964, in cifi c types of hair or from certain areas lying biological causes, ultimately lead- At the YouTube web site, a search on Appleton, Wisconsin, no one had any idea on the head, while others pull only after ing to better treatments. the term “trichotillomania” will lead you what an “impulse disorder” was. Most of twirling and feeling “right” for that par- There are various treatments for TTM to videos by people talking about their my “therapy” consisted of relatives shout- ticular hair. Some pull out hair only from but no cures. One treatment with a mod- struggles and reports by professionals. ing at me: “Just stop it!” in frustration. eyelashes and/or eyebrows. erately high success rate is called: Habit A peer support group for people with Thirty-five years later, I was doing I had the ritual type. (I say “had” be- Reversal Training. This is a “cognitive be- TTM meets every Tuesday night in Man- in-home therapy for autistic children in cause I stopped pulling at age 15 though havioral therapy” based on recognizing hattan. There are two other TTM sup- Brooklyn. One day, while writing notes the urge continues). Pulling for me had impulses, redirecting the urge to anoth- port groups serving residents of north- on a session with one of my kids, I no- to “feel right.” I pulled from only the left er activity, motivational reward systems, ern New Jersey. Contact information is ticed that his mother was watching a TV side of my head. I had no impulse nor and generalizing the replacement activ- on the www.trich.org website. show about compulsive hair pulling. It received no satisfaction from pulling ity to other environments. immediately drew my attention. When anywhere else. After a hair was pulled, Medications such as those used for Benyamin Wolfson is a board cer- they mentioned the word: “trichotillo- I had to bend it a certain way and then, OCD and depression, SSRI’s like Prozac, tified behavior analyst presently mania,” I jumped off the couch and said, eat it. Eating hair is called: trichophagia etc., used in combination with behavior- working with autistic children in “What? There’s a name for this? Other and can lead to what is called, “Rapun- al techniques have been helpful to many Brooklyn, NY and can be contacted people do it too?” zel syndrome.” This is a build-up of hair of those who suff er from the disorder. at [email protected]

Psych Ward Diary letter to the president, then a poem I notice the door, at the far end angry – and then pull myself togeth- to express my feelings. Satisfied, I lay of the room. I make my way over. My er. We play some cards. I pretend Continued from Page 30 back down. shadow Rose is occupied. I calmly to care to know what is going on, Two hours later, tossing and turn- walk over and turn the handle. Noth- but I am exhausted. I excitedly dis- As I come to, I see people, fac- ing, I take a trip to the nurses’ station ing. Blood rushes to my face, reflect- cuss the new meds I would be tak- es and a window, and am aware of for more meds and then go back to ing my disappointment and shock ing that night to help me sleep. I ex- smells. I walk from the hard plas- bed. Restless, I listen to music, then at realizing that I am locked in. Sad- plain the side effects, and weigh the tic chair I had been resting on, and get up to walk back and forth. I lie dened, I try relaxing on the sofa. I pros and cons. press my nose against the glass down again and close my eyes, deep contemplate a question: If I could Squinting, I spot my psychiatrist. window pane. Instantly I am calm. in thought then, suddenly, morning walk free would I leave? I made the I mouth “thank you”. I had finally I close my eyes and see water, rain- arrived. choice to come. I wanted to feel safe slept, the smiles and the nodding drops and a beach. I sense a person Rose, my shadow for the morn- and get well. I conclude that while heads confirm. Sleep no longer elud- behind me. She introduces herself. ing, brings me a schedule; there this is hard, it is still the best place ed me. My journey of recovery had She is my nurse for the morning. I are many different therapy sessions for me now to heal. finally started. get up to go check out the hospital which she encourages me attend. It has been two weeks, why am I Today, twenty six months lat- floor. She follows. I now have a per- I enjoy music and art, but media- still suffering? er, I am home. I continue to be sta- manent shadow. tion is really hard. I find myself in- I anxiously stare at the door. Vis- ble and lead a healthy lifestyle. I am Nights are hard. I close my eyes; terrupting the instructor. I go to the iting hours have started. My mom holding a full time job. I run volun- thoughts follow one after the oth- library and sit in front of a comput- comes late, and my older sister fol- teer programs at different organi- er. Ignoring the night nurse sitting er. It takes me ten minutes to find lows. We chat. My mom has brought zations. I am now seeing a psychia- in my room, I grab a pen and paper the Internet icon. My eyesight is ter- me home-made food. I force myself trist and therapist. I am on medica- and start writing. First, I write my bi- rible. I am drugged. I lose patience to take a bite. Because I have no ap- tion and plan to remain on the meds ography, then, a few minutes later, a and leave. petite, it’s tough. I smile, laugh, get indefinitely. 32 | August 2011 HEALTH LIVING Mind, Body & Soul continued Help For Anxiety, Obsessions, And Compulsions By Mirel Goldstein, LPC your individual symptoms, however, did something wrong or wheth- Most people with OCD know that can be somewhat of a maze to sort er the other person will stop liking the thoughts they have and the things Some forms of anxiety are benefi - through! you. You might feel like you need to they do don’t make a lot of sense, but cial because they motivate us to take One common type of obsession has call this person over and over again feel that they cannot help themselves. healthy action. For example, anxiety to do with worrying about what other to make sure that everything is still They may be ashamed of their symp- about illness might lead us to seek treat- people will think of you. You might be “okay” between you. For someone toms and try to hide them from others. ment. However, there are other times overly concerned with how you look else, however, a trigger for obsessive They may even create a secret world when feelings of anxiety can be a disor- or how you perform. This kind of ob- thoughts might be work-related; a by putting up a painful wall between der; for example, if the anxiety doesn’t session may lead to compulsive diet- fear of making a mistake on the job them and other people in their life. make sense in a given situation, or if it ing or exercise, or a compulsive need and being criticized or causing harm Or, they may feel fi ne as long as they is so intense that it can interfere with a to check your work over and over again to someone. can manage to “control” the minimum person’s sense of wellness or quality of to make sure that you don’t make any In these cases, the root of the anx- number of things needed to manage life. The diagnosis “Obsessive Compul- mistakes. Or, you might be compulsive- iety and obsessive compulsive symp- their anxiety. But they might be driving sive Disorder” (OCD) specifi cally refers to ly nice all the time to everyone, and toms may be a need for approval from everyone around them crazy, leading a type of anxiety disorder in which anx- have trouble standing up for your own others or an underlying self-esteem to interpersonal confl ict. Sometimes iety over unwanted thoughts leads to needs. Everyone’s obsessions/com- problem. A history of trauma could a person with OCD may actually not repetitive behaviors meant to decrease pulsions are diff erent. You may even lead to a belief deep down that you know that his repetitive thoughts and such anxiety. In this article, however, the be perfectionist about certain things, are “bad” and “unlovable.” Obsessive actions do not make sense. This can term “OCD” will refer more loosely to but pretty relaxed about other things. thoughts and rituals can also be a way lead to feelings of bewilderment if oth- anxiety disorders in general. Your obsessions might be trig- of punishing and tormenting yourself ers around you are telling you some- While obsessions or compulsions gered by interpersonal conflict, for feelings which you feel guilty about thing that you do not believe inside. can be extremely painful symptoms, such as a fear that someone is an- or that make you feel out of control, Among the diff erent types of help they are also highly treatable. Trying gry with you; you may start to wor- such as anger or greed. available for obsessive compulsive dis- to determine the best kind of help for ry excessively about whether you There is also another type of OCD order are medications which decrease which is more about wanting a sense anxiety; cognitive techniques which of “control” over your own life or envi- help a person learn to think diff erently ronment. You might feel a strong need (for example, challenging the idea that for certain “things” in your life to be germs are really so dangerous); behav- in a certain “order” or to go a certain ioral techniques which help a person way. For example, you might feel like to act diff erently by ignoring obsessive you constantly need things to be more thoughts and not repeating compul- “even” or “neat” or “clean”. You might sive behaviors and psychodynamic ap- rearrange things many times a day, or proaches which might try to uncover Nefesh International in Conjunction with wash your hands again and again to re- whether there are meanings to the ob- The Lander College at Touro in Flatbush and the Orthodox Union move “germs.” Sometimes this can be sessions or compulsions that are not im- are Proud to Present: a reaction to feeling a lack of enough mediately obvious, such as underlying “control” in other areas of your life, or feelings of guilt. having lacked enough control in an You may need to try several ap- earlier traumatic situation. Control- proaches until you fi nd the one that Trauma & Teshuva ling the things around you that you works for you. It is important that you Date: September 11, 2011 can control makes you feel like at least feel comfortable with the approach Time : 8:30 Registration there is “something” that you are in that your therapist uses. Don’t be shy 9:00 AM-1:00 PM charge of, or that you can prevent up- to ask about that in your initial consul- Location: Touro College setting things from happening to you tation, and “shopping around” for the 1602 Ave J in the future. person who will be just right to help Brooklyn, NY 11230 Sometimes this kind of OCD can you with your individual symptoms. Nefesh Member Fee $65 ~Non Member Fee $75~Student Fee $45 makes it hard for others to live with Remember, the “label” OCD describes a you. You may even want to stop need- set of thoughts, feelings, and behaviors Topics to be Discussed ing to control so much, but fi nd that that you are having trouble with, but Does trauma facilitate Teshuva, or impede it? ~Do religious people handle trauma differently or better you are actually controlled by the need doesn’t really say that much about the than others ?~ Is personal meaning always found in collective trauma? ~Are spiritual reactions to trauma a defense, a coping strategy or a healing step? ~Why do some traumatic events effect us more for control. For example, if you are a cause of your symptoms, their mean- deeply, and haunt us much longer, than other traumatic events?~ How can we help others who are mother who is obsessed with avoid- ing, or what will help you manage or traumatized when we ourselves are traumatized? ing germs and you have a two-year old eliminate them! who likes to play outside in the dirt all the time, this can lead to confl ict; ei- Mirel Goldstein, MS, MA, LPC is ther you will make yourself emotion- a licensed therapist with a pri- ally unhappy by allowing your child to vate practice in Passaic, NJ. She play in the dirt, out of rational belief specializes in treating long-stand-

Guest Speaker that this may be healthy for your child ing personal and relationship is- Chairperson Guest Speaker Rabbi Dr. Dovid Fox Dr. David Pelcovitz Rabbi Dr. Tzvi Hersh Weinreb Clinical and Forensic Psychology Professor, at his stage of development, , or you sues. Mirel can be reached at Strauss Professor of Executive Vice President Emeritus, Psychology and Education CSPP-LA Orthodox Union Azrieli Graduate School, Rav, Hashkama Minyan, Young Israel of Hancock might anger your child by excessively 303-204-7039 or via her website, Yeshiva University Park, Visiting Dayan, Bais Din of the Rabbanut restricting his normal play. www.goldsteintherapy.com. Yerushalayim HEALTH LIVING August 2011 | 33 Mind, Body & Soul continued ‘Stop Being So Negative’ A Parent’s Guide to Understanding Negativity in Children

Mark Staum, LCSW Tamar Chansky, in her book Freeing Your Child From Anxiety, off ers an analogy for how to help chil- After a long day of school, Reuven comes home dren learn how to ‘fl ip their brain’ to learn to focus excited to tell his mother about his class’s contest. more on the positive aspects of a situation. In her dis- Here is their conversation: cussion about anxiety, Dr. Chansky writes that one’s Reuven: In class today, Rebbi told us that we are brain can be likened to a train track. As a train ap- going to be having a contest. Each talmid will be al- proaches a fork, it can go in one of 2 directions; to lowed to sell raffl e tickets. If we sell $100.00 worth of the right or to the left. Similarly, a child’s ‘brain train’ tickets, each talmid will be award- ed a special prize. Mother: That’s great!! I am so excited for you! Let’s make a list of people that you can call to sell tickets. Reuven: I am not sure that I really want to do this. What if no one wants to buy any tickets? Mother: Let’s give it a shot! I know that you can do this! You did a great job selling the tickets for the shul raffl e two years ago! Reuven: Forget it No one is going to buy from me anyway! Negativity or negative think- ing relates to the way that we per- ceive people, things, and events, and can infl uence the way that we respond to daily events. In the above example, Re- can also go in one of 2 directions. One can choose uven’s belief that he would not be able to sell tickets the smart track or one can choose the worry track. Women-centered therapy focused may have infl uenced his decision not to even make Helping the child to understand this ‘brain train’ anal- on life’s turbulence any eff ort to sell any tickets. ogy helps them to understand that just as their brain and transitions Negative thinking children focus solely on the focuses on the worry track, the child can also ‘talk downside of a situation more than other children, back’ to his/her brain to help the brain transfer to Dodi Lee Lamm, who seem to possess a better balance between pos- the smart track in other to achieve a diff erent result. 516-255-2009 itive and negative aspects of circumstances. Further- Similar to anxiety, negativity also involves choosing Making that first therapy more, these children often experience an overeggat- one view of a given set of facts over another. Help- appointment is tough. When you call, erated reaction in response to a negative situation. ing the child realize that there are 2 sides of the coin I will help lead you on a journey that For example, the child who feels that he never gets (the negative and positive/problem solving side) will is full of acceptance, empathy, growth, what he wants, may react angrily to an unfavorable help the child to begin to focus on potential solu- and insight. dinner choice by saying, ‘ In this house I never get tions to the problem. anything that I want,’ and then storms off to his room. Negative thinking can also lead to anger. There- Dodi Lee Lamm, Licensed Clinical Social Worker, 100 North Village Avenue, Suite 20 As the negative elements of a situation are magni- fore, it is important to help one’s child learn how to Rockville Centre, NY 11570 fi ed, the child may not focus at all on other, more pos- recognize and deal with his anger. Relaxing, taking itive elements of the situation. This magnifi cation of- deep breaths or engaging in an enjoyable activity ten leads to sadness, anger, and other negative emo- can often help a child to step away from a diffi cult tions that may impact the child‘s daily life. Research situation, enabling the child’s mind and body to re- on brain fl exibility tells us that this can be remedied; lax. This will then help to prepare them for dealing NechamaNechama however, by reframing and positive thinking can help with the situation in a diff erent way. Helping when help is needed most to shift this negative predisposition in a child. In many situations, the dynamics and circum- Dawn Huebner, in her book What to Do When You stances may be very complex. If your child seems Nechama is an organization dedicated to Grumble Too Much, suggests techniques to help em- to respond or act negatively, it is important to take helping all family members who have power parents to be their child’s coach. As a ‘coach’, notice and assess the impact that it has upon their experienced infant and/or pregnancy loss at a parent can relate to their child’s inner-workings by home and social interactions. One should not hesi- any time in their lives. We provide immediate making statements like, ‘I see why you are so frus- tiate to contact a mental health professional if one assistance and guidance to the family while trated’ or ‘this must be making you really angry.’ This has any specifi c questions about their child’s mood dealing with the loss. Nechama runs monthly helps the child feel validated and understood. Once and functioning. support groups and individual counseling to the child feels validated, the ‘coach’ (in this case, the all family members, and is in touch with parent) can encourage the child to refl ect on what Mark Staum is a clinical social worker at The medical personnel, Rabbis, and Rebbetzins. he/she would like to be done in this situation. For ex- Frisch School in Paramus, NJ and is a staff ther- We also run community awareness programs ample, a parent can ask the child-‘What would you apist at Bikur Cholim of Rockland County’s Cen- to help members of the community, family, like to do now? How do you think that the situation ter for Applied Psychology. Mark deals extensive- and friends be prepared if and when this tragic can be handled?’ These questions allow the child to ly with children and adolescent mental health event occurs. get past his complaints and emotions, and begin to and maintains a private practice in Teaneck, NJ. Reva Judas, Director tell himself that this is a problem that I can overcome He can be contacted directly at 201-952-4436 or 642642 MaitlandMaitland AveAve and make better. 201.692.9302 [email protected]. Teaneck,Teaneck, NJNJ 0766607666 201.692.9302 34 | August 2011 HEALTH LIVING Feature Story

vania, “We saw at least a 1,000-fold acute lymphocytic leukemia, as well the condition. The company has chal- News from the Front increase in the number of modifi ed as pancreatic and ovarian cancer and lenged the FDA panel’s fi ndings, and in the War on Cancer T-cells in each of the patients. Drugs mesothelioma. asked for more time to conduct addi- Continued from Page 1 don’t do that,” He noted that T-cells at- tional tests to prove the drug’s eff ec- tack viruses that way, but this was the DISAPPOINTMENT tiveness. At the FDA hearing in June, at the University of Texas disagrees. He fi rst time that behavior has been seen WITH AVASTIN some defenders of Avastin testifi ed notes that medical science still does in their action against cancer. There has been particular disap- that they believe that it has extended not know enough about what causes “We were surprised it worked as pointment with the results from the their lives or the lives of family mem- most cancers to justify diverting re- well as it did,” Dr. June said. “We’re just drug Avastin, which was introduced bers suff ering from breast cancer and sources away from the traditional ave- a year out now. We need to fi nd out in 2004 to attack cancerous tumors accused the FDA of bias against Avas- nues of cancer research, which is mak- how long these remissions last.” by trying to cut off their blood supply. tin because of its high cost. ing some progress, although obvious- While it has been useful against some However, several leading breast ly not fast enough. RESULTS IN 4 WEEKS early-stage cancers, it has not been as cancer advocacy groups and experts The article described the expe- eff ective as had been hoped in treat- praised the FDA’s actions. They urged HUNTERKILLER TCELLS rience of one 64-year-old patient in ing advanced cancers which had al- the agency to base its decisions on the There continue to be signs of prog- detail. When he began the new treat- ready begun to spread throughout scientifi c evidence, rather than emo- ress in research for treatments against ment, his blood and marrow were the body. In tests on patients with ad- tional appeals. specifi c forms of cancer, but after 40 “replete with tumor cells.” After two vanced colorectal tumors, in conjunc- “Now we must focus attention years filled with many disappoint- weeks with no change, he became ill tion with chemotherapy, it was able and resources on drugs that will truly ment, it is diffi cult to get excited about with chills, nausea and fever, indicat- to extend life expectancy by about make a diff erence for women suff ering promising reports from early research. ing that a large number of cancer cells five months, but it could not fore- from breast cancer. Avastin does not,” The most recent cause for hope were dying. At the same time, blood stall death. said Fran Visco of the National Breast involves results obtained from ge- tests showed a huge rise in his T-cell In addition, the Food and Drug Cancer Coalition. netically modified T-cells in the count. “It was like the worse fl u of their Administration has refused to au- The disappointing clinical results, blood, an element of the body’s im- life,” June said. “But after that, it’s over. thorize the use Avastin against early combined with its very high price, mune system. The researchers engi- They’re well.” By the end of the fourth stage breast cancers, because its ef- has caused Britain’s National Health neered the T-cells to hunt and attack week, his blood was completely clear fectiveness was not proven in sever- Service to reconsider using Avastin cancer cells in patients with chron- of leukemia cells. al clinical trials. for the treatment of any kind of tu- ic lymphocytic leukemia, or CLL. It The main complication from the A crucial six-member FDA advisory mor, in the belief that it may not be as is the second most common type treatment is that it also destroys some committee unanimously concluded in cost-eff ective as less expensive cancer of adult leukemia after chronic my- of the body’s other infection-fi ghting June that the drug was harming wom- treatments. eloid leukemia Bone marrow trans- blood cells; requiring the patients re- en with advanced breast cancer more SHOULD PROSTATE CANCER plants are the standard treatment ceive other treatments to boost their than it was helping them. If the FDA BE TREATED AT ALL? for patients with this form of leuke- immune systems. revokes its recommendation of Avas- New research has also cast doubt mia, but there is a 20 percent risk of Dr. Walter J. Urba of the Provi- tin for use against advanced breast on the entire approach to diagnos- death from the procedure and cure dence Cancer Center in Portland, Or- cancer, it will still remain available on ing and treating prostate cancer. A rates are only about 50 percent. egon, writing in an editorial that ac- the market, since the drug has proved 20-year study of 9,000 men conduct- According to a study published in companied the report on the study in useful against other forms of cancer. ed by researchers at the Karolinska In- the New England Journal of Medicine, the New England Journal of medicine, However, insurance companies may stitute in Stockholm, shows that while researchers tested the technique on called its fi ndings “pretty remarkable” decide to stop covering the cost of its diagnostic blood tests and digital rec- three men with advanced cases of the but added, “It’s still just three patients. “off -label” use in the treatment of ad- tal exams have helped to detect pros- disease. They removed a sample of the Three’s better than one, but it’s not vanced breast cancer, which can range tate cancers they did not reduce the patients’ T-cells and genetically mod- 100,” noting that much more exten- as high as $100,000 a year. death rate due to the disease over ifi ed them to attack all cells that ex- sive testing of the treatment will be Avastin’s 2008 FDA approval for that period. press a certain kind of protein, CD19, required before it can be declared safe breast cancer was controversial from Prostate cancer is the second-most which includes tumor cells. Then the and eff ective for general use. the start. Only one of the fi rst studies common cancer in US men. It caused modifi ed T-cells were re-injected into One of the three fi rst test patients, conducted found that the drug ap- 217,730 new cases, and 32,050 deaths the patients’ bodies. who himself is a scientist, called him- peared to slow the growth of an ad- last year, according to the American Earlier attempts at genetically self “very lucky.” vanced breast tumor, delaying pro- Cancer Society. modifying T-cells have had limited He was fi rst diagnosed with CLL gression by about 5 1/2 months. Tak- The screening for prostate cancer is success; but once inside the body, the 15 years ago at the age of 50, which en as a whole, the initial drug stud- done by measuring the levels of a pro- modifi ed cells failed to reproduce well had been successfully treated initial- ies were inconclusive about the ef- tein known as PSA in the blood. But and quickly disappeared. Therefore, in ly with chemotherapy until eventual- fectiveness of the drug, so the FDA elevated PSA levels are not a reliable the new study, the T-cells were also ly it no longer worked. gave Avastin a conditional approv- indication of prostate cancer, which engineered to start replicating them- Almost a year since he entered the al, to make it available to patients in can only be confi rmed with a biopsy. selves as soon as they attached them- new T-cell study he wrote, “I’m healthy treatment quickly, with that approv- Last year, the American Cancer So- selves to a cancer cells, allowing them and still in remission. I know this may al to become permanent if later tests ciety changed its guidelines to refl ect to maintain their potency and contin- not be a permanent condition, but I by the drug maker, Genentech, could other research fi ndings that prostate ued hunting down the cancer cells in- decided to declare victory and assume prove it eff ectiveness. screening tests may do more harm side the body. that I had won.” However, a panel of FDA experts than good, especially in older pa- The study reported that two of Another researcher involved with in July, 2010 concluded that the new tients. The new guidelines take into the subjects are completely cancer- the study, David Porter, wrote, “Most studies had failed to shown that the account the high incidence of false free up to a year after treatment. Af- of what I do is treat patients with no drug extends life or slows breast tu- positives from the PSA test, and the ter a year, the third patient is much other options, with a very, very risky mor growth for much more than one side eff ects from prostate cancer treat- improved, but still has some cancer therapy with the intent to cure them. month. ments which may do more damage cells in his body. This approach has the potential to do Before the FDA announced in De- than leaving the slow-growing tu- According to the senior author of the same thing, but in a safer manner.” cember that it may revoke Avastin’s mors alone. the study, Dr. Carl June, a gene ther- Researchers now intend to test the approval for breast cancer treatment, There has also been criticism of the apy expert at the Abramson Cancer same gene therapy technique in treat- the drug was being prescribed annu- use of Provenge for treating prostate Center of the University of Pennsyl- ing non-Hodgkin’s lymphoma and ally to about 17,500 US women with cancer. Some have questioned wheth- HEALTH LIVING August 2011 | 35 Directory Feature Story Advertising er its $93,000 cost is justifi ed, given that test shows Researchers continue to add to the long list of that it extends a patient’s life by an average of only substances which are known to cause cancer. The four months. latest addition by the National Toxicology Program of the National Institute of Environmental Health AN ALTERNATIVE Sciences is the widely used industrial chemical TO A COLONOSCOPY formaldehyde, which it says is a cause of throat can- Researchers are also investigating a new, non- cer and one form of leukemia. The same scientists invasive way to detect colorectal cancer using can- also said that they now suspect that other common cer-sniffi ng dogs. A study conducted in Japan found substances which may cause cancer. These include that a specially trained Labrador retriever, sniffi ng styrene, which widely used in the manufacture of a patient’s breath or stool, was at least 95% as ac- rubber, insulation, pipes, car parts, carpet backing curate in detecting colorectal cancer as a colonos- and disposable food containers; cobalt-tungsten copy. The dog was particularly eff ective in detect- carbide, which is found in cutting and grinding ing the cancer at its earliest stages, and were even tools used in many industries, the glass wool fi bers capable of detecting the diff erence between pre- found in home and building insulation, and o-ni- cancerous polyps and active malignancies. trotoluene, which is a common component of col- The dog’s ability to detect colorectal cancer at or dyes, and has a number of other industrial uses. the earliest stages is particularly valuable, because at that point, 90% of patients can be cured with sur- ANOTHER BENEFIT OF ASPIRIN, AND AN gery. According to the American Cancer Society, UNANSWERED QUESTION there were 140,000 cases of colorectal cancer di- Another study suggests that the risk of contract- agnosed in the US last year, and more than 50,000 ing colorectal cancer may be reduced by as much deaths due to the disease. 50% by the regular use of non-prescription painkill- The dog was tested by sniffi ng 5 samples at a ers like aspirin or ibuprofen, even for those with a time taken from 48 people with confi rmed colorec- family history of colon cancer. This result confi rmed tal cancers, mixed in with samples from 258 other the fi ndings of an earlier study which also found presumably healthy subjects. that aspirin can reduce the risk of colon cancer. Other tests on dogs have confi rmed their abil- The more often painkiller was used, the great- ities to detect, by smell alone, patients with skin, er the reduction in the cancer risk. Daily use result- bladder, lung, breast and ovarian cancers. ed in a 28% drop in cancer risk, while monthly use ARE CELL PHONES provided a 14 percent reduction. A CANCER RISK? Researchers also could not explain a fascinating The debate in the scientifi c community still rag- diff erence they found between the kind of protec- es over whether cell phone use increases the risk tion off ered by taking aspirin daily and the other of contracting cancer. Even though the radio sig- non-steroidal anti infl ammatory drugs, known as nal generated by a cell phone is relatively weak, be- NSAIDs, such as ibuprofen (Advil) and naproxen so- cause it is held directly next to the brain in typical dium (Aleve). Aspirin provided a 62 percent drop use, even a very small added cancer risk could be in the risk for rectal cancer, but left the risk of co- signifi cant, given the fact that there are today near- lon cancer unchanged, whereas the other NSAIDs ly fi ve billion cell phones in use around the world. provided a 56 percent drop in the risk of cancers Part of the diffi culty in evaluating the extent of in the part of the colon farthest from the rectum the cancer risk is that widespread cell phone use (the proximal colon), but left the risk of rectal can- is relatively recent. As a result, there is only 10-15 cer unaff ected. years of research data available to judge the can- The study was funded by the National Institutes cer risk for adults, and no reliable data at all for cell of Health, and its fi ndings were published in the phone use by children. Furthermore, the nature of American Journal of Gastroenterology. cell phone radiation has changed as cell phones Dr. Andrew Chan, a gastroenterologist at Massa- evolved from analog to digital technology in re- chusetts General Hospital, said the study confi rmed cent years. previous research indicating “that aspirin use reduc- This helps to explain the wide variation in the es the risk of colorectal cancer,” but since aspirin can results of recent published studies on the cancer promote the development of ulcers and bleeding, risk from cell phones. there were many questions that still needed to be For example, the UN World Health Organization’s answered before doctors could safely recommend International Agency for Research on Cancer recent- that their patients take it as a preventative measure. ly classifi ed cell phone use as “possibly carcinogen- ic to humans.” Other items which the WHO labeled A STRAWBERRY A DAY as potential cancer risks included lead, pickled veg- However, there are no such dangerous side etables and coff ee. eff ects from eating strawberries, which research- However, a group of experts from the US, Eng- ers at Ohio State University have found can slow land and Sweden who conducted a major review the growth of precancerous lesions which even- of all the research conducted on cell phones so far tually lead to esophageal cancer. The researchers and found no convincing evidence of any cancer conducted a pilot study of such lesions in 36 peo- 'U=HY0D\EUXFK risk. The experts also said that there was little rea- ple who consumed 60 grams a day of freeze-dried Comprehensive Dental Care son to believe that even much stronger radio signals strawberry concentrate for six months. The growth with Emphasis on Snoring could cause glioma or meningioma brain tumors. of the lesions was slowed in 29 of the subjects. and Sleep Apnea Treatments. “Although there remains some uncertainty, the The study was a follow up on earlier research Mention The Jewish Press trend in the accumulating evidence is increasingly which showed that strawberries could slow the and receive $100 towards creating your beautiful smile! against the hypothesis that mobile phone use can development of tumors in lab rats. The study was cause brain tumors in adults,” the experts wrote in funded by the California Strawberry Commission, 5Gw.HZ*DUGHQV+LOOV1< the journal, Environmental Health Perspectives. which also supplied the freeze-dried strawberries.  36 | August 2011 HEALTH LIVING Directory Advertising Health Provider Bulletin Jerusalem’s Alei Siach Provides Innovative Care to Special Needs Community

By Steve K. Walz casions. Graduates of the Alei Siach training pro- gram are employed at the in hospitals, daycare During a recent national conference in Tel Aviv, centers, schools and business offices, —and even which focused on the mushrooming “special needs” in the Knesset! community in Israel, a member of the Alei Siach or- Less than a week after the new center opened, ganization was invited to join a panel of legal, rabbin- all 120 job training slots were filled, which spurred ical and psychological experts who debated the issue of dat- ing and marriage amongst physically and mentally chal- lenged young adults. Rather than delivering a traditional speech, the Alei Si- ach panelist screened a short, state-of-the-art video about a young ‘special needs’ couple and their desire to create their own Jewish household and family as a true Bayis Ne’eman B’Yisroel. After demonstrat- ing the couple’s mature un- derstanding of that would be required of them within Esther Hornstein L.Ac. the context of their physical Licensed Acupuncturist, msac and mental short-comings, 917-414-3831 A proud Rav Chaim Perkal (center) watches as one of his job-training participants the video culminated with describes her work to Jerusalem Mayor, Nir Barkat at the recent opening of Alei Si- their spectacular chuppah, ach’s rehabilitative occupation center. Private Acupuncture & Facial Rejuvination in Flatbush www.2ndNatureAcu.com which was attended by distin- Community Acupuncture Treatments in Bensonhurst guished community and rabbinical leaders, moving Rav Perkal to seek additional avenues of assis- Sliding Scale $20-$40 many people in the audience to reach for a tissue to tance in order to expand the program. “We have www.CommunityHeartAcupuncture.com Placenta encapsulation for Post Partum Recovery wipe away the tears. a long and growing waiting list of people who [email protected] This creative, out-of-the-box thinking has become want to enroll in the program, but we need more the hallmark of Alei Siach’s approach to meeting the space and funding in order to meet the requests needs of the physically and mentally challenged from the parents of special needs youngsters and youngsters and young adults in metropolitan Jeru- young adults,” Rav Perkal told the Jewish Press. He salem’s Chareidi community. Founded 20 years ago added, “There are many people today across Isra- by Rav Chaim Perkal, after he realized that the Chare- el who don’t have access to similar programs for idi community lacked the services needed by his own their special needs youngsters because they sim- autistic daugher, Rivka. ply don’t exist.” Under the leadership of Rav Perkal, Alei Siach has The many achievements of Alei Siach have be- emerged to become the leading non-profi t, commu- come a source of pride for Jerusalem Mayor Nir nity outreach organization in metro Jerusalem. It has Barkat, Israel’s Minister of Social Welfare, Moshe developed an extensive network of sector-appropri- Kahlon, and even President Shimon Peres. They ate services, ranging from sheltered housing, day-care have come to rely on Rav Perkal’s quiet brilliance centers, respite care and day camps to counseling and and persistence in creating personalized revolu- assistance in all areas relating to children and adults tionary care for special needs children, teenagers with Down’s Syndrome, Asperger’s, autism and oth- and adults via Alei Siach’s various programs. Sever- er disabilities. The organization currently serves over al of Alei Siach’s communal programs receive assis- 1,000 teens and adults, with nearly 500 workers and tance from the municipality of Jerusalem and the volunteers tending to their daily needs. Several of the Ministry of Social Welfare, and President Peres has programs have been extended to include teenagers bestowed national awards to Rav Perkal. and young adults from the national religious com- Word of the success of Alei Siach’s innovative munity as well. approaches has also reached the US. Rav Perkal One of Alei Siach’s most innovative programs is also told The Jewish Press, “During the past few housed in their new rehabilitative occupation cen- months, we have also been contacted by Amer- ter which is providing training for employment or ican Jewish organizations and parental groups work for over 120 young adults. The spacious new who wish to understand and learn more about center was designed and equipped to accommo- our unique programs. We would be more than date Alei Siach’s population of special trainees, happy to show our programs to leaders of Ameri- including a unique wing reserved just for autis- can Jewish organizations, parents and philanthro- tic adults. Those working at the center produce a pists whenever they visit Israel. Tikkun Olam is not line of handmade art, Judaica and novelty items, a private venture. It’s a mission that belongs to all which can be ordered for events and special oc- of Klal Yisroel.” HEALTH LIVING August 2011 | 37 Directory Health Provider Bulletin Advertising Chayim Aruchim - The Address for Families, Rabbanim and Medical Professionals Dealing With End-of-Life Issues NEW LEGISLATION kos – a day when the chevra’s members would be busy Most of us are inundated daily with numerous re- preparing for the approaching Yom Tov and would be minders of how Torah values diverge from that of the available only in event of an emergency. The “unavail- secular world around us. A most poignant sign of this ability” of that day caused the family to further delay reality surfaced recently with the passing of legisla- their regrettable plans. In the meantime, the patient tion in New York State that gives government more regained consciousness and arose from his sick bed. of a say as regards providing life-sustaining medical In one situation, when a choleh’s family members care to hospital patients. and their Rav told a frum intern that halacha directs The law requires physicians who treat the termi- that life-sustaining measures be implemented in the nally ill to off er their patients and their family mem- case, the intern revealed that his medical training had bers information and counseling regarding prognosis him believe the opposite. Clearly, the medical per- and palliative and end-of-life care, including pain management and hospice care, as well as options for life-sustaining treatment. Additionally, askanim have re- ported that they have learned from reliable sources that hospital patients – even not those critically ill -- will be urged to sign a “Do Not Resuscitate” order if a life-threaten- ing situation, chas v’shalom, was to set in. Perhaps the most serious de- velopment that has emerged, ac- cording to Rabbi Shmuel Lefkow- itz, Vice President for Communi- ty Services of Agudath Israel of America, is that hospitals will be Standing right to left- Abe Eisner, NYS Health Commissioner Nirav R. Shah, evaluated on the basis of mortality M.D., M.P.H., Rabbi Gedaliah Weinberger and Rabbi Shmuel Lefkowitz rates, meaning that if a large num- ber of patients die in a particular hospital, it will be spective and the halacha on these issues are often given a more negative rating. In their desire to keep not “on the same page.” Rabbi Gedaliah Wajsfeld, the mortality rates low, hospital administrations will feel Agudah’s Chairman of the Board, points out that the compelled to discharge critically ill patients, thus pos- secular world looks at the gravely ill and the elderly sibly denying them of life-saving care. as having fulfi lled their purpose in life and is looking In response to this state of aff airs, Agudath Israel to advance their exit from the world. The Torah view is of America, has established Chayim Aruchim-the Cen- that as long as a person exists, it is obligatory to pro- ter for Culturally Sensitive End-of-Life Advocacy and vide care and keep alive as long as possible. Counseling, to serve as a resource for families, Rab- banim and health-care professionals grappling with KNOWLEDGE OF THE ISSUES a medical crisis. If a hospice is chosen, care must be taken to select a hospice that respects halacha and considers the rab- FAMILIES IN CRISIS bi an integral part of the treatment team. Rabbi Aron Wajsfeld, who serves as Chayim Aruchim’s director, has a solid background in work- ROLE OF THE RABBANIM ing with patients and families in crisis. He depicts Harav Avraham Y. Friedlander, Hivnover Rav, shli- for us this scenario: A hospital patient is gravely ill ta, and mechaber of sifrei Chasdei Avraham on inyanei and the hospital is pressing the family to make de- refuah, in his long tenure as Rav of Maimonides Hos- cisions of life-and-death magnitude. At such a time pital, has always advocated interaction between the people are under tremendous pressure. It is very Rabbanim and the medical community. He also add- encouraging to know there is someone out there ed that it would be a good idea to organize regular to contact for guidance and information. People meetings between Rabbanim and doctors to foster can call Chayim Aruchim and receive direction at this communication. such a time. To contact or for information on Chayim Aruchim, Rabbi Wajsfeld related that there was a critically ill please call 718-535-9061 or email to chayimaruchim@ patient whose nonobservant family resolved that due agudathisrael.org. to their loved one’s desperate situation they would di- No halachic conclusions regarding medical and end- rect the hospital shortly to “pull the plug,” and even con- of-life issues should be made based on this article. Such tacted a chevra kaddisha to schedule a levayah. The day decisions must be made by a competent Rav on a case- they unwittingly selected for the levayah was Erev Suk- by-case basis. 38 | August 2011 HEALTH LIVING At a Glance Health & Living Checklists Continued from page 3

Spiders: There are both venomous and non- venomous species of spiders. They generally bite Back To School Health Checklist humans when they feel threatened, or when they Time to start putting away the sunscreen and wa- EYE EXAM mistake a human fi nger as its natural prey, like a ter balloons and dig out the notebooks and pencils. If your child daydreams a lot or has a short atten- caterpillar. The pain from non venomous spider Parents are so focused on purchasing everything on tion span, this could be the result of poor vision. Par- bite will typically subside within an hour, while the the supply list, that they can neglect to make sure their ents often associate squinting or headaches as signs pain from venomous spider bites will typically lasts child is prepared academically by being up to date with that their child has vision issues, but that is not al- for more than a day. Spider bites require medical their health checklist as well. ways the case. Vision problems can aff ect the way attention if the reaction continues to worsen after your child learns in class. Your child’s fi rst eye exam 24 hours, including symptoms such as a spreading SHOTS should take place at 6 months of age, and compre- redness, a halo-like discoloration or drainage from Make sure your children are up to date with their im- hensive eye exams should be conducted beginning the site of the bite, or an increase in pain or numb- munizations, or else they will not be allowed in school. at 3 and then every 2 years. Just as in hearing tests, ness and tingling. Every state and school, for that matter, has diff erent re- children can be labeled dyslexic, ADHD or hyperac- quirements, so fi nd out what they are. There are also tive when really the problem is poor vision. PREVENTING BITES more shots required now than before, including hepa- The more of your skin is covered, especial- titis B, chickenpox, and possibly a booster of the MMR SPORTS ly on the arms, legs and head, the less likely you in junior high. Some schools even recommend flu If your child plays sports, the American Academy of are to get stung. It is also believed that certain shots. For a complete list of which shots are needed for Ophthalmology recommends one-piece wraparound stinging insects are attracted to brightly colored which age, visit The American Academy polycarbonate sports frames for all contact sports, clothing, or fl oral prints, as well as perfumes and of Pediatrics (AAP) web site, which to protect their eyes. All children wearing glasses scented shampoos. Substances which are be- fully explains childhood vacci- need sports frames for gym. Lenses should be made lieved to repel biting insects include fabric soft- nations. Your school district or of shatterproof polycarbonate. ener sheets, vinegar, garlic as well as foods con- local health department will Sports played on the play- taining garlic or thiamine (vitamin B1). also make this clear, and you ground can be just as dan- Commercially sold insect repellents may pre- can consult your pediatrician gerous as those on a profes- vent a bite from a mosquito, tick, or chigger but as well. sional fi eld. Each year, the ER are not eff ective in repelling stinging insects. sees 135,000 cases of sports- or DEET is the most eff ective insect repellent on CONTACT NUMBERS recreation-related brain injury trau- the market, and is available in sprays, liquids, Parents take it for granted mas, including concussions, in chil- creams and wristbands. It is safe for use in adults that the school has their emer- dren ages 5 to 18, according to the and children as young as 2 months old. Apply it to gency numbers already filed, CDC. Because of these alarming num- your clothes, and avoid contact with broken or irri- but you need to make sure bers, many states now have concus- tated skin or near the eyes or mouth. Higher con- your child’s emergency tele- sion guideline laws designed to centrations of DEET will repel insects for longer phone numbers are accu- keep school kids off the playing

periods of time. rate and kept current. Your fi eld until they’ve completely re- list shouldn’t be limited to covered from even minor head in- TREATMENT: relatives either. You also need to write your juries. Find out your school’s concus- Bee Sting: If the stinger is still in the wound, child’s physician and dentist’s numbers. Some- sion guidelines. If it doesn’t do not try to pull it out with your fi ngers or a twee- times children’s roughhousing knocks out a tooth have any, teach your child zers, and do not scratch or pinch the site of the and this requires immediate attention. It is also useful and friends the signs of a concussion (bad headache, wound. Any of these actions could inadvertently to make your pharmacist’s number available in case unusually sleepy or confused conduct, vomiting re- squeeze more of the venom from the stinger into there are complications with their medicine. peatedly or a seizure). the wound. The proper way to remove a stinger from your skin is by scraping over it lightly with a MEDICINE DENTAL VISIT credit card or fi ngernail. The school nurse and/or school secretary also needs Take your children to the dentist a few weeks be- All other insect bites and stings: If it itches, to know what prescriptions your child takes. Even if fore school starts. If your child needs to have a wis- apply calamine lotion or baking soda and water. the child takes the medication only at home, the nurse dom tooth extracted, root canal or braces, it is best Wash the site of the bite and the surrounding area should know in case your child falls ill or experiences to do this before the start of the school year, since of- thoroughly with soap and water. The prompt appli- side eff ects. If the child is to take the drugs at school, ten the child will have to take a few days off to deal cation of cool compresses or ice packs will usually they should be sent in the pharmacy bottle, clearly with the pain. help ease the pain and prevent swelling. marked, and not in Ziploc bags. Here is a list of non-prescription, over the coun- If your child suff ers from allergies, the school should LICE ter remedies for the reactions and pain from com- be notifi ed so that teachers will be on guard against a Children are especially prone to lice after being mon insect bites. In each case, carefully read the product or food that may trigger the allergy. in summer camp, in close quarters. Kids ages 3 to label for proper dosages and possible side eff ects: If your child has asthma, a scoliosis brace, or a heart 11 have the highest risk of catching infestation, and Local Anesthetics: Benzocaine (Americaine), murmur your school should know. passing them onto others. Most schools do check for Pramoxine (Itch-X), Benzyl alcohol, Lidocaine (So- lice and nits, but it is best to fi nd and eradicate them larcaine), Dibucaine (Nupercainal) and Phenol HEARING EXAM at home, to spare the child the awkwardness of be- Antihistamine: Diphenhydramine HCl (Bena- Have you noticed your child raising the stereo vol- ing sent home or isolated from other students. dryl)- Available in tablet, capsule, liquid, cream, ume, asking you to repeat yourself when calling on To check for lice, sit your child in a well-lighted gel, or spray. the cell phone, or favoring one ear over the other? room and comb through his wet hair in sections us- Counterirritants: Camphor (Band-Aid Anti-Itch Your child may be suff ering from hearing loss. Most ing an ordinary fi ne-tooth comb. Look for lice or their Gel), Menthol states now mandate hearing tests for babies, but many eggs (nits) on the scalp and on hair shafts near the Hydrocortisone: Cortaid and Lancort- Relieves school-age children have not been tested. Your child’s scalp. You may also fi nd some stuck to the comb. You Available in the form of cream, gel, lotion, oint- academic performance can be compromised if he can’t may be able to remove them all by hand, if you are re- ment, spray, or stick. Do not use if you have sca- hear his teacher in school. You would be surprised how luctant to expose your child to harsh over-the-counter bies, an existing fungal or bacterial skin infection. many kids are misdiagnosed with learning disabilities or prescription treatments. After treating your child Skin Protectants: Zinc oxide and Calamine- or ADHD when the problem all along has been a hear- for lice and nits, check their head one more time, care- Available in lotion, ointment, and cream. ing (or vision) issue. fully, to make sure that you got them all. HEALTH LIVING August 2011 | 39 From the Doctor’s Desk: Dr. Norman Saffra Let Our Children See

In my capacity as the chairman of normal blood vessels, while leaving oth- the Ophthalmology Department at Mai- er healthy tissue in the eye undisturbed. monides Medical Center in Brooklyn for Furthermore, new drugs coming on the the past 18 years, it has been my pleasure market promise to drastically cut the cost ™ to found and direct The Eye Institute, a of eff ective treatments for wet macular state-of-the-art facility to diagnose and degeneration. treat all types of opthalmologic problems, A complication of diabetes known as using the most up to date treatments, in- diabetic retinopathy is the fi fth leading cluding medications, laser surgery and cause of adult blindness. However, we microsurgery. have learned that by keeping blood sug- The Institute has recently opened a ar levels under control, we can reduce the new Pediatric Eye Center. It is outfi tted damage to vision from diabetes by half, Where Shabbos is not just with state-of-the-art equipment for di- with laser treatments and medications agnosis and management of pediatric further improving the outcome. another day of the week. eye disorders such as cross eyes, strabis- Recent advances in minimally invasive mus, lazy eye, and amblyopia, with an microsurgery have also transformed the Nothing can hold a candle to the SHABBOS SPIRIT emphasis on early intervention for opti- vitrectomy, a procedure in which some of at Margaret Tietz Nursing & Rehabilitation Center. mal results. the internal fl uid in the eye is removed to From the davening to the heimish seudos We are blessed to be living at a time correct retinal detachments or to repair when new treatments, medications and macular holes. Until recently, it was ma- prepared by Chef Yossi & Chef Eli . . . we provide surgical techniques have revolutionized jor surgery, but today it is routinely per- SPIRITual Sustenance as Your Body Recovers!™ opthalmolog. Today we have the tools to formed on an outpatient basis, using lo- prevent or cure conditions which had, in cal anesthesia, and often not even requir- • Daily and Shabbos Minyanim the past, permanently blinded millions of ing stitches. • Festive Shabbos & Holiday Meals conducted by our Shabbos Rabbi older Americans. In the June 2011 edition of the jour- Our newfound ability to preserve vi- nal Ophthalmology, we have published • Shabbos Hospitality Apartment for visiting family members sion into old age and maintain quality of the research results of a massive screen- located only a block away / Complimentary meals included life is more important than ever before ing program of 11,000 children, mostly • Newly expanded Eruv connecting our facility to Kew Gardens because of the dramatic increases in life from the Boro Park community. One of Hills, Jamaica Estates/Holliswood and Hillcrest/Fresh Meadows expectancies today. the goals of the study was to scientifi cal- For updates call our Eruv Hotline at (718) 298-8800 In the Third World, cataract blindness ly test the common folk belief that giving continues to rob the vision of both adults young children glasses at too early of an • Shabbos Elevator and children. According to the World age will make them more nearsighted. • Shiurim / Study Groups with the Rabbi Health Organization, it is responsible for al- Our research found no evidence that • Dedicated Glatt Kosher Kitchen under Vaad Harabonim of Queens most 50% of the cases of blindness around giving children corrective lenses, or en- the world. By contrast, in the United States, couraging them to read or do other close cataract surgery has become the single work at a young age, will have any neg- most common operation performed on ative impact on the acuity of their vision. those over the age of 65. Furthermore, As a result, our strong recommenda- thanks to new lens implants inserted as a tion to parents who say the bracha of “po- routine part of cataract surgery, many pa- kayach ivrim” each morning, is to have tients emerge from it with better vision their child’s eyes tested at the fi rst sign than they ever had in their lives before. of vision problems, or, at the latest, by Glaucoma is known as the “silent thief the time they reach school age. Let your of sight” because it gradually reduces our child see the world around them, both to peripheral vision. Using new medications help them learn and to walk about safely! and laser treatments, we now can pre- vent glaucoma, the world’s second lead- Dr. Norman Saffra, MD, FACS, re- ing cause of blindness, from causing irre- ceived his medical training and did his versible damage to the retinal nerve cells. residency at the Albert Einstein College In just the last two years, we have seen of Medicine and a fellowship at SUNY major advances in the treatment of the Downstate Medical Center. He is Board third most common cause of blindness, Certifi ed in Ophthalmology, and an ex- age-related macular degeneration, which pert in the diseases of the Retina and today is the leading cause of irreversible Vitreous. In addition to his chairman- vision loss after age 65. Using small injec- ship of the Ophthalmology Department tions into the eye of medications like the at Maimonides Medical Center, he is anti-cancer drug Avastin, doctors can halt a Professor of Clinical Ophthalmology the development of abnormal blood ves- at the Mt. Sinai School of Medicine in adlibunlimited.com sels in the eye which are responsible for the New York City, and an Adjunct Profes- “wet” form of the disease, and actually help sor of Ophthalmology at NYU Medical A Member of the Beth Abraham Family of Health Services to repair some of the damage already done. Center. He is also on staff at Lenox Hill Margaret Tietz Center is the proud sponsor of Previously, the only way to treat the Hospital and NY Eye and Ear Hospital "JEWISH MUSIC UNDER THE STARS" presented by the QJCC condition was to destroy the abnormal in Manhattan. He may be contacted at Aug. 17: Yiddish Fest • Aug. 24: Jewish/Israeli Music • Aug. 31: Family Entertainment blood vessels with lasers, which could The Eye Institute at 902 49th Street, in damage other parts of the eye. The drugs Centrally located near the Queens communities Boro Park (718) 283-8000, or at its Five of Kew Gardens Hills, Hillcrest & Jamaica 164-11 Chapin Parkway, Jamaica Hills, NY 11432 are far superior because they act like a Towns location at 22 Bayberry Road, Estates. Only 20 minutes from Brooklyn, 718-298-7800 • www.margarettietz.org “smart bomb,” destroying only the ab- Lawrence, NY (516) 239-6789 Manhattan & the Five Towns.