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CONTENTS A publication of the Jewish Press, publishing since 1960

7 Digest 8 Lessons from the Oregon Study

Supplement Publisher Senior Editor

Yaakov Kornreich

10 The Impact of Child Molestation 12 How to Afford Overnight Camp? 14 Music and Your Child’s IQ

Amy Dubitsky Avigayil Perry Leah Rothstien Ita Yankovich

WOMEN’S HEALTH

Advertising Sales

Memory?

18 Treating Menopause Naturally ✪

Design

Feeling Spacy? 16 Losing Your Memory? You’re not crazy – your hormones are messing with your mind. Learn how menopause impacts memory loss.

Alana White

GOLDEN YEARS

HEALTHY LIVING

28

MEDICINE TODAY

Shaindy Urman

16 Is Menopause Pausing Your

How to strengthen community efforts to protect our children and penalize predators. At risk? Our precious Jewish neshamas.

GOLDEN YEARS

Heshy Korenblit

Advertising Coordinator

10

The Abuse— Ruchniyus Battle

Advertising Director Arthur Klass David Hoppenwasser

Groundbreaking Oregon study reveals few gains, huge expenses with Medicaid expansion.

WOMEN’S HEALTH

Associate Editor Rachel Wizenfeld Features Editor Ita Yankovich Contributing Writers:

RAISING OUR CHILDREN

Is More Medicaid a Good Thing?

RAISING OUR CHILDREN

Moshe Klass

8

ISSUES

ISSUES

INTRODUCTION

INTRODUCTION

20 Alzheimer’s - The Disease of

February 2014

2014 Issue

25 Risks for Alzheimer’s 26 Visiting Someone with Dementia 28 Time to Retire From Driving 30 Problems with Medicare

Advantage Plan

5

Seize the Keys

Scared about your parents’ driving skills? It may be time for that tension-filled talk about taking away the car keys.

COMMUNITY PROFILE

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Tomorrow

H&L TECH


INTRODUCTION

INTRODUCTION Introduction

CONTENTS

RAISING OUR CHILDREN

ISSUES

32

Dentures are so Last Year

MEDICINE TODAY

32 Dental Implants Versus Dentures 34 FDA Monitor ✪ 35 Managing Diabetes at Home 36 Genetics and the Dating Scene? ✪ 37 Genetic Counseling as a Career

WOMEN’S HEALTH

Implants are the wave of the tooth-replacement future. Here’s why.

38

HEALTHY LIVING

GOLDEN YEARS

A Passover Dilemma

38 Pesach on a Restricted Diet 41 10 Facts About Chocolate th AND Living Service Marketplace 42 Weight Loss and the Teenager ✪ ADDICTION RECOVERY 44 43 Fast Chicken Dinners ✪ What to eat when you can’t wheat, or sugar, or nuts or anything else that’s a Pesach pantry staple.

MEDICINE TODAY

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48 Community Profile 52 49 Medical Profile 50 Community Provider Bulletin 51 Community Calendar 52 Health and Living Service

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Dear Reader: This issue of Health and Living deals with two serious challenges: the lack of an effective treatment as the incidence of Alzheimer’s disease increases with the aging of the baby boomer generation, and the severe spiritual damage being inflicted on our children by predators in our midst. On a lighter note, as we struggle through a severe winter, this issue looks past the snow to preparations for Pesach for those on special diets, and resources to help us pay for summer camp for our kids. As usual, there is something in this issue for almost everyone, including a broad range of interesting facts and tips, as well as practical advice on healthy living, which we respectfully submit for your enjoyment and enlightenment.

The Editors SUBMISSION INFORMATION

Health & Living invites readers to submit letters to the editor. Letters will be selected for publication at the sole discretion of the editor, and may be edited for size and content. Submissions become the property of the Jewish Press. Please e-mail your letter to the editor to magazine@jewishpress.com. Health & Living, in its sole discretion, reserves the right to decline any submitted advertisement or to discontinue publication of any advertisement previously accepted. The acceptance of advertising by Health & Living does not constitute endorsement of the services, products, or information advertised. For subscription requests, advertising rates, general inquiries, calendar information and schedules contact Health & Living at 718.330.1100 ext. 352. You may also write to: Health & Living c/o The Jewish Press, 4915 16th Avenue, Brooklyn, NY 11204-1115 or e-mail magazine@jewishpress.com.

February 2014


Digest

?

H

? ?

Health Tip

It’s scary to be short!

Off-Hours Heart Attack Patients Get Slower Hospital Care And Are 5% More Likely To Die.

Scientists from Oxford University used virtual reality technology to reduce the height of volunteers traveling on a computersimulated train by 10 inches. They found that the experience of being shorter increased reports of negative feelings, such as being

Not that you choose when to get a heart attack anyway, but experts are advising hospitals to rethink their staffing structure and ensure optimum capacity 24/7, not just during office hours. No matter what day or time it is, however, the second you suspect you’re having a heart attack, call an ambulance. (Source: USA Today)

were also more likely to think someone else in the virtual train was deliberately staring, thinking badly about them, or trying to cause distress.

(Source: The Telegraph)

– CEO of AOL Tim Armstrong on why he’s cutting pension benefits, in a human resources gaffe that went viral.

Bad at Math? You may just need an electric jolt.

New research shows that higher consumption of yogurt, compared with no consumption, can reduce the risk of new-onset type 2 diabetes by 28 percent. Scientists found that in fact higher consumption of low-fat fermented dairy products, which include all yogurt varieties and some low-fat cheeses, also reduced the relative risk of diabetes by 24 percent overall. (Source: Science Daily)

7

COMMUNITY PROFILE

In a lab in Oxford University’s experimental psychology department, Israeli researcher Roi Cohen Kadosh is testing an intriguing treatment: He is sending low-dose electric current through the brains of adults and children as young as 8 to make them better at math. This relatively new brain-stimulation technique called transcranial electrical stimulation may help people learn and improve their understanding of math concepts. However results are very individualized and can sometimes backfire, due to an incorrect current or poor environmental factors. What is clear is that anyone trying the treatment would need to train as well as to stimulate the brain. Otherwise “it’s like taking steroids but sitting on a couch,” says Dr. Cohen Kadosh. (Source: WSJ)

H&L TECH

Yogurt consumption reduces the risk of type 2 diabetes.

HEALTHY LIVING

Research Study

Need to Know

February 2014

MEDICINE TODAY

We had two AOL-ers that had distressed babies that were born that we paid a million dollars each to make sure those babies were OK in general. And those are the things that add up into our benefits cost.

GOLDEN YEARS

Quote

WOMEN’S HEALTH

incompetent, dislikeable or inferior. Height-reduced participants

RAISING OUR CHILDREN

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Fast Fact

ISSUES

By Elisheva Stein

INTRODUCTION

RAISING OUR CHILDREN ISSUES


INTRODUCTION ISSUES RAISING OUR CHILDREN WOMEN’S HEALTH

? Oregon Medicaid Study Disturbing Lessons from the By Elisheva Stein By Yaakov Kornreich

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? n 2008, the state of Oregon de? cided to use available state budget funds to expand the enrollment ??? in its state-administered Medicaid health coverage program. The expansion included adults between the ages of 19 and 64 and earning less than $10,400 a year, or $21,200 for a family of four. Because there was only enough money to cover 30,000 out of a total of 90,000 people in that income category, the state conducted a lottery to randomly choose who from that population would receive Medicaid coverage. The Oregon expansion provided the unique opportunity for a research team at the Harvard School of Public Health to conduct a randomized scientific study of the benefits of providing free health care to those who were previously

uninsured. The Harvard researchers, led by Katherine Baicker, an economist at Harvard, tracked various health care statistics for those who were the beneficiaries of the Oregon Medicaid expansion, compared to those in Oregon who lost the lottery and remained uninsured, who served as a “control group” for the study. The study, carried out under near-ideal conditions, provides hard evidence about the value of the Medicaid program. The Oregon results can also be used to predict the results of the expansion of Medicaid coverage to everyone earning less than 138% of the federal poverty guidelines living in the 25 states and the District of Columbia participating in that aspect of Obamacare. The study’s surprising results contradict two of the main benefits that have been touted by supporters of Obamacare. They argued

that it would provide health coverage to the more than 40 million Americans without it, and save the state and federal governments a great deal of money by reducing the number of uninsured Americans who seek their non-emergen-

The results of the Oregon study contradict both of those conclusions. A report published last May in the New England Journal of Medicine found that those who had been given Medicaid coverage by the Oregon lottery made

cy health care at a hospital emergency room, which is much more expensive than an office visit to a primary care doctor. The supporters of Obamacare claimed that giving free Medicaid health coverage to millions of the low-income uninsured would significantly improve their overall health and reduce their health costs. How? Because they would be able to see, at no cost to them, a primary care physician for routine and preventive treatment, rather than much more expensive hospital emergency rooms.

greater use of primary care physicians for preventive treatment. But overall, they were not significantly healthier than those in the control group with respect to three of the most serious chronic medical conditions, high blood pressure, high cholesterol, and high levels of blood sugar, even though the number of those given Medicaid diagnosed with diabetes and prescribed medicine to control it increased. The greatest benefits measured among those getting Medicaid were financial and psychological, due to its protection

COMMUNITY PROFILE

H&L TECH

HEALTHY LIVING

MEDICINE TODAY

GOLDEN YEARS

RAISING OUR CHILDREN ISSUES

8

February 2014


H

acare supporters can still point to the financial and psychological benefits from Medicaid’s protection from catastrophic medical costs confirmed by the Oregon study, but Obamacare critics argue there are much less expensive

MEDICINE TODAY

THE ANNUAL AWARDS GALA 5/21/14

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at Museum of Jewish Heritage in NYC WeThe areProud Proud Name ThisYear’s Year’s Honorees: We are totoName This Honorees:

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H&L TECH

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HEALTHY LIVING

Weare areProud ProudtotoName NameThis ThisYear’s Year’sHonorees: Honorees: We We Weare areProud Proudto toName NameThis ThisYear’s Year’sHonorees: Honorees: DavidA.A. David Staffenberg,MD MD Staffenberg, Physician of the Year Physician of the Year David A.A. David AwardA. Award David Staffenberg, David A. MD Staffenberg, MD Staffenberg, MD Staffenberg, MD Physician of the Year Physician ofof thethe Year Physician Year

an Anglo-Jewish journalist for more than 40 years, and writes regularly on a wide range of both Jewish and secular topics. He is the senior editor of two supplements published by The Jewish Press: “Health and Living” and “Building Blocks,” and a co-author of the book “Young Israel at 100,” published in 2012.

GOLDEN YEARS

invites you to

Yaakov Kornreich has been working as

WOMEN’S HEALTH

The explanations as to why there is no difference in the overall physical health of those getting Medicaid coverage compared to those with no coverage are more troubling. Dr. Ashish Jha, a Professor of Health Policy and Management at

and disruptive ways to achieve the same benefits. There is an ongoing debate within the health care establishment as to the lessons to be learned from the Oregon study’s surprising findings. The dominant explanation given

Harvard, writing in the The Health Care Blog, says that the Oregon study failed to find a significant improvement in the health of those being given free access to doctors accepting Medicaid because the payment system is not currently structured to reward doctors for providing higher quality care and better health outcomes. Dr. Jha says that the problems revealed by the Oregon study extend far beyond Medicaid. Low quality health care due to skewed payment priorities is a characteristic of the entire American health care system, and the root cause of its high cost, especially when compared to health care in many other advanced countries.

RAISING OUR CHILDREN

“The supporters of Obamacare claimed that giving free Medicaid health coverage to millions of the low-income uninsured would significantly improve their overall health and reduce their health costs.”

ALEH Foundation

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for the increased use by Medicaid patients of hospital emergency rooms, even during their primary care doctor’s normal office hours, is that it is still more convenient than waiting to be seen after making an office appointment.

ISSUES

against catastrophic out-of-pocket medical costs. As a result of having that worry eliminated, the rate of depression experienced by those By Elisheva Stein in the Oregon who got Medicaid lottery was 30% less than those in ? the control group. The? second finding, published in the journal Science in January, ???that those receiving Medicaid was in Oregon were 20% more likely to use emergency room services than those in the control group, and that the average number of visits they paid to the emergency room after receiving their Medicaid coverage increased by 40%. The accuracy of the Oregon study’s results is unchallenged. Obamacare advocates are no longer predicting any savings from the reduced usage of hospital emergency rooms from its expansion of Medicaid, and are finding it more difficult to argue that giving the uninsured Medicaid coverage will make them significantly healthier, or reduce the number of them dying from treatable diseases. Obam-

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INTRODUCTION

RAISING OUR CHILDREN ISSUES

SM, MD, SM, MD,FACP FACP Medical Medical Medical Medical Volunteer Award Leadership Award of Excellence Leadership Award of Excellence Medical Volunteer Award Leadership Award of Excellence Leadership Award ofofExcellence Seereverse reverseside side forSponsorships Sponsorships Reservations! See for &&Reservations! Leadership Award Excellence

See Seereverse reverseside sidefor forSponsorships Sponsorships& &Reservations! Reservations! See && Reservations! Seereverse reverseside sidefor forSponsorships Sponsorships Reservations! The Aleh Foundation USA

February 2014

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INTRODUCTION ISSUES

RAISING OUR CHILDREN

The Devastating Impact of Child Molestation on Spirituality By Rabbi Yerachmiel Milstein

COMMUNITY PROFILE

H&L TECH

HEALTHY LIVING

MEDICINE TODAY

GOLDEN YEARS

WOMEN’S HEALTH

RAISING OUR CHILDREN

E

vidence-based scientific research is rare in the discussion of problems faced by the frum community. Whatever research that may be available is generally sponsored by government agencies, such as the Census Bureau, public or private think tanks, or industrial mega-giants, all of which are sorely lacking in places frum people live like Beverly/La Brea and Boro Park. The struggle by the frum community to fund its own schools and other essential services is so difficult that there is rarely any money available for it to fund its own studies into even the most pressing of its social problems. As a result, when it comes to analyzing disturbing trends or explaining communal crises in the frum community, we necessarily have to rely primarily on anecdotal evidence. That is why this article’s discussion of the awful impact of child molestation on the victim’s spirituality draws heavily on the admittedly anecdotal and highly personal perceptions of those of us who have been actively working with victims of child molestation in our community over the last 20 years. Nevertheless, we are confident that our conclusions are accurate, and that the problem is more serious than most people in the frum community realize. The good news is that nearly all of us have seen considerable success in helping these most hurt members of Klal Yisroel find a renewed sense of spirituality. According to our experience, this is how it works. Regardless of the age of the victim, the molestation of a sentient minor is almost without exception a highly traumatic event and often results in the onset of a collection of symptoms and behaviors called Post Traumatic Stress Disorder (PTSD), a term more commonly usually used to describe the psychological damage suffered by soldiers in combat. Studies show that the brain scans of adult victims of child molestation closely resemble

those of Holocaust survivors. In fact, many a victim I worked with said that they wished the predator would have killed them instead of molesting them. One molestation victim was particularly affected when little Leiby Kletzky, a”h, was brutally murdered. She said she was depressed because she was envious of Leiby and wished she had been killed like him. To explain the effects of child abuse, we need to review a few basic concepts of human develop-

mated object for the gratification of the adult predator. Often the terror and emotional devastation of molestation is accompanied by significant physical pain and even injury. Sometimes, the attacker is not just oblivious to the victim’s pain, but may actually desire it in order to heighten his or her enjoyment. Children may not realize it during the attack and for some time thereafter, but when the reality of the abuse finally sinks in, it can be devastating. In the wake of

“The good news is that nearly all of us have seen considerable success in helping these most hurt members of Klal Yisroel find a renewed sense of spirituality. …” ment. For children to develop normally, they require an environment that provides both physical and emotional sustenance. It almost universally accepted that the most basic emotional need we all have is for safety and security. To thrive as human beings, we must grow up with the perception that the world is a relatively safe place. Second, we need to know that we are, each of us, individuals who matter to ourselves and others. These basic selfperceptions give us the self-esteem we need to take the necessary risks to form relationships, grow and even excel. The more firmly we are rooted in our healthy self-perceptions, and the more confident and secure we are in our feelings of self-worth, the more potential we possess for growth and eventual self-actualization. Beyond any physical damage, child molestation is a shattering and vicious attack on a child’s selfperception. The victim absorbs the lesson that he or she does not matter, and is a merely an ani-

the attack, the child feels completely vulnerable and depersonalized. The victim is robbed of the crucial perception that he or she is a valid, love-worthy, self-determining human being. Instead, survivors of abuse begin to see themselves as nothing but an afterthought to someone’s gratification. One of the most gut-wrenching conversations I have ever had, was with a victim of systematic abuse who was so shattered that he could only muster a monosyllabic yes or no to my questions. I thought I might able to draw him out by asking, “If you were a color what color would that be?” He said, “nothing.” Okay, I thought, let’s try this another way. “If you were an animal what animal would be?” I queried. Again he said, “Nothing.” After a few more tries, he sighed and simply said, “Rabbi Milstein, don’t you know that I am nothing?” Were a child to be molested even just once, it could result in lifelong damage. However, most of the cases we have witnessed in our com-

10

munity have been unending, longterm nightmares. The severe psychological impact resulting from molestation can wreak havoc on every part of a child’s life and especially on the victim’s view of ruchniyus. Children who have been molested commonly blame themselves for their own victimization. Since molestation is rare, the child thinks that he or she must be “bad” or “caused” the predator to act this way. Worse still, some children believe that having been permanently “soiled,” they are spiritually irredeemable and are doomed for eternity. This prompts them to give up on “being good.” Children who consciously or subconsciously think this way may suffer such unrelenting guilt that they sometimes attempt to escape the despair by rejecting their identification with religion, redefining their beliefs or value system or insisting they are atheists. Another way they may arrive at the same spiritual conclusions is by focusing their anger towards their parents and Hashem, who “allowed” this to happen to them. Reb Noach Weinberg zt”l of Aish HaTorah often said that Jews are so holy that they would rather deny G-d’s very existence than say that He was unmerciful! Some survivors of childhood abuse seek escape from their suffering by engaging in the most stimulating activities they can find, such as alcohol or drug abuse, or by, ironically, acting out sexually. The intense momentary experience may give them a temporary respite from their constant anguish. However, many then experience even more guilt for having acted out. The intensified need to escape from the additional pain causes them to act out again, which for some leads to a full-fledged addiction. Here again, victims may claim to have revamped their beliefs to deal with the crushing guilt and depression from their behavior. Molestation also has an impact on a child’s ability and motivation to learn. Some researchers

February 2014


Rabbi Yerachmiel Milstein is a wellknown Jewish communal activist and lecturer, who currently serves as executive director of Project Innocent Heart.

COMMUNITY PROFILE

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H&L TECH

February 2014

HEALTHY LIVING

was able to regain his official position in the community and reportedly resumed his old, nefarious ways. When he learned of this, the victim was so re-traumatized that he left his family and his observance and has now become emotionally unstable. All too often, the ultimate price we pay for molestation is the loss of the life of the victim through suicide or by accidental drug overdose. By no means is every “off the derech” child a victim of molestation, but there certainly exists a broad consensus of agreement among clinical therapists that a

MEDICINE TODAY

has been abused by a respected and established frum authority figure. A number of years ago, a young man from a small mid-western community revealed he had been repeatedly violated by a much beloved and revered religious figure. When his accusations were widely rejected, he decided to leave his town and his religion behind. He sought refuge in the world of drug dealing and abuse. Finally, the young man sought treatment, settled down and had charges successfully brought against the perpetrator who was forced by law enforcement to permanently leave

GOLDEN YEARS

may cause them to re-experience the trauma of their abuse. Poor academic performance in a religion, culture and society that so highly prizes learning achievement can also serve as ample cause for them to reject frumkeit. Some abuse victims find a way to ignore their pain and despair by escaping into the fantasy world of their imaginations where they may tell themselves happy or stimulating stories to escape the recurring flashbacks of the offending abuse. By paying attention and listening in class, they risk suddenly being thrust back to the present and the

disproportionately large part of the “at-risk” community consists of abuse victims. Furthermore, while there are no hard statistics to back this up, there is a rare, near universal agreement among my colleagues that the untimely deaths of frum young people by means other than natural causes is almost always attributable to their having been abused as children. Parents and friends need to be able to recognize the sudden behavior changes which are the most common outward signs of molestation, or some other serious problem. These include: children who use age-inappropriate explicit language, obsession with sexual anatomy, drastic declines in social habits and academic performance, unexplained anger, depression, fear of authority, unwillingness to be examined by a doctor, heightened sensitivity to normal touching and touching other children inappropriately. These signs do not, by themselves, prove anything, but further inquiry is most certainly recommended. There is one bit of good news in all of this. These children can heal significantly if they receive the proper professional help. It cannot be emphasized enough that early therapeutic interventions by properly trained professionals can, over the long term, help them lead fully functional lives. I recently attended the wedding of a young man I helped remove from his terribly abusive home years ago. He has been receiving quality therapy for five years. He has gone from repeated hospitalizations to becoming completely self-reliant and operating a successful business which he now shares with his wife. As a community, we need to spend more time, resources and energy to prevent child molestation. We need to become far more vigilant and proactive about the safety of our children in our schools, shuls and homes. The costs of prevention are minimal compared to the cost of attempting to repair the shattered neshama of a once sweet, innocent heart.

WOMEN’S HEALTH

his position of authority and undergo treatment. The victim decided to give observant Judaism another chance and studied hard to become a rabbi. Eventually he married, became a father and led a rich and rewarding kollel life. The perpetrator in the meantime found a legal loophole and left treatment. Shortly thereafter he

RAISING OUR CHILDREN

awful reality which they were so desperate to escape. Child molestation becomes further complicated with the morally repugnant sin of chillul Hashem when the offender is identifiably frum. The deleterious effects of chillul Hashem can rarely, if ever, be expunged. Although very rare, the worst of all scenarios is when a child

ISSUES

believe that severe trauma negatively affects the neural pathways of the brain and interferes with the physical learning process. At the very least, children diagnosed with PTSD have a hard time focusing in a classroom setting. Being put in a situation where they are again being told what to do by a powerful adult (in this case, the teacher)

INTRODUCTION

RAISING OUR CHILDREN


INTRODUCTION ISSUES RAISING OUR CHILDREN WOMEN’S HEALTH GOLDEN YEARS

Can You Afford Overnight Camp? By Avigayil Perry

W

hile hot, summer days still seem far off in the distance, parents shouldn’t postpone thinking about summer plans. Many parents opt to send their children away to overnight camp for an experience that will leave warm, lasting memories. But they may find themselves shocked by the high costs of camp tuition, ranging anywhere from $2,500 and $5,000 for just one month of camp, and going above $7,000 for a full summer. To compound matters, parents often have multiple children to send to camp simultaneously and are already struggling to pay school tuition during the academic year. But financial aid is available from a variety of sources, as long as you start planning early Parents can pursue a few op-

tions to pay for sleepaway camp without breaking the bank. Some

org) and PJ Goes to Camp (pjlibrary.org), specifically target first-

The Jewish Children’s Regional Service is another source provid-

$1000 grants, including the One Happy Camper (onehappycamper.

time campers. The Foundation for Jewish Camp (FJC) offers the One Happy Camper incentive grant for parents of public school children attending Jewish overnight camp for the first time. PJ Goes to Camp, sponsored by the FJC and Harold Grinspoon Foundation, is an incentive grant for PJ Library participants, siblings, and alumni. (PJ Library is a program that sends Jewish books and CDs to Jewish children across North America.) Both of these grants are not scholarships, and thus not needs-based.

ing scholarships for many nonprofit Jewish camps throughout the United States and Canada. However campers must reside in Alabama, Arkansas, Louisiana, Mississippi, Oklahoma, Tennessee or Texas, so this is likely not an option for families in mainstream Jewish communities. Parents are also urged to contact their synagogues for help with camp tuition. Some synagogues have funds allocated for this specific purpose, and rabbis can point to philanthropists or

At a Glance

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Overnight camp is expensive, but the experience can be transformative for many children. To get the most bank for your buck, register early to get available discounts and apply for scholarships from the camp directly. Your local synagogue may offer camp scholarships, and check with your rabbi who can potentially help you fundraise from the community. The below organizations offer additional grants and subsidies for Jewish campers, however be aware that they may only provide grants for nonprofit camps affiliated with the Foundation for Jewish Camp. Many Orthodox camps will not fit the bill. ❧ Most Jewish Federation offer camp subsidies: www.ujafedny.org (for New Yorkers) or www.jewishfederations.org (to locate your own) ❧ One Happy Camper offers grants to first-time campers: www.onehappycamper.org ❧ PJ Goes to Camp offers grants to first-time campers: www.pjlibrary.org ❧ Bunk Connect (www.bunkconnect.org) is another way to score cheap camp tuition for first-time campers.

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February 2014


$4,598 for a full summer are lower than most since they are all-inclusive, covering costs for transportation, luggage, laundry service, and trips. Other camps charge separate fees for certain expenses.

New York Methodist – Cornell Heart Center

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We fixed that.

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The specialists at the New York Methodist-Cornell Heart Center provide a full range of heart care services in the newest, most modern cardiac center in Brooklyn. The center’s services range from diagnostic procedures and medical and interventional cardiology to minimally invasive and conventional cardiac surgery – performed by a team of outstanding physicians, including surgeons from the renowned Weill Cornell Medical Center at NewYork-Presbyterian Hospital.

GOLDEN YEARS

“I was afraid my heart disease was going to slow me down.”

Avigayil Perry lives in upstate NY and is a contributor to The Jewish Press Health and Living supplement.

WOMEN’S HEALTH

Camp Moshava, a religious Zionist camp sponsored by Bnei Akiva, has devised a system for raising scholarship money as part of the tuition process. The camp asks that parents donate $250 to complement their tuition in order so that more campers can enroll. This donation is voluntary. Much work is still needed in the area of camp scholarship fundrais-

RAISING OUR CHILDREN

“Many parents opt to send their children away to overnight camp for an experience that will leave warm, lasting memories…”

ing. In order to address this need, BunkConnect (BunkConnect. org), a camp tuition affordability initiative for first-time campers is being launched this month by the FJC along with The Center for Entrepreneurial Jewish Philanthropy (CJEP). This program seeks to make quality non-profit Jewish summer camps financially accessible to all families. Eligibility is determined by the number of dependent children, adjusted gross income, and location of residency. Families can enter their financial details, including number of children, gross income and location of residence into a private system. Then BunkConnect supplies the parents with open camp sessions at very low costs. “BunkConnect has the power to change how we look at scholarship, affordability, and the capacity for Jewish camp and beyond,” explained Jeremy J. Fingerman, CEO of FJC.

ISSUES

potential donors in the communi- financial aid. Nesher is affiliated ty who may be willing to help. Lo- with the New Jersey Y, and Dora cal Jewish Federations are another Golding is affiliated with the UJAgood resource and often provide Federation; both camps say they camp scholarships to families in never turn away a camper because need. New York families can visit of a parents’ inability to pay. www.ujafedny.org for information on how the Federation can help them. Many camps work very hard to help struggling parents in their ability to send their children to camp. Camp Stone, located in Western Pennsylvania and affiliated with Young Israel and Bnei Akiva, offers need-based scholarships, requiring parents to submit tax returns along with the application. Camp Nesher, a Modern Orthodox camp in the Pocono Some camps find ways to bend Mountains, uses factors such as over backwards in keeping tumarital status of parent, parents’ ition costs as low as possible. The employment status, and if a child SHMA (Sternberg, Heller, and Mareceives a scholarship to attend gen Avraham) family of Orthodox a Jewish day school to determine Jewish camps, located in Narrowseligibility. Camp Dora Golding, burg, NY, and Dora Golding both an Orthodox camp also located offer early-bird discounts which can save parents several in the Pocono Mountains, uses 5-17-13_Layout NYM_CARDIAC_JewishPress-1/2pgHor_ 1 5/23/13 4:24 hundred PM Page 1 dollars. SHMA’s tuition rates of the parents’ income(s) and other $2,399 for one-month session and factors to determine eligibility for

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February 2014

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INTRODUCTION ISSUES RAISING OUR CHILDREN WOMEN’S HEALTH GOLDEN YEARS MEDICINE TODAY HEALTHY LIVING H&L TECH COMMUNITY PROFILE

RAISING OUR CHILDREN

Does Music Make Kids Smarter? By Avigayil Perry

M

any parents encourage their kids to take piano lessons, or flute, or trumpet, or voice, in the hopes that doing so will increase their overall brain acuity. Now, a number of recent studies are demonstrating the positive impact of music lessons on children’s brain development, making even more of a case for parents to invest in another afterschool activity. Several months ago, researchers at a meeting for the Society of Neuroscience in San Diego presented findings from a study that showed that music lessons begun prior to age seven appeared to thicken areas of the brain involved in language skills and executive function, which is a person’s ability to plan and carry out tasks. The study compared 48 Han Chinese aged between 19 and 21 who had received formal music training for at least a year sometime between the ages of three and 15, and measured the size of their brain’s cortex and overall grey matter. “We’re not sure why these changes arise, but a reasonable explanation is that early starters might rely more on auditory clues during learning music, since it might be more difficult for younger children to read music,” said researcher Yunxin Wang of Beijing Normal University, who devised the study, as quoted in The Guardian. It appears that the benefits to brain development only come through active involvement with music, as opposed to passive listening. Dr. Oliver Sacks, a professor of neurology and psychiatry at Columbia University, disputed the Mozart effect, which maintains that just listening to classical music can positively impact mental ability. Dr. Sacks cited a study of children after one year of instruction on the violin using the Suzuki method, which created visible changes in the brain, while simply listening to music shows no measurable effects. Recognizing the positive impact music instruction can have,

initiatives have sprouted in NYC public schools, like Music and the Brain (MATB), a rigorous program that includes ear training, singing,

dents. The instructors teach sixteen original well-known musical pieces every school year, culminating in a “Name That Tune” competi-

opposed to poems. Lercari described the language of music as “simple and very accessible with clear patterns.” Music

movement, appreciation, analysis, and reading music. Founded in 1997 by Lisha Lercari, a former NYC music teacher, MATB seeks to teach the language of music to children as young as 4 or 5 years old. “Often the more advanced music students, those studying at conservatories or privately, focus on playing a piece of music and working on technique, but don’t always know much about what happens in that music. They don’t think about the piece they play, but just play it. We want our students to think and participate in the learning process” explained Lercari. Music Memory is another initiative started by the NYC-based Riverside Symphony. This program reaches out to thousands of 3rd through 6th grade NYC public school stu-

tion where students identify names and composers of pieces they have learned in depth. “Students jump for joy when hearing Beethoven,” commented Sharon Golub, a music teacher at P.S. 11 in NYC who is involved in the program. Golub also uses the MATB curriculum with her students, and believes that the music study has helped her students succeed in other areas, such as math and chess. Lercari believes that rhythm is the most important element of music, and therefore has the greatest effect on brain development. “Even 2 and 3 year olds catch onto rhythm. They hear it, respond to it, and can even read it easily…it becomes glued in the mind,” she said, explaining why children find it easier to memorize song lyrics as

inherently teaches listening and tuning in, resulting in greater attention span and memory skills. “Teaching through music is the ultimate. Once a fact or concept comes in through music, it sticks.” But parents considering music lessons for their children should keep in mind that in addition to the hoped-for enhanced brain development, music should also be a fun activity that they enjoy. Both Golub and Lercari stressed the importance of the joy and love that kids can and should develop for music. “Don’t think about the benefits of music beyond the joy of music,” advised Lercari.

14

Avigayil Perry lives in upstate NY and is a contributor to The Jewish Press Health and Living supplement.

February 2014


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INTRODUCTION ISSUES

WOMEN’S HEALTH

Is Menopause Pausing Your Memory? By Ita Yankovich

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here did I put my cellphone? Why did I enter this room? Wasn’t I supposed to do something after work? These are questions many women asks themselves daily, and although most laugh it off as a sign of getting older, a more probable culprit could be a hormonal imbalance that causes menopausal women to suffer memory loss. Menopause brings with it a variety of symptoms that complicate the lives of women and those around them. Women experience daily insomnia, hot flashes, weight gain, irregular or heavy periods, mood swings, low libido, and memory loss. Often times low levels of the hormones estrogen and testosterone are the root cause of these symptoms. Hormones are the messengers that travel through the blood stream activating and regulating physical and chemical functions and processes across all body systems. Ovaries are the source of estrogen and progesterone, the two key hormones that control the reproductive system, and during menopause, the number of ovarian follicles declines and the ovaries become less responsive to the two other hormones involved in reproduction—Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH). As ovaries age and release fewer hormones, FSH and LH can no longer perform their usual functions of regulating estrogen, progesterone and testosterone. This rapid drop wreaks havoc on women’s minds since estrogen promotes increased blood flow to the brain and activates the hippocampus, which is the area that is responsible for memory. Estrogen is responsible for maintaining healthy memory. Lost levels of this vital hormone will affect your brain’s ability to function. Couple all this activity with the fact that menopausal woman are already experiencing stressful circumstances with numerous midlife transitions- aging parents, empty nest syndrome, illness, de-

pression , loss of youth and vitality, and midlife crises and all this can lead to forgetfulness, loss of concentration, poor memory retrieval and mental confusion. There is a bias towards menopausal women, especially in the workforce, where it is not uncommon for women to be labeled as overemotional, irrational or suffering from PMS. Some women have gone to drastic measures,

changes. “A more serious problem may be present if daily living is affected. Also, as opposed to menopause-related memory changes, which improve post-menopause, dementia will progress and worsen over months to years.” Surprisingly, new reports do not point to a correlation between memory problems and hormone levels. In fact, estrogen replacement therapy (ERT), which was

even having hysterectomies in an attempt to circumvent these issues, only later to discover that removing these organs may predispose a person to the onset of dementia and Alzheimer’s, according to Dr. Gino Tutera, founder and medical director at SottoPelle Therapy in Arizona, a hormonal treatment and wellness center. But how can one differentiate between menopause-related memory loss or something more serious, like Alzheimer’s or dementia? Dr. Mary L. Rosser, an OB/GYN at Montefiore Medical Center in NY, says the answer is not black and white. There is some forgetfulness that comes naturally with age, but the aging process usually affects short-term memory, and this can be exacerbated by medications, hormonal changes and/or sleep disturbances. Symptoms of dementia include constant forgetfulness, repetitive conversation, inability to make decisions or complete tasks, and personality and behavioral

typically what was prescribed for menopausal women in an attempt to stave off memory loss, has been found to be ineffective. Dr. Carolyn Dean, the author of Menopause Naturally and 365 Ways to Boost Your Brain Power, states that according to the Women’s Health Initiative, hormone therapy didn’t improve cognitive function in women 65 years and older, and that it actually increased the risk of dementia in these women. The jury is still out as to whether this is also true for younger women. The good news is that this problem is not permanent and tends to rebound, with full return to baseline happening in the early postmenopausal period. There is no obvious treatment for memory loss as there is no clear etiology. However, neuroscientists believe that an “active brain” and general overall wellness is essential for optimal functioning. So other than hormonal replacement therapy, how can this be treated?

16

Magnesium balances the body’s estrogen and progesterone is also useful in reversing and preventing memory loss, according to Dr. Dean. There are other natural methods to keep your memory sharp: Exercise the Brain: Keep your brain strong by working it out with books, learning a new language, crossword puzzles, and brainteasers like Sudoku. Sleep: Menopause and its symptoms can cause insomnia. Dr. Rosser explains that estrogen results in vasomotor symptoms, such as hot flashes and night sweats. These in turn prevent a woman from having adequate REM sleep and thus, a well-rested night. The lack of sleep and hormonal changes, including stress hormones, are likely at play with regard to memory, mood changes (including depression) and vasomotor symptoms. Sleep will keep your energy levels high so your brain can function clearly and retain information. Healthy Eating: Eat lots of fresh fruit and vegetables together with a balance of protein and carbs. Avoid alcohol, which only impairs memory. Certain foods have been linked to improved acuity. These include blueberries, which contain a memory boosting phytochemical called anthocyanin. Fish (salmon, tuna and sardines) is an excellent source of omega-3, which has been shown to combat many symptoms of menopause especially vaginal dryness, reducing blood clotting and inflammation , and lowering cholesterol. Legumes have been shown to alleviate hormonal fluctuations with their high content of fiber, antioxidants, isoflavones and calcium. Reduce Stress: Stress causes your body to release the hormone cortisole, which blocks memories from being stored. Menopausal women are more susceptible to stress due to all the changes that are bombarding them. Meditation, breathing, yoga, swimming, and walking are great ways to reduce stress. Ita Yankovich is a freelance writer. She also teaches English Literature at Kingsborough and Touro College.

February 2014


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INTRODUCTION ISSUES

WOMEN’S HEALTH The Alternative Way By Esther Hornstein, L.Ac. s we discussed in last issue’s article, Chinese Medicine has many uses in the world of women’s health. From menarache, the first period, through menopause, acupuncture and oriental medicine are known to help regulate every process. So when friends, family and patients ask if I can help with issues they are having from A-Z, I can say with confidence, “Yes, there’s a point for that.” What is acupuncture and how does it impact menopause? Acupuncture is one method of Oriental healing that consists of inserting hair-thin needles into

cine claims that the kidneys hold “life force,” called Jing in Chinese. This Jing is replete when we are born and steadily declines as we age. When Jing is gone, the body dies. Jing is closely related to kidney energy because the kidneys are said to “house” the Jing. When kidney energy is low it can manifest as loss of hearing, incontinence, brittle bones and weakness in the back and knees, all signs of getting on in years. The foundation of reproduction and conception rely on the integrity of Jing. Thereby, children born to parents (or a parent) with weak kidney energy or Jing tend to be deficient, weaker or predisposed to

ter another in a relatively short amount of time, and without proper rest and care, can lead to Jing deficiency. (For information about postpartum rest and care, please see the previous article in November’s Health and Living.) Many symptoms that arise during the transition into menopause relate to the kidneys and other organs addressed in Chinese Medicine. Why menopausal symptoms form and what can be done According to Chinese medicine, the body’s building blocks for balance are called yin and yang. Yin is described as being cold, dense, dark, viscous and heavy. Yang is described as being hot, airy, bright

❧ Hot, spicy foods ❧ Stimulants such as caffeine, alcohol, cigarettes, recreational drugs ❧ Sugar

MEDICINE TODAY

Foods to add to tonify yin

HEALTHY LIVING H&L TECH COMMUNITY PROFILE

that boils out the water, then the pot and rice will be burned. If there is too little heat to make the water boil into vapor, then the rice just will not cook. Now you are wondering what cooking rice has to do with hot flashes, irritability, headaches, insomnia and night sweats. Those are all symptoms of menopause and pre-menopause, but also symptoms of the body struggling with depletion of yin. Acupuncturists treat most cases of menopause with yin-building herbs and acupuncture protocols. Treatments to tonify the kidney also serve to prolong life and reduce stress. One can also increase kidney yin through diet.

Foods to avoid

GOLDEN YEARS

WOMEN’S HEALTH

RAISING OUR CHILDREN

A

There is a Point for that: Transition into Menopause

the skin on areas called acu-points. Acu-points are located on channels or meridians that eventually, internally connect to organs. Traditional Chinese physiology differs from Western Medical physiology in that the organs hold holistic and multi-faceted roles. The kidneys hold a pivotal function in women’s health. According to Chinese medicine, these organs are important in terms of longevity and reproduction. Chinese medi-

illness, delays etc. It is said that the kidneys are the first of the organs to be formed in a new fetus, thus outlining the importance they have as the backbone of health. Factors that lead to kidney/Jing deficiency in an otherwise healthy person are: stress, lack of sleep, poor eating, and standing for long periods of time. Men and women have different circumstances by which Jing depletes. For women, having many pregnancies one af-

and lightweight. The way they work together towards balance can be illustrated by visualizing a pot of boiling rice (go figure, everything in the Orient has to do with rice!). Water is in the pot boiling the rice, and there is water above the pot in the form of vapor. The water inside the pot is considered yin, while the water vapor above is considered the yang aspect of water. Both are needed to effectively cook the rice. If there is too much yang (heat)

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❧ Barley, millet ❧ Adzuki beans, kidney beans, black beans, black soya beans, mung beans ❧ Beef, duck, fish, eggs ❧ Sesame seeds, black sesame seeds and walnut ❧ Asparagus, artichoke, pea, potato, seaweed, sweet potato, tomato (organic) ❧ Apple, pear, pomegranate, watermelon, banana, avocado Taking care of one’s self throughout life will help minimize unpleasant transitions to menopause. It is never too early to start nourishing yourself, but it is also never too late. Esther Hornstein is a New York State-li-

censed acupuncturist practicing in Brooklyn, NY. A graduate of Pacific College of Oriental Medicine, she has participated in acupuncture research in Lutheran Medical Center, labor and delivery and in hospital projects in NYU Hospital for Joint Diseases. In her practice she addresses pediatric ailments, woman’s health, pain management and overall wellness. E-mail her at acupunturesther@gmail.com or visit www.2ndNatureAcu.com.

February 2014


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? ?

Alzheimer’s The Disease of Tomorrow By Yaakov Kornreich

A

lzheimer’s disease is one of the fastest growing public health threats facing this country. About one in eight elderly Americans today suffers from Alzheimer’s. In 2012, there were an estimated 5.2 million Americans over the age of 65 with Alzheimer’s, in addition to about 200,000 Americans under age 65 with the early onset form of the disease. Alzheimer’s is the fifth leading cause of death for those age 65 and older. Kornreich Continues on Next Page ➙

20

February 2014


“Half of Americans over age 85 are afflicted with the illness.”

Kornreich Continued from Page 20 ➙

doubled, from 38.3 years then to 75.7 years for a baby born in 2004. However, much of that improvement was the result of modern medicine’s success in treating or eliminating most of the common diseases of childhood through the use of vaccines and antibiotics. While the treatment of diseases that primarily affect adults also improved during that period, the impact of those advances on extending life expectancy has been less dramatic. In 1850, a 20-yearold adult while male could expect

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21

Kornreich Continues on Page 23 ➙

HEALTHY LIVING

to live until the age of 60.1 years, whereas someone who was 20 in 2004 could expect to live to the age of 76.7, less than half the 37 year extension in life expectancy for newborn babies between the same two dates. The primary reason for this difference is that it has been more difficult for medical science to identify the complex causes of heart disease, stroke and cancer, which are among the leading killers of people who survive to middle age and beyond. For example, more than 40 years after President Nixon declared war against cancer, medical science has largely given up the search for a single cause or “magic bullet” to

MEDICINE TODAY

for research to learn more about the basic nature of Alzheimer’s and three other diseases whose root causes remain a medical mystery. Modern medicine has made great strides in extending our lives. By the latter half of the 19th century, the introduction of vaccines that prevent many of the infectious diseases which had been the scourge of mankind, and the development of the germ theory, the medical community became confident that it could eventually prevent or cure almost all diseases by identifying and attacking their causes, rather than merely treating their symptoms. Since 1850, the life expectancy of a newborn white male has almost

GOLDEN YEARS

President Reagan with Rabbi Sholom Klass, the publisher and founder of the Jewish Press

treat cancer’s various manifestations. The causes of cardiovascular disease, which leads to heart disease and stroke, are also still not completely understood. Scientists are much further behind in gaining a clear understanding of the basic mechanisms responsible for the development of Alzheimer’s. The only definitive way to diagnose Alzheimer’s is through an autopsy. It reveals the telltale sign of the disease, which is the buildup of tangled “plaques” of a protein called beta amyloid in the victim’s brain. However, it is not clear whether the plaques are the root cause or just a byproduct of the disease. It can take as long as a decade for clear outward symptoms of Alzheimer’s to become apparent. This makes it very difficult to judge whether a new drug can halt or slow the progression of the disease, especially in its early stages. These difficulties make testing a new Alzheimer’s treatment hugely expensive. Each final stage clinical study of an Alzheimer’s drug costs $50 to $100 million, and the total cost of developing a new Alzheimer’s drug can exceed $1.3 billion. The disappointing performance of so many new drugs which had entered clinical trials with high hopes caused the CEO of French drugmaker Sanofi to announce last year that his company has stopped developing new Alzheimer’s drugs. He said, “we have to do a lot more basic science work to understand what’s going on. We really, at best, partially understand the cause of the disease. “ This realization has led to the formation of a partnership including the National Institute of Health, 10 large drug companies and seven non-profit organizations. They will be participating in a five-year, $230 million basic research effort into Alzheimer’s and three other diseases: Type 2 diabetes, rheumatoid arthritis, and lupus, which are still not well-understood by medical science.

WOMEN’S HEALTH

February 2014

disease, typically for six to twelve months, for between 40-70% of the patients taking them. They cannot stop Alzheimer’s gradual destruction of brain cells, or reverse its symptoms. Because of the failure of so many new Alzheimer’s drugs, some pharmaceutical industry leaders are now questioning the two main theories for the cause of Alzheimer’s which have served as the basis for new drug development. This has contributed to the formation of a new industry-wide partnership

RAISING OUR CHILDREN

Alzheimer’s affects about 5% of people between the ages of 65 and 75. The risk of Alzheimer’s roughly doubles with every five-year increase in age, reaching 45% by the age of 85. As the baby boom generation ages, the number of Americans with Alzheimer’s is expected to increase by 44%, totaling 7.7 million people by 2025. The symptoms of Alzheimer’s disease were first described in 1906 by German psychiatrist and neuropathologist Alois Alzheimer, but most of the serious medical research into its causes and treatment has taken place within the last 30 years. Alzheimer’s gained international prominence in November, 1994, when former President Ronald Reagan, in a farewell letter to the nation, disclosed that he had been diagnosed with Alzheimer at the age of 83, and was withdrawing from public life. He wrote, courageously, “At the moment I feel just fine. I intend to live the remainder of the years G-d gives me on this earth doing the things I have always done…I now begin the journey that will lead me into the sunset of my life. I know that for America there will always be a bright dawn ahead.” Reagan was to live for another decade, suffering a gradual mental decline, and died in June, 2004, at the age of 93 (see sidebar). Following Reagan’s letter, there was an explosion of research and an intensive effort to develop an effective preventive treatment or cure for Alzheimer’s. Since 1998, American pharmaceutical companies have tested more than 100 new Alzheimer’s treatments, but virtually all have failed. Only two classes of drugs are FDA-approved to treat Alzheimer’s today. They are called cholinesterase inhibitors and NMDA receptor antagonists, and work on two different chemical messengers inside the brain. They can only slow the progression of the symptoms of the

ISSUES

(Alzheimer’s Association)

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November 5th, 1994 cted with Alzheimer’s Disease. My Fellow Americans, millions of American who will be affli the of one am I that told ntly rece ld keep this a private matter or I have been de whether as private citizens we wou deci to had I and cy Nan s, new this Upon learning wn in a public way. ugh our disclosure we were able whether we would make this news kno I had my cancer surgeries. We found thro and cer can st brea from ered suff cy testing. They were treated in early In the past Nan a result many more people underwent as that py hap e wer We ss. rene awa to raise public lthy lives. our hearts, we hope this might stages and able to return to normal hea ortant to share it with you. In opening imp is it feel we , now So gan Rea ald ing of the individuals and families President Ron it will encourage a clearer understand aps Perh . ition cond this of ss rene awa promote greater on this earth doing the things I have who are affected by it. the remainder of the years God gives me live to nd inte I . fine just feel I ent I plan to enjoy the great outdoors At the mom with my beloved Nancy and my family. ney jour life’s e shar to inue cont will I always done. supporters. en. I only wish there was some way I and stay in touch with my friends and es, the family often bears a heavy burd ress prog ase Dise er’s eim Alzh as ly, with your help she will face it with Unfortunate en the time comes I am confident that Wh ce. rien expe ful pain this from cy could spare Nan wing me to serve as your President. faith and courage. le for giving me the great honor of allo peop an eric Am the , you k than me for this country of ours and eternal In closing, let be, I will leave with the greatest love may that er nev whe e hom me calls When the Lord a there will always be a bright optimism for its future. sunset of my life. I know that for Americ the into me lead will that ney jour the I now begin Sincerely, dawn ahead. ays bless you. Thank you my friends. May God alw

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Ronald Reagan

Reagan’s Public and Poignant “Long Goodbye” By Leah Rothstein

“I

now begin the journey that will lead me into the sunset of my life.” When he received the painful diagnosis of Alzheimer’s disease, former President Ronald Reagan chose to go with dignity into that good night. Reagan’s handwritten, poignant letter was published on November 6, 1994, announcing the tragic news directly to the public in simple and unaffected language. “My fellow Americans, I have recently been told that I am one of the millions of Americans who will be afflicted with Alzheimer’s disease.” Rather than keeping the news quiet or trying to hide his condition, Reagan chose to share it with the public, hoping to accomplish some good by using his high profile to raise awareness of the disease. The public’s reaction to the letter was a flood of interest in the condition and many people contacted the Alzheimer’s Association and other foundations, inquiring about the symptoms of the disease and seeking news of the latest medical breakthroughs. The Reagan family created the Ronald Reagan Research Institute within the previously established

Alzheimer’s Association to continue to raise awareness and obtain research funds. In his fading years, Reagan stayed largely out of the public eye. He continued visiting his office and engaging in outdoor activities like golf for several more years, but his deterioration soon became apparent. Two years after the letter, he failed to recognize visitors like his own Secretary of State, and the former “Great Communicator” was reduced to speaking only in short, clipped phrases. A special report on his condition published in the New York Times in 1997 reported that while he would still warmly greet passerby while out for walks in his neighborhood, “on most days Mr. Reagan does not seem to know why they are hailing him -- that for eight years he was the most powerful man in the world.” Reagan’s announcement helped change the public perception of the disease and lessen the stigma faced by sufferers and their families. One physician who treated Reagan, neurologist Ron Petersen, told USA Today in January 2011 that Reagan succeeded in removing the stigma because he was a highly successful, physically and

intellectually active man, and still succumbed to the disease. On the flip side, Petersen said that people shouldn’t be discouraged by this fact from living healthfully, as it is possible that his lifestyle delayed the effects of the disease. The disease also takes a terrible toll on family members and caregivers. Reagan was well aware of what his family would soon face when he wrote in his letter: “Unfortunately, as Alzheimer’s disease progresses, the family often bears a heavy burden. I only wish there was some way I could spare Nancy from this painful experience. When the time comes, I am confident that with your help she will face it with faith and courage.” Indeed, his wife did not have an easy time of it. Nancy Reagan, in a speech in 1996, talked about “the terrible pain and loneliness that must be endured, as each day brings another reminder of this very long goodbye.” In the later years, he only “sometimes” knew who she was. Some controversy persists about when exactly Reagan began showing signs of the disease, including arguments among his own sons that he started to show signs of forgetfulness while he was president,

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but his doctors have stated that it only began three years after his presidency ended. There is currently no cure for the fatal Alzheimer’s disease, a slowly advancing permanent memory loss and dementia caused by beta and tau amyloid plaque accumulation in the brain that is one of the ten leading causes of death in the United States. There are some medications that can ease the symptoms of the early stages, but scientists are still searching for ways to detect and prevent it. As the baby boomer generation ages, the disease is predicted to affect rapidly escalating numbers of Americans. Reagan died ten years later at age 93 on June 5, 2004 of pneumonia, a common complication in late-stage Alzheimer’s. His courageous actions in the face of the grim diagnosis succeeded in pushing the country in a direction towards greater awareness; and hopefully someday soon, to a cure, even though none came in time to spare himself. Leah Rothstein lives in Elizabeth, NJ

and is a frequent contributor to The Jewish Press. She is also the director of marketing and operations for www.jewinthecity.com.

February 2014


Kornreich Continued from Page 21 ➙

zheimer’s patients in autopsies is caused by another protein, called tau, found in the affected brain neurons. Lilly’s latest anti-Alzheimer’s initiative is a combination drug which attacks both the beta amyloid deposits and the tau protein tangles. Despite the huge cost of develop-

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ulated the body’s immune system to attack the plaques. Its clinical trials were halted when some subjects showed signs of developing a brain inflammation. A follow-up study found that even though the vaccine did clear the brain of amyloid plaques, it did not halt the progression of Alzheimer’s symptoms. There is a competing theory, which says that the tangles of proteins found in the brains of Al-

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American society. The US health care system is now spending $109 billion annually caring for people with all kinds of dementia, including Alzheimer’s, which is more than for heart disease and cancer. That is just the tip of the iceberg. Eighty percent of home care for dementia patients is being provided by over 15 million unpaid family caregivers, and the disruption of ing and testing a new Alzheimer’s their lives also needs to be counted drug and the recent failures, Merck in the overall cost of Alzheimer’s. and Lilly are going forward be- Caregiving for a family memcause of the enormous market for ber with Alzheimer’s is never a successful treatment. Industry easy. It is very hard to see a loved analysts say that if MK-893 proves one suffer the anxiety, hallucinato be effective at slowing or halting tions, depression, fear and anger the progression of Alzheimer’s, it that comes with the gradual loss has a potential for as much as $20 of their memory and their ability billion in annual sales. to grasp reality, according to Mrs. MeadowParkAd_NEW_JP_4.25x5.625_color A successful Alzheimer’s treat- Leah Horowitz, director 1/20/14 10:33 PM Page 1of Zicharment would be hugely beneficial to Kornreich Continues on Next Page 24 ➙

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The team approach is also necessary because of the huge amount of raw new scientific data now being generated about all four diseases, thanks to recent advances in generic sequencing and other new technologies. This information must first be thoroughly analyzed and used to update current theories before it can lead to new ideas for treatment and targets for drug development. The research partnership will also seek to develop more reliable molecular and imaging indicators of the rate at which early-stage dementia is progressing in an Alzheimer’s patient. Meanwhile, researchers at Merck are testing a drug called MK893, which may help to settle the question of whether the amyloid plaques are the cause or just a symptom of Alzheimer’s. MK-893 acts by blocking the BACE enzyme which releases the beta amyloid proteins from their normal functions in the body and allows them to clump together into plaques. Researchers are growing more

pessimistic about the theory that plaque causes Alzheimer’s. They note the failure in late stage clinical trials of the two newest drugs aimed at slowing plaque formation, Pfizer’s bapinezumab and Eli Lilly’s solanezumab. They also point to the failure of an anti-amyloid plaque vaccine called AN1792, which stim-

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on, a privately funded organization which provides training and support for caregivers in the Orthodox community. Caregiving can often be even more challenging when the Alzheimer’s patient is religious. They may believe that every day is Shabbos. They may refuse to eat because they don’t recognize their caregiver as a member of their own family, and fear that the food they are being served is not kosher. Holocaust survivors may also be reliving the horrors of the death camps in their minds, and refuse to take a shower or allow themselves to be given an injection. Zicharon provides 10-hour training classes, approved by the American Alzheimer’s Association, which deal with problems which are

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Kornreich Continues from Page 23 ➙

bors of an Orthodox Alzheimer’s patient to take the initiative by offering the caregiver a brief period of respite, or help with such tasks as household shopping. Meanwhile, ongoing research continues to reveal important new facts about Alzheimer’s. Scientists at the University of California-San Diego School of Medicine have found that those who develop the disease in their 60s and 70s typically suffer a faster rate of deterioration in their cognitive abilities than those who are first diagnosed in their 80s or later. Another study by researchers at the Mayo Clinic has established that people who in their 70s and 80s who reported having suffered a concussion earlier in their lives were 20% more likely to show a buildup of

ing at compounds found in the common spice cinnamon, highdose B-vitamins, and even the flavonoids in green tea as possible treatments or preventive measures for Alzheimers. While this research is still preliminary, it shows that scientists are now approaching the problem of Alzheimer’s with open minds, after 30 years of disappointing progress against a disease which is becoming one of America’s most serious public health challenges.

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beta amyloid plaques in PET scans of their brain than those who did not have a history of head trauma. Swiss drugmaker Roche is developing a new way to bring drugs made up of large molecules, such as antibodies, across the blood-brain barrier. The system uses a natural transport mechanism which the body uses to transfer proteins inside the brain. In tests, the mechanism has been used to increase the concentration of antibodies in the brains of mice. Finally, scientists are now look-

who can no longer be reasoned with. To educate the Orthodox community about its unique Alzheimer’s challenges, Zicharon has sponsored three public symposiums in Boro Park, attracting standing-roomonly crowds. Zicharon’s support groups for Orthodox caregivers meet on a regular basis. For more

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information on Zicharon’s services, programs and resource materials, see its website at www.zicharon.org. Mrs. Horowitz says that someone whose family member has been diagnosed with Alzheimer’s should also consult a geriatric psychologist. Their insights and suggestions are very helpful for coping with the symptoms of Alzheimer’s over the long haul. Caregiver burnout is a major problem, and caregivers are often reluctant to ask for help. Mrs. Horowitz urges friends and neigh-

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Yaakov Kornreich has been working as

an Anglo-Jewish journalist for more than 40 years, and writes regularly on a wide range of both Jewish and secular topics. He is the senior editor of two supplements published by The Jewish Press: “Health and Living” and “Building Blocks,” and a co-author of the book “Young Israel at 100,” published in 2012.

February 2014


A

revealed by the brain scans. Those with mothers who had Alzheimer’s showed more pre-Alzheimer’s signs than those whose fathers had the disease, with the lowest incidence in the group whose parents were free of Alzheimer’s. That is consistent with previous research showing that the risk of Alzheimer’s is higher for someone whose

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newly published study shows that middle-aged adults who have both parents suffering from Alzheimer’s disease show an increase in their own brains of the physical changes which are often associated with Alzheimer’s disease. While none of the 52 individuals in the study showed symptoms of dementia, the brain changes in-

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REHAB with RESULTS

Study Points to a Parental Risk for Alzheimer’s

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mother had the disease than those whose father had it. The lead researcher for the study, Lisa Mosconi, an assistant professor of psychiatry at NYU Langone Medical Center, emphasized that “some of the same brain changes that we see in Alzheimer’s disease can also be seen in healthy younger people. Just because they have these [indicators] doesn’t mean they’ll develop Alzheimer’s. We know that many older people with Alzheimer’s brain pathology do not develop dementia,” Dr. Ronald Kanner, the chairman of neurology at North Shore University Hospital in Manhasset, Long Island, called the findings of the study “quite significant” in suggesting a genetic component in the risk factors for the most common “late onset” form of Alzheimer’s. He suggested that the next step in the research should be to follow the participants over time to see how many in each group will develop the disease. The study’s findings were reported this month in the journal Neurology.

s

dicate that they are more likely to develop Alzheimer’s later in life. The study by researchers at the NYU School of Medicine did MRI (magnetic resonance imaging) and PET (positron emission tomography) scans of the brains of four groups of 13 healthy people mostly between the ages of 40-60: those with both parents who had Alzheimer’s, those with a mother with Alzheimer’s, those with a father who had the disease, and those whose parents showed no signs of Alzheimer’s. The key finding of the brain scans was that people with both parents who had suffered from Alzheimer’s had 5 percent to 10 percent more beta-amyloid plaques (deposits) in their brains than the other three groups. The brain scans of the group in which both parents had Alzheimer’s also showed that they had a lower volume of gray matter (the part of the brain which processes information) and a slower metabolism of glucose, the brain’s main fuel, than the others. The four groups showed distinct differences in the level of indicators

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How to Visit Someone with Alzheimer’s Disease or Dementia By Harriet Blank

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hen I am asked how to best visit someone who has Alzheimer’s Disease (AD) or another cognitive impairment, I almost feel like the great sage Hillel. The simple premise is to have realistic expectations and goals; the rest is all “commentary.” In truth, though, realistic expectations are not always so easy. We come with past histories and feelings that often become obstacles in our relationship. It is difficult to visit someone who has experienced major cognitive changes. They are not the person you remember. We fear that they will not recognize us, much less our children. How has their personality changed? What if they keep repeating themselves? How can I accept the person in front of me? These are difficult questions,

whether you see the family member frequently or occasionally. It is important to be prepared before any visit. If your parent has AD

loved ones with this disease. There are many sources that can help you learn what you must know to best cope with this diagnosis and its de-

“It is difficult to visit someone who has experienced major cognitive changes. They are not the person you remember. We fear that they will not recognize us, much less our children…” or a dementia diagnosis, learn all you can about the illness, whether through books, Internet or other people who have experienced

clining process. Don’t forget to ask your family doctor for information. The best coping tool in handling this diagnosis and its effect

on you and your family is knowledge. When you watch your parent or loved one behave in a way that is so atypical for them, it is essential that you understand that what you are observing is the disease, not the beloved family member. Visiting can get complicated if the relationship was complicated. (And what relationship isn’t?) You may never get the answers you wanted from the person with AD. You will have to explore those unresolved feelings yourself with the help of friends, family or therapy. When visiting with someone who has AD or dementia, there should be a feeling of positivity and love for the person as well as the family caregiver. Human contact is important for the person, even if they don’t know or remember you. A word of caution: negative or hostile feelings can be picked up by the

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pets, music or art. Be prepared to stop or skip an activity if you see it is not working. Be calm and speak in calm tones. Respect personal space. Make eye contact with the person. Speak slowly and approach the person from the

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front. Allow for extra time for responses, accept silences and try other forms of communication such as singing or touch. Remind them of who you are, whether they seem to remember or not. Do not argue with the person if they appear confused. Respond to their feelings and distract if necessary. Always let the person save face. Don’t correct them if they are wrong or ask questions. Do not tell them to remember something. Speak about the topic or event to help remind the person or at least speak about the memories. Do not bring up upsetting topics or remind them about relatives who have died. Children who visit a person with AD or dementia can have a positive experience since both children and the adult can respond with emotion. In addition, the child often does not have the “baggage” that the adult has and can enjoy the moment the same way as the older adults. The basic skills or format of planning visits are the same throughout the process of the illness. This includes visits made in the person’s home or in a nursing home. A visit to a loved one with AD or dementia never remains the same even if the person asks the same question over and over or repeats themselves. Human connection is valuable for all of us, including the person with AD, dementia or other cognitive impairment. There is value in caring, respecting and loving our ill family member. We are helping our children learn to care for others, which provides us with hope for our future. Always remember: Be prepared to be surprised and to love, so that you can make new and happy memories for yourself and your family.

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“When visiting with someone who has AD or dementia, there should be a feeling of positivity and love for the person as well as the family caregiver…”

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person with dementia, even if you feel the person does not understand you at all. These negative feelings can cause a catastrophic reaction that will have a negative impact on you, your family member and caregivers. Think about your feelings and discuss them with children and grandchildren prior to the visit. Plan the visit but do not over plan; allow yourself to expect the unexpected. AD, dementia or other cognitive impairments are not stagnant diagnoses and decline takes its own course. Behaviors and reactions do change over time and some disturbing behaviors will stop as the disease progresses. The overall goal of your visit is that it should be enjoyable for everyone. No one wants to leave feeling frustrated, upset and disappointed. Plan the visit for a time of day when the person with Alzheimer’s is at their best. Many people with cognitive impairment become more confused in the evening (this is called the Sun Downing effect). In addition, think about whether this is the best time for you or any of the children who might be visiting. Ask in advance about the person’s schedule and if the visit might be disruptive. Don’t bring hungry and tired young children to the visit. Consider the length of time that you may visit so you do not tire the older adult or the visitor. Try to stay “unplugged” during the visit. Consider an activity that is familiar and pleasant for you and the person. This might include photo albums, crafts, listening to music or Jewish material. Some people with AD respond to

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INTRODUCTION ISSUES

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Is It Time For Your Loved One to Retire From Driving? By Mutty Burstein

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O

ne of the most difficult talks adult children can have with their aging parents is about driving. Taking away the car keys means a loss of freedom and independence and is understandably fraught with resistance. At some point you may feel concern or even fear that your parents should no longer drive an automobile. This is one of the most important deliberations, considerations and possible actions you will probably face as the family caregiver. One of the main reasons seniors are reluctant to give up driving is that it is one of the few ways they can continue to feel self-sufficient. Taking the car keys removes the parent’s independence: the ability to drive to the supermarket, meet friends for coffee at the senior center, the library or to visit the children. The experience can be traumatic. If not handled properly, forcing an older driver to give up the car keys involuntarily can trigger feelings of depression and isolation. This, in turn, can eventually lead to a more rapid deterioration in physical and mental health. The discussion becomes even more difficult when the person still maintains most of his or her faculties, just not those that enable safe driving. Many older adults are capable of driving safely, even into their 70s and 80s. But people age differently. Older motorists lose their ability to drive when the aging process kicks in. For these individuals, driving skills lessen because of poor vision caused by cataracts, glaucoma and macular degeneration, compounded with poor hearing, lack of flexibility, limited range of motion and reduced reaction time. All of these make the complex tasks associated with driving more difficult. Oncoming cognitive impairments, such as Alzheimer’s disease and dementia, can also impact one’s ability to drive safely. Several of these factors place seniors at much greater risk for road accidents and affect seniors’ driv-

ing ability. More importantly, a person 70 or older involved in a car accident is more likely to be seriously hurt, require hospitalization or die than a younger person in-

 Getting lost - especially in famil iar locations  Confusing gas and brake pedals - slow responses from one to the other

volved in the same crash. The facts remain: Drivers over 75 have the second highest rate, after teenagers, of fatal crashes per miles driven. The fatality rate for those drivers over 85 is 9 times higher than the rate for drivers aged 25-69. Here are some hints for determining your mom or dad’s ability to drive. Take a ride or two with your parent and observe his or her physical ability in controlling the vehicle, staying within the lane, how turns are handled, the driving speed, ability to scan from left to right, any visual susceptibility to glare, and for any possible confusion in traffic. Sometimes, arthritis pain may prevent them from looking over their shoulders when pulling out and changing lanes. Do your observations simply, without nagging or distraction. Make notes, for you may need to share them with others later.

 Finding dents or scratches on car, garage door, etc.  Having trouble seeing road signs, traffic signals, pavement markings  Getting angry, experiencing road rage, cursing, getting honked at often  Misjudging highway exit/entrance ramps  Receiving tickets or warnings  Difficulty in concentration/ confusion  Having a difficult time with changing lanes, backing up, checking rear view mirror It helps to have a thoughtful, caring plan in place before saying anything. Be empathetic. Imagine yourself in your parent’s situation. Ask others to join you in a meeting with them. It helps to involve other family members in the discussion to help, but not to confront. It sometimes helps to speak with the family doctor and have him join the conversation at the next doctor visit. Keep the conversation nonaccusatory, honest and between “adults,” not “child and parent.” Say

TEN SIGNS IT’S TIME TO QUESTION DRIVING

 Frequent “close” calls

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things like, “We’re concerned,” “We care” or “We don’t want you to get hurt or to hurt others.” If a financial legacy is important to the person, you could say, “All your savings could be wiped out with one accident.” Once you’ve both come to an agreement, you can continue to support your loved one in ways beyond just offering rides. If you fear that they may still try to drive, put “The Club” on the steering wheel. You might consider putting a notch in the keys so they won’t work, yet they can keep the keys, which may help give them a feeling of security. Also, explain that if you sell the car, the money that is saved on insurance and maintenance can be used for their transportation needs. Help the senior make a schedule. He or she can plan activities and combine trips on days when a caregiver can drive. The consequences of doing nothing far outweigh the wrath of an angry parent. Stories of tragedies that could have been avoided had those keys been taken away are sometimes all the inspiration needed to stand firm and make a painful decision with confidence. Actually, taking away a parent’s car keys is not a conversation; it’s a process. It is painful, difficult, and ultimately necessary because it is literally a matter of life and death. Mutty Burstein is the Education Out-

reach Manager of the Patient Relations Department at Americare CSS, a Certified Home Health Agency. The Americare Companies, founded in 1982, provide high quality home care services in the N.Y. metro area, including the 5 boroughs, Long Island, and Westchester, Rockland, Orange, Dutchess, Putnam, Sullivan, and Ulster counties. Americare integrates compassionate patient care with family needs and is ready to serve 24/7 with registered nurses, home health aides, PT’s, OT’s, speech therapists, and social workers. In addition to all the regular aspects of home care, Americare has a special license to work with patients with behavioral health issues and patients with dementia, Alzheimer’s, and/or depression, as well as the developmentally disabled. Mutty can be reached at 917-287-1636 or mburstein@americareny. com for any questions regarding home care both private pay and insurance provided, eligibility for Medicare, Medicaid, and managed care.

February 2014


Tips for Safe Senior Driving

RAISING OUR CHILDREN WOMEN’S HEALTH GOLDEN YEARS

 Plan your route before you drive.  Drive during daylight and in good weather.  Find the safest route with well-lit streets, intersections with left turn arrows, and easy parking.  Have your eyes checked by an eye doctor at least once a year. Wear glasses and corrective lenses as required.  Leave a large following distance behind the car in front of you.  Avoid distractions in your car, such as listening to a loud radio, talking on your cell phone, texting, and eating.  Considering potential alternatives to driving, such as riding with a friend or using public transit, that you can use to get around. Source: www.CDC.gov

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D

riving as an older adult can hold potential risks. Per mile traveled, fatal crash rates increase starting at age 75 and increase notably after age 80. This is largely due to increased susceptibility to injury and medical complications among older drivers rather than an increased tendency to get into crashes. Here are some tips from the Centers for Disease Control and Prevention (CDC.gov) to help make this everyday activity safe for older adults.  Exercise regularly to increase strength and flexibility.  Ask your doctor or pharmacist to review medicines, both prescription and over-the counter, to reduce side effects and interactions.

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Medicare Advantage Plan Drops Doctors, Cites Obamacare as Cause By Adam Pearlman, MBA

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HEALTHY LIVING

MEDICINE TODAY

GOLDEN YEARS

WOMEN’S HEALTH

RAISING OUR CHILDREN

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COMMUNITY PROFILE

Health & Living continues after the Mind, Body and Soul section…

popular AARP-endorsed Medicare Advantage HMO plan by UnitedHealthcare, the nation’s largest health insurer, is dropping a large number of doctors from its provider network, generating cries of outrage nationwide from older patients and medical groups who say the seniors were not given enough time to shop for new insurance. Seniors have a limited window each year — from Oct. 1 to Dec. 7 — to decide which type of Medicare plan they want for the coming year. Medicare Advantage plans offered by competing companies are following UnitedHealthcare’s example by dropping the highest cost providers from their network in response to cutbacks by the federal government in Medicare Advantage payments to the insurance companies. More seniors are choosing one of the Medicare Advantage plans instead of traditional Medicare because Medicare Advantage can offer additional benefits such as gym memberships, at no additional cost to their members. Some Medicare Advantage plans also do away with the traditional Medicare deductibles and the monthly premium for prescription drug coverage. They often cost seniors less up front than traditional Medicare with a supplementary Medigap plan. As a tradeoff, Medicare Advantage plans

generally require participants to go only to doctors and hospitals included in their networks, and may have other departures from traditional Medicare coverage.

ment deadline — forced many seniors to choose between keeping their monthly costs down or staying with doctors they’ve been using for years for the treatment

includes $156 billion in reduced payments for Medicare Advantage. Medicare officials review the private plans every year to make sure they comply with network ad-

The notifications about dropped doctors — which some UnitedHealthcare plan members say arrived too close to the re-enroll-

of glaucoma, heart disease or agerelated conditions. United concedes it is reducing the size of its Medicare Advantage provider network, saying it will shrink by about 10% to 15% by the end of next year. United said in a statement to CNN, “These changes are necessary to meet rising quality standards in an era of Medicare funding cuts, and will improve our ability to work closely with physicians and encourage better health outcomes for our members.” The insurance industry’s trade group argues that the cutback in the provider networks is due to the decision by Congress to pay for Obamacare by cutting more than $700 billion out of Medicare’s budget over the next decade. That

equacy and other requirements, but the agency did not approve the reconfigured networks resulting from the new provider cancellations. A Medicare spokesman said the agency “is currently reviewing UHC and other plans’ provider networks and closely monitoring all areas that have experienced disruptions to ensure that beneficiaries have full, transparent and timely information and access to needed care.” State medical groups have been protesting against the cutbacks, and have provided the public with the number of doctors being removed from provider networks. In Connecticut, UnitedHealthcare was terminating about 2,250 physicians, including 810 special-

Medicare Advantage (MA) plans are becoming a less reliable option for seniors as insurers are increasingly dropping physicians and institutions from the MA plan networks. ❧ UnitedHealthcare, the nations largest health insurer, concedes it is reducing the size of its Medicare Advantage provider network by about 10% to 15% by the end of next year. ❧ Medicare Advantage plans offered by competing companies are following United’s example by dropping the highest cost providers from their network. ❧ To pay for Obamacare, Congress decided to cut more than $700 billion out of Medicare’s budget over the next decade. That includes $156 billion in reduced payments for Medicare Advantage, causing the federal government to cut back on MA payments to insurance companies. ❧ Seniors may need to consider a different insurance carrier, switching to traditional Medicare with a supplement plan, or trying an MA-MSA (Medical Savings Account) plan.

Key Points

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Pearlman Continues after the MBS Section ➙

February 2014


MIND, BODY & SOUL

February 2014 A Publication of

In Collaboration With:

3RI

A Mental Health Magazine

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MIND, BODY SOUL CONTENTS &

FEB 2014

PARENTING

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Parenting Success

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When Children Lie

FAITH

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Dr. Susan K. Gardin, PH, MPH, MS, MA, MHC Dr. Sara Teichman, PsyD

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Belief: An Effective Therapeutic Tool

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Anxiety Disorders: Time to Have a Little Faith

Kalman Canant, LCSW Dr. David Rosmarin, Ph.D.

Challenging Children: Drowning in a Sea of Frustration

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Chana Kaiman, LMSW and Miriam Yerushalmi, MS

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How Parents Can Bully-Proof Their Bullying Kids Dr. Deb Hirschhorn, Ph.D., LMHC

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8 14 SELF-IMPROVEMENT RELATIONSHIPS

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Sustaining the Excitement of the First Year of Marriage

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Circuits of Attraction

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Sarah Kahan, LMSW Dr. Michael J. Salamon, Ph.D.

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The Skill of The Apology Reizl Kessin, MHC

Practical Tips for Procrastinators Shimmy Feintuch, LMSW

Guilty As Charged Mindy Hajdu, MS, LCSW & Happenings MIND, BODY SOUL & Further Reading MIND, BODY SOUL

SELF-DESTRUCTIVE BEHAVIORS

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Self-Injury in the Jewish Community: An Overview

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Roots of Addiction: Vulnerability

Chaya Berger

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Avi Shteingart, LMSW, CASAC

& MIND, BODY SOUL Is a publication of the Jewish Press Published since 1960 and in collaboration with Nefesh International

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ARTICLE COORDINATOR Chaim Sender, LCSW SENIOR EDITOR Lisa Twerski, LCSW SUPPLEMENT COORDINATOR Shaindy Urman Rabbi Simcha Feuerman, LCSW-R, President, Nefesh International Miriam Turk, LCSW - Executive Director, Nefesh International Alice Tusk, LMSW - Director of Operations, Nefesh International DESIGNER Alana White • lanala8@gmail.com

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February 2014


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Dear Readers, W

hen I think about the phrase “ one step at a time,” I think of a process that someone goes through to get from point A to point B. This certainly could include the process of making changes in your life. The problem is that while this may sound straightforward, simple even, it is not. Deciding that something in your life needs to change is actually fraught with so many possibilities at different stages, that people often get overwhelmed and say “forget it” to the whole notion of trying to make things better. Which is such a shame, because all too often, the initial instinct was right, and something really should change. So before you begin to read about how to incorporate all these changes in your life in this installment of Mind, Body & Soul, I’d like to break down the actual process. People have different reactions when coming to the realization that something is wrong and they want it to change. Some experience dread, some relief, some sadness, others fear… the list goes on and on. Regardless of someone’s emotional reaction, coming to that conclusion is really only the beginning, and figuring out where to go from there can feel very overwhelming. Often, that’s because although they know something is wrong, they are not sure what the source of the problem is and so where to turn can be confusing. For example, someone knows that they are having difficulty with one of their children. They’ve come to the conclusion that things cannot continue the way they are, but, is it a parenting issue and they need to pursue parenting classes or does the child need services, and for what? Anxiety, attention deficit, something else? Many people grapple with this exact conundrum. It goes something like this: “If I knew what the source of the problem was, I’d know what type of help to pursue, but if I don’t. Where do I get help with determining this?” There are a number of ways to approach this issue. One person may do their own independent research, perhaps informally asking someone they know to be knowledgeable in resources for various issues. Someone else might read an article, perhaps within these very pages, that hits home and makes them want to reach out for help to the author. There are also referral services, like Relief Resources, that helps a caller figure out this exact thing and will then make referral suggestions. There are helplines and hotlines like the Yitti Leibel Helpline that deals with an array of problems, as well as hotlines like Shalom Task Force and SOVRI that deal with various issues around the specific problems of domestic violence and child sexual abuse respectively, for someone who does know this is the problem they are dealing with, but who is too overwhelmed to be able to figure out where to go or what to do first.

The main issue to understand is that there are resources to help you figure out which path to start out on to get help. And, generally speaking, when going down one of these paths for a recommendation to a professional, even in the event that you actually need something different, because you’ve been referred to a professional, they will recognize that and help you reroute yourself if necessary. Some people give up before even starting because they think that they have to figure out what they need and they don’t know. First, know that there is help for that stage as well. The next question that then usually comes up for people is how to know whether something is helping. So now, whether you brainstormed with a referral agency or helpline with regards to what type of help you need, or you brainstormed yourself or with a friend or family member and have now pursued a good recommendation from someone you trust, a reputable organization or helpline, the question now becomes: Is this recommendation working for me? How do I know if it’s working? The first thing that is helpful in this quest to make sure therapy is “working” is to have clear goals. Even if you don’t know what the source of the trouble is with your child, for example, you can still know that you’d like to see him or her happier, getting along better with his/her siblings, or being less fearful of going to school. Discuss your goals with whomever you are referred to and ask them how they see your goals. One thing to look out for is to make sure you are not making goals for someone else if that person is not a child. Having goals that your spouse will stop doing X or start doing Y is going to get very frustrating unless your spouse shares those goals. We cannot change other people and going into therapy with that type of goal is contraindicated. Next, understand that if therapy is what it’s called for, it’s a process that takes time and that does not go in a straight line. What this means is that you cannot look at things after a few weeks and be disappointed. Usually, months are involved. In addition, change happens unevenly, which means that you should be able to see that things are going in a positive direction, moving towards your goals, overall, but there may be setbacks or disappointments along the way. As long as the overall feeling you have is that there is improvement, you are probably on the right path. How long that path is will vary from situation to situation. But if you know it’s the right one, you are well on your way.

Lisa Twerski,

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PARENTING

Parenting Success By Dr. Susan K. Gardin, PH, MPH, MS, MA, MHC

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any years ago, when I was a relatively new parent, I struggled with getting my 3-year-old son to pick up his toys. At the end of the day when my son and his friend had spent hours building forts from couch pillows and battling mythical creatures from the Evil Empire, I would survey the carnage of my den/ battlefield with dismay. While I was grateful that the boys had entertained themselves with imaginative play (not electronic devices!) all day, I dreaded that moment before dinnertime when I would have to ask my son to put his toys away. It would have been easier to do it myself, yet the voice in my head said that I needed to teach my son responsibility. Another voice said: I’m too tired for either option. It was during a conversation with my older sister, a pediatric occupational therapist, that she made a most enlightening suggestion: Rather than command my son to pick up his toys lest he become the recipient of dire consequences, she suggested saying: I wonder who can pick up the most toys the fastest? I think it’s me! The first time I uttered those words, it was like magic. With laughter and smiles, my son and I both raced to put the toys away. A task that had previously taken 30 awful, arguing minutes was miraculously finished in 10 minutes. The dreaded chore had become a wonderful shared activity. My son had learned about responsibility, making good choices and the value of teamwork, and together we built bonds that lay the foundation of the connection we share today. My sister’s suggestion changed my life, and I began to view parenting from a different vantage point. With the arrival of my two beautiful daughters, I tested out new parenting skills and learned how to adapt to their unique personalities and temperaments. Decades later, I now work as a psychotherapist advising parents of children of all ages how to eliminate power struggles, build lifelong connections, and raise children who are responsible, appreciative, successful and connected. I truly believe that every parent starts out wanting to be the best parent he or she can be; yet without knowledge and training, success is hard to achieve. In this, our most important task, we often lack even basic skills. Instead, we fall back on the disciplinary techniques of our parents, which may have been helpful (or not), but which may not be appropriate for our children, whose needs and temperaments may be different and who are growing up in a world that looks very different from the world of our childhoods. The task of parenting is one that cannot be shied away from if we are to raise a generation that will lead klal Yisrael toward greater heights and a closer connection to HaKadosh Barch

Hu. The words we use in parenting our children will echo in their ears for the remainder of their lives, impacting their self-esteem and selfefficacy, and determining whether they have the confidence to make the decisions they need to succeed, while retaining firm boundaries to protect their integrity. The parenting path we ultimately pursue will also determine whether

your child choices, you teach him responsible decision-making and reduce the likelihood of power struggles. By the time your child is an adolescent, making good decisions and taking responsibility for the consequences of those decisions will be second nature. Consistency: Children are smart. The first time you are not consistent, your child

we have our children and grandchildren in our lives for the rest of our lives. Given all of this, it is essential that we take the task of learning parenting skills with great seriousness. Listed below are a few simple parenting ideas that can help you be the best parent you can be: Expectations: Before setting up rules and consequences, think about realistic behavioral expectations based on your child’s age and stage of development, whether he is tired or sick, and other momentary stressors. If you are expecting your 3-year-old son to withstand a 5-hour shopping trip to the mall because you need a new outfit for Yom Tov, you are setting both of you up for failure. Alternatively, if you want to take your 15-year-old daughter on this trip, it could be a wonderful bonding experience. Preparation: Before you leave home, explain to your child the planned activity and your expectations. If you anticipate a long day, plan breaks. If you anticipate boredom, prepare an alternative activity. For example, if you are going to a restaurant, bring a box of crayons and drawing paper. That way, both of you will enjoy the relaxation and enjoyment of dining out. Consequences: The best consequences are natural. For example, if your son gets in his pajamas without arguments or delay, he will have time for you to read two stories; if not, there will be time for only one. When you give

learns that unacceptable behavior happens without consequences. The first time you don’t follow through on a promise, she learns that you can’t be trusted to keep your word. Once your child has either of these experiences, she will remember and test her conclusions over and over again. Listen from the heart: Your children are not out to get you. If they are acting defiant or engaging in challenging behaviors, there are reasons that you can discover if you listen closely for their underlying feelings and needs. Even as adults, we sometimes “act out” feelings. Have you ever had a bad day at work, and, rather than express your frustration to your boss, come home and had less than the ideal amount of patience for your spouse? Your children also experience frustrations, hurts and disappointments. When your child suddenly lashes out or acts in ways that seem inexplicable, try to help her identify the root cause of her fury and label her feelings. Once identified, the feelings won’t be so frightening and real problem-solving can begin.

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Dr. Susan Gardin, who has advanced degrees from

Stanford, Harvard, UCLA & USC, is an emotionallyfocused psychotherapist specializing in individual, marital & parenting issues. Dr. Gardin is on staff at Tikvah (Brooklyn) where she sees clients and runs parenting groups. Dr. Gardin also runs parenting seminars for private groups (minimum 10 parents). She can be contacted at dr.s.gardin@gmail.com.

February 2014


& MIND, BODY SOUL

When Children Lie One area of lying that is actually fostered and encouraged by parents and teachers is the social lie. The child is encouraged to tell moribund Aunt Toby that she “looks nice,” but never “so old.” He is also told to thank children he never wanted to invite for coming to his party. While we as adults understand that these half truths [or white lies] may be in service of humanity, good will, and shalom, the difference may not be as clear to the young child who is concrete and black and white. All he may understand is that sometimes it’s okay to lie and sometimes it’s not, and he’s not always sure of the difference! Such situations need to be handled with great skill and acumen in order to convey to the child that it is not the half-truth that we support, but rather the respect for others. Though lying in the 0-6 range is no cause for concern, it may be quite a serious matter for the older child who knows better. If your child is engaged in a pattern of lying, a consultation with a mental health professional is advisable.

I

t is worrisome when our children are less than truthful; however, for ages six and under, what is perceived as lying by the adult is simply childish immaturity. In fact, it would be best for parents to avoid the term “lying” lest it turn into a self-fulfilling prophesy. Let me explain what I mean. Children, particularly those younger than six, have a very hard time differentiating between fantasy and reality. So, for example, a child may say to his mom that he was student of the day, or that there would be a big party the next day – because he wishes it were so. Similarly, he may come to school and tell his Morah that his Bubby is coming on Sunday and taking him to the zoo. This kind of confusion of fantasy and reality is typical, age appropriate, and no cause for concern. When it is clear that the child is conflating the two, a simple clarification like: “You wish there were a party” or “You really want to go to the zoo,” is enough to highlight for the child that there is, indeed, a difference between wish and reality. It is important to recognize that the child’s intention is not to connive, but rather to turn his wish into a reality. This process for the child is simply wishful thinking, done out loud. As we mature, we learn by experience and trial and error that, other than in fairy tales, wishing does not make it so. However, introducing the idea that the child’s wishful thinking is lying and hence wrong is setting up an unhealthy dynamic – labeling the child’s normal developmental process as “bad.” And as we all know, unfortunately, thinking and expecting a child to be “bad” is often the precursor to his becoming “bad.” In addition, young children [ages 3-6] often make up whole stories or tell tall tales. This is quite typical because children enjoy hearing stories and making up stories for fun. When children blur this boundary between fantasy and reality, we call this confabulating, the creation of fabulous, fantastical tales to amuse one’s self and others. Again, confabulation is a normal process in early childhood and parents need not worry that it will develop into lying. As children grow up, however, they often do what adults do – use lying to escape punishment. This is a fairly ubiquitous behavior where people use lying in a self-serving way: e.g. to avoid doing something or deny responsibility for their actions. An example of this might be blaming traffic for your lateness when, if fact, you just overslept. Though lying to escape consequences is not strictly lying [i.e. the intent is not to lie but to get out of something], it can become habit-forming, nevertheless. We all know children, and adults, who would just as soon feed you a lie as the truth – for no perceptible reason. If your child is embarked on this course of behavior, it is important to be proactive and not provide opportunity for such manipulation. Instead of saying to the child with cracker crumbs on his mouth: “Did you take crackers before dinner?” pre-empt his denial and let him know that you know the score. A calm: “No nosh before dinner” states your rule without providing the temptation to lie. Rather than ask your daughter if she davened when you know that she hasn’t, simply hand her a siddur and say: “It’s time to daven.” In this fashion, you forestall the lying and do not allow it to become habit forming. Certainly, the last thing you want to do is set up and entrap your child, creating a situation where you ask your child for a truth that is known to you, but where he would be tempted to lie. If you know the truth, state it up front, rather than catching him being “bad.”

“Children, particularly those younger than six, have a very hard time differentiating between fantasy and reality…”

February 2014

Dr. Sara Teichman, PsyD maintains a private counseling practice in Los Angeles, Cali-

fornia where she sees children, adolescents, and adults. In addition, she is the Clinical Director at ETTA at OHEL. She is the author of a bi-weekly parenting column, Child in Mind – Ask Dr T in Binah Magazine. Dr. T also gives parenting lectures, in person and by teleconference, all around the United States. To contact Dr. Teichman, email her at sara.teichman@etta.org. s’’xc

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By Dr. Sara Teichman, PsyD


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PARENTING

Challenging Children: Drowning in a Sea of Frustration By Chana Kaiman, LMSW and Miriam Yerushalmi, MS

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arenting is a tough journey, but it’s especially hard if you’re the parent of a child with social, emotional, and behavioral challenges. Strong-willed, active children can become “challenging” when their caregivers run out of the energy and patience needed to deal with their behaviors. Most children can be difficult at times, but some are more challenging than others. Dr. Ross Greene, author of The Explosive Child and Lost at School, has introduced a more compassionate and effective approach to address challenging children. Dr. Greene proposes that having a basic concept about children is important because that becomes the operating system – the way you will respond to meltdowns and tantrums – when the going gets tough. His key theme is: Kids do well if they can. According to Dr. Greene, if you think a child is not doing well because he does not want to, the only role that the parent plays is to make the child want to do well. However, if we believe that the child does want to do well but lacks the cognitive or emotional capacity to follow instructions, adapt to new situations and control impulses, then you can identify the obstacles and resolve the issues for a longlasting solution. Although there are many different types of explosive children, all of them share certain behaviors. These common behaviors allow us to develop a general treatment strategy that is helpful for all inflexible, explosive children: CHARACTERISTICS OF THE INFLEXIBLE / EXPLOSIVE CHILD: • Unable to shift gears • Becomes quickly overwhelmed • Unable to think of ways to resolve conflict • Extremely low frustration tolerance • Meltdowns seem out of the blue All inflexible/explosive children have a type of difficult temperament called “poorly adaptable.” There are other types of difficult temperaments that can exacerbate the frustrations of an explosive child. Some children with difficult temperaments are highly intense in their emotional responses, whether they are miserable, angry, or happy. These children respond intensely to frustration – so intensely, in fact, that their emotional arousal interferes with their ability to think rationally or even listen to what the other person is saying. Some children with difficult temperaments are moody, easily irritated or thrown into despairing, morose moods. You can never tell when this child will be hungry or tired, so there are frequent conflicts over meals and bedtimes. Some children with difficult temperaments are

insecure and will cling, protest, or tantrum if forced to go forward in a new situation. Certainly, the child does not enjoy these incidents and does not intentionally behave this way. It is actually frustrating for the child because they feel they are not being understood. They do not wish to act in a way which makes themselves and their families miserable. Many

does is important, why and when he’s doing these things are much more important. How can we understand and help behaviorally challenging children? When children feel overwhelmed by demands that are placed on them, that they are more than they can tolerate, that is the warning sign that a meltdown is about to erupt. Care-

families become totally unbalanced and the siblings resentful when there is an inflexible/ explosive child in their midst. Explosive children are not capable of quickly shifting gears between their agenda and someone else’s agenda. They are not capable of remaining relatively calm, coherent, organized, and rational when frustrated by their parent’s commands. They can’t utilize their knowledge that compliance is necessary, that compliance would lead to rewards, and that non-compliance would result in consequences or punishment. When a child becomes enraged, he loses the capacity to consider what is in his own best interest, and loses any memory of previous consequences for noncompliance or meltdowns, so he can’t learn from previous experiences. Adults are constantly trying to “teach them lessons” by punishing the child and often demand that the child explain his/her actions. Adults are perplexed when the child either says he doesn’t know, or just melts down further. When do challenging children let us know they are struggling? When a child is having difficulty, the common behaviors you will experience are: whining, pouting, sulking, withdrawing, crying, screaming, swearing, hitting, spitting, kicking, throwing, breaking, lying, stealing, and the list goes on. Although it may feel that what a child

givers need to pay attention to the challenging activities that the child is having difficulty with and also identify the settings or conditions of when those behaviors occur. What can parents and caregivers do differently to help challenging children cope? When a child has lagging skills and can’t meet the adult’s expectation they do not lack motivation. Popular approaches of reward and punishment may not work. We are all in a better position to make lasting changes if we believe that challenging behaviors are due to unsolved problems and therefore are highly predictable. In his approach, Dr. Ross Greene described the explosive child and describes a method of treating the problem. Dr. Greene suggests that, to solve the problem, adults cannot impose on the child as this will result in increased challenging episodes. Rather, to solve problems durably, the adult and the child need to work collaboratively and over time, both will acquire the skills they were lacking. This contains three steps: Step 1: Empathy Dr. Greene says: “Empathy is an access code to the child’s brain,” allowing the child to see the parent as an advocate and not an adversary. Here is where the parent initiates a pathway to communicate with the child using compassion. This involves gathering information from the

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orative Problem-Solving Approach. New York, NY. The Guilford Press. Greene, Ross W. (2008). Lost At School: Why Our Kids With Behavioral Challenges Are Falling Through The Cracks And How We Can Help Them. New York, Ny. Scribner. Greene, Ross W. (2001). The Explosive Child: A New Approach For Understanding And Parenting Easily Frustrated, Chronically Inflexible Children. New York, NY. Harper Collins Publishing Inc.

Chana Kaiman, Lmsw Is A Psychotherapist Who Works With Children, Adolescents And Families In A Clinic. She Earned Her Degree At Wurzweiler School Of Social Work. Chana Has Background Experience In The Interpersonal / Relational Model Of Treatment And Brings A Unique Approach To Collaboration Of Supports In Treatment. She Is A Child And Family Therapist Working At Interborough Developmental And Consultation Center Where She Applies Multi-Modal Strategies For Stabilizing Crisis Cases.Chana Can Be Reached At Chanat01@aol.com. Miriam Yerushalmi, Ms, Was Trained At Pepperdine University And Is Uniquely Skilled At Combining Behavioral And Humanistic Approaches To Address A Wide Spectrum Of Psychopathology. Miriam Applies Essential Torah Principles To Empower Individuals To Release Their Inner Healing Potential While Aligning With Life’s Purpose. Miriam Works In Private Practice With Families And Children, Restoring Healthy Functioning Through Multi-Sensory systems approach. From panic disorders to addiction to depressive disorders, anxiety, anger management and adhd, miriam imparts self regulation techniques where clients learn to develop tools for a balanced, fulfilled and enriched life. Miriam lectures internationally and has over 250 audio classes available on cd. She authored multiple books on marriage, family and mastery of emotional self-integration. Additionally, miriam leads a non-profit organization, providing a resource for the neediest to access appropriate mental health care. Miriam can be reached at 646-243-0842 or via e-mail at 770sane@gmail.com.

February 2014

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PARENTING

child in order to achieve a clear understanding of their perspective on a particular situation. As parents learn just how difficult it is for the child to process information and to function behaviorally in ways we normally expect, the more empathic and tolerant the parent becomes. The Torah world has long taught the importance of the mitzvah of ahavas Yisrael, which has been described as unconditional love — especially for our children. Unfortunately, many of us, as parents and teachers, have builtin narratives of children as oppositional, defiant and manipulative. Parents need to be role models displaying mood regulation and responding in a flexible manner while maintaining their coherence. A young child learns primarily by example. Step 2: Define the Problem Communicating to the child in a language they can understand, the parent’s perspective on the problem and making sure that the child is convinced that both adult and child’s concerns need to be addressed. Step 3: Invitation Finally, both adult and child brainstorm solutions so they can satisfy a plan of action that is both realistic and mutually satisfying. The Talmud teaches us that habits become second nature. Just like in the world of Torah and mitzvos, creating good habits is a high-order priority. Likewise, parents learn to create a “user-friendly environment” through habit by responding consistently to certain behavioral warning signals of the child and then taking quick and consistent action when the signals are present. In Pirkei Avot it states: “Silence is a fence for wisdom.” In this context, the goal is to teach the parents to be proficient in the language of silence. Yet this must be balanced by good speech – to praise the child at every opportunity, reward good behavior and even finding situations that make the child look good to bolster the child’s self-confidence and self-esteem. Another important aspect that Dr. Greene suggests is to not simply tolerate undesirable behaviors, but to prompt the child to develop his/her own way to make amends for these events. This creates a more harmonious environment than applying consequences or punishments. The importance of parental engagement in this process is paramount. As Dr. Greene observes: “Half-baked understanding of the child’s challenges leads to a half-baked solution.” This is a team effort and everyone needs to be on board and rowing in the same direction. Neuroscientists for the past 30-40 years have tested, proven and supported this approach and observed remarkable results in treating challenging children. Sources: Greene, Ross W.,& Ablon, J. Stuart (2006). Treating Explosive Kids: The Collab-


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PARENTING

How Parents Can Bully-Proof Their Bullying Kids By Dr. Deb Hirschhorn, Ph.D., LMHC

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ictims of bullying face lowered self-esteem, depression, and even suicide. Bullies, as adults, tend to have higher divorce rates, domestic violence, job loss and criminal records. They tend to underachieve in life or misuse power. However, it is possible for schools, communities and parents to work together to reduce and prevent bullying. The problem is not bigger than they are. For parents, stopping their bullying child will take some effort, but not only is it doable, the rewards are huge. Studies show primarily three reasons why children may bully:  They have gotten away with it at home.  They are victims of aggression at home.  They see it as a way to fit in at school. Let’s take a look at each and how parents can respond. Getting Away With It Have you ever been in a store and seen a small child not merely having a meltdown because he wanted something, but hitting or kicking his mother? His mother, noticing the eyes on her, decides to stop him by giving in. What message did he get? Be persistent and you will get what you want! This unfortunate toddler doesn’t know that he is being taught how to be a bully. He thinks he’s just being persistent, a wonderful trait for getting ahead in this world. The kicking and hitting are instinctive to a toddler. But now, they are being reinforced. The same thing often happens between siblings. An older, stronger, or braver child attacks the sibling to get a toy – or power. Hassled parents figure, incorrectly, that “children have to work it out.” Although children do need to learn to work things out, it’s up to parents to teach them how to do it civilly. Otherwise, parents are teaching one child to be a bully and the other to hate the bully. This may last a lifetime. Learn to Stick to Limits The solution is difficult for soft-hearted parents, but it’s a must – and it must start when the child is young: Set limits. A parent’s hesitation to say no to a toddler is understandable; when do you stop meeting all your baby’s needs and start disciplining? The answer is somewhere after the first birthday or certainly by a year and a half. Another difficulty is the thought that the child is so cute, how can this behavior really be a problem? This is the blind (and loving) eye of parenthood. It’s a beautiful thing. Research, however, shows that toddler bullying can turn into adult bullying. Therefore, the more objective corner of the parent’s heart must speak up and assert limits. Stopping toddlers is made easier by distract-

ing them, but the firm “No!” can’t be spared. When the child is older, say of school age or even in adolescence, there are several steps to stop his or her bullying. First, sit down with your child when things are calm. Next, explain that you have not been the best parent because you have not clarified the difference between acceptable and unacceptable behavior. You are very sorry for this and now you want to do so. You can add that it may seem great to get what

conquer these behaviors alone, especially because dealing with the behavior isn’t enough. It is necessary to heal from your own hurts that led to them – and this will be a huge step towards helping your child. The Quest for Popularity A child might, in some cases, be unsure of himself for many reasons that have nothing to do with parents being too soft or too harsh. He may therefore jump at the opportunity to feel

you want, but it does not lead to true happiness. Third, spell out the unwanted behaviors and the consequences. Tailor them to fit the child’s age. It helps to clarify the behaviors you want, too. Ask if this makes sense and if the child agrees that it does, it will help you enormously later on. If it doesn’t, don’t let that throw you. Imitating What They Know The second cause of bullying is that children may imitate what they see and experience at home. According to research, in a home in which parents threaten abandonment, denigrate, are not emotionally present, have only conditional love or are unloving, have unrealistic needs of the child, display anger, or reprimand the child, he will feel rejected, angry, and confused. This can lead to his or her bullying others. The solution requires an honest look at oneself. If any of the above is true, you are not alone. You may even have been an abuse victim yourself. If so, it’s time to stop the intergenerational cycle: Get help! It may be impossible to

like a leader by bullying others. Aside from the talk, described above, in which you let the child know that there will be consequences for the unwanted behavior, it is helpful to channel the child’s desire for leadership into more constructive forms. Consider sports, chess, drama, art, school politics, volunteering, internships or part time work to help bring out the strengths in your child and raise his self-esteem. Taking these steps can restore your child’s sense of self, create a healthier and happier relationship between you and him, and even break a multi-generational cycle of abuse.

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“Dr. Deb” is in private practice in the Five Towns, Long

Island and also sees clients via Skype nationwide. In addition to writing for the Jewish Press, she has a regular column in The Five Towns Jewish Home, has presented for the OU, has been on radio and television, and has written a best-selling book, The Healing Is Mutual: Marriage Empowerment Tools To Rebuild Trust and Respect --Together. Follow her blog at www.drdeb.com.

February 2014


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Sustaining the Excitement of the First Year of Marriage By Sarah Kahan, LMSW

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February 2014

sharing a moment of humor can often do more benefit than several hours of discussion. Maintaining healthy relationships means we take time to consider others, such as remembering birthdays and anniversaries. Focus on building spontaneity and newness by doing something unexpected sometimes. It helps to keep the relationship strong and exciting.

healing can occur. Discuss how you feel about the problem and work on common understanding. The goal is to connect emotionally and not necessarily about resolving the problem. Don’t attack, defend, avoid, or deny. When in conflict, focus on the feeling and emotion behind it, and not the action itself. What is more important – being right or maintaining harmony? Many problems in relationships occur because of our pride. We often want to win and sometimes insist on having the last word. Healthy relationships are built, not by winning every argument. Be willing to back down; most arguments are not of critical importance anyway. Forgiveness is a powerful and important factor in maintaining healthy relationships. Real forgiveness is when we are willing to forget the experience. If we forgive, but bring up the incident later on, this is not real forgiveness. When we make mistakes, just consider how much we would appreciate others forgiving and forgetting. Humor is a very powerful tool to use to keep the relationship enjoyable. Don’t take yourself too seriously and be willing to laugh at yourself. Humor can also relieve tense situations and

When should a couple consider marital counseling? When discussions often have a negative, accusatory, critical, or a contemptuous tone. Excessive negativity leads to a distorted perception that can affect the past, present and future relationship. Escalated conflict usually leads to one spouse tuning out the other, often making it impossible to problem solve. A competent therapist can help the couple work through these issues and help the couple use more effective tools of communicating and connecting to each other in a more meaningful way. Most couples can look back to the first year of marriage with tremendous excitement. Are you still excited when you see your spouse come through the door? Do you still laugh at each other’s jokes? Do you still enjoy sharing about your day with your spouse? If your answer is no, maybe it’s time to do something about it.

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hat do women and men want? Lo tov heyos adam levado. As human beings we seek connection – with people, with parts of ourselves that we repressed, and with the world around us. How can we experience life to the fullest? When we have an intimate relationship with another human being, our lives feel more complete. Many couples fail in relationships because they did not receive it in childhood, so the healing done in the intimate relationship has the ability to heal the present and the past. How do you define true love? It is the ability to provide respect to the other person based on what the other person is and not by what you want the other person to be. It is the ability to value the other person based on their uniqueness. Safety is the number one precondition for connection. Two people cannot connect if they are busy defending themselves against a barrage of negativity and mistrust, or if they fear being abandoned by their spouse. Safety is creating an environment where it is okay to sometimes feel lonely, vulnerable, sad, and weak. What are the values we find essential to have in a good relationship? Honesty, trust, loyalty, respect, care, responsibility, empathy, and compassion. The more one demonstrates these traits to their partner, the more these traits will be reciprocated. How can you make your relationship a sacred place? By finding the right balance between connectedness and separateness in the relationship. Accept the reality that your partner isn’t you and that your partner cannot fulfill all your needs. Create a porous wall around both of you and keep others out and in when appropriate. Often in relationships, couples may find it challenging to separate themselves from parents and in-laws that are too intrusive. Make the connection with your spouse your primary connection. Gently but firmly give the message to outside family members that your allegiance lies with your spouse. This usually gets easier over time. What are things you can do to make the love grow between each other? Use words that make your partner feel appreciated and special. Spend quality time together. Designate a time once a week to do something fun together. Buy gifts that are thoughtful. Do acts of service such as making supper, cleaning the house, and buying groceries that the other one likes. Learn each other’s language. Some will verbally express love and some will show it in actions. Show each other compassionate curiosity. Don’t assume the other knows what you want. Be tuned to your triggers. Know that when you are physically and emotionally depleted, you will feel more vulnerable.

How can you use conflict in a relationship as opportunities for connection? Learn how to reflectively listen, validate and empathize. By repeating back to your spouse what was said to you, by expressing your understanding of how difficult the other spouse must feel and by putting yourself in their shoes, you help strengthen the relationship. Through rupture and repair,

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Sarah Kahan, LMSW provides psychotherapy to indi-

viduals, couples, adolescents and their parents. She will be running a series of workshops for newly married women to strengthen their relationship. For further information please contact her at 347.764.9333 kahan.sarah@gmail. com. She is also the Coordinator of the Simcha Program @ OHEL Children’s Home and Family Services.


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Circuits of Attraction By Dr. Michael J. Salamon, Ph.D.

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everberating circuits in the nervous system are bundles of nerves that return their signals to the original source, creating a positively reinforced structure. While this connecting loop happens among certain neurons within our bodies, there is increasing evidence that this type of circuitry can occur between two individuals who are attracted to one another. These reverberating circuits seem to jump across the space between two people. How this works can best be understood by example: If there are two musical instruments near each other, say a piano and guitar, striking an “E” note on the piano will cause the “E” note on the guitar to vibrate as well. The sound waves set up a reverberating circuit to the tone that causes the second instrument to reverberate together harmonically with the first. It makes sense that sound waves can carry tones across the space between instruments, but how can it work between people? The truth is that we are not really sure just how this system operates, but we have some ideas and we do know that it works and may even be instrumental in how people are attracted to one another. Though we do not quite know how, we do know that being in the presence of someone we are attracted to triggers chemical reactions in our bodies. Some of the reactions are hormonal and some impact our brain via neurotransmitters – the chemicals that cause the brain to respond to stimuli. These neurotransmitters include dopamine, serotonin, vasopressin and oxytocin. These chemicals cause us to feel excitement – happy and emotionally bonded with others. The key to the triggering of the neurotransmitters release in our own brains is that we feel certain camaraderie with the other person. Much like playing the same musical notes, people we are attracted to are similar to ourselves. The old adage that opposites attract is simply untrue when it comes to friendship and relationships. We have more in common in terms of our basic personalities with those we are attracted to than with people with whom we do not feel a connection. In fact, if we attempt to force a connection with someone who is too dissimilar, we may be creating a disharmony in ourselves. Psychologists have found that personality can be categorized according to what has come to be known as the Big Five Factors of personality. Each of the following five factors is scored along a continuum from low to high, and can usefully describe every person: • Openness to new experiences, which comprise a measure of creativity and willingness to meet new challenges • Conscientiousness, scored according to how devoted a person is to the tasks they undertake

• Extraversion or introversion, how sociable a person is • Agreeableness or how easygoing each individual is • Neuroticism, which is based on how comfortable an individual will be in stressful situations. Scores can be plotted to create a profile that indicates how everyone’s personality functions. Perhaps surprisingly, people who are attracted to one another have very similar profiles.

to test for it using personality measures, but there is a more natural way. If you take the time to really get to know yourself and how you relate to the other person, you are increasing the odds of getting to see how comparable and compatible you are with one another. If you feel very comfortable and have the sense that each of you can anticipate the other’s thoughts and actions, if you tend to be creative or adventurous to the same degree and share similar life

This attraction is stronger among one’s closest friends, more so than with friends or acquaintances who are somewhat distant. In my own research, I’ve found that those in the happiest and most stable marriages are couples who share a profile that ranges from 60–80% comparable. You simply cannot have too little in common to be easily happy together but you also cannot be exactly the same to be happy together, as that may become just a bit too boring. This does not mean that individuals cannot be happily married if their profiles are below 60% congruence. What it may mean, however, is that a couple with less in common may have to learn to work harder to understand one another and learn to accommodate more to each other. How does one know if he/she has the 60–80% personality profile compatibility? It is possible

goals and hobbies, odds are that you have a lot in common. If you feel like you are forcing activities or that you think differently than the other person about a variety of things, then perhaps you do not have enough in common. Remember though, too much in common, just like too little in common, may not work. Research supports the notion that by using this approach, you may very well increase the odds of finding the most harmonious relations in both friends and a marriage mate.

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Dr Michael J. Salamon, a Fellow of the American

Psychological Association, is the founder and director of ADC Psychological Services in Hewlett, New York. He is the author of numerous articles and several psychological tests and books. Among his most recent texts is “Every Pot Has a Cover: A Proven System for Finding, Keeping and Enhancing the Ideal Relationship.”

February 2014


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The Skill of The Apology By Reizl Kessin, MHC

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February 2014

anniversary card like I always do. You were waiting all day and I said nothing, which could easily have made you feel worthless. I really understand how that could make you feel unloved by me.”

of his hurt or disappointment, he will still feel better knowing that he is missed and loved and thought about. Emotional hurt has the power to destroy relationships by destroying mutual trust and shutting down vulnerability. The art of effective apology is even more valuable when it comes to a spouse. As the age old adage goes: “If you’re happy, then I and the rest of the household are happy, and if you are not happy…” It behooves all couples to master the skills of apology for shalom bayis and for good modeling for children. So what constitutes a good apology? First, let’s see what should not be said. We never want to blame the other for their feelings. One should ever say: “I’m sorry you were hurt but you’re just too sensitive.” The contrite awareness is negated by the insult. This will just lead to further hurts and the need for more apologies. When saying sorry, we must not tell the other that they have no right to the way they are feeling. Do not say: “How can you be hurt by that? What is wrong with you, are you such a baby? No normal person would feel that way.” Again, the person is being disrespected and any desires to connect back are squashed. A good apology consists of the following: • We must acknowledge the other person’s hurt as a right or entitlement as a human being with no objections. The essence of an apology is not to defend ourselves; it is to heal the other. • A good apology details the hurt that the other is feeling. “It must feel awful to think that I didn’t care about us because I forgot to give you an

• You express the fact that you had no idea that what you said or did would hurt the other. There was no intent and no malice on your part at all. • You must be willing to do whatever they say to make it right, within reason. “I will do whatever is necessary to show you how sorry I am for your hurt.” • You must sincerely let them know that you never meant to hurt them and that you now understand what it was that created this terrible rift, and that you will make every effort with every fiber of your being not to let this happen again. This conclusion is most important. It is human to err. When we let someone know that we never want them to feel hurt again, we show our commitment to them and our love for them and their needs. Why is it so difficult for most people to apologize well? The answer is simple. Apologizing means that I made a mistake, I must critique myself and admit it to you, making myself incredibly vulnerable. I become open to being chastised and hurt by you by giving you this admission of guilt. Apologizing well, however, is an act of great maturity. It is too difficult for those with low self-esteem. The good news is that by mastering the art of successful apologizing, we can actually increase our self-esteem and grow the insecure child within us up.

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ftentimes we believe that it is enough to just say “I’m sorry” when we have hurt someone. Perhaps in some cases that is sufficient, but when it comes to more intimate relationships, such as a spouse, sibling, parent or child, we need to make amends in a deeper, more substantial way. The reason is simple: Acts of hurt and disrespect and careless disregard occur on a daily basis. No one wants to hurt someone they love, ever, but life happens; people make mistakes and hurt results. If it is not remedied in a substantial way where the hurt party feels compensated and cared about, the relationship is threatened. If left like an open wound, it can easily become infected and lead to irreversible damage. More divorces occur because of unresolved hurt and sadness than from anything else. It is so much easier to destroy intimacy and connection than to create and nurture it. What is ironic about this emotional downward spiral is that the perpetrator of the pain usually has no intention to hurt another. Almost always the offending party has been hurt themselves and now, as they try to protect themselves from further hurt, they wind up hurting the other. That is why the Torah teaches us that we should judge all people favorably, especially those we love. It would certainly be easier if we really understood that their intent was not to hurt us at all but rather, to protect and defend themselves. For example, a young child is promised a treat by his father for good behavior. An older brother (who doesn’t know this is a reward) sees this act as one of favoritism and feels less loved by his parent. When the father wants to schmooze and learn with him later on that night, the boy will say he is too busy and shrug the dad off in classic passive/aggressive fashion. Dad, not knowing what is really going on, responds by feeling disrespected and disappointed and moves further away emotionally from that child. He may accuse him of being disrespectful, further pushing the already pained boy further away. The child now feels even more unloved and more alone. If left unchecked, this small episode can spiral out of control and lead to a real chasm in their relationship. To be effective and protective over our family ties, we need to be ever aware and vigilant about the hurts our loved ones may be experiencing, especially those hurts that they do not tell us about. Pre-emptive apologies for hurts not told to us are an even greater sign of love and concern. For example, if the father in the above scenario now senses that his older son is upset about something and approaches him with compassion and understanding, the matter can be resolved, sometimes without further discussion. Son, I see that you are a bit withdrawn from me. Is it something I did or did not do for you? Are you aware of feeling distant

from me? It saddens me when we are not close. I miss you and our times together. Please tell me what I can do to fix this so that we can be close again. Even if the hurt person is not cognizant

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Reizl Kessin, MHC is available for counseling. She lec-

tures and conducts workshops on communication skills, assertiveness training and many other topics. She can be reached at 718.951.7042 or Reizlk@aol.com.


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Self-Injury in the Jewish Community: An Overview By Chaya Berger

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on-suicidal self-injury, the act of deliberately harming one’s own body without suicidal intent1, has been called a “silent epidemic.”2 Affecting upwards of 13% of adolescents3, this phenomenon challenges us with its apparently anti-human quality. Human nature is to protect oneself in every sense at all costs – so why do many elect to engage in self-violence? More relevantly, is this something that has reached the frum community as well? And how can we stop this “silent epidemic”? These questions were brought to my attention while conducting a study examining the coping skills of addicts. Comparing behavioral addictions, such as self-injury and disordered eating, with substance addictions such as drug and alcohol addiction, I sought to discover similarities in coping techniques. What I found was surprising, saddening, and even frightening. In a sample of over 200, 38.5%4 of participants who indicated “Judaism” as their religion reported having engaged in self-injury at some point in their lives. More astonishing than the prevalence were some of the comments at the end of the survey, and I knew I could not ignore this information. I read through comments such as: “[I] enjoy the pain like a pleasure pain, it has become a habit that I can’t stop. It’s only after I do [it] that I feel bad about myself ” or “[I am] trying to replace my emotional pain with physical pain. I didn’t want to feel my emotional pain anymore.” Self-injury affects children as young as 7 years old, although the typical age of onset is 12. On a global scale, it affects females as well as males, although each exhibits different types of self-injury5. There are many reasons why even young children choose to physically harm themselves, including mental illness, trauma and abuse. However, in looking at the sheer numbers, it must be understood that this is no longer an activity exclusive to the extremely ill. This silent epidemic is more rampant than anorexia or bulimia; it is more invasive than obsessivecompulsive disorder or borderline personality disorder6. This behavior may be understood as an inability to regulate emotions. When we experience emotions, we have different skills by which we regulate that experience. If someone is incapable of regulating an emotional experience, that experience can become overwhelming. This is what is called “emotion dysregulation.” Many self-injurers describe this experience as being so intense that some form of release from the tension is needed. Self-injury can provide that release. The human experience of distress results in a fight-orflight response. The body prepares to defend itself or to escape by raising the heart rate to be

able to run faster, dilating the pupils to see better, sweating to cool down the body, drawing the blood from the extremities to the central organs. This is fantastic for someone running from vicious lions. If people experience this frequently, however, it can become painful. The human experience of pain is cushioned by the release of pleasure chemicals in the brain known as endorphins. This pleasure in the place of pain, this

children and adolescents, but also to acquire a sort of image of the factors that place a child at risk of such behavior. A method of prevention may then be instituted in schools to address the specific needs of our youth based on the collected data. Further, if within our religious community, there is a link between spirituality as a coping technique and rates of self-injury, then we are equipped with yet another tool in

release from tension, can become so rewarding that the process of hurting oneself can become habitual, even addictive.7 Self-injury is dangerous for a number of reasons. Those engaging in this behavior are clearly at a risk of severely hurting themselves. They are also at a higher risk for suicide, for a number of comorbid disorders, and for substance abuse. Additionally, this behavior can become a social contagion, spreading amongst peers, as it becomes an experimental method of coping. Individuals who learn to use this behavior to regulate themselves will be challenged to find more effective ways of coping, ways that do not cause themselves harm. It is interesting that greater importance of spirituality and religion has been found to be associated with lower rates of self-injury8. It is possible that this phenomenon is purely a secular one, however, based upon the research, it appears that this is not so. In speaking with educators and administrators of both high schools as well as middle schools, self-injury is a problem that eventually must be dealt with. These sorts of issues are challenging to tackle and have traditionally, both in the secular and frum worlds, taken time to be recognized and to be understood, and for methods to be put in place to prevent and deal with them. My question is: Why wait? As principal investigator of Lander College’s study on Risk Factors and Resiliency for Nonsuicidal Self-injury in Orthodox Jewish Adolescents, my aim is to not only gain insight into the frequency of nonsuicidal self-injury in frum

the prevention of self-injurious behaviors. As Orthodox Jews, we have Torah to guide us; we are not left to figure out the answers on our own. However, until a problem is acknowledged, it cannot begin to be resolved. B’ezras Hashem, this problem should be dealt with appropriately and eradicated from our community quickly.

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1 Favazza, 1989 2 Bare & Hamlyn, 2010 3 Nock, 2010 4 Berger & Cohen, in press 5 Nock, 2010; Barrocas, Hankin, Young, & Abela, 2012 6 Nock, 2010 7 Nock, 2010; Favazza, 1989 8 Kress, Newgent, Whitlock, & Mease, in press

References: Bare, I. (Director), Hamlyn, M. (Writer). (2010). The Silent Epidemic [Documentary]. Australia. Barrocas, A. L., Hankin, B. L., Young, J. F., & Abela, J. R. (2012). Rates of nonsuicidal self-injury in youth: Age, sex, and behavioral methods in a community sample. Pediatrics, 130(1), 39-45. Berger, C. L., & Cohen, A. (in press). Distress Tolerance as a Coping Skill in Addicted Individuals. Favazza, A. R. (1989). Why patients mutilate themselves. Hospital and Community Psychiatry, 40, 137-145. Kress, V., Newgent, R., Whitlock, J., & Mease, L. (in press). Spirituality, life satisfaction, and life meaning: Protective factors for non-suicidal self-injury. Journal of College Counseling. Nock, M. K. (2010). Self-Injury. Annual Review of Clinical Psychology, 6(1), 339-363.

Chaya Berger has done research at the NY Obesity Research Center and at the Emotion and Self-Regulation Laboratory. She currently is conducting a study under the guidance of Perella Perlstein, Psy.D. She has published in Touro’s Journal of Experimental Psychology.

February 2014


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Roots of Addiction: Vulnerability By Avi Shteingart, LMSW, CASAC

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think he is sad and he realizes it’s serious but I don’t think he really knows how serious it is. He saw me crying the other day but I’ve been trying to be strong.” I interpreted “trying to be strong” to imply that he was holding back his tears around the son. I responded by suggesting that sometimes it is okay to not be strong in front of him – to cry and express sadness, explaining that it is powerful for him, even if it can make him very sad or even scared. Teaching our children this same lesson, giving them room to feel painful emotions, is one of the best drugprevention skills they can ever have.

depressants are the most frequently prescribed medication in adults 18-44; their prescription rate has skyrocketed 400% in the last 15 years), extreme debt, and soaring divorce rate. I will not audaciously state that I have the preventative tool for addiction. However, I deeply believe that any movement we make towards accepting our own vulnerabilities diminishes the chances of addiction and unhealthiness cropping out. A father once texted me, stating that his father was in critical care in the hospital and things were not looking well. He was worried about his 10-year-old son, my client. I asked how the son was reacting and he responded, “I

Please note: All identifying details have been altered to protect confidentiality, and permission has been ascertained from individuals described in the article.

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ast night, an educator in a prominent high school called me after her son had dropped out of treatment. She has always projected a strong and confident demeanor, but our conversation suggested a different side to her. She struggled to hold back tears as she asked, “What do I need to do?” She explained that her position required offering solutions for parents and students: She needs a math tutor… Your daughter will not receive a regents diploma unless she… And yet now, she found herself baffled, frustrated, and on the verge of a breakdown. “We did everything right with our kids, we provided them with everything, and yet he refuses to get better. He sits at home and refuses any help.” Finally she asked the question that parents and family members inevitably ask: “Why him, what did we do wrong?” Addiction is an amazingly complicated disease. In Alcoholics Anonymous they label it: “Cunning, baffling and powerful.” Identifying, diagnosing, and treating it are incredibly difficult, and yet understanding its roots, where it emanates from, is nearly impossible. I do not believe that one single factor can account for the development of an “addictive personality.” However, through my work in this field, I have been able to identify common denominators that exist amongst most of the clients who walk through my door. One of the most frequent indicators of addiction is the inability to experience vulnerability, which is endemic to Western culture. We live in a world where the message is often: emotions=weakness. Sometimes we even grow up in homes where that idea is communicated. Imagine an 8-year-old who runs home crying after being teased on the bus, and the father’s first instinct is to tell him to stop crying and man up. Or similarly, his mother suggests that he ignore those bullies. Both of these suggestions implicitly tell the child that his experience feeling these negative emotions – pain, hurt, shame – should not occur. He is being told to make believe, to act as if nothing happened. I have been guilty of doing this same thing with my child. When he trips, grazes his knee, and comes running to me, crying “booboo,” my gut reaction is to say: “Don’t cry, it doesn’t hurt.” It does hurt, or so my son perceives it as such. Addicts have often described to me the difficulty they encounter when things do not go their way. Many people, not just addicts, struggle with this. Similarly, we inevitably experience moments of paralyzing fear, guilt, deep frustration, rejection and hurt. As a culture, we have been programmed to instinctively react by drowning these out and moving past. We have many techniques that allow us to remain distracted, to not dwell in the negative emotions.

So many of my clients come into my office desperately trying to purge all negative feelings – ironically, creating even more anxiety and tension. They boldly state: “Emotions are weakness.” By “emotions,” they are only referring to the negative experiences; they would never purposefully want to dull happiness, confidence, belonging or excitement. Drugs and alcohol are probably the best numbing method. However, they are not the only technique we humans use to avoid reality. Just look at the soaring obesity rate, excessive reliance on mood-altering medications (anti-

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Avi Shteingart, LCSW CASAC, is a licensed therapist

practicing in the tri-State area and working at The SAFE Foundation, a premier substance abuse and gambling outpatient serving the Jewish community. He has worked in a number of other outpatient rehab centers, and maintains offices in Queens and Brooklyn. He specializes in addiction, as well as work with adolescents, young adults and adults struggling with anxiety, depression, social struggles, and transitions. He can be reached at avi.shteingart@gmail.com or 201.410.5883.


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Belief: An Effective Therapeutic Tool By Kalman Canant, LCSW

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racha showed up late to her job late that morning on September 11, 2001. To her shock, nothing was left of her coworkers and acquaintances. Everything was destroyed by the terrorists. By the time Bracha made her way to my office 10 years later, it was still a struggle to even leave her residence. In addition to teaching Bracha coping tools of how to manage her PTSD symptoms, a main healing factor was her developing a belief perspective about the trauma. During her therapeutic journey, we identified that a major cause of her disturbance was the belief that the entire incident was senseless. Over time, we developed and adopted the belief that every person in those buildings was supposed to be there on that day and at that time. Bracha renewed and strengthened her belief that G-d orchestrates every detail of our lives with exacting precision. The events of 9/11 were no longer senseless and cruel to her, even if they still weren’t completely understandable. I am happy to say that this year’s 9/11 anniversary was meaningful and purposeful for Bracha. Belief is a broad term with multiple implications and meanings. I refer here to the belief that events and circumstances are orchestrated and directed by some Higher Power. Needless to say, therapy without this kind of belief is also effective. However, it behooves the clinician to assess existing strengths and belief systems and to build upon them, in order to optimize therapy effectiveness. The strengths perspective utilized in psy-

chotherapy means building upon existing strengths that clients already possess. It’s logical to strengthen tools and mechanisms that are already working. Jews and gentiles and even atheists usually have a spiritual or belief system, such as Karma or “what goes around comes around.” When assessing clients’ strengths and supports, they almost always express surprise when I ask questions such as: “Do you have a spiritual or belief system? Is belief in G-d a support for you? Is praying or speaking to your higher power one of your strengths?” Often the response is: “Wow, I never thought of that as a strength,” and yet it has been there for them the whole time. Couples find their way to my office complaining about their spouse and seeking resolution. Usually, their conception of that resolution means working to change their spouse. At the right moment, I may encourage them to ponder the possibility that maybe it’s not a mistake that this seemingly mix-matched pair was put together. It’s important to direct them to consistently ask the question: “How should I grow from this situation?” The couple can learn the perspective that everything happens in their lives for a reason and for their ultimate best, including their marital partner and associated difficulties. They can both then learn to cultivate their capacity to respond to these difficulties by growing and changing from them. We often can’t very well control our life situations. Try as we may, we seem to come up against a brick wall when trying to bring about desired improvements. But the one thing we can always change is our perspective, to view the situation with belief. Consider the following case: John originally presented with anxiety and suicidal ideation. Soon in the therapy, we identified that his symptoms and disturbance were driven by a basic lack of confidence, based on childhood historical factors. We spent time working to correct the childhood distorted thinking patterns, resulting in great improvements. John began one session expressing his desire to never feel insecure and unconfident again. My response to him was: “When you discover that, please let me know.” I explained that regression is expected and normal, such as when faced with increased stressors. I offered to him that an enduring solution is to develop his belief by opening up a more consistent dialogue with G-d and to rely on His confidence. John is achieving his treatment goals and gaining mastery. A belief perspective can enhance treatment of even psychotic disorders: Dave had a diagnosis of schizophrenia. One of his coping mechanisms for coping with his paranoia was to pray that he arrive safely to his destination, without incident. This, however, was only minimally effective. During his sessions, we were able to upgrade and improve on the content of his prayers. For example, Dave learned to pray for the clear awareness that every bullet flying through the air is actually directed by exacting divine providence. He could then calmly say: “I only have to worry about those bullets if G-d wants them to penetrate and hurt me.” His praying in this way reduced anxieties and paranoia, and led to his increased functioning. The few examples presented here demonstrate how belief can be an effective ingredient in therapeutic work. Irrelevant of the therapist’s religion or ideology, building upon clients’ existing strengths in this way enhances and optimizes treatment success. Kalman Canant is a licensed clinical social worker. He practices psychotherapy at the

Interborough Clinic in Crown Heights, Brooklyn and maintains a private practice in Ditmas Park. Kalman Canant can be contacted at kacanant@gmail.com. You can follow him on twitter @Kalman_LCSW, and learn more about his approaches at kalmancanantlcsw.blogspot.com.

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Anxiety Disorders: Time to Have a Little Faith By Dr. David Rosmarin, Ph.D.

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ccording to the Gallup Poll and Pew Forum, more than 90% of Americans believe in G-d, and religion is “very important” to more than 50% of the population. In fact, even in the least religious enclaves of the country (e.g., New Hampshire), nearly a quarter of residents attend religious services weekly and more than two-fifths pray on a daily basis. Furthermore, even in this increasingly secular period of history, spirituality continues to shape political, economic, and familial trends on a global scale. And let’s not forget that every bill printed by the United States Mint boldly displays the phrase: “In G-d We Trust.” Given the centrality of spirituality in the general public, it is no surprise that more than 50% of psychotherapy patients in national surveys wish to discuss this subject matter in the context of their care. Indeed, a study I recently conducted at Harvard’s McLean Hospital in Eastern Massachusetts – not exactly a hotbed of religious fundamentalism – found that 56% of patients had such a desire. It is therefore not surprising that clergy are far more likely to be approached for help with emotional difficulties than mental health professionals. Furthermore, the most widely practiced modality of psychosocial treatment in the world is Alcoholics Anonymous – a spiritually-based treatment program for addictions that has over 2,000,000 members! Despite these facts, however, G-d has virtually no place in psychotherapy for anxiety disorders. Most of the mental health clinicians I have encountered barely inquire about their patients’ spirituality, let alone address it. Utilization of spiritual beliefs or practices – e.g., by framing psychotherapy concepts with a religious lens, or identifying religious observances to focus on in treatment – is almost anathema. Even more unfortunate, many close colleagues from our communities, who are deeply religious and highly observant themselves, remain reticent to approach the subject matter of religion in the therapy room. Some have even criticized me for being a proponent of spiritually-based treatments, despite growing evidence that such approaches are effective, as well as preferred by many patients. Why is this the case? Why is a field dedicated to the alleviation of emotional suffering so hesitant to include G-d in the process of treatment? Why does the inclusion of G-d into treatment seem so foreign, even to mental health professionals who themselves profess faith in G-d? I don’t know the answer for sure, but it certainly didn’t help when Sigmund Freud came

out in spades against G-d by openly calling religion a “neurosis”. Today, anti-religious sentiments in the mental health disciplines are less common (though not entirely uncommon). However, what does remain is widespread apathy for spirituality and religion. To put it simply, many mental health practitioners simply don’t care enough about this domain and therefore they fail to envision how helpful it can be to patients. The irreligious culture of mental health, especially against the backdrop of previous antipathy towards religion, creates widespread reluctance to address the subject matter – even among religious practitioners. The result is

step closer and closer towards a real, live (nonpoisonous) snake until its cold, scaly and slimy skin is placed on your forearm. Frightening? Perhaps. But the miracle of treatment, if you will, is that people can overcome life-long fears in a matter of a few days, and sometimes in just a few hours. More centrally, the message of exposure therapy is clear: At each point in the treatment process, patients are encouraged to take small steps towards their goals despite the fact that they are experiencing inner struggle in the form of high levels of anxiety. In other words, patients are encouraged to practice emunah. Of course, exposure therapy – like other CBT approaches – are not explicitly spiritual, and most CBT practitioners do not speak about their practices in spiritual terms. However, framing the process of exposure therapy for patients as an exercise in building emunah can do two things. First, it can help patients to get through treatment. Needless to say, exposure therapy is difficult work. It takes immense inner strength and persistence to overcome one’s fears. Viewing treatment as an exercise in building emunah can help increase motivation when things get tough. Many patients, whom I’ve treated using an emunah-based explanation of exposure therapy, remarked to me that they would have given up midway had they not held this message in mind. Second, and perhaps more important, framing exposure treatment in terms of emunah can turn treatment into an exercise in spiritual growth. Numerous patients I’ve seen for treatment of specific phobias have been highly successful individuals whom are happily married, but they remain burdened by one or more specific fears. What motivation could such people have to overcome a phobia, you might ask? Several have entered and completed treatment simply because they saw it as a spiritual quest. As one patient recently remarked to me: “G-d doesn’t want me to live in fear, so it’s time that I learn to get over this.” Needless to say, not all individuals wish to involve G-d, faith, spirituality or religion in treatment. But many do, far more than we might think. And for those individuals – many of whom reside in our communities – it’s time to take a step forward and offer spiritually-based treatments en masse. In other words, it’s time to have a little faith!

“Emunah is actually the bedrock of one of the best established cognitive behavioral therapy techniques (CBT) for the treatment of anxiety disorders: exposure therapy…”

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David H. Rosmarin, Ph.D., is an Instructor in the De-

partment of Psychiatry at Harvard Medical School, and Director of the Center for Anxiety in New York City, a clinical-research facility with a focus on the Jewish community. He can be reached at 646.837.5557 or info@centerforanxiety.org

FAITH

February 2014

many patients who lose out. Fortunately, the tide is beginning to shift – albeit slowly. The past decade has seen a sharp rise in research on Spiritually-Integrated Psychotherapy, and results are most promising. However, the availability of Spiritually-Integrated Psychotherapy remains limited. Further, most people – mental health professionals and laypersons alike – remain ignorant about how G-d can be brought into the treatment process. To this end, here is one example of how spirituality can be successfully integrated into treatment. It involves emunah. In his famed Da’as Torah, the Mir Mashgiach, HaRav Yerucham Levovitz zt”l, defined emunah as faithfulness – remaining steadfast in one’s actions despite inner struggle. Commenting on the lives of the Avos, he points out that emunah involves moving forward in the direction of one’s goals and dreams despite a lack of certainty that things will work out in a manner that one expects or desires. L’havdil, as Martin Luther King Jr. is reputed to have said: “Faith is taking the first step, even when you don’t see the whole staircase.” This being the case, emunah is actually the bedrock of one of the best-established cognitive behavioral therapy (CBT) techniques for the treatment of anxiety disorders: exposure therapy. Specifically, exposure therapy involves encouraging patients to approach their anxieties head-on, step-by-step, until their distress comes down. The process isn’t pretty. Imagine being afraid of snakes and being encouraged to


& MIND, BODY SOUL

Practical Tips for Procrastinators By Shimmy Feintuch, LMSW

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t’s midnight before the big exam, and you’re just pulling out the book to study. The garage is full of junk, and you’ve been promising to clear it out since the Mets won the World Series. There are so many things to do, they need to get done right now, and yet they linger on the list. What’s going on here? Why can’t we just get things done? The concept seems simple enough. Something needs to get done, so do it! But somehow, it doesn’t always work that way. We tell ourselves there’s no time, or we suddenly become interested in doing something else. Anything else, really. Time to prepare your taxes? But the plants need watering! Homework due tomorrow? Suddenly it’s time to catch up on all the news you missed last week. And so on. Procrastination is pervasive, yet seldom understood or conquered. Why do we put off doing things that need to get done? Why We Procrastinate The myth of procrastination is that it is caused by a lack of discipline, willpower or self-control. This is rarely the case. Perhaps the simplest way to explain this phenomenon is that we put off tasks that make us uncomfortable. Certain activities, such as taking out the garbage, can be unpleasant. Other activities, such as exercising, can take a lot of effort, especially if they aren’t ingrained as a habit. Cleaning out that closet can seem like it will take forever. Preparing a will or setting up life insurance is a task fraught with often unconfronted fears of death. It can be easier to avoid all of these. And, to complicate matters further, our feelings about the tasks on our list are often below the level of our awareness. Here is a list of some characteristics of activities we push off. (Keep in mind that one task can have multiple characteristics, and that this is a simplified list.)

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Large tasks: We put off cleaning the house, learning a language, and planning a vacation because these tasks seem daunting and insurmountable. We may not know where to start, and we may be afraid that we’ll never finish.

Take going to the gym as an example. Your brain has a field day with this! If you want to go to the gym, you may naturally think about all that is involved with the trip. And your brain will be off to the races: What if your shoes don’t fit? The parking in that neighborhood is a pain. What if there are no machines available to use? Should you buy a membership? Maybe you should bring your own music, since you don’t really like the music they pipe in. And what about the next time? Will you really be able to do this on a consistent basis? Next Tuesday there’s a wedding. Will you able to go then? And you can’t just exercise without dieting as well! What kind of food plan should you go on? And so on, and so on. Thus, a relatively simple task like going to the gym one time becomes a monumental undertaking. We get overwhelmed, and we don’t even start. These items can stay on our to-do lists for days, months or even years, taking up brain space and causing much anxiety. And sometimes, the sheer number of the things on our to-do list can paralyze us as well. Things we want to do well: Writing a research paper, updating a resume, and creative projects are good examples of things we want to do well. We fear we won’t be able to do them perfectly, or that we will fail, so we don’t do them at all. “It will never be good enough, so I may as well not do it.” Fortune telling: We put off applying for a job, asking forgiveness, or pursuing a relationship because we are concerned about the outcome. We may be afraid of rejection or harsh criticism. Often, we tell ourselves a story about what the outcome will be before we even start. Of course, this causes us to not want to start in the first place. Fears or insecurities: Going to the doctor, dieting or exercising, even pursuing a dream can bring up deep-seated fears, anxieties, or self-doubt: What is that pain in my knee? Will I need surgery? Can I lose weight and keep it off? What if I can’t? What if I try to start my dream business and find I’m just not cut out for it? Often lurking below our level of awareness, these feelings cause us to do anything to avoid confronting our worst nightmares. Subconsciously, it’s easier to think we could have succeeded rather than to know for sure that we can not. Underlying distress: Often procrastination is accompanied by shame and guilt. We feel badly and berate ourselves for our lack of action. The longer we have been procrastinating, the greater the shame and guilt. The anxiety of an undone task grows as well each time we put it off. So as we procrastinate, the difficult emotions grow, and the more effort it takes to finally accomplish the task. Continues on Next Page ➙

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February 2014

and get going. No distractions. When the timer buzzes, it’s up to you to decide if you want to stop or keep on going. Do a cost-benefit analysis: This is a more advanced technique. Try to figure out what you gain from procrastinating. Take a piece of paper and list the benefits of doing the task now alongside the benefits of putting off the task. Some payoffs to putting off may be: avoiding fears, retaining the right to feel bad or complain about it, taking the easy way out, or the hope that someone else may do it eventually. There are many payoffs to procrastination. That’s why we procrastinate in the first place! Bringing these hidden motives to the light is the first step to addressing them. Focus on what you have already done: Too much focus on what still needs to be done can be overwhelming. If you’ve started the task, even just a little bit, give yourself a pat on the back. You’ve started! That’s great! Try this the next time you’re reading a book. How many of us flip to the back to see how many pages are left? Instead, try flipping to the front and show yourself how much you’ve already read. Cut the list down to size: Are there things that have been on your list for weeks, months, or years? If something has been sitting untouched on your to-do list for that long, that may be an indication that you’re just not ready to do it. Cross it off, and let it go. When you are ready, you’ll come back to it. Or, if you want, keep a separate “wish list” and revisit it once a month or once a year. If procrastination persists, and especially if it significantly interferes with your life, it may be time to consult a mental health professional. A therapist can help guide you through the issues that are holding you back, so that you can finally do all those things you wanted to. You can be free from the anxiety of procrastination. You can do it tomorrow. Or you can do it today. Shimmy Feintuch, LMSW is an associate in private practice at Ratzon Counseling in Brooklyn, NY (Yitzi Horowitz, LCSW, Director). Shimmy is currently accepting referrals for adolescents and adults with issues on the depression and anxiety spectrums (including procrastination!). Email therapy@shimmyfeintuch.com or call 530.334.6882.

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SELF-IMPROVEMENT

Tips for Overcoming Procrastination Now that you know some of the underlying causes of procrastination, you can try to work through some of the angst. Here are a few specific tips: Put the lie to putting off: A common underlying thought when putting something off is: “I’ll feel better if I don’t think about this now” or “It will be easier to do it later.” The truth is exactly the opposite. The shame, guilt and anxiety associated with procrastinating only gets worse with time, never better. And so, in an effort to feel better, we make ourselves feel worse. Instead, we can choose momentary discomfort (doing the action) over longer-term pain (procrastinating). If we don’t do it now, we are not free. We pay for it in stress. Feeling better about our workload comes from doing the things that we want to be doing. Break it down: This works especially well for tasks that are overwhelmingly large or long. We think about the entire task and we’re exhausted before we start. The truth is that the only way to accomplish any task is to take one step at a time. Force yourself to pick one small step to start with. Don’t spend too much time thinking about what to do - that will give the anxiety time to kick in. Action is the name of the game here. Pick a small piece of the task, and do it. In the best cases, this can lead to a sense of relief of having started the job, and it will be much easier to continue than it was to start. Continuing with this technique, focus on doing small, manageable pieces of the puzzle. Before you know it, you will have done a whole lot. Embrace imperfection: Being perfect is exhausting. It’s also impossible! The idea of perfection is so daunting that it scares us away from even trying. Be realistic, and lower the bar. This is painful for perfectionists, but necessary if they are to be productive. Say to yourself: “I’m going to do a pretty good job. And that will have to be good enough.” Use a timer: An old-fashioned egg timer or the timer on your phone will do. The goal here is just to get started. Remember, it’s much easier to continue than to start. Set the timer for a short amount of time (15 minutes, or even 5),


& MIND, BODY SOUL

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is a not-for-profit organization services are free of charge to all families. For more information call TAFKID at (718) 252-2236 or e-mail: tafkid@aol.com

By Mindy Hajdu, MS, LCSW

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our friend asks you for a favor. “Would it be okay to drive Chani to school until busing starts up again? Yanky has to be at work early, and it’s just too hard to get out with the baby. You know, weather and all…” “Sure!” you find yourself saying. A lady from the shul Sisterhood calls to let you know that Sarah just had a baby. “Can you make a meal for her tomorrow? I know it’s short notice, but she is new to town and doesn’t have any family around…” “Not a problem!” you hear yourself answer. The True Story You’re exhausted. It’s been a long winter. Busing has been suspended until further notice. Chani lives 3 miles away. You have been schlepping your four kids, Chani, (not to mention your baby), each to their own school by car, amidst the snow and subfreezing weather. You have been scrambling to work (an hour travel each way), only to then rush home to do the carpool thing all over again. With minimal groceries in the pantry (who has time to go shopping?), you tell the kids for the 10th night in a row that they will have to fend for themselves. Now if only you could find something to make for that new mother… How did you get yourself into this mess? Guilt. Or better known as the “Jewish women’s disease,” the one we all suffer from. The one that tells us we can’t say NO. The one that allows us to bite off more than we can chew. Why do we feel it and where does it come from? The Source Guilt is an emotion we experience when we feel we have violated a moral standard that we ourselves believe in. For many of us, helping out a friend or doing acts of chessed is that moral standard. Guilt has no passage of time. We can feel guilty about the past (I would’ve, should’ve, could’ve, done…), guilty of how we fill the present (I shouldn’t be doing this right now), and anticipate guilt for the future (If I don’t do this, I know that I’ll feel guilty later on). And because for most of us, guilt underscores our own vulnerability, it makes it even harder to set limits; especially when the social pressure is on. Shedding the Guilt: Creating Realistic Expectations: The Art of Saying “No” How can I be helpful to others without becoming overextended? How can I set realistic expectations so that I do not neglect myself or my family? And better yet, how can I learn to say “no” without feeling guilty? • When someone asks you for help, allow them to hold the problem. Sometimes we get carried away and we begin to make the problem our own. If I don’t give Chani a ride to school, well then how will she get there? This problem belongs to Chani’s parents, and to them alone. Maintaining an objective perspective towards the problem, will allow you to provide an honest answer.

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• Consider the meaning you attach to the situation. What will it mean if I can’t help out at the ladies luncheon? I must not have it together. I am lazy and unhelpful. Instead of acknowledging the real reason why we are unable to help, we create a self-image that is false and inaccurate. Expand your self-concept to include the many wonderful things about yourself. Guilt takes up little space in a person who knows her true self worth. • Consider the present context of your life. What’s going on right now? Does cooking a meal for someone fit into your schedule? Or is life too hectic right now? Again, this does not mean you are an uncaring person or that you will never make a meal for someone in the future. • When you are overextended and someone asks you for help, it’s hard to know what to say. Acknowledging your desire to help while expressing your lack of availability is one way to do it. You might even consider offering when you might be available to help in the future. Here is an example to fiddle with: “I would love to be able to help you (give Chani a ride, make a meal, etc.), it’s just not a good time. I might be available to help out more in a few weeks.” • People can be pushy or forceful when they ask for help. Sometimes they are the ones that are making you feel guilty! With that said, allow them to own their feelings without pushing them onto you. When people push their agenda, we can keep our distance by creating clear boundaries. No one can force you to do anything. Keep in mind that the answer belongs to you and to you alone. • Buying yourself time when you feel guilty about saying “no”, is another way to derail the guilt. When we are put on the spot, it can be difficult to think clearly and make a sound decision. Saying something like “let me think about it”, allows you to consider your options and respond from a more centered, grounded place. Just remember to get back to the person! • Consider the (false) picture we have in our minds of superwoman. You know, the one who can be everywhere and do anything? For many of us, guilt surfaces when we are in pursuit of this ever-elusive woman. When we feel we need to be perfect in every aspect of our lives. A life on overdrive is not a healthy one. Take breaks. Stay balanced. Maintain perspective as to what is really important to you, and let everything else go. Staying balanced can allow us to take charge of our guilt, instead of being guilty as charged. Mindy Hajdu, MS, LCSW, received her MS in Second-

ary Education from Azrieli Graduate School, her MSW from Wurzweiler School of Social Work and has completed a year of training in family therapy at the Ackerman Institute for the Family. For close to nine years, Mindy acted as clinician and supervisor at OHEL’s Preventive Care Program. Presently, Mindy works as a therapist at Pride of Judea mental health clinic, serves as adjunct professor at Touro College and maintains a small private practice in Queens, specializing in children and families. Mindy can be reached at mindyhajdu@gmail.com.

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Happenings: & MIND, BODY SOUL

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olumbia University Medical Center is pleased to be able to provide high quality treatment for OCD (Obsessive-Compulsive Disorder) with frum-friendly, sensitive practitioners at no cost that may improve your symptoms and quality of life. Learn more about OCD and what our no-cost treatments have to offer for adults and children with OCD. It is sometimes hard to recognize symptoms: An obsession is an intrusive or upsetting thought, image, or impulse that we would rather not have or that does not make sense but may keep coming back to us again and again even when we try not to have it. Common Obsession Themes: • Doubting oneself and one’s experiences • Fears about dirt, germs, or becoming contaminated • Thoughts about symmetry, sequence, exactness • Needing things to be or feel “just right” • Unwanted “taboo” thoughts (e.g. fearing homosexuality) • Unwanted, aggressive thoughts about harming others or harming oneself • Excessive fears related to religion, offending G-d, or committing sins In response to obsessive thoughts, people engage in compulsive behaviors to decrease their anxiety and distress in the moment. Common rituals include: • Checking behaviors (locks, stove, light switches, faucets) • Asking many questions to gain reassurance from others or minimize doubt • Repeating a behavior multiple times (e.g. hand washing, tapping/touching things)

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EFESH International is a network and training association of Orthodox Mental Health Professionals, Rabbanim, and educators. NEFESH is constantly developing new training opportunities to promote professional development of its community of practitioners. We are proud to share with you highlights of our upcoming programs. If you would like more information about our events or NEFESH Membership, visit www. NEFESH.org. NEFESH: WORK THE NETWORK UPCOMING PROGRAMS FOR 2014 February 26: Dr. Ronen Hizami: Realistic Expectations of Psychotropic Medication

February 2014

• Having trouble throwing things away • Engaging in repetitive mental activities to cancel, neutralize, or undo bad thoughts, actions or images (e.g. reciting a specific passuk) • Avoiding activities because you are afraid you’ll make a mistake or will have bad thoughts If you are having persistent bothersome symptoms, you may be eligible for treatment that is available through one of two research studies: Adult OCD Treatment: Cognitive-behavioral therapy is offered at no cost to individuals who qualify. If you are on medication and your symptoms are still bothering you, or you think OCD is relevant to you and want to know more, contact us! For more information or for a confidential screening, please contact Dr. Marcia Kimeldorf at 646.774.8049. Child OCD Treatment: A study at Columbia University is providing a known antibiotic treatment at no cost for youth ages 8-20 years with OCD. If your child is on an antidepressant medication and still experiencing OCD symptoms, they may be eligible to participate. Our team provides a full diagnostic evaluation, psychiatric care throughout the duration of the study and up to 3 additional months of no-cost treatment including medication management and/or Cognitive Behavioral Therapy (CBT) for OCD after the study. Participants will also be compensated $350 for their time. For families who are interested in participating but may not be eligible at this time, we can also provide care to optimize current treatment prior to enrolling in the study. For more information, call us at 646.774.5793. We hope to provide no-cost treatment to family members and friends struggling with OCD. Reach out to us.

March 2, 3 and 4: Gina Colleli, LCSW: EMDR Basic Training Level 1 March 12: Ricki Bernstein, LMSW: Somatic Interventions: Protecting Ourselves From Vicarious Traumatization April 3: Jodi Mullen, PHD, LMHC: Play Therapy Beyond the Basics May 4: NEFESH West Coast Conference May 19 and 20: Dan Wile, PhD, ABPP: Collaborative Couple Therapy June 8, 9 and 10: Gina Colleli, LCSW: EMDR Basic Training Level II September: Trauma and Teshuva III November: NEFESH International Melava Malka December 28 and 29: 18th Annual NEFESH International Conference Hyatt Regency Hotel, Hauppauge, NY

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To advertise in the next issue of & MIND, BODY SOUL , call Shaindy: 718.330.1100 x373 or e-mail: shaindy@ jewishpress.com.

NEFESH INTERNATIONAL IS EXCITED TO ANNOUNCE EMDR TRAINING THIS YEAR WITH RENOWNED TRAINER GINA COLELLI, LCSW EMDRIA APPROVED TRAINER EMDR LEVEL I: MARCH 2, 3 AND 4, 2014 EMDR LEVEL II: JUNE 8, 9 AND 10, 2014 LOCATION: 2112 59TH ST. BROOKLYN NY 11204 Register online www.NEFESH.org REGISTRATION: NEFESH MEMBER $1550 NEFESH NON-MEMBER $1600 Early Bird: Register before February 16th for a $50 discount Anyone interested in registering for this training must have an accredited license. Please email or fax your license to secretary@NEFESH.org OR Fax: 347-342-3046


& MIND, BODY SOUL

Further Reading Breaking the Silence: The Boy Who Was Sexual Abuse in the Jewish Raised as a Dog: And Other Stories from a Child Community David Mandel and David Pelcovitz

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he reality of sexual abuse in the Jewish community has necessitated a guide for parents, mental health professionals and community leaders outlining practical approaches to prevention and intervention. The focus of this book is on helping parents and professionals understand the distinctive ways that Orthodox Jewish culture, beliefs and practices can result in a unique presentation in child and adolescent sexual abuse victims. Practical approaches to prevention and protection that are culturally sensitive to the unique needs of the Orthodox community include chapters which will serve as a guide to parents, teachers, and community leaders on how to effectively implement prevention efforts in homes, schools and communities. The book also contains sections describing the impact of abuse in the voices of survivors, a summary of how traditional Jewish law views the responsibility of the community in dealing with sexual abuse, and a section for mental health professionals that details psychotherapeutic approaches in work with victims and perpetrators. This volume should serve as an essential resource for parents, educators, professionals and community leaders interested in learning how to better fulfill our responsibility to protect and nurture the next generation. Breaking the Silence: Sexual Abuse in the Jewish Community is published by KTAV Publishing House, Inc. and is available in Jewish book stores and on the web.

Uncle Willy’s Tickles:

A Child’s Right to Say No Marcie Aboff

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story about “your body belongs to you” and a child’s right to say no. This book is designed to help children learn about body boundaries and express themselves when they don’t like something. A “Note to Parents” section is included. Appropriate for ages 3-8.

Uncle Willy’s Tickles is published by Magination Press and is available in major bookstores and on the web in hardcover and paperback.

Psychiatrist’s Notebook: What Traumatized Children Can Teach Us About Loss, Love, and Healing Bruce D. Perry, M.D., Ph. and Maia Szalavitz

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hild psychiatrist Bruce Perry has treated children faced with unimaginable horror: genocide survivors, witnesses, children raised in closets and cages, and victims of family violence. Here he tells their stories of trauma and transformation. The Boy Who Was Raised as a Dog and Other Stories is published by Basic Books and

is available in major bookstores and on the web in hardcover, paperback, NOOK book, and audiobook formats.

Conquering Panic and Anxiety Disorders:

Success Stories, Strategies, and Other Good News Jenna Glatzer, Editor Commentary by Paul Foxman, Ph.D.

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nxiety disorders are the most common mental health problem in America, affecting one in every nine people. Conquering Panic and Anxiety Disorders brings us triumphant tales by those who have overcome them. Men and women of diverse ages and backgrounds share their individual experiences battling anxiety. Offering hope and inspiration, their essays discuss methods for recovery and techniques to manage symptoms. Each account is followed by a therapist’s explanation of the recovery techniques used and how others can apply these techniques to their lives. Conquering Panic and Anxiety Disorders is published by Hunter House and is avail-

able in major bookstores and on the web in hardcover and paperback.

20

February 2014


Pearlman Continued from before the MBS ➙

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vantage-MSA (Medical Savings Accounts) programs that allow members to see any doctor who participates in the traditional Medicare program. The patients will pay the Medicare contracted

obtain coverage with a provider of their choice. It may push those who need specific doctors or facilities to pay some higher premium costs with a supplement plan to cover the gaps, but that may be the best

RAISING OUR CHILDREN

“More seniors are choosing one of the Medicare Advantage plans instead of traditional Medicare because Medicare Advantage can offer additional benefits such as gym memberships, at no additional cost to their members…”

rate the provider has and utilize the funds given to them by the plan. For example, a new Medicare Advantage-MSA plan offered by a popular carrier features a $4,250 max out-of-pocket cost. Since the plan includes a $2500 pre-funded amount in the account, the member’s cost is limited to $1,750 out of pocket for this plan. That could end up being less than a regular Medicare Advantage plan, especially if they are seeing “out-ofnetwork” doctors who participate in traditional Medicare. For more information when you are ready to enroll initially or during open enrollment, you can contact Adam Pearlman at 212223-5471 ext. 104 or AdamP@betterbenefitsconsulting.com. (Sources include: The NJ Record and Kaiser Foundation Health News)

ISSUES

ists, said Mark Thompson, executive director of the Fairfield County Medical Association, prompting the medical associations in Fairfield and Hartford counties to file a federal lawsuit to stop the cancelations. In New York City, UnitedHealthcare’s contracts with about 2,100 physicians will be canceled, affecting some 8,000 patients, according to the Medical Society of New York. In Florida, UnitedHealthcare has dropped the state’s only National Cancer Institute-designated cancer treatment facility, the Moffitt Cancer Center and its 250 physicians in Tampa. I am not sure how all these changes will play out in the marketplace over the next year/several years due to the immense changes created by the Affordable Care Act and our federal budget, but we will have to see how the industry responds. Affected members who want to minimize their out-of-pocket or

out-of-network costs can either find another doctor who participates with their plan or they would need to switch to another carrier or choose traditional Medicare with a supplement plan if they want to

INTRODUCTION

GOLDEN YEARS


INTRODUCTION ISSUES RAISING OUR CHILDREN WOMEN’S HEALTH GOLDEN YEARS MEDICINE TODAY HEALTHY LIVING

MEDICINE TODAY

Dental Implants a Better Option Than Dentures, But Pricey By Dr. Steven Davidowitz

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tatistics show that 69% of adults ages 35 to 44 have lost at least one permanent tooth to an accident, gum disease, a failed root canal or tooth decay. Furthermore, by age 74, 26% of adults have lost all of their permanent teeth. Dentures, which are removable false teeth, have long provided a solution for the problem of missing teeth. Although many patients wearing complete dentures may be fairly satisfied with their function and aesthetics, a significant percentage of patients complain about poor speaking and chewing comfort due to poor stability of their dentures. Dentures often move and slide around, causing discomfort and embarrassment while eating and speaking. Denture sliding and discomfort is particularly evident on

cedure is straightforward. A dental implantologist places a titanium screw in the jawbone, and then

Enter: dental implants. Implants offer a far superior alternative to dentures. They are the modern-day solution to missing teeth. The pro-

secures the prosthetic teeth to the implant. Implants don’t wiggle or slip, as dentures can, making them more comfortable overall. There are no clicking sounds or chewing problems that often plague regular denture wearers. Another very important advantage of dental implants versus conventional dentures is that implants better preserve the bone. Because they are anchored into the jaw and integrate with the jawbone, they replace some of the missing tooth root. This helps to prevent the gums and bone from deteriorating which can cause recession of the jawbone and facial collapse. However, implants can be costly. An implant to replace a single tooth can cost up to $5,000, depending on where you live, while implants to replace a full or partial set of teeth can run to as much as $45,000 per jaw. Several office visits, as well as long healing periods, are needed to put in the screws and to add the prosthetic teeth. Compare that to dentures, which can cost up to $6,000 for a set (both upper and lower jaws) and can be fabricated in a matter of weeks. Getting your dental insurer to pay for all or even some of a dental implant procedure can be challenging. You may need to set up a payment plan with your dentist, fund an F.S.A. (Flex Spending Ac-

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count), or apply for a line of credit with companies that offer assistance with large dental bills, such as Care Credit. Implants can be utilized to support individual crowns or to support removable dentures. Implantsupported dentures will not slide or move, thus eliminating the embarrassment and discomfort associated with dentures, as well as significantly reducing the cost. Not everyone is a candidate for implants. Smokers or those with medical conditions, such as uncontrolled diabetes, may not be suitable for implants. However, there is another option for these individuals. Implants can be used to stabilize existing and new dentures by engaging the denture over small non-invasive implants. These “mini-implant overdentures” are ideal treatment options for the geriatric patient or immunecompromised patient. The new paradigm in dental care has miniimplants keeping full dentures in place, rather than globs of fixadent denture adhesives. The American Association of Oral and Maxillofacial Surgeons recommends implants as the best treatment option for missing teeth. The procedure has an impressive success rate: failure rate is less than 5%, and implants typically last a lifetime, with little or no maintenance needed. In conclusion, dental implants have become the standard of care in the replacement of missing teeth. They can be used to replace a single tooth all the way to a full complement of teeth, replacing the need for conventional dentures. Dr. Steven Davidowitz, DDS, FICOI, is one of the Upper East Side’s leading cosmetic dentists in designing and maintaining beautiful smiles, with offices in Brooklyn and the Upper East Side of Manhattan. Dr. Steven received his DDS degree from the New York University College of Dentistry and received a fellowship in implantology from the International Congress of Oral Implantologists. He can be reached via 212.759.7535 (Manhattan office) or 718.376.1606 (Brooklyn office), or online at www.luxurydentistrynycblog.com.

February 2014


April 30, 2014


INTRODUCTION ISSUES

MEDICINE TODAY

Most Online Pharmacies are Fraudulent Warns FDA

FDA Monitor

By Ita Yankovich

COMMUNITY PROFILE

H&L TECH

HEALTHY LIVING

MEDICINE TODAY

GOLDEN YEARS

WOMEN’S HEALTH

RAISING OUR CHILDREN

I

n today’s fast-paced life, almost anything can be purchased online, whether clothes, furniture, food and even drugs. Online pharmacies have become more and more popular in American’s quest for healthcare savings. Americans think they can trust Canadian online pharmacies for cheap and legal prescription drugs, but the FDA is warning consumers that this is a potentially dangerous place to seek out medications since many of these websites are not only not Canadian, they are not even legitimate pharmacies. The threat in filling prescriptions through online pharmacies is that the drugs are frequently counterfeit. The medicines sold on these websites are often labeled as “brand name” or “FDA-approved” when they are neither, making an unsuspecting consumer take medicine that either is ineffective for their ailment, or has undisclosed ingredients that could endanger their health or even be life-threatening. An Internet survey conducted by the FDA questioned 6,090 adults. It found that nearly one in four Internet shoppers has bought prescription drugs online, and nearly three in 10 said they weren’t confident they could do so safely. Fake online pharmacies are an emerging health threat. The FDA has a special team called Cyber Crime Investigations Unit (OCI) and since the summer alone they have already shut down 1,677 illegal pharmacy websites. Many of the

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websites appeared to be operated by a criminal network that represented itself as various Canadian pharmacies. Products purchased by federal agents bypassed safety controls required by FDA, including that they be used with a valid prescription and under the supervision of a licensed health care provider. “Consumers are able to buy prescription drugs, unapproved drugs and potentially counterfeit drugs without a full understanding of the risks that they take when they do that,” says OCI Director John Roth. “What worries me is that people naively believe that these medicines are safe.” Online pharmacies use clever names to trick consumers into thinking that they are legitimate stores such as www.walgreens-store. com and www.cv-s-pharmacy.com. The OCI estimates that there are 40,000 to 60,000 domain names that could be tied to illegal online pharmacies typically from Southeast Asia, the Middle East, North Africa and South and Central America. The benefits of filling a prescription through an online pharmacy is that one can find drugs at significantly reduced prices due to lower overhead costs compared to conventional pharmacies, convenience if you cannot physically visit or don’t have time to wait at your local pharmacy, and privacy since you can speak to someone about your prescription and medical problem anonymously or over the phone, rather than in person. But there are more risks involved with on-

line pharmacies than benefits, since many of these pharmacies do not require a prescription, and therefore they cannot adequately safeguard your health by mailing you medication that could be dangerous for your condition. (PharmacyChecker. com-approved pharmacies must require prescriptions.) In addition, customers think they are initially saving money but in the long run they can lose money in the hidden and surprise fees added to the price in the form of a shipping fee, medical fee, and/or an account setup fee. Prices can also change without notice as some pharmacy sites post lowball prices to attract customers, and then raise them. In addition to health threats, these illegal websites also present other dangers such as identity theft, computer viruses or credit card fraud. FDA asks consumers to report suspected criminal activity at www.fda.gov/oci. One way to identify a fraudulent pharmacy site is if they offer users a referral discount if they bring in more customers, or “bonus pills” for filling a prescription. The FDA provides information on how consumers can identify a fake online pharmacy and offers advice on how to find a safe online pharmacy on their website, FDA.gov/Drugs. Legal online pharmacies should require a doctor’s prescription, provide a physical address and telephone number in the U.S., have a pharmacist available to answer questions, and of course be licensed with your state’s board of pharmacy.

FDA Explores Impact of Arsenic in Rice

he Food and Drug Administration (FDA) has taken a major step towards learning whether levels of arsenic in rice and rice products pose a risk to public health. The agency has collected a total of more than 1,300 samples of rice and rice products and has tested them for both arsenic and inorganic arsenic, the more toxic form. FDA scientists have determined that the levels of inorganic arsenic

found in the samples are too low to cause immediate health damage. But what about the long-term impact? After all, rice is a food that people eat over the course of a lifetime. The next step for FDA will be to conduct a comprehensive risk assessment, explains Suzanne C. Fitzpatrick, Ph.D., the senior advisor for toxicology in FDA’s Center for Food Safety and Applied Nutrition (CFSAN). This

analysis of the health risk associated with eating rice and rice products will be the foundation of future FDA actions. “These are the next steps. To look at exposure levels, to analyze the risk, and determine how to minimize that risk for the overall safety of consumers, including vulnerable groups like children and pregnant women,” says Fitzpatrick.

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Approvals, Recalls and Going Generic APPROVED -Kinsa - A new smart thermometer has just has received approval and is already taking preorders on its website. The Kinsa wirelessly connects to your smartphone and users can contribute to a real-time health map that tracks the spread of illness such as flu and strep throat… APPROVED - Sumavel - A new needle-free delivery system can treat migraine suffers who require management of side effects. It also has been shown to reduce substances in the body that can trigger headache pain, nausea and migraine symptoms such as sensitivity to sound and light…APPROVED - Velphoro - The first noncalcium iron-based chewable phosphate binder was approved for the control of serum phosphorus levels in patients with chronic kidney disease (CKD) on dialysis…APPROVED - Varithena - was approved for the treatment of patients with incompetent veins…RECALLS - TRUEbalance and TRUEtrack Blood Meters – Several hundred of these meters are being recalled due to an incorrect factory-set measure that displays the result in mmoi/L instead of mg/dl. Consumers are urged to check their devices’ serial number against information provided at www.NiproDiagnoatic. com/product-notice or by calling 866-236-4518…RECALLS - Gardasil - Merck issued a voluntary recall of some Gardasil vaccines due to the risk that some viles may contain glass particles. The company states that the vaccines were distributed between Aug. 2013Oct. 2013 and that only 10 out of 743, 360 vials in the lot may have been affected…GOING GENERIC - Asacol (generic Mesalamine) - used to treat and prevent ulcerative colitis (bowel disease) by affecting a substance in the body that causes inflammation, tissue damage and diarrhea…GOING GENERIC - Avelox (Moxifloxacin) - is an antibiotic used to treat bacterial infections such as sinus, skin and abdominal infections, and pneumonia… GOING GENERIC - Celebrex (Celecoxib) - a non-steroidal anti-inflammatory drug used to treat acute pain, menstrual cramps, rheumatoid arthritis and arthritis of the spine and inflammation due to osteoarthritis. It also reduces the number of growths in the wall of the lower intestine and rectum in people suffering from colorectal polyps. It can cause serious ulcers and bleeding of the stomach and intestines; this can be life threatening since these side effects can occur without symptoms… GOING GENERIC - Lunesta (Eszopiclone) - is used to help with insomnia. It can become habitforming so store it in a safe place to prevent overuse and abuse.

February 2014


Managing Diabetes at Home

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Empower yourself with knowledge! Be aware of signs and symptoms of high blood sugar (hyperglycemia) and low blood sugar (hypoglycemia) and the actions to take if they occur. There are multiple resources available online. A popular resource is

and maintaining a healthy lifestyle. Type 1 diabetes can’t be prevented; however, healthy lifestyle choices remain essential to prevent pre-diabetes and type 2 diabetes. Educating oneself on diabetes and staying in contact with a health care professional is crucial for home management. The health care professional will track your blood glucose levels, educate you on monitoring your blood sugar at home, your diet, how to manage “sick” days, and recommend support systems that are available in your area. Your health care professional might refer you to a podiatrist, ophthalmologist, nutritionist or endocrinologist. Depending on

healthy diet that includes foods that are low in sugar, fat and calories such as fruits, vegetables, legumes, chicken and fish. Adding a moderate amount of physical activity to one’s day can help a person lose weight, have more energy and improve selfesteem. Living with diabetes is at times frustrating and difficult. Even though you might be following your diabetes management plan, blood sugar levels might remain elevated and uncontrolled. Don’t give up! A support group might be beneficial to you. Sharing your frustrations with other people in the same situation enables you to share ideas, solutions, diet tricks (especially for simchas/ Yom Tovs) and general information.

The American Diabetes Association (www.diabetes.org). Even though there is no cure for diabetes (yet), it can be managed with the help of your health care professional, family support and lifestyle changes. Many people that have been diagnosed with diabetes live long, productive lives. With proper care, correct treatment and education, diabetes can be controlled and managed at home, by yourself, with the help of your health care professional and family support system.

WOMEN’S HEALTH GOLDEN YEARS MEDICINE TODAY H&L TECH

Yaffa Blazer, R.N., WCC, COS-C, has

been working for the last 33 year as a registered nurse. She is the Branch Manager/ Corporate Compliance Officer at Preferred Home Care, Brooklyn. NY.

COMMUNITY PROFILE

35

HEALTHY LIVING

February 2014

the type of diabetes you have, the health care professional will decide if you require insulin injections, oral medications, diet control and/ or blood sugar monitoring at home. Managing diabetes at home entails a commitment to maintain a

RAISING OUR CHILDREN

eeling thirsty? Feeling hungry even though you’re eating? Tired? Do you have cuts or bruises that are healing slowly? Or how about frequent urination? These are all common symptoms of diabetes which affects approximately 25.8 million people in the United States. That’s 8.3 % of the population! The pancreas is an organ in our bodies, which is involved in making insulin to help absorb sugar from the food we eat. Insulin is a hormone (a chemical substance that is formed in one organ or part of the body and carried in the blood to exert functional effects) that is made and secreted by a group of cells in the pancreas called “islet” cells. Insulin tells the cells to let the sugar in. If the body doesn’t have enough insulin, than not enough sugar goes into the cells. It then stays in the body’s blood stream and builds up. There are two types of diabetes. Type 1 is an autoimmune disease, where the body destroys its own insulin-producing cells, leading to the body’s inability to make insulin and push it into the blood stream. Type 1 diabetes is only treated with insulin. Type 2 interferes with the body’s ability to use digested food for energy. After eating, the body begins to break down the food into different components that the body can use. One of those products is glucose. This is used for energy. When glucose levels rise in the blood stream, insulin is produced to help convert the glucose into energy. In this type of diabetes, that process doesn’t work correctly. Either insulin is not produced or it’s produced in insufficient quantities to lower the blood sugar. (There is also a condition known as gestational diabetes, which only affects pregnant woman.) Once diagnosed, a person must realize that diabetes is a serious disease that requires management and changing one’s lifestyle. This disease can affect the kidneys, heart/blood vessels, eyes, skin and nervous system. Therefore,

by monitoring and controlling the body’s blood sugar (glucose), the risks of experiencing complications are lowered significantly. Being diagnosed with diabetes requires diet changes, maintaining a healthy body weight, exercising,

ISSUES

By Yaffa Blazer

INTRODUCTION

MEDICINE TODAY


INTRODUCTION ISSUES RAISING OUR CHILDREN WOMEN’S HEALTH GOLDEN YEARS MEDICINE TODAY HEALTHY LIVING H&L TECH COMMUNITY PROFILE

MEDICINE TODAY Positions in Health Care

By Barry Katz

W

hen a couple becomes engaged, they start to plan for their wedding. They also think about their future together and discuss where they want to live. They talk about raising a family, and imagine how things will be in 20 years from now. Meeting with a genetic counselor to discuss their options for having children, however, is often the furthest thing from their minds. Genetic counselors explain complex genetic problems to patients and their families and help them understand their options for treatment. Besides helping couples who are considering having children, they can advise adults – whose ancestors have died of certain diseases – of what they can do to best prevent them from becoming sick, or they can explain to parents who have discovered that their child has a genetic disease how to best treat the patient. Genetic counseling is a relatively new field. According to the National Society of Genetic Counselors, the first class to graduate with degrees in genetic counseling was from Sarah Lawrence College in Bronxville, NY, in 1971. Today, the Accreditation Council for Genetic Counseling lists 32 colleges in the United States and three in Canada that offer these masters’ degrees. The field is strong, according to the U.S. Department of Labor. It estimates that over the next ten years, the genetic counselor position is expected to grow 41 per-

Genetic Counseling a Growing Career Option cent, which is nearly four times the national average. The Bureau of Labor Statistics estimates that there were 2,100 genetic counsel-

requires its members to take continuing education courses every five years to recertify. Furthermore, some states require licensure.

The perception of the field has also changed, McCarthy adds. In the 1970s and 1980s, it was common for doctors to look askance at

ors in 2012, and it says that the median salary was $56,800. To become a genetic counselor, one must obtain a master’s degree. While the pre-requisite courses vary among programs, most require a number of science courses, such as biology, chemistry, psychology, and statistics. Additionally, some schools require students to take the Graduate Record Examination (GRE), a standardized test to determine one’s aptitude in writing and math. Once students have completed their graduate level courses, they can take an exam to receive certification from the American Board of Genetic Counseling. To keep up with changes in the field, the ABGC

Janelle McCarthy, a laboratory genetic counselor at the Icahn School of Medicine at Mount Sinai in New York City, entered the field in an unconventional way. Many decide to enter the field because they had pursued the social sciences at first and viewed genetic counseling as an extension of those fields. McCarthy, however, had done a great deal of genetic research in a lab during her undergraduate years. But she says she was “a little more social than what a lab entails. And the work that I was doing in a lab, and the time that it would take from what I was doing until it was actually going to reach a human being was a really long time.” Thus, she found genetic counseling to be a “good mix of the two.” Given the great number of genetic diseases that are discovered each year, how does a genetic counselor keep up to date? McCarthy says that although it is impossible to know everything, there are experts in each area whom she and the other counselors can contact for more in-depth knowledge. In addition, she can obtain the information from the Internet as well as from lectures and webinars.

genetic counselors. Within the past 20 years, however, health care professionals have come to realize how knowledgeable and helpful genetic counselors are, and because genetics is their area of expertise, at times they might know more about the field than the doctors. And while genetic counselors have been what McCarthy calls “underpaid” relative to the work they do, that is beginning to change, as the public realizes their worth. Although the field is open to both men and women, it has been predominantly female. McCarthy attributes this partly because the Genetics Counseling major began at Sarah Lawrence College, which was an all-women’s school until 1969, and partly because the position was not perceived as a fulltime job in its early years. As the field of genetic counseling continues to expand, one who is both adept at science and sociable has the potential for a satisfying and lucrative career.

At a Glance

Genetic counselors explain complex genetic problems to patients and their families and help them understand their options for treatment. Genetic Counseling is a growing field, expected to grow 41 percent over the next 10 years, which is nearly four times the national average. The median salary for a genetic counselor in 2012 was $56,800. Although the field is open to both men and women, it has been predominantly female. While in past years physicians have looked askance at genetic counselors, today health care professionals have a growing recognition of the need for genetic counselors.

36

Barry Katz is a college administrator

and adjunct professor who lives in Brooklyn, NY with his wife and three children. He can be contacted at iambarrykatz@ gmail.com.

February 2014


By Estie Rose

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H&L TECH COMMUNITY PROFILE

selor with Montefiore Medical Center and the Program for Jewish Genetic Health of Yeshiva University/Albert Einstein College of Medicine. To find a genetic counselor near you, visit www.nsgc.org or contact Ms. Rose at 718.430.4156. To learn more about Jewish genetic health conditions, visit the Program for Jewish Genetic Health’s website at www.yu.edu/genetichealth and the MyJewishGeneticHealth.com Online Educational Series (formerly GeneSights) at www.MyJewishGeneticHealth.

HEALTHY LIVING

37

Estie Rose, MS, CGC, is a genetic coun-

MEDICINE TODAY

than-average risk to develop the same or a related condition, but this is not definite. I would like to draw attention to something that many people don’t like to hear. We all have something in our families—whether it is mental illness, predisposition to cancer, or more common conditions like diabetes or hypertension. And some of us don’t even realize we have things going on. But the fact is that we are all carriers of about five to ten genetic mutations for diseases that could affect our offspring! So while some things may be more public and seem more apparent, others are less conspicuous but still in existence. No one can predict what health issues tomorrow, next week, or next year may

GOLDEN YEARS

sibling, or child. Here there is still more narrow-mindedness than I wish there would be. Recently, I have met with several families with mental health issues. Many of them are particularly worried about the stigma that this can have on the affected individual. But beyond that, I am finding that the siblings of those individuals are concerned about their own “marriageability.” These siblings worry that they may not be desirable for fear of their developing mental illness themselves and/or of their passing on the mental health problem to the next generation. It is important to note that mental illnesses are understood to be inherited in a multifactorial pattern. This means that there is

bring to light. For individuals and families who are dealing with genetic health issues, my message to you is that disclosure at the appropriate time during the dating process is essential. In addition to halachic rulings on this topic, if you are deliberately hiding personal information from your partner, you are part of a relationship that is not based on trust and is therefore tenuous. When you disclose significant information about yourself or your family before marriage, you may see that you can learn a lot about a person and his or her ability to cope with difficult situations or decisions. And if we all work hard enough to break the stigma of disease, the fear of rejection will diminish and disclosure will not be as difficult a task as it seems to be today. I will never forget that when I was at one of our program’s educational events about the halacha of disclosure in the dating setting, one man came over to me afterwards to ask me a question. He started by saying, “I am coming to you privately since I would never raise my hand in public. My daughter is in the dating scene and people would think I have something to hide if I ask a question.” How distressing it is that it needs to come to the point where people are scared to ask innocent questions! We as a community should be more considerate about and tolerant of these issues as opposed to automatically creating stigmas or rejections around them. Genetics does not have to be a deal-breaker. Focus on the bigger picture, since there is a lot that needs to be “just right” for a good partnership.

WOMEN’S HEALTH

February 2014

some genetic component that can actually involve multiple genes, as well as some environmental or situational component to trigger its onset. This is why it is not surprising to see that mental illness will “run in a family,” but that not everyone will be affected. So if a man has mental illness, each of his children, siblings, and his nieces and nephews will have a higher-

RAISING OUR CHILDREN

he Midrash tells of an exchange between a Roman matron and Rabbi Yose: “How has your G-d been occupying His time since the creation of the world?” asks the matron. Rabbi Yose replies, “He has been busy pairing couples; for God, it is as intricate as the splitting of the sea” (Bereshit Rabbah 68:4). Although this statement has become a cliché in the world of dating and marriage, it certainly bears truth. The selection process for finding the perfect mate has become so complex and detail-oriented that when a couple ties the knot, it really is a true miracle. There are so many factors that need to click before a couple decides to get married. Part of my job as a genetic counselor is to check if couples are a genetic match, that is to verify that they are not both carriers of the same genetic disease that could affect their offspring. If they are both carriers, there is a 25% chance that each of their children would be affected. However carrier couples have many reproductive options, especially if they find out before getting pregnant, and do not necessarily have to break up. Carrier screening for common diseases in the Ashkenazi population has been around since TaySachs testing began in the 1970s, and has since expanded to testing for over a dozen diseases. While preconception carrier screening cannot eradicate all genetic diseases and birth defects, the number of children who are born with serious conditions has dropped dramatically since screening programs for these specific conditions began. In the early days of genetic testing, when the public was not wellinformed about genetics, many people felt that carriers of these diseases were “genetically unfit,” and therefore undesirable. We have come a long way since then, and now it is generally understood that carriers of these diseases are perfectly suitable mates. In fact, one

in three Ashkenazi Jews carries genetic changes (mutations) associated with one of these common diseases—can you imagine if every third person out there had a big “NOT GOOD ENOUGH” printed on their foreheads? But the situation seems very different when it comes to families that have members with a genetic disease already present in a parent,

THE GENETIC FRONTIER

ISSUES

Should Genetics be a Deal Breaker in the Dating Scene?

INTRODUCTION

MEDICINE TODAY


INTRODUCTION ISSUES RAISING OUR CHILDREN WOMEN’S HEALTH GOLDEN YEARS MEDICINE TODAY HEALTHY LIVING H&L TECH COMMUNITY PROFILE

HEALTHY LIVING

On a Restricted Diet? How to Eat Well on Pesach By Amy Dubitsky

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esach can be a challenging holiday for anyone. All the cleaning, packing, shopping, kashering, cooking, hosting and traveling takes a huge toll on our already busy lives! But for those with a restricted diet – and the people who cook for them -- Pesach brings additional challenges. While meal planning throughout the year can be hard for people with allergies or other dietary restrictions, Pesach’s halachic food restrictions make things even harder– causing some people to wonder if there is anything left on the planet to eat for one meal, let alone all eight days. Digestive disorders and food sensitivities vary greatly in their severity and needs, so when it comes to fulfilling the actual mitzvos of the seder, every person should consult with their doctor and rabbi in order to determine what is permissible and required of them. Someone with diabetes may need to dilute the wine or grape juice they use for the four cups and monitor carefully the amounts of matzah they consume. Those with gluten sensitivity or Celiac disease may be able to swap a traditional wheat matzah for one made from oats. Other digestive disorders, such as Crohn’s disease or colitis, can be much more severe. Ester Russ, manager of Digestive Wellness (digestivewellness.com), an online health food store for people avoiding carbohydrates, explained that her mother, Rochel Weiss, is unable to wash for bread the entire year due to her Crohn’s disease. On Pesach, Weiss is only able wash for the afikomen and consume one kezais of matzah at each seder. If this is the first Pesach where you or a family member is dealing with a dietary restriction, be sure to contact your doctors and rabbis early enough so that you can prepare what you need for the seder in advance. A guide provided by the Jewish Diabetes Association suggests some proportions for wine dilution to be done before the seder, and adds a recommendation

to label it separately as the owner’s “Special Reserve.” If you need specialty items to fulfill your mitzvah, keeping them well labeled and away from children is recommended so the intended recipient has what he or she needs at the right time. Fortunately, today there are a tremendous amount of products available that make it simpler for people to enjoy their holiday. Ste-

stuffed cabbage, kneidel mix, pasta, and blintzes – all gluten-free. They also have a “shehakol” matzah that is not acceptable for the seder, but can be used as an addition or base for another meal or as a kid-friendly snack. Russ explained that people following the Specific Carbohydrate Diet, like her mother can’t eat gluten, potato starch or any refined

cided she needed more variety in her menu and got to work creating recipes. Her cookbook, A Taste of Wellness, is filled with tips, menu ideas, and hundreds of recipes and photos. Russ explained that the entire cookbook is gluten-free with about 75% of the recipes being acceptable for Pesach as they are printed – and many of the rest easily adapted for Pesach by eliminat-

ven Lieber, owner of the The Gluten Free Shoppe in Brooklyn (theglutenfreeshoppe.com), offers a lot of guidance to customers with special dietary needs -- especially those new to a gluten-free diet. For Pesach they carry many ready-toeat products as well as basic ingredients, so that people can make their own baked goods. Baking from ingredients other than potato starch and matzah meal is recommended by the Jewish Diabetes Association, as those products tend to be low in nutritional value and high in sugar. According to Lieber, some of their most popular items for Pesach include: gefilte fish – both jarred and frozen, breaded chicken and turkey cutlets and nuggets, shelf-stable

sugar, so they need to make almost everything from scratch. A staple ingredient of theirs is almond flour, which is full of nutrients, is lighter and finer than other nut flours, mild in taste and extremely versatile. A five-pound bag is about $37 from Digestive Wellness and can be bought in many supermarkets, or online from Amazon. “Desserts made from potato starch are empty calories,” explains Russ. “Almond flour-based desserts are loaded with nutrients that are filling and leave you feeling good; plus they taste good so the whole family eats them, not just the person with the special diet.” After finding improved health from her diet, Russ’s mother de-

ing the kitniot/legume ingredients. “People that need to follow restrictions all the time have already created healthy recipes that are colorful, taste better, and are better for you than the typical Pesach menu items. Everyone can enjoy them,” Russ says. Here are some tips from Russ on surviving Pesach gluten-free:  Use winter squash in recipes instead of potatoes or rice  Use spaghetti squash in recipes instead of pasta  Marinate chicken cutlets in lemon juice for five minutes then dip in seasoned almond flour and fry for delicious schnitzel – or try using a cashew butter/egg mixture to

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February 2014


Stroke Prevention Guidelines Published for Women the condition of high blood pressure during pregnancy known as preeclamsia. There are also differences in the way men and women react to a stroke. The effects of a stroke in a woman are often more subtle, and more frequently affect their ability to think or communicate. The new stroke prevention

guidelines urge younger women to pay greater attention to maintaining a healthy blood pressure. They are urged to be screened for high blood pressure before beginning to take contraceptives, and to be given preventive treatment to avoid preeclampsia during pregnancy if they already have a history of high blood pressure.

Teaching Old Brains New Tricks

buns” and some cake loaves that are sweetened with honey. Allergic to nuts, eggs, or dairy? Be sure to check all labels very carefully as formulations of products you regularly use may be different for Pesach. Be extra cautious if you are staying at a hotel, as the serving staff on the floor may not have the best information on how a food item is prepared ingredient-wise, or in terms of cross-contamination with other foods in the kitchen. Researching and experimenting with recipes and ingredients that meet your family’s specific needs in advance will help keep you healthy and satiated throughout Pesach. Or, of course, you can always continue the annual family contest of “how many ways can we cook a potato?”

A Gluten-Free Pesach Recipe: “Spaghetti” Mushroom Casserole

Immediately turn squash cutside up and cool slightly. Meanwhile, heat oil in a large skillet on medium heat. Add onions and saute until translucent, about 10 minutes. Add mushrooms and sauté for another 20 minutes. Separate spaghetti squash strands with a fork and place in a medium bowl Add mushrooms, onions, eggs, salt and pepper to bowl and mix well. Pour into prepared baking dish and spread evenly. Bake for 11/4 to 1 ½ hours, until golden. Yield: 10-12 servings. Reheats and/or freezes well Variation: Sprinkle 4 oz. of Cheddar cheese over top for the last half hour of baking.

adhere the coating.  Use almond flour as a binder in kugel recipes.  You can’t swap out matzah meal or potato starch for almond flour on a one-for-one basis, so find recipes that specifically use almond flour.

Aside from their kosher for Pesach nut flours – also available in cashew, hazelnut and more -Digestive Wellness does a special Pesach run of their “soft matzah

February 2014

Amy Dubitsky is a freelance writer in Phoenix, Arizona.

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Recipe provided with permission from A Taste of Wellness by Rochel Weiss: 1 large spaghetti squash, halved lengthwise and seeded 2 large onions, peeled and cubed 3 Tbsp oil 10 oz fresh mushrooms, peeled and cubed 5 large eggs, lightly beaten 1 ¾ tsp salt 1/8 tsp black pepper Preheat oven to 350 degrees. Lightly grease a 9x13-inch pyrex baking dish and set aside. Place squash cut-side down on a cookie sheet lined with parchment paper. Bake for 40 minutes or until strands can be separated.

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to re-mold and rewire themselves to learn new functions, but more recent work with patients who had lost motor function due to a stroke has shown that adult brains can still adapt in that way. There is evidence that youthful brains make such adaptations more easily than in older individuals, but the experiment with adult mice does offer the hope, according to neurologist Krish Sathian of Emory University, that the brain’s “neuroplasticity can be harnessed for rehabilitative training of individuals with various kinds of sensory loss, such as visual or hearing loss.”

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between the different centers of the brain which control hearing and vision which would explain how the brain can make this adjustment. The best explanation is that this is an example of brain plasticity, its ability to adapt to an injury by training an uninjured portion of the brain to take over the functions usually controlled by the part which had been damaged. The results of the experiment with mice is particularly encouraging because it demonstrates brain plasticity in adulthood. It had once been thought that only the brains of children had the ability

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Once the mice were returned to an environment in which they could see, they lost their heightened sense of hearing in about a week. The same phenomenon was observed when the experiment was reversed. Researchers found that the visual centers in the brains of adult mice who were deprived of their sense of hearing quickly developed a greater sensitivity to visual changes. The findings are consistent with the widespread belief that people who have been blinded often develop a heightened sense of hearing, but scientists have been unable to find any physical connection

GOLDEN YEARS

new study conducted by researchers at the University of Maryland on adult mice has found biological evidence confirming that the brain will compensate for the loss of one of the senses by heightening its sensitivity to the others. An experiment in which mice were kept in total darkness for a week found that they compensated for their loss of vision by building up the portion of their brains connected with their sense of hearing. The blinded mice responded to a wider range of sounds than a control group of mice who were not kept in the dark. However, the effect was temporary.

WOMEN’S HEALTH

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nancy and the hormones used in contraceptives. It has also been shown that women who suffer from migraine headaches, depression, diabetes and the abnormal heart rhythm known as atrial fibrillation have a heightened risk of suffering strokes. Another risk factor for stroke in later in life is

RAISING OUR CHILDREN

he American Heart Association has published the first gender specific set of recommendations specifically designed to reduce the risk of strokes in women. While women share many of the same risk factors for stroke as men, they are susceptible to additional risks from stroke related to a specific complication in preg-

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10 Interesting Facts About Chocolate

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ISSUES

By Leah Lebel, MS, CNC

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ith Valentine’s Day in the air, chocolate is everywhere – and oh so delicious. From chocolate chip cookies, to chocolate milk, to ice cream, to the famous Hershey’s kiss, chocolate is not only America’s favorite flavor, but an integral part of American culture. Just how much? Stay tuned to learn more about and fall even more in love with this incredible sweet.

processes. First, there’s conching, which kneads the chocolate mixture until it’s smooth and even, and then there’s tempering, which raises and lowers the temperature until the chocolate reaches the right consistency. Finally, chocolate is molded into its desired shape, such as kisses (chocolate’s most popular shape).

to popular belief,  Contrary studies have demonstrated

chocolate is not the healthiest food available, it does contain  While potassium, calcium, iron, and riboflavin, and most of its fat is unsat-

thought of historically as a mythical food eaten by and fit for the gods. In Mayan civilization, cocoa beans were the currency. How’s that for value of chocolate? In fact, people even counterfeited cocoa beans by making similar-looking things out of clay. Today, chocolate is used for more than just indulgence. In Mexico, traditional healers use chocolate to treat bronchitis, and many children are told to drink chocolate as a way to ward off bee stings.

average 2,500 beans, or enough for 6.5 pounds of pure chocolate. Cocoa can only be grown in very specific locations near the equator. Therefore, the world’s supply of cocoa comes primarily from West Africa, Central and South America, and Southeast Asia.

ened, trained experts pick the pods off the fragile cocoa trees, then gather and transport them to a facility that breaks them open. Once released from the pods, beans are fermented, which makes the beans less bitter and develop a more “chocolaty” flavor. The beans are then dried, packed into sacks, and shipped to factories for chocolate making. 400 beans are needed to make a pound of chocolate.

all chocolate tastes  Think the same? Natural chocolate

the factory, the beans are roasted and shelled to produce choco Inside late nibs, chocolate pieces containing 54% cocoa butter and unrelated

hitting the taste buds releases a host of endorphins,  Chocolate which are chemicals in the brain triggering a feel-good sensa-

Leah Lebel holds a Master’s degree in nutrition and is currently a law student intending to specialize in nutrition law and public health policy. She can be contacted at leah_lebel@yahoo.com.

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tion. Chocolate also contains tryptophan, which is an essential amino acid required for the body to produce serotonin. Serotonin modulates moods, and high levels can make you feel good overall. In addition, the caffeine in chocolate and its creamy texture combine for a happy eating experience.

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to the nibs candy sold on the market. The nibs are then ground, which releases the cocoa butter and leaves behind chocolate liquor, a liquid substance. Chocolate liquor gives chocolate products their unique flavor, and is completely distinct from chocolate liquor sold as an alcoholic beverage. The cocoa butter that’s been separated from the nibs has independent uses in things like cosmetics and some food products. The chocolate liquor that’s leftover still generally contains about 10% cocoa butter. Chocolate liquor is then pressed to form cocoa powder. There is no chocolate liquor in white chocolate, which is a chocolate derivative consisting mainly of cocoa butter, sugar, milk solids and salt.

beans come in 300 different flavors. In addition, chocolate sold in supermarkets usually contain such a low percentage of actual cacao that it’s loved mostly for its sugars, additives, and flavorings, which can vary from brand to brand.

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cocoa tree produces flowers, which are pollinated to produce pods.  The Pods contain seeds which later develop into cocoa beans. When rip-

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Cocoa’s history is, well, rich. The word for cocoa trees in Latin is cocoa trees can live up to 200 years, they produce cocoa  Though beans for only 25 years. During that time, cocoa trees produce on  Theobroma Cacao, or “food of the gods,” because chocolate was

GOLDEN YEARS

urated. When choosing chocolate for health, look for dark chocolate varieties with a high percentage of cocoa solids. Dark chocolate is chock-full of heart-healthy and cancer-fighting antioxidants. It’s also been shown to increase blood flow to the brain, which boosts memory, attention spans, reaction time on a number of performances, and may even improve vision. Chocolate is also known to reduce blood pressure, help with platelet function, and insulin sensitivity in diabetes.

that chocolate does not cause acne. However, some studies do show that chocolate may make acne worse. It’s unclear if chocolate itself, as opposed to the caffeine in chocolate or some other additive, is what worsens acne.

WOMEN’S HEALTH

shey’s bars! The U.S. also produces – and consumes – more chocolate than any other country. (As an example of its popularity, every American space voyage has included chocolate bars.) Chocolate manufacturers are also making use of other food industries, such as the nut industry. Chocolate companies use 40% of the world’s almonds and 20% of the world’s peanuts. The most common type of chocolate eaten is milk chocolate, and American manufacturers use 3.5 million pounds of milk daily to produce milk chocolate.

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love their chocolate so much that the average American Supermarket chocolate un Americans eats 11 pounds of chocolate a year. That’s nearly 200 small-sized Her-  dergoes another series of


INTRODUCTION ISSUES RAISING OUR CHILDREN WOMEN’S HEALTH GOLDEN YEARS MEDICINE TODAY HEALTHY LIVING H&L TECH COMMUNITY PROFILE

HEALTHY LIVING Trim & & &Fit

By Tanya Rosen

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hrough years of working with teens and helping them to lose weight, I have found that just like every other population, teens have their own unique challenges. Because I primarily work with girls, the statements and suggestions below will largely apply to the female gender. I will begin with the advantages that teens have when it comes to weight loss.  A faster metabolism While this is a generalization, usually the younger someone is the quicker their metabolism functions. This helps burn their food quicker and keeps it from “sticking,” so to speak. And most likely the teen has never crash-dieted or went on an extreme plan, creating an even more unharmed and untouched metabolism.  Teens have less responsibility at this stage in their life than they will have later on as adults Tests and extra-curriculars may seem overwhelming, but it’s nowhere near what these teens will face when staying up with crying babies, or running from work to make suppers, or juggling motherhood and a career, etc. Life is less loaded and busy than it will be later on, which gives them the opportunity to focus on their meal plan, if they choose to do so.  The parents are probably paying for the program and supporting their efforts Chances are, the teen is being “sponsored” by his/her parents on many levels, such as financially (by paying for it), emotionally (by encouraging it), and even practically (by cooking and shopping for the teen).  A fresh perspective A teen has not experienced “diet burnout” yet, which is common for many people who have been dieting for many years. To them, this is fresh, new, and exciting. There are some disadvantages, but none too serious or unmanageable.  A changing body Puberty, and the start of the

Teenage Weight Loss: What’s Hard and What’s Not menstrual cycle for girls, all contribute to a changing body and changing hormones. It is important to explain to girls that it’s normal for weight to fluctuate around the time of their period and that it does not mean they gained weight. It is also important to check height on a regular basis, as that can account for a change on the scale as well.  Peer pressure When I was in high school (a long time ago!), we really never cared what anyone weighed, what

size they wore, or what they ate. Nowadays, even amongst younger kids, there is pressure to be thin. This is obviously more true for girls than for boys, but boys feel the pressure too.  Inability to cook for themselves Teens are often at the mercy of what is being served at home, as most do not cook for themselves. If the correct meals are not being prepared, it often sabotages their efforts.  Relying on school lunch I always jokingly say that when I retire, I will be busy reforming school lunches. Although many schools have gotten better, there is still much to improve. “Fruits” are often canned in sugar and syrup, “vegetables” are canned and

full of sodium, and many schools only serve white bread and full-fat milk. For the sake of helping teens feel “normal,” I often tell them to eat school lunch twice a week, and bring their own lunch the rest of the days. Other considerations when working with teens:

talking about food, abusing laxatives, or excessive exercising.

These young minds are very formative. My goal when working

Tips for parents of overweight teens:

Teach them how to eat for life, not just “diet”

with anyone, and especially teens, is to teach them the proper way to eat and empower them with the knowledge they need so that they can continue eating correctly for the rest of their lives. I don’t think anyone is too young to understand food groups, or how to read a food label.

Beware of eating disorders

Getting healthy is great, getting obsessed is not. It is important for professionals and parents to watch out for signs of eating disorders. There is not enough space here to cover this topic, but some signs to look out for may include; sneaking food, obsessive weighing of oneself, wanting to lose more weight than necessary, constantly thinking and

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Boost their confidence

Compliment their necklace or hat, admire their grades, or notice how pretty their smile is. Just because there is a weight issue, do not let that weigh down (pun intended) their confidence. This applies to both parents and professionals working with the teen.  DIET and FAT are unacceptable words. Replace those words with “healthy” or “proper eating.”  Involve the family. Even if no one else needs to lose weight, make it a family affair by serving healthier foods, as well as more fruits and vegetables for everyone. Besides the obvious benefit of everyone living a better lifestyle, the overweight child will not feel singled out and resentful.  Control what comes in to the house. Healthy living and eating begins in the grocery store. Aside from buying the “right” things like fruit and vegetables, wholegrain bread, and wholesome snacks, try to avoid buying the kinds of foods that will sabotage a dieter. The less temptation in the house, the easier the diet journey will be.  Involve the teen and don’t do everything for him/her. It is sometimes easier to do all the shopping, cooking and preparing all by yourself, but try to involve your teen in some way. This will give her ownership of the plan. Some mothers even go as far as filling out the food diary and making appointments with me, while she is perfectly capable of doing this herself. The more ownership and responsibility you give your teen with this journey, the more likely she is to feel invested and succeed. Tanya Rosen M.S CAI CPT is a nu-

tritionist, personal trainer, and aerobics instructor. Tanya is also the owner of Shape Fitness and the creator of the Shape Kosher Workout DVD for ladies, and the Shape Kosher Workout DVD for girls. Tanya can be reached at 917.913.1523 or tanyashape@gmail.com.

February 2014


By Elizabeth Kurtz

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I’m busy cleaning for Passover, planning a simcha, or simply working, dinner is one of those things that needs to come together fast. I know I’m not alone because I receive loads of emails from readers requesting easy, delicious, and homemade recipes that can be made without fuss. Here are some simple recipes to please all palates and save you time. You can’t beat great taste with minimal effort!

Roasted Chicken with Balsamic Onions, Zucchini, and Tomatoes

Sesame Chicken with Broccoli

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wine. Bring to a boil; reduce heat and simmer uncovered for about 10 minutes. Stir in nondairy creamer, simmer briefly, and mix with pasta. Serve immediately.

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February 2014


1-1/2 cups chicken broth 
¾ cup oil-packed sun dried tomatoes, drained and chopped
 ½ cup white wine 
3/4 cup nondairy creamer or soymilk Cook pasta according to package directions; drain and keep warm. Directions: Meanwhile, in a large skillet, heat oil to medium-high and briefly sauté garlic. Add chicken strips, basil and crushed red pepper. Cook, stirring, until chicken is browned, about 5-8 minutes. Add broth, sun-dried tomatoes and

GOLDEN YEARS

Serves 8 This pasta dish is light with tons of flavor and protein. It’s also filling and a crowd pleaser. Add zucchini or mushrooms if you want more veggies. Ingredients: 16 ounces farfalle (bow tie pasta) 
2 teaspoons minced fresh garlic 
4 tablespoons olive oil
 2 pounds skinless, boneless chicken breasts, cut into strips 
2 teaspoons basil 
¼ teaspoon crushed red pepper

Bow Tie Pasta with Chicken and Sweet Cream Sauce (non-dairy)

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Serves 5 My kids love going out for Chinese, but take-out can be expensive and less healthy than homemade food. So I created this great recipe that tastes just like restaurant version but is lighter on both the budget and the waistline. Serve it with fresh white or brown rice. Ingredients: 1 pound, approximately 4, chicken cutlets, boneless and skinless, cut into 1 inch pieces 2 tablespoons cornstarch 3 tablespoons canola oil 1 ½ cups broccoli florets 2 tablespoons sesame seeds, opt. Sauce: 2 tablespoons hoisin sauce 1 1/3 cup water ½ teaspoon garlic powder ¼ cup sugar 1 teaspoon fresh ginger 2 tablespoons soy sauce Directions: Place chicken and cornstarch in a ziploc plastic bag. Shake bag to coat the chicken in the cornstarch. Set aside. In a medium bowl, whisk together water, sugar, soy sauce, hoisin sauce, garlic powder and ginger. Set aside. In a large skillet with sides, heat oil over medium-high heat. Add chicken and brown on both sides, about 3 minutes per side. Add broccoli and cook 1 minute more. Pour sauce over chicken and reduce heat to medium-low. Simmer for 5 minutes, until all ingredients are cooked through and sauce has thickened slightly. Sprinkle with sesame seeds, if desired. Serve with rice.

Serves 6-8 This extraordinary roasted chicken is topped with a secret spice, sumac, which gives it great color and flavor. Sumac is usually available in the spices aisle, but if you can’t find it, just substitute a bit of lemon juice, lemon zest, and paprika. Ingredients: 3 1/2 tbsp. olive oil, divided 3 pounds chicken, cut into 1/8’s 1 teaspoon onion powder 2 medium red onions, sliced 1 teaspoon garlic powder 2 zucchini, chopped in chunks 1 teaspoon kosher salt 1 cup grape tomatoes ½ tsp. ground black pepper 5 cloves of garlic, halved 2 teaspoons ground sumac ½ teaspoon dried thyme 2 1/2 tablespoons balsamic vinegar Directions: Preheat oven to 375 degrees. On a large rimmed baking sheet, scatter the onions, zucchini, tomatoes, and garlic. Drizzle with the thyme, balsamic vinegar and 2 1/2 tablespoons olive oil and stir to combine. Sprinkle with a bit of kosher salt and pepper to taste. Place the chicken on top of the vegetables. Generously sprinkle the chicken with onion powder, garlic powder, and sumac. Add salt and pepper to taste. Drizzle the chicken with the remaining olive oil. Place the pan in the oven and roast, until the skin of the chicken is golden and an instant-read thermometer reads 165 degrees at the deepest part of the chicken’s thighs. It will take about 40-60 minutes. Remove from the oven. When you are ready to serve, spread some of the onion mixture on the bottom of the serving platter, top with the chicken, then coat the chicken with the vegetables and balsamic glaze.

RAISING OUR CHILDREN

’m Elizabeth Kurtz, creator of GourmetKosherCooking.com and a wife and mom of five kids, all food lovers. Welcome to my cooking adventures as I explore how to make almost anything kosher and delicious! I feel like it’s always a busy time of year, but especially now. Whether

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Fast Chicken Dinners (for pre-Pesach and every day!)

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INTRODUCTION ISSUES RAISING OUR CHILDREN WOMEN’S HEALTH GOLDEN YEARS MEDICINE TODAY HEALTHY LIVING H&L TECH COMMUNITY PROFILE

H&L TECH Tech Support

By Shimon Lewin

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ight bulbs are one of the most significant inventions of the last 200 years. Before the advent of the light bulb, kerosene lamps and candles were what kept things light at night. A lot of maintenance was involved with keeping these lamps lit, so when the light bulb came along, everything changed. One of the first types of bulbs created was the incandescent light bulb. These light bulbs are what we all remember as kids and have used until now. But after this year, incandescents will become a thing of the past and replaced with other alternatives. One of these alternatives is the CFL (compact fluorescent lamp) bulb. These types of bulbs are much more energy efficient. Depending on the type, CFL bulbs can use as little as one fifth of the electricity needed to power an in-

The Lowdown on Light Bulbs candescent bulb. Another advantage of CFL bulbs is their lifespan. These bulbs will last up to 7 times

to purchase (about $2-$3 for a standard 60-watt replacement, as opposed to 99-cent incandes-

damage a person’s retina. Many people are unhappy that the incandescent bulb is being LED

CFL

Incandescent

longer than an incandescent bulb. There are some drawbacks. For one, CFL bulbs can cost more

cent bulbs), and furthermore, they can be a serious health risk. What makes these bulbs dangerous? They contain mercury. If a bulb breaks it can be dangerous to small children and women who are pregnant. These bulbs also require special handling in regards to recycling. In addition, they do not work so well in very cold temperatures and most of them cannot be dimmed. So if you are a fan of dimming the lights in your room, you will need to buy CFL bulbs that are labeled as dimmable and a matching new dimming switch. A different, perhaps better, alternative is the LED (light emitting diode) -based bulb. These bulbs are starting to become popular but are much more expensive than the others to purchase. However, on the positive side, they use even less energy than CFLs and last for a very long time, even significantly longer than a CFL bulb. While you may have to put out a lot for the initial investment, since a 60-watt replacement LED bulb can cost upwards of $15-$20, you will come out ahead in the future with reduced energy bills. Like the CFL bulb, this bulb also has its own possible health risks. Though more studies need to be done, there are experts who say that prolonged exposure to these types of bulbs can permanently

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phased out. While energy costs are higher and the lifetime span is shorter, the fact is they are the cheapest bulb for the average consumer (in regards to initial cost). Many people do not want to have to spend as much as $20 to buy a light bulb. It is expected that over time, the steep prices for LEDs will come down. However many health conscious consumers who cannot afford an LED bulb object to putting their families at possible risk to mercury exposure with a CFL bulb. If you are a fan of the old fashioned incandescent bulb, I would strongly recommend stocking up on these types of bulbs, because in the very near future these they will be extremely difficult to get. As of January 1, 2014, the U. S. government has banned the production of 40 and 60watt bulbs. Over the last few years, manufacture of the 75 and 100-watt bulbs have been discontinued as well. They will not be available after current stocks are sold out. The U.S. is not the only country banning the incandescent light bulb. Many other countries have taken similar steps or are in the process of phasing these bulbs out. Shimon Lewin is the IT director at The Jewish Press and the author of numerous articles on technology and software. He can be reached at electoday@jewishpress.com.

February 2014


A “Fantastic Voyage” Through Your Colon

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February 2014

function as mobile wifi hotspots. This means that an app on the smartphone can be turned on to transform the T-Mobile cell phone signal into a wifi signal that any wifi-enabled laptop or tablet in the immediate vicinity could use to connect to the Internet. The data transmitted by the wifi signal is counted against the speed and volume limitations of the smartphone’s data plan. Another device which can be useful to TV-addicts traveling abroad who don’t want to miss their favorite shows is the Slingbox. Once it is connected to a cable TV box and the Internet service in your home, the Slingbox allows you to remotely control the cable box and watch programming on any of its channels, live, on your laptop, smartphone or tablet, via the Internet, anywhere in the world.

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he recent price war initiated by wireless carrier T-Mobile has shaken up the cell phone market, causing AT&T, Verizon and Sprint to adjust their rates and service plans to keep up with T-Mobile’s innovations. One of those innovations should be of particular interest to those who travel abroad to more than 100 countries, including Israel. It allows those who have signed up for T-Mobile’s current rate plans to use their regular American smartphones phones while they are abroad through an arrangement with local cell phone companies. T-Mobile customers will be able to make or receive calls in the foreign country and to or from the United States for 20 cents per minute, and they will have unlimited access to texting and data at no extra charge. In the United States, T-Mobile also enables their smartphones to

MEDICINE TODAY

New Technology Brings Home Comforts to the World Traveler

that pictures of the large intestine taken by the Pillcam are not quite as clear as those generated during a standard colonoscopy. Therefore, the FDA approval applies only to the estimated 750,000 patients each year who attempt, but cannot complete, the standard colonoscopy procedure, due to a variety of reasons. The Pillcam provides the gastroenterologist with another diagnostic tool for their patients who are unable to undergo a standard colonoscopy, or who are unwilling due to fear of pain or embarrassment. The Pillcam procedure costs only $500, compared to the typical cost of a colonoscopy, which is $4,000. The Centers for Disease Control and Prevention recommends regular colonoscopies for all men and women between the ages of 50 and 75. However, many patients are reluctant to undergo the procedure.

GOLDEN YEARS

taken by the Pillcam, and made it available on YouTube under the title of “Journey of the Colon.” The video is reminiscent of some of the scenes from the 1960s science fiction movie. The company has introduced other diagnostic devices based on similar technology over the past decade, which provide doctors with close-up views from inside the small intestine and the esophagus. Even though the Food and Drug Administration did not clear the Pillcam until this month, it had previously been approved for use in 80 countries, including Japan and most of Europe and Latin America. When the technology was first being developed, some had expected it to become a direct competitor to traditional colonoscopy. However, doctors soon discovered

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cancer, It has just been approved by the FDA as a non-invasive alternative for patients who cannot tolerate a traditional colonoscopy. The patient swallows the pill, which contains a tiny, battery-powered camera which takes a series of digital photos as it travels through the length of the intestinal track over a period of 8 hours. During its journey, the camera transmits the photo data using wireless technology to a portable data recorder which the patient wears around his waist. Once the journey is complete, and the pill is expelled from the body, the pictures are downloaded and reviewed by the doctor for signs of the disease. The ingestible pill camera is called a Pillcam Colon 2. It is a product of Given Imaging, headquartered in Yoqneam, Israel. The company has produced a 1-minute long video out of the pictures

RAISING OUR CHILDREN

he Fantastic Voyage was one of the most popular science fiction films of the 1960’s. It was a tale about the exploration of inner space, in which a crew of American doctors are miniaturized, along with a submarine, and injected into the body of world famous doctor who is dying of a blood clot in his brain. Their mission is to make their way into his brain, and save his life by breaking up the clot by shooting it with a laser beam. The movie features a graphic journey of the miniature submarine and its crew through the blood vessels and organs of the body during the rescue mission. Today, Israeli missile defense technology has been adapted to create a miniaturized pill camera which conducts a similar “fantastic voyage” through the colon of a patient searching for growths called polyps and other early signs colon

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INTRODUCTION

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Showcase Nu Café 47’s Sensational, Healthy Food

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GOLDEN YEARS

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hef Abie Maltz, the man behind Nu Café 47 on New Utrecht , dishes to Health & Living about his healthy, new offerings. In his own words: “I needed to lose weight and improve my nutrition. But as a professional chef, I could not settle for dull food and feeling deprived. “Over time, I developed gluten-free, low-sodium dishes with no added sugar. I was able to enjoy pasta and other foods made from wholesome organic ingredients. More fish, fresh salads, and homemade soups made it onto my plate. Customers with diabetes, hypertension, gluten intolerance, and those just seeking to lose weight also enjoyed these dishes. “Surrounded by goodies in

New App by Frum Lactation Consultant Provides Nursing Support

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                    

my own restaurant, I was tempted by cheesecake and muffins that were not on my diet. Determined not to be caught staring at my customer’s desserts, I started baking my own special cookies. After a lot of research and experimenting, cookies with the snap, aroma, and taste I craved emerged from the oven. “Eventually, buckwheat, chickpeas, coconut oil, agave nectar, vanilla beans, and natural peanut butter coalesced into an array of delicious cookie flavors. People noticed me snacking, and demand for the new cookies grew. Now everyone can get the dishes and desserts that worked for me at Nu Café 47. “I am glad to cook both familiar comfort foods and new healthier dishes and desserts. Stop in and say hello today.” Nu Café 47 is located at 4709 New Utrecht Ave in Brooklyn.

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ara Chana, a popular homeopath, lactaction consultant and TV personality has released a new app to help new moms with nursing challenges. Too often women say, “Breastfeeding is just not working!” But according to Sara Chana, there are solutions to 98% of breastfeeding challenges. Through videos, articles, pictures and more, this app can help you find your solution. This FREE app, called “Sara Chana’s Breastfeeding for Woman,” has 103 entertaining and educational three-minute videos, 350 easy-toread original articles, and hundreds of pictures that allow women

to identify their problems and then find quick and easy solutions. Sara Chana provides accurate conventional medical advice as well as alternative medicine choices, including homeopathy, herbs, and essential oils. “Encouraging women to breastfeed is only part of the process” says Sara Chana. “Teaching them how to solve their problems while breastfeeding and giving them tools to succeed is my goal.” Some of the issues Sara Chana addresses include sore nipples, cracked nipples, thrush, engorgement, breast infections and more.

Do you have a product or service that you would like us to feature? E-mail us at: sales@jewishpress.com 46

February 2014


Showcase

worlds: it tastes like starch, but works like fiber. You can enjoy the foods you love – lasagna, spaghetti, noodle kugel, cheese crackers, and more – but with only the half the calories, and a huge boost of fiber to enhance your health. FiberGourmet offers a complete line of pastas, including a “Mac-mmmCheese” kit for a quick and easy dinner for kids, as well as a line of Thinables crackers, with flavors like Wheat Cheese, Nacho, Cinnamon

and not only make them kosher but also easier to prepare. We are featured weekly in the Jerusalem Post, on Aish.com and the videos can be found on both AOL and Yahoo, under the series title: Your Heart’s Best Friend recipeboxtv. We teach cooking classes all over the tri-state area and hope to inspire every cook 100% to try new recipes and enjoy the kitchen!

Grape Seed Oil

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aged balsamic and organic aged balsamic vinegars along with organic red wine vinegar and organic white wine vinegar. Now joining De La Rosa’s premium MedFind in your local Find in your local iterranean extra virgin oil is a line markets or marketsolive or of extra virgin olive oils from Morocco, on Amazon.com on Amazon.com available both filtered and unfiltered. * Enhances the Flavor In addition *the company also Acid sells * Enhances the Flavor Extremely Rich in Linoleic * Extremely Rich in Linoleic Acid grape seed oil, *organic wine, ofbrandy, Excellent Source Vitamin Egrappa and * Contains Fatty Acids are ko* Excellent Source of Vitamin E other spirits. All of De Essential La Rosa’s products * Ideal Oil to use for Passover * Contains Essential Fatty Acids sher and most are kosher for Passover. A portion De La Rosaare Real Foods & * Ideal Oil to use for Passover of the company’s profits donated to Vineyards the “Res(718) 333-0333 cue the Children Fund” to aid abused children De La Rosa Real Foods & Vineyards www.DeLaRosa613.com though the Lev Avraham Foundation. (718) 333-0333 For more information on De La Rosa Real Foods & Vineyards, please visit www.delarosa613.com. www.DeLaRosa613.com

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February 2014

Real Foods for Real People

HEALTHY LIVING

De La Rosa – Bringing Organic Purity Real Foods into the Kosher Food Business for Real People

e La Rosa Real Foods & Vineyards is a company dedicated to providing the highest standard of purity in food and wine, based on the principle of humane treatment of the Divine Creation. Protecting the environment and eating organic foods -- key to overall health and wellbeing – are central to the company’s ideals. One of the stars of their product line is their new 100% organic red grape juice named “WOW!” Unsurpassed in flavor and taste, it is produced from organically grown grapes from a family farm near Lake Neusiedl in central Europe. The juice is never from concentrate, and no preservatives, additives, water, sugar or sulfites are ever added. De La Rosa also has a line of Italian vinegars –

100% Grape Seed Oil

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Your Heart’s Best Friend

GOLDEN YEARS

ourmetkoshercooking.com is the premier site for kosher recipes, cooking tips, videos, kosher wine and products. The site has a recipe index with over 6,000 recipes and features new recipes, posts and videos each week. We search the latest cooking magazines, cookbooks, and TV shows to find the best recipes and food trends,

WOMEN’S HEALTH

and more. The Thinables line is available in Wegmans while additional products can be found in kosher supermarkets. You can also order online at FiberGourmet.com for healthful snacking delivered right to your door.

Recipes, Tips and More at Gourmet Kosher Cooking Site

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RAISING OUR CHILDREN

ost “reduced-calorie” foods are really just “reduced-fat” foods, which replace the fat with sugar, flour, or other full-calorie ingredients. That means the actual caloric reduction is small, if any. But the specially formulated snacks by FiberGourmet replace ingredients like flour with zerocalorie fiber, resulting in significant caloric reductions (40%, 50% or even 60% fewer calories than the conventional version), at the same time giving you that “full” feeling. FiberGourmet’s patented system allows them to manufacture low-calorie foods that look and taste just like the full-calorie versions. They do this by adding high amounts of a unique form of fiber, called resistant starch. It’s the best of both

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Fiber Gourmet’s Special Formula Makes for Healthy Snacking

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Community Profile

Round-the-Clock Chesed at Chesed 24/7 Columbia (Milstein) Hospital For Special Surg

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By Sandy Eller

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ore than two decades ago, when a New Square couple decided to devote themselves to helping neighbors in need, it’s doubtful they envisioned they were planting the seeds for an organization that would one day prepare and deliver thousands of meals annually, in addition to running hospitality rooms in over a dozen New Yorkarea hospitals. Yet for Rabbi Shulim Greenberg and his wife, Chavi, their desire to do for others mushroomed into an organization that provides invaluable services to the sick, the elderly, the developmentally disabled and countless others. “They were a young couple who had just moved to New Square and loved helping people,” Rabbi Tzvi Miller, director of development at Chesed 24/7, told The Jewish Press. “They started small at the time, but they were doing chesed, which was what they loved to do,” At her husband’s suggestion, Mrs. Greenberg contacted a New Square resident who was involved in chesed and began offering her services, in time taking on full responsibility for the fledgling organization, which grew into Chesed of New Square. Rabbi Greenberg also devoted his spare time to the community, going to Manhattan every Wednesday to visit hospital patients and writing down the names of all the Jewish patients he met. In time, Rabbi Greenberg developed a connection with hospital administrators at Columbia University Medical Center, but it was Mrs. Greenberg who managed to convince the hospital to donate space for Chesed of New Square’s first official chesed room. “Space is always at a premium and hospitals never have enough room, but the Greenbergs convinced Columbia that it was something that would benefit their many Jewish patients and their families,” said Rabbi Miller. Having found a listening ear at Columbia, the Greenbergs set their

called in to help people who are Columbia (Children’s) not on our regular routes. We have

sights on other area hospitals, telling administrators that it would be in their best interests to set up chesed rooms of their own in order to keep their Jewish patients from flocking to Columbia. As Chesed of New Square continued to broaden its range to encompass the greater New York area, it changed its name to Chesed 24/7. In addition to two chesed rooms at Columbia, Chesed 24/7 also maintains facilities at Lenox Hill Hospital, Cornell Medical Center,

people who pack up our Shabbos in a Box. We have women who make meals. People who donate cake. People who package cake. There are literally hundreds of people involved in our work.” While it is hard to pinpoint exactly how many people partake of the food distributed by Chesed 24/7, Rabbi Miller estimated that they go through 144,000 coffee cups annually, with approximately10,000

Hackensack University Medical Center, Good Samaritan Hospital, Englewood Hospital and Medical Center, Mount Sinai Hospital, Memorial Sloan Kettering, Hospital for Special Surgery, Catskill Regional Medical Center, Ellenville Hospital, Montefiore Medical Center, Valley Hospital and Calvary Hospital. The rooms are stocked with freshly prepared foods, prepackaged meals, snacks, Jewish reading materials, seforim, a refrigerator, two separate microwaves for meat and dairy, couches, Shabbos warmers and other amenities, with Chesed 24/7 representatives visiting the facilities to serve as liaisons with hospital staff as needed. While Chesed 24/7 has been operating for well over twenty years, the operation has grown significantly within the last decade, acquiring scores of new volunteers and offering many innovative services. “We have hundreds of volunteers,” said Rabbi Miller. “There are some who drive patients, some who deliver meals to hospitals. We have a lot of special people who get

meals distributed each year. While some meals go to hospitalized patients and their visitors, others may be sent to often-neglected family members who live in the Monsey/ New Square area. Chesed 24/7 also prepares special meals for those dealing with dietary restrictions including Crohn’s Disease, diabetes and other digestive issues. Other services offered include Boost in a Bottle, which supplies patients with nutrient-rich pomegranate juice. Volunteers seed and juice over 30,000 fresh pomegranates each year, packing the resulting juice in 20,000 eight-ounce bottles which are frozen for future use. Shabbos in a Box provides hospitalized patients with a custom-made hospital tray cover, electric candles, a kiddush cup, a challah cover, Shabbos chocolates, havdala spices and even a fresh flower, adding a touch of hominess to the holiest day of the week. A twice-daily shuttle between Rockland County and Manhattan takes riders to all New York City hospitals at no cost, and free transportation is also available for Rockland

Lenox Hill Hospital

NY Cornell Hospital

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County residents to local doctors and medical and rehabilitation facilities. A round-the-clock support hotline, local medicine chests and hospital visitation programs ensure that emotional support and assistance are always available. Share 24/7, a division of Chesed 24/7 offers comprehensive care for the developmentally disabled with respite programs, weekend retreats, employment services and habilitation programs. In a unique twist, Share 24/7 gives participants the opportunity to take part in Chesed 24/7’s programs. “Every human being wants to give back, and in most programs for special needs individuals, people are doing for them all day and they don’t have a chance to give back,” explained Rabbi Miller. “Our participants take part in our chesed organization, according to their level of ability. They package cake, they go down and deliver meals. I don’t know of anyone else who does anything else like this.” For Rabbi Miller, one of the most special components of Chesed 24/7 is seeing people from completely different walks of life discover that they have much in common. “What you have in the chesed world is unique,” observed Rabbi Miller. “The walls are down and people who would never meet each other end up becoming best friends. This has become so much bigger than just New Square. We evolved into Chesed 24/7 because we provide a service for all of klal yisroel, by klal yisroel. People have a perception of the chasidishe world as being closed-minded, but that is not what goes on here. There are so many people who love to help, and we want people from all over to join and to volunteer: both accepting and giving our services.”

Mount Sinai Hospital

Montefiore Medical Cent Calvary Hospital

Hackensack Medical Cen

Sandy Eller is a freelance writer who

has written for websites, newspapers, magazines and numerous private clients in addition to having written song lyrics and scripts for several full scale productions. She can be contacted at sandyeller1@gmail.com.

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Ash Tewari MBBS, MCh, FRCS (hon).

Medical Profile Dr. Steven Davidowitz, DDS, FICOI

ELANA KASTNER, M.D.

Dr. Steven Davidowitz, DDS, FICOI, is one of the Upper East Side’s leading cosmetic dentists in designing and maintaining beautiful smiles, with offices in Brooklyn and the Upper East Side of Manhattan. Dr. Steven received his DDS degree from the New York University College of Dentistry and received a Fellowship in Implantology from the International Congress of Oral Implantologists. Dr. Steven is a member in the American Academy of Cosmetic Dentistry (AACD), the American Dental Association (ADA), and the Academy of General Dentistry (AGD). Dr. Steven has been designated an Invisalign Elite Provider, a special designation from Invisalign given to the top 3% of Invisalign providers. He has lectured on the use of plastic aligners and hosts local study clubs to spread his knowledge to other dentists on the use of Invisalign.

DR. GEORGE FIELDING MBBS, FRACS, FRCS (Eng), FRCS (Glas)

DR. JACQUES DOUECK

Dr. George Fielding completed medical school and surgical training in Brisbane, Australia, before doing fellowships in pancreatic, liver and colorectal surgery in Britain and Switzerland. He commenced laparoscopic general surgery in 1990 in Australia, and started laparoscopic bariatric surgery in 1996. After several years teaching and advising U.S. surgeons on bariatric surgery, he was offered a position at NYU Langone Medical Center in 2004, and performs all bariatric operations, including lap band, bypass, sleeve gatrectomy and revisional operations. He also specializes in upper GI surgery, including surgery for reflux, hiatal hernia and achalasia, and complex general laparoscopic surgery. He is listed in “Super Doctors” and Castle Connelly “Top Doctors”.

MARTIN ZONENSHAYN, M.D., F.A.C.S.

DR. CHAIM J. BERNSTEIN, M.D., F.C.C.P.

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Pulmonary and Critical Care Beth Israel Medical Center 3131 Kings Highway, Suite D10 718.252.3590  Dr. Chaim Bernstein is a renowned pulmonologist who has dedicated his career to the physician community and residents of Brooklyn. He has been associated with Beth Israel Medical Center for 15 years. In his role as Director of Pulmonary and Critical Care, he promoted the first ICU in the facility. Dr. Bernstein was promoted to Associate Medical Director 7 years ago and has introduced PA’s to the hospital’s professional pool of providers, integrating them fully with hte numberous busy voluntary physicians on the hospital medical staff. Dr. Bernstein maintains a busy private practice with over 2000 patients, and is sought after by the physician community for pulmonary consultation. His contributions to the healthcare community as a skilled physician, teacher and leater have been outstanding and are the result of his tireless efforts and unending commitment.

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Chief of Neurosurgery New York Methodist Hospital 263 Seventh Avenue, Suite 4-D Brooklyn, NY 11215 718.246.8660 Martin Zonenshayn, M.D., is a board certified neurosurgeon and member of the Congress of Neurological Surgeons and American Association of Neurological Surgeons. After earning his medical degree from the New York University School of Medicine, Dr. Zonenshayn completed his residency in neurosurgery at Weill Cornell Medical College, as well as a fellowship in stereotactic and functional neurosurgery at the New York University Medical Center. Currently recognized as a “Top Doctor” by both New York Magazine and U.S. News and World Report, Dr. Zonenshayn specializes in minimally-invasive spinal surgery and brain tumor surgery, as well as stereotactic and functional neurosurgery for pain management and movement disorders.

HEALTHY LIVING

563 Kings Highway • Brooklyn, NY 11223 718.339.7982 www.DoueckDental.com www.AvoidRootCanal.org www.HealthWatchRadio.com Dr. Doueck is a member of the American Academy of Sleep Medicine, Academy of Dental Sleep Medicine, and Academy of Minimally Invasive Biomimetic Dentistry. He is certified by the Academy of laser Dentistry and has Ozone certification from the American College of Integrative Medicine and Dentistry Clinical consultant for the Dental Advisor, Dr. Doueck writes monthly articles for Image and Community Magazines. He hosts a 45 minute weekly radio show Mondays 8PM on 97.5FM on various health topics.

MEDICINE TODAY

Minimally Invasive General Surgery, Bariatric Surgery, Upper GI Surgery NYU Langone Medical Centre 530 First Ave, Suite 10S, New York, NY 10016 212.263.3218

GOLDEN YEARS

Women’s Contemporary Care Associates 444 Merrick Road, Lynbrook, NY 11563 516.536.5656 www.winthropwcca.com  Elana Kastner, M.D., is a board-certified obstetrician/gynecologist. She has been on the staff of the Winthrop-University Hospital since she graduated from Cornell University Medical College in 1994. Dr. Kastner is a diplomate of the American Board of Obstetrics and Gynecology and an Assistant Clinical Professor of Obstetrics and Gynecology at SUNY Stony Brook School of Medicine. She is a member of the full-time faculty and had been the director of the 4th year stutents’ medical subintership for over 10 years. She has been awarded the Patients’ Choice Award by the American Registry annually since 2008. Dr. Kastner is fluent in Hebrew, and is sensitive to the needs of the Orthodox community and the issues related to the laws of family purity.

WOMEN’S HEALTH

Luxury Dentistry 1714 East 23rd Street 328 East 74th Street, Brooklyn, NY 11229 New York, NY 10021 718.376.1606 212.759.7535 www.luxurydentistrynycblog.com

RAISING OUR CHILDREN

After obtaining his medical degree and specialized training in India, Dr. Tewari did his residency at Henry Ford Hospital in Detroit and his urologic oncology fellowships in California (UCSF) and Florida (UF). A renowned leader in robotic prostate surgery, Dr. Tewari has performed more than 5,500 robotic prostatectomies, making him one of the most experienced robotic prostate surgeons in the world. His Advanced Robotic Technique (ART™) prostatectomy offers prostate cancer patients, who are candidates for the procedure, superior cancer control while preserving erectile function and continence. He is a Castle Connolly “Top Doctor,” NY Magazine “Best Doctor” and a “Most Compassionate Doctor” (Vitals).

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Chairman, Milton & Carroll Petrie Department of Urology Professor, Department of Urology Icahn School of Medicine at Mount Sinai 1425 Madison Avenue, New York, New York 10029 212.241.9955 www.mountsinai.org/roboticprostate

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Community Provider Bulletin

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MEDICINE TODAY HEALTHY LIVING H&L TECH COMMUNITY PROFILE

Ashutosh K. Tewari to Head Mount Sinai’s Urology Department

shutosh K. Tewari, MB BS, one of the foremost leaders in robotic prostate surgery and prostate cancer research in the world, will serve as chairman of The Milton and Carroll Petrie Department of Urology at the Icahn School of Medicine at Mount Sinai. “Dr. Tewari is a top-flight urologist and physician scientist of national and international repute who will position Mount Sinai as a urologic center of excellence, offering world-class urologic care, practicechanging research, and patient-centered care,” said Dennis S. Charney, Anne and Joel Ehrenkranz Dean of the Icahn School of Medicine at Mount Sinai, and president for Academic Affairs of the Mount Sinai Health System. Dr. Tewari pioneered robotic prostatectomy and he has performed more than 5,000 robotic prostatecto-

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mies, and other minimally invasive procedures for various urological cancers. He has managed a robust urologic training program at New York Presbyterian Hospital-Weill Cornell Medical Center since 2004. Last year, the American Urological Association awarded him the prestigious Gold Cystoscope Award for his outstanding contributions to the field of urology and urologic oncology. He is actively pursuing studies of the radiological phenotype of aggressive prostate cancer using novel imaging and genomics and has published in many peer reviewed journals. The Mount Sinai Health System is an integrated health system committed to providing distinguished care, conducting transformative research, and advancing biomedical education. For more information, visit www.mountsinai.org.

Aleh Foundation Dinner Recognizes Achievers in Medicine, Mental Health and More

he Aleh Foundation will honor distinguished civic and medical leaders impacting areas of medicine and mental health, education and arts at their upcoming dinner on May 21, 2014 at the Museum of Jewish Heritage in NYC. The Civic Leadership Award will be presented to Congressman Robert Turner, who has shown dedication and immeasurable support to important global causes as well as major Jewish causes, including hunting down Nazi war criminals. The Medical Leadership Award will be presented to Dr. Vincent Calamia, the medical director of Eger Health Care & Rehabilitation Center - among the largest of New York nursing homes - for his contributions to mankind. The Physician of the Year Award will go to Dr. David Staffenberg, the clinical professor of plastic surgery and chief of pediatric plastic surgery at the NYU Langone Medical Center. Among other notable achievements, Dr. Staffenberg is well known for the successful separation of conjoined twins joined at the tops of their heads. The Volunteer of Excellence Award will be presented to Mr. Ephraim Gartenhause, for his heroic achievements

in founding the volunteer project in Aleh’s first major center located in Bnei Brak, Israel. Since its humble beginnings more than twenty years ago, The Aleh Foundation attracts thousands of friends who are eager to join in supporting leading institutions for the care and treatment of severely developmentally disabled infants and children in Israel. For more information, visit AlehFoundationUsa.org or call 800-317-ALEH.

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February 2014


COMMUNITY CALENDAR Cognitive Behavior Therapy for Children and Adolescents

March

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Where: CHEMED-1771 Madison Ave. Lakewood, NJ 08701 Time: 8:45am-4:00pm More info: 1.877.EDU.OHEL (877.338.6435) Early bird rate (through 2/11): $400, regular rate (after 2/11): $450, walk-in Rate: $500 This experiential three-day workshop will provide participants with valuable insights and hands-on clinical skills for using cognitive behavior therapy (CBT) to treat children and adolescents, ages 7-18, with depression and anxiety disorders, including generalized anxiety disorder, phobias and social anxiety.

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April

1

Team Sharsheret NYC Half Marathon

Team Sharsheret is an official charity partner of the 2014 NYC Half-Marathon. Runners will compete in a 13.1-mile race that begins in Central Park and finishes in lower Manhattan. To apply for a slot in this race e-mail athletes@sharsheret.org.

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May

March for Babies

March

Where: Lincoln Center Area, 65th Street and Amsterdam New York, NY 10023 Time: 10:00am; registration time 8:30am Walk for babies and help improve infant health by raising money. There’ll be family teams, company teams and people walking with friends - it’s a great feeling knowing we’re all helping real families.

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Where: American Visionary Art Museum Baltimore, Maryland Time: 1:00- 5:00pm More info: Kari Gorkos at kgorkos@mhamd.org

May

Adults-Baby Wearing Workshop

May

North Fulton Autism Speakers Panel

Where: Brooklyn Central Library (Information Commons Lab) 10 Grand Army Plaza, Brooklyn, NY 11238 Time:1:30-2:30pm Learn about options for carrying your baby to be mobile and get things done around the house or around town. Bring your carrier, and try different carriers, wraps and knapsacks as well as different carries (front-carry, backcarry, hip-carry, tandem-wear, toddler-wear, newborn-wear).

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Stress Management Group for Heart Patients

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Where: Location TBA Time: 2:00-4:00pm RSVP: DebbieDobbs@Comcast.net

COMMUNITY PROFILE

Where: The Cardiac Health Center 174-03 Horace Harding Exp., Fresh Meadows, NY 11365 Time: 6:00pm-7:30pm More info: Call Dr. Robert Allen at 212.831.3131 to sign up at The Cardiac Health Center

February 2014

Open Minds: Raising Mental Health Awareness Through Art

H&L TECH

March

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Where: 120 Broadway, New York, NY 10271, USA Suite 1050A Time: 6:30-8:00pm More info: rdomilici@ccfa.org

HEALTHY LIVING

March

May

Crohn’s and Colitis Disease Support Group

MEDICINE TODAY

MAY 2014

Purim Celebration for Persons with Disabilities

Where: Bet Torah Synagogue. 60 Smith Ave. Mount Kisco, NY Time: 1pm RSVP: Carol Williams: 914.761.0600x107 or cwilliams@wjcs.com

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HealthCorps Annual Gala

Where: Waldorf Astoria New York Time: 6:30pm – 12:00am To purchase tickets go to www.healthcorps.org/gala HealthCorps®’ Eight Annual Gala, raises funds to fight the child obesity crisis and expand the organization’s groundbreaking in-school health education programming. HealthCorps founders Dr. Mehmet and Lisa Oz will co-host. The black tie event promises guests a magical evening of dining, dancing and entertainment.

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GOLDEN YEARS

Free Medicare Counseling

Where: New Rochelle Library 1 Library Plaza, New Rochelle, NY 10801 Time: 10:00am More info: 914.231.3260 Meet with trained counselors to get more information about Medicare Part A (in-patient) and Part B (out-patient) coverage, Part D prescription drug coverage, Medicare Advantage Plans, with or without drug coverage, and Medicare Savings Plans, Extra Help and EPIC for seniors with more limited incomes. Some assistance is also available for those who are looking for other financial benefit programs, such as HEAP (Home Energy Assistance Program) and food stamps.

Senior Wellness Program

Where: Caroll Gardens Library (Basement auditorium) 397 Clinton Street • Brooklyn, NY 11231 Time: 10:00-11:00am Chair exercises, stretching, and yoga for seniors.

WOMEN’S HEALTH

April

RAISING OUR CHILDREN

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March

The Truth about Thyroid Disease

Where: 92nd St. Y: Lexington Avenue at 92nd St. (Warburg Lounge) Time: 7:00pm More info: 212.415.5500; tickets start at $22 Gain understanding for the causes and contributing factors associated with thyroid and adrenal issues; including hormone levels, environmental influences, nutritional deficiencies, medication and lifestyle stressors. Develop a holistic approach to addressing these often misunderstood causes; employing core naturopathic principles such as herbal, nutritional and glandular interventions for optimizing thyroid function. April

Where: 92nd St. Y: Lexington Avenue at 92nd St., Warburg Lounge Time: 7:00pm More info: www.92y.org; costs $22 and up Hear about the future of cancer therapy specifically the identification of molecular defects that drive the growth of cancer and the development of specific cancer therapies that kill cancer cells while leaving normal cells unharmed. March

Where: Arden Heights Blvd. Jewish Center 1766 Arthur Kill Rd Staten Island, NY 10312 Time: 10:00am

APRIL 2014

The End of Cancer is Within Reach

March

American Red Cross Blood Drive

March

ISSUES

MARCH 2014

INTRODUCTION

COMMUNITY PROFILE


INTRODUCTION ISSUES

COMMUNITY PROFILE

Health AND Living Service Marketplace Placenta Encapsulation

Facial Rejuvenation

Healing

Pain Relief

“My migraine headaches are debilitating!” Call 2nd Nature Acupunture, we can help...

H&L TECH

HEALTHY LIVING

MEDICINE TODAY

GOLDEN YEARS

WOMEN’S HEALTH

RAISING OUR CHILDREN

917-414-3831

For a full list of conditions we treat,visit www.2ndNatureAcu.com Email: AcupuncturEsther@gmail.com

Esther Hornstein L.Ac., Dipl.

Brooklyn, NY

ADDICTION RECOVERY

Community Services

1.877.8.HOPENY (or) 1.866.569.SAFE KnowTheOdds.org Problem gambling is treatable & support is available. Get help now!

Frum professional staff. Some insurances accepted. Sliding scale.

Safe Foundation

ASSISTED LIVING Ateret Avot

1410 East 10th Street, Brooklyn, NY 718.998.5400 Luxury senior retirement facility. Exciting & stimulating activities for Jewish seniors, morning and afternoon programs available.

Lakewood Courtyard

Genesights: The Jewish Genetics

Online Educational Series Visit www.GeneSights.com and get to know your genes, your risks and your options. This newly developed series will explain various medical conditions and diseases that have a genetic component.

COMMUNITY SUPPORT Aleh Foundation USA

52 Madison Avenue, Lakewood, NJ 08701 732.905.2055 • lakewoodcourtyard.com A glatt kosher assisted and independent living community, located in the heart of the Lakewood community.

5317 13th Avenue, Brooklyn, NY 11219 800.317.ALEH www.alehfoundationusa.org Center for the rehabilitation and advancement of special children.

The New Nautilus

Prospect Park Residence

151 W. 30th Street, New York, NY, 10001 212.465.1300 • www.chailifeline.org Through programs that address the emotional, social, and financial needs of seriously ill children, their families, and communities, they restore normalcy to family life, and better enables families to withstand the crises and challenges of serious pediatric illness.

Regency Home Health Care

718.535.9061 • www.chayimaruchim.com/network Get updated with the latest information about the world of medical care from a patient sensitive and halachic perspective.

2001 Ocean Boulevard, Atlantic Beach, NY 11509 516.239.1400 • www.newnautilushotel.com An upscale oceanfront Senior Residential Hotel that provides a socially active retirement lifestyle in a secure and friendly environment. One Prospect Park West, Brooklyn, NY 11215 718.622.8400 • www.prospectparkresidence.com Quality senior living. Community within a community. 5110 19th Avenue, Brooklyn, NY 11204 718.223.1520 Your family members will enjoy a community setting and quality of service that is second-to-none at our modern facility in the heart of Boro Park.

CHIROPRACTIC CARE Dr. Melinda Keller

5911 16th Ave. Brooklyn, NY 11204 718.234.6206 • www.brooklynspinecenter.com Brooklyn Spine Center helps treat neck and back pain, pediatric care, posture correction, pregnancy care, stress relief etc.. Modern treatment done with old fashioned care.

Dr. Christopher Tabick 718.745.8177

COMMUNITY PROFILE

Counterforce 718.787.4412

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Chai Lifeline

Chayim Aruchim

Chesed 24/7

845.354.3233 • www.chesed247.org Your home in the hospital. Kosher hospitality rooms. Daily meals. Shabbos boxes. Patient services.

JCC of Greater Coney Island

718.449.5000 Homecare, Medical Transportation, Housekeeping, Friendly Visiting, Holocaust Survivor Support Systems

OHEL Bais Ezra Sibshops

800.603.OHEL · www.ohelfamily.org Lively and fun groups for fun, support & inspiration for siblings of individuals with developmental disabilities.

February 2014


Health AND Living? Service Marketplace

OHEL Morris Pinsky Simcha Program!

Rofeh Cholim Cancer Society

762 Bedford Ave. Brooklyn, NY 11205 718.722.2002 • www.rccscancer.org An array of services for cancer-stricken patients in need, including the subsidizing of health insurance premiums, enabling them to obtain the best medical care. 646.723.3955 • www.yadempowers.org The Jewish disability empowerment center provides coaching and mentoring, advocacy, and resource information, led by Jews with disabilities.

Yad v’Ezer

Zicharon Memory Loss

DAY CAMPS Noam Day Camp

Luxury Dentistry

Dr. Steven Davidowitz: Brooklyn: 1714 E. 23rd Street, Bklyn., NY 11229 718.376.1606 Manhattan: 328 E. 74th Street, New York, NY 10021 212.759.7535 • www.luxurydentistrynycblog.com

Dialysis

Gateway Dialysis Center

1170 East 98th Street, Brooklyn, NY 11236 Irena: 718.223.2122 • Jacob: 718.223.2108 Our certified training nurses and staff train patients at our center to find independence with Home Hemodialysis. Following a simple training process of approx. 4 weeks, patients and their family members are prepared to administer treatments in their own home. (see our ad on page 11)

ELDER LAW

Yitzchak Weissman

February 2014

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COMMUNITY PROFILE

• Manhattan • Brooklyn • The Five Towns 347.522.3272 • 866.WEISMAN www.weissmanelderlaw.com Call for a free phone assessment of your planning needs.

H&L TECH

1876 50th Street · Brooklyn, NY 11201 718.236.0305 Noam Day Camp has been servicing the Brooklyn yeshiva community for the past 40 years, offering the total summer experience: a highly qualified learning program in conjunction with an array of the most exciting trips and activities.

1420 Ave. P Brooklyn, NY 718.339.7878 • www.josephlichter.com Now in a new and expanded facility, laser, cosmetic and comprehensive dental work offered to all phases in family dentistry. Convenient appointments as well as emergency service and treatment available.

HEALTHY LIVING

718.534.1008 • Zicharon.org Caregiver support, medical referrals, homecare planning, home safety, financial advice

Joseph Lichter D.D.S

MEDICINE TODAY

718.613.1818 Under the guidance of Rabbi Yosef Y. Holtzman, chief Rabbi at SUNY Downstate Medical Center, Yad v’Ezer provides freshly cooked meals to families in temporary need.

DENTISTRY

GOLDEN YEARS

Yad HaChazakah

Simcha Day Camp (for boys)

257 Beach 17th Street · Far Rockaway, NY 11691 718.868.2300 x233 · www.RuachDayCamp.com Located in Far Rockaway on a 9.5 acre campus. We build your son’s skills, sports clinics, instructional swim, professional Rebbeim, middos workshops, amazing trips and so much more.

WOMEN’S HEALTH

800.603.OHEL · www.ohelfamily.org Have a disability, and looking to become more self-confident and engaging with others? Join OHEL’s Morris Pinsky Simcha Program!

2611 Ave Z · Brooklyn, NY 11235 718.646.8500 x1123 · www.RuachDayCamp.com Ruach Day Camp is the premiere innovator in day camping. We boast on-site facilities including our in-ground pool, an exciting calendar of events, extended hours, focus on Torah, and amazing sports, outdoor swimming, overnights and weekly trips - all at a price that can’t be beat. Our staff is warm and devoted and will ensure that your child grows over the summer months. Experience the Ruach!

RAISING OUR CHILDREN

125B Spruce Street · Cedarhurst, NY 800.603.OHEL · www.ohelfamily.org Join a Caregiver Support Group led by OHEL Geriatric Specialists. Get the support you need and learn about new training ideas, techniques, tips and secure your own piece of mind.

Ruach Day Camp (Boys & Girls separate)

ISSUES

OHEL Family Caregiver Support Group

INTRODUCTION

COMMUNITY PROFILE


INTRODUCTION

COMMUNITY PROFILE

ISSUES

ELDERCARE ADVOCATES

Health AND Living Service Marketplace ElderCare Advocates

ElderCare Advocates, Inc.

1309 Avenue I, Brooklyn, NY 11230 718.252.2580 • www.agingstrategies.com

ELDER LAW ATTORNEYS 590 Madison Ave., Suite 1800, NY, NY 10022 800.702.8677

86-16 Queens Boulevard, Elmhurst, NY 11373 800.483.2175

COMMUNITY PROFILE

H&L TECH

HEALTHY LIVING

MEDICINE TODAY

WOMEN’S HEALTH

FELDMAN & FELDMAN, Counselors at Law

GOLDEN YEARS

RAISING OUR CHILDREN

155 W 20th St #1, New York, NY 10011 718.252.2580 • www.agingstrategies.com/

Goldberg, Sager & Associates 1628 Kings Highway at East 17th Street Brooklyn, New York 11229-1210 347.497.3245

Gross & Levin, L.L.P.

Law Office of Amy Posner

20 Vessey Street, New York, NY 10007 212.385.1951

Solomon Blum Heymann LLP

40 Wall Street, 35th Floor, New York, NY 10005 212.267.7600

family health Dor Yeshorim

5205 New Utrecht Ave, Brooklyn, NY, 11219 718.384.6060 • www.modernlab.org/doryeshirum An international, confidential genetic screening system which attempts to prevent the transmission of genetic disorders among members of the Ashkenazi Jewish community.

Puah Institute

1709 Kingshighway, Brooklyn, NY 11229 718.336.0603 • www.puahonline.org Experts in the World of Jewish Fertility: devoted to providing counseling, advocacy, halachic and medical diognostics and expertise, supervision, research and education worldwide.

Relief Resources

5904 13th Ave. Brooklyn, NY 11219 718.431.9501 • www.reliefhelp.org A non-profit organization dedicated to providing medical referrals, research, advocacy and support to individuals and families facing medical challenges.

Fitness

HOME HEALTHCARE

917.842.8490 • www.noobi3fitness.com Chaim Friedman: chaim@noobi3fitness.com Fitness made simple

171 Kings Highwway, Brooklyn, NY 11223 Insurance-covered home care: 718.872.2630 Private Pay Services: 866.331.6873 Nurses / Therapists / Social Workers / Home Health Aides

Noobi3fitness

Shape Fitness

718.338.8700 • www.shapefitnessgym.com The fitness DVD you’ve been waiting for. Order now!

Americare CSS

Caring Professionals, Inc.

De La Rosa Real Foods & Vineyards 718.333.0333 · www.DeLaRosa613.com Real foods for real people. Find in your local markets or on Amazon.com.

Brooklyn: 1424 Sheepshead Bay Rd., 2nd floor Queens: 70-20 Austin St., Suite 135, Forest Hills, NY 347.779.2273 • www.CaringProfessionals.com The leading home health agency serving the Jewish and Russian community since 1994. Aides trained in kosher kitchen, Shabbat and Jewish holidays.

Fiber Gourmet

HamaspikCare

HEALTHY EATING

All the taste, half the calories. Ask for it at Wegmans and your local kosher market. Order online at www.FiberGourmet.com

855.HAMASPIK Home health aide, personal care aide, nursing, PT/OT, speech therapy, social work, nutrition.

Kosher in the Kitch

Preferred Home Care of New York

www.kosherinthekitch.com Fresh and fast recipes. Sign up for free weekly dinner menus.

Mauzone Mania

646.206.1220 or 855.MAUZONE www.MauzoneMania.com

NU Café

4709 New Utrecht Avenue, Brooklyn, NY 718.871.4747 Let us help you lose weight! Catering food for: Pre-diabetics and Diabetics, Celiac or Gluten Intolerance, Crohn’s Disease, IBS, SED, Low Sodium, High Protein, 100% Whole Wheat Pastries with No Sugar Added

Taft Foodmasters

646.206.1220 or 855.MAUZONE Fully cooked, plant based vegan all natural products available in the freezer or refrigerated sections of fine Brooklyn kosher markets.

Yaffa’s Living Well - Nutrition and Weight Loss Center

Yaffa Regev - Nutrition Consultant, Herbalist & Organic Chef 1322 East 14th St., Brooklyn, NY 718.627.3438 · www.yaffaslivingwell.com QMR Whole Body Health Analyzer, Cancer& Diabetic Programs, Vitamins vegetarian, Infrared Sauna, Ionic Foot Bath, Ear Candling, Customized Food Menu

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Corporate Headquarters: 1267 57th Street, Brooklyn, NY 11219 Manhattan Office: 1370 Broadway, NY, NY 10018 718.841.8000 • 212.444.9009 www.preferredhcny.com

Quality Healthcare

718-388-8500 • www.QualityNY.com Quality Healthcare specialists are with you each step of the way to ensure a smooth transition to homecare.

Reliable Community Care, Inc.

160 Broadway, 16th fl. NYC, NY 10038 212.587.1400 • reliablecommunitycare.net When you entrust your loved one to Reliable Community Care, you become a member of our family. Call today for help with home care or private nursing services.

Revival Home Health Care

5350 Kings Highway, Brooklyn, NY 718.629.1000 • revivalhhc.org Skilled RN’s, home health aides, PT/OT, speech/ lanuguage pathology, nutrition, infusion therapy, medical supplies, equipment, and social service.

Insurance

Adam Pearlman & Associates

212.223.5471 x101 • adampearlmanassociates.com Personal Insurance PlanningLife Insurance | Long Term Care | Disability Insurance | home of Solutions for Seniors

February 2014

medicaL SUPplies


Health AND Living Service Marketplace NEFESH International

800.877.9100 www.AmericanDiscountMed.com Never pay retail for medical equipment. We specialize in pediatric and adult home care equipment.

201.384.0084 • www.NEFESH.org The international network of Orthodox mental health professionals.

Surgical Sock Shop

800.603.OHEL • www.ohelfamily.org/kadimah Providing a warm and welcoming environment for men and women managing their mental illness.

Shabbos Stairlift

888.506.7162 • www.innocentheart.org Safeguarding our community from harm, one innocent heart at a time.

MEDICAL PRACTICE Dr. Lawrence Levitan

Dr. Masha (Friedman) Lewin

Dr. Andrea S. Wolf,

Women’s Contemporary Care Associates

Mental Health Services Counterforce Therapy Program

February 2014

Yaffa’s Living Well

Yaffa Regev - Nutrition Consultant, Herbalist & Organic Chef 1322 East 14th St., Brooklyn, NY 718.627.3438 · www.yaffaslivingwell.com Facials, Acne Facial, Scars, Massage, Infrared Sauna, Laser & Resurfacing , IPL, Micro Channeling The best new treatments in the market to look younger and healthier.

NUTRITIONAL SUPPLEMENTS Bluebonnet Nutrition

bluebonnetnutrition.com Kosher certified Targeted Multiples® that are scientifically formulated to meet women’s and men’s specific and changing nutritional needs as they age.

Kosher Vitamins

800.645.1899 - koshervitamins.com Better health is only a click away. Largest selection brand name kosher vitamins at discounted prices.

Maxi Health

1.800.544.MAXI • www.maxihealth.com Get your children to take their vitamins with Maxi Health’s tasty and fun tablets. Offered in strawberry, fruit punch and assorted flavors, the new Multi Yums allows your children to get their daily intake of nutrients with no artificial coloring or flavoring.

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COMMUNITY PROFILE

718.787.4412 Frum professional staff. Some insurances accepted. Sliding scale.

MEDICAL SPA

H&L TECH

Joan Altman-Nueman, MD 1175 West Broadway, Suite 33 Hewlett, NY 11557 516.616.4522 Board certified obstetrician and gynecologist offer routine OBGYN care in addition to treatment of irregular bleeding, menopause, sonograms, family planning and Kallah needs with full knowledge of Tahart Hamishpacha laws. Sunday and evening hours available.

Tikvah at OHEL

800.603.OHEL • www.ohelfamily.org Professional out-patient services by dedicated and caring team of highly specialized psychiatric specialists.

HEALTHY LIVING

Mt. Sinai Medical Center Division of Thoracic Surgery 1190 Fifth Ave., Box 1028, New York, NY 10029 212.241.9502 Dr. Wolf specializes in General Thoracic Surgery for men and women, with expertise in robotic and minimally-invasive techniques.

888.613.1613 Emotional support for Orthodox victims of sexual abuse.

MEDICINE TODAY

One Two I-Care, LLC 1577 East 18th Street, Brooklyn, NY 11230 718.819.9560 Routine eye exams, contact lens fitting, vision therapy evaluation, DMV forms filled out, frames for every budget

Sovri Helpline

GOLDEN YEARS

212.679.2223 • PREMIERNYOBGYN.COM Dr. Levitan, who is affiliated with Lenox Hospital, is temporarily located at 18 E 41 St. 1st FL. New York, NY 10017. Watch for the grand opening of their new NY location at 137 E36 NYC 10016

Project Innocent Heart

WOMEN’S HEALTH

646.543.8811 Your home becomes accessible again. Everyday. Shabbos and Yomim Tovim included.

OHEL Kadimah Clubhouse

RAISING OUR CHILDREN

5818 13th Avenue, Brooklyn, NY 11219 718.436.7880 • 115 Avenue J, Brooklyn, NY 718.338.7993 • www.supportsockshop.com

ISSUES

American Discount Medical

INTRODUCTION

COMMUNITY PROFILE


INTRODUCTION ISSUES RAISING OUR CHILDREN WOMEN’S HEALTH GOLDEN YEARS

Health AND Living Service Marketplace Pharmacies J Drugs

1205 Avenue J, Brooklyn, NY 718.258.6686 • www.myGNP.com Try the excellent service and professional care available at your local Good Neighbor Pharmacy. Free delivery. Curbside service.

Kings Bay Chemists

Margaret Tietz

CenterLight Health System 164-11 Chapin Parkway, Jamaica Hills, NY 11432 718.298.7800 • www.tietzjewish.com Providing the Jewish Community with high quality sub-acute rehabilitation, hospice and long-term care services in a newly renovated luxurious and completely Kosher setting.

Meadow Park

3610 Nostrand Avenue, Brooklyn, NY 718.891.3447 • www.myGNP.com Try the excellent service and professional care available at your local Good Neighbor Pharmacy. Free delivery. Curbside service.

718.591.8300 Ext. 248 - mprcare.com Queen’s only glatt kosher rehabilitation and health care facility. Professional chef on staff for an exquisite dining experience.

J Drugs II

1516 Oreintal Boulevard, Brooklyn, NY 11235 718.646.4411

3402 Avenue N, Brooklyn, NY 718.258.5858 • www.myGNP.com Try the excellent service and professional care available at your local Good Neighbor Pharmacy. Free delivery. Curbside service.

New Age Pharmacy

2918 Avenue J, Brooklyn, NY 11210 718.253.1700

REFERRAL SERVICES Medstar

718.787.1800 • www.medstarmedical.org Providing medical referral and guidance to the Jewish community for 20 years. Comprehensive health care information for the Jewish patient and traveler in NY, New Jersey, Florida and cities all over the world.

REHABILITATION CENTERS

HEALTHY LIVING

Boro Park Center for Rehabilitation and Healthcare

801 West 190th Street, New York, NY 10040 212.543.6400 • forttyronrehab.com

H&L TECH

MEDICINE TODAY

COMMUNITY PROFILE

2519 Avenue U, Brooklyn, NY 11229 718.743.8900 Physical therapy and rehabilitation center, equipped with modern technology, including therapeutic pool and hydro massage.

4915 10th Avenue, Brooklyn, NY 11219 718.851.3700 www.BoroParkCenter.net

Fort Tryon Center for Rehabilitation & Nursing Ideal Medicine

Menorah Home and Hospital

Parker Jewish Institute for Health Care and Rehabilitation

271-11 76th Ave., New Hyde Park, NY 11040 516.322.6223 • www.parkerinstitute.org Sub-Acute Care/Post-Acute Care, Short Term Rehabilitation, Nursing Home, Medical Model Adult Day Health Care, Social Model Alzheimer Center, Long Term Home Health Care, Community/Inpatient Hospice

Sephardic Nursing & Rehabilitation

2266 Cropsey Ave., Brooklyn, NY 11214 718.266.6100 - sephardichome.org Our mission is to provide the elderly with the best quality of life in a respectful, dignified, safe and compassionate environment, in accordance with Jewish tradition.

SENIOR CENTERS

Agudath Israel of America Community Services, Inc.

Boro Park Senior Citizens Center 5602 11th Avenue Brooklyn, NY 11219 718.854.7430 • 718.854.7610

Boro Park Y

4912 14th Avenue Brooklyn, NY 11219 718.435.3804 • www.boroparky.org

Jewish Community Center of Staten Island 1466 Manor Rd, New York, NY 718.475.5200 • www.sijcc.org

Young Israel of Midwood

COMMUNITY PROFILE

1694 Ocean Avenue, Brooklyn, NY 11230 718.692.2107 • www.yimidwood.org

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SOCIAL SERVICES Nachas Health

1310 48th Street, Suite 402, Brooklyn, NY, 11219 718.436.7373 • www.nachashealth.org

Ohel Bais Ezra

4510 16th Ave, Brooklyn, NY, 11204 718.851.6300 • www.ohelfamily.org Protects and strengthens individuals and families by meeting the diverse social service needs of the community through programs of excellence. It seeks to identify community social challenges by pioneering new programs that elevate the lives of individuals and families.

Yeled V’Yalda

1312 38th Street, Brooklyn, NY, 11218 718.686.3700 • www.yeled.org The agency provides the New York City area with a variety of educational programs and social services, offering a seamless blend of child care and developmental services, as well as health and nutritional guidance.

Urgent CARE MedRite

919 2nd Ave (Bet. 48 & 49) NYC 330 West 42nd St. (Bet. 8 & 9 Ave.) NYC 212.935.3333 • www.medriteurgentcare.com Emergency care and general health care. X-ray and lab onsite - Open early till late.

Mount Sinai Doctors Urgent Care

300 Camden Plaza West, 18th Fl, Brooklyn, NY 929.210.6300 • www.UrgentCareBklyn.org Urgent care in Brooklyn Heights; Mount Sinai physicians board certified in family medicine

HELP WANTED

Assistant Residence Manager

Experience working with individuals with intellectual disabilities in a residential setting. Responsibilities include staff supervision and familiarity with IRA operation. Must be responsible, organized & passionate. Driver’s license preferred. Call 718.535.1989, Email resume: hr@hasccenter.org

Challenge Early Intervention Center Service Coordinator, F/T Queens Location BA in Human Services or related field, Computer literate, detail-oriented, excellent communication skills. Bilingual Russian-Hebrew preferred. Experience in EI service coordination desirable. Competitive compensation package. Fax resume to: 718.261.7302 or email: cara.challenge2@thejnet.com.

February 2014


4709 New Utrecht Ave. Brooklyn

Health AND Living Service Marketplace Will you be in the hospital over Shabbos or Yom Tov? Are you in the hospital and need kosher food? The following Hospitality Rooms (also known as Chesed Rooms) can help, providing you with kosher food, assistance and care.

Calvary Hospital (Bronx)

at HASC Center is looking for Counselors, 18 and older, for late afternoon/early evening and Sundays, to work with female individuals with developmental disabilities. 10-15 hours a week. Boro Park, Flatbush and Kensington areas of Brooklyn. Competitive salary. Call Aviva at 718-535-1948

CSW &/or Mental Health Counselor

Catskill Regional Medical Center (Harris Hospital)

to work two 60min/week in Boro Pk for PreSchool age 3-5. Send resume & cover letter to HR@skhov.org

Columbia University Medical Center

Direct Care Worker/Male Wanted

Main Building, 4th Fl, #455

Babies and Children’s Hospital 6th Floor Lobby, Room #662

Radiology Waiting Room

Englewood Hospital & Medical Center 3rd Fl, Room #632

(Suffern) Main Lobby

Hackensack University Medical Center

5th Floor West - Women Building, Room #121

Hospital for Special Surgery 2nd Floor, Room 252 West

Memorial Sloan Kettering Hospital 1st Floor Room C-170

Montefiore Medical Center

Albert Einstein – Weiler Division 4th Floor, next to cafeteria

New York Hospital Cornell Medical Center 2nd Floor North, Room #107 Tel. in Room: 212-746-7335

Valley Hospital

Mother Baby Unit, B3224

Ei Service Coordinator

Have an AA or BA in ED or Health Related field? You may qualify for Early Intervention Service Coordinator position. Skills required include strong interpersonal skills, highly organized, computer proficient & detail-oriented. Experience a plus. Fax resume to: 718.686.2498 or email to: jobs@yeled.org, Att: Miriam

Medical Assistant

Qualified & exp’d for busy, fast paced primary care office in Midwood. Must have experience in pediatrics, be familiar w/vaccines. EMR experience a must. Hours include Sundays, afternoons & eves. Resume: familymed.bklyn@gmail.com

Morning Supervisor

Experience working with individuals with Intellectual disabilities in a residential setting. Responsibilities include staff supervision, morning routine, medical appointments & paperwork. Must have good organizational and communication skills. Driver’s license preferred. Call 718.535.1989 or email resume: hr@hasccenter.org

Nurse Administrator

Growing healthcare agency in Rockland County seeking to hire a F/T Registered Nurse (RN) with administrative nursing experience. Great pay & excellent health benefits. Send resume to: nurseposition101@gmail.com

57

COMMUNITY PROFILE

February 2014

Direct Support Counselors

to work in adult day habilitation programs and group residences located in Brooklyn. All shifts. F/T. Competitive salary + benefi ts. Call 718.535.1989 or email: hr@hasccenter.org

H&L TECH

All the above rooms are fully stocked with kosher food, snacks, drinks and many other amenities a member of the community may need while in the hospital. For patients or families stranded in the hospital over Shabbos or Yom Tov, each Chesed 24/7 Hospitality Room is equipped with a Shabbos warmer, fully prepared Shabbos meals, a hot water urn, grape juice, challah rolls, electric candlesticks, siddurim, machzorim and other items one may need. Many of the rooms have a Chesed 24/7 patient representative who is available to assist and help in any way they can. A hot cup of coffee, a piece of cake, and knowing someone cares can make all the difference in the world. May the Chesed 24/7 Rooms be used only for simchas. This list is sponsored by Chesed 24/7. For additional assistance or information, please call Chesed 24/7 at 845-354-3233 or visit www.chesed247.org.

Direct Support Counselors

to work in a residential home for boys with autism located in Flatbush. F/T. Competitive salary + benefits. Call 718.535.1989 or email: hr@hasccenter.org

HEALTHY LIVING

Mount Sinai Hospital

Guggenheim Pavilion, 2nd Floor, near the shul

Call or visit today and start enjoying your diet!

MEDICINE TODAY

Lenox Hill Hospital

4th Fl (off waiting room)

4709 New Utrecht Ave. Brooklyn

GOLDEN YEARS

Good Samaritan Hospital

718-871-4747 www.NuCafe47.com

2 locations for your convenience

Ellenville Regional Hospital

Nu Cafe 47

P/T for community residence. Call Joe or Mikhael: 718.486.5800

and our NEW location 330 West 42nd St, (Bet 8th & 9th Ave)NY, NY 10036

Milstein Hospital Pavilion 6th Fl North, Room #6-112 Tel. in room: 212-305-5622

gluten free - sugar free - low fat - low sodium

WOMEN’S HEALTH

Columbia University Medical Center

COOKIES & DINING JP AD: 19 THAT FIT YOUR DIET!

RAISING OUR CHILDREN

3rd Floor, off the Family Lounge

Community Habilitation Department

ISSUES

HOSPITALITY ROOMS

INTRODUCTION

COMMUNITY PROFILE

Call or visit today and start enjoying your diet!


INTRODUCTION ISSUES

COMMUNITY PROFILE From the Doctors Desk

By Dr. Natan Haratz-Rubinstein

COMMUNITY PROFILE

H&L TECH

HEALTHY LIVING

MEDICINE TODAY

GOLDEN YEARS

WOMEN’S HEALTH

RAISING OUR CHILDREN

O

ne of the great health achievements of the Orthodox community is its widespread participation in the Dor Yeshorim genetic screening program for Ashkenazic Jewish genetic diseases. By detecting the carrier status of most of its young people of marriageable age, it has greatly reduced the number of babies born with tragic conditions, such as Tay-Sachs disease. But even couples found to be free of the genes for Jewish genetic diseases are still at risk for other common congenital conditions, such as cardiac abnormalities, which occur at the rate of 3-5 per 1000 births, and spina bifida, which has an incidence of 1-2 per 1000 births. New, non-invasive diagnostic and imaging tools, such as 3-dimensional and high-resolution 2-dimensional sonography, enable us to detect fetal abnormalities with greater accuracy and at an earlier stage of pregnancy, without posing any danger to the fetus. For non-pregnant patients, the enhanced accuracy and clarity of pelvic images, particularly in heavier patients, has improved our ability to find tumors and diagnose conditions of the ovaries, uterus, and the Fallopian tubes, potentially improving and possibly saving the lives of victims of gynecological cancers through earlier diagnosis. Current imaging technologies can reveal hints of congenital conditions as early as the 11th or 12th week of the pregnancy. In cases where a chromosomal abnormality is suspected, these findings can be confirmed by a cell-free DNA test in the mother’s blood to detect fetal DNA fragments, without touching her womb or endangering the fetus. The test can reveal chromosomal abnormalities responsible for conditions such as trisomy 21 (for Down Syndrome) and trisomy 18 (for Edwards syndrome), as early as 10 weeks into the pregnancy, with an accuracy of 99%. Some of my patients from the Orthodox community are reluc-

What You Need to Know About Your Unborn Child tant to screen their unborn babies for congenital defects. They believe screening is unnecessary, because their religious beliefs prompt them to carry the baby to term, even if they know the fetus has a serious congenital problem. I tell them that if they are determined to give birth

surgeons can operate on a newborn infant to close the opening over the exposed parts of the spinal cord. Surgeons are also testing experimental prenatal surgical techniques on a fetus with spina bifida while still inside the womb. I urge my pregnant patients to un-

ing conditions of high blood pressure and Type 2 diabetes. Obesity also results in high-risk pregnancies. This makes it doubly important for women who give birth to attempt to get back down to their pre-pregnancy weight before becoming pregnant again.

to their baby, it is doubly important to uncover any congenital conditions. That way, the right specialists can be standing by at the time of delivery, to provide the newborn baby with the indicated medical or surgical treatments as soon as possible. For example, a child born with a congenital defect in the conduit connecting the right ventricle of their heart and their lungs can be treated with minimally invasive surgery to extend their life. As a result of such treatments, more than 1 million American adults are now living with congenital heart defects, according to the National Institutes of Health. Spina bifida, the incomplete closure of an embryo’s spine, leaves a portion of the spinal cord exposed, which leads to permanent damage to the exposed nerves. To prevent further damage, pediatric neuro-

dergo these screening procedures to give their unborn child the best possible chance for a happier, healthier and longer life. During their pregnancy, I tell them to cut out all alcohol consumption and stop smoking, and to eat a balanced diet. I tell other patients who may become pregnant to eat a healthy diet and take a folic acid supplement, which is proven to reduce the chances of birth defects such as spina bifida. I urge all of my patients to maintain a healthy weight, which is one of the most sensitive of all health issues. Between 60-70% of my patients are overweight, a much higher percentage than when I first became a doctor 25 years ago. Many do not see their weight as a health issue, despite clear evidence that obesity diminishes their quality of life, and leads to the life-threaten-

All women should follow the current age-based guidelines of the Centers for Disease Control for testing with pap smears and mammograms, and take advantage of today’s improved diagnostic and imaging tests, which can be potentially lifesaving for their unborn child and for themselves.

58

Dr. Natan Haratz-Rubinstein is a Fetal

and Pelvic Imaging specialist at New York Methodist Hospital and Director of the Advanced Women’s Imaging and Prenatal Testing Center. He is Board Certified in Obstetrics and Gynecology. He currently holds an academic appointment at WeilCornel Medical College and has in the past held academic appointments in the Departments of Obstetrics and Gynecology at SUNY Downstate Long Island College Hospital and Columbia-Presbyterian Medical Center. He has lectured nationally and internationally and has published numerous articles in his field. His office is at 506 Sixth Street, Brooklyn NY, and can be contacted at 718.780.5799.

February 2014


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1/16/14 9:46 AM


The Milton and Carroll Petrie Department of Urology Icahn School of Medicine

Welcomes

Ash Tewari, MBBS, MCh Kyung Hyun Kim, MD Chair in Urology Chair, Milton and Carroll Petrie Department of Urology, Professor, Urology

n Internationally renowned prostate cancer robotic surgeon and prostate cancer researcher n Pioneered ART™, nerve-sparing surgical technique to preserve sexual and urinary function n Over 5500 robotic prostate surgeries performed; outcomes considered amongst gold standard n Large and innovative active surveillance program (wait to treat) n Targeted biopsy protocol for more accurate diagnosis n Author of over 250 articles and textbooks on prostate cancer and robotic surgery

To schedule an appointment with Dr. Tewari, please call 212-241-9955 Ext. 2 or visit www.mountsinai.org/roboticprostate


H&l february 2014 low res