Page 1

A Publication of

Inflated, Overpriced American Medicine Page 8

Starting Braces Page 12

Nutrition and Food

Aging Gracefully Page 18

Mind, Body & Soul Inside

SEE INSIDE

SPECIAL

Subscription Offer

Page 31

What are we really eating? Page 34

May 2014


CONTENTS A publication of the Jewish Press, publishing since 1960

Supplement Publisher

RAISING OUR CHILDREN 10 The Dangers of Declining

Senior Editor

Yaakov Kornreich

Amy Dubitsky Avigayil Perry Leah Rothstien Ita Yankovich

Face Time

12 Braces? Appliances?

How Do I Know?

Our Kids’ English

12

13 Bilingual Nannies and Dentist

WOMEN’S HEALTH 14 Help for the Too-Busy Woman ✪ 16 All About Massage

My child has crooked teeth – help! At what age do I take him to an orthodontist?

Heshy Korenblit

Advertising Sales

Arthur Klass David Hoppenwasser Shaindy Urman

Women

Design

Alana White

Challenges for a New School Year

The Quest for Longevity

Among Seniors

and their Doctors

24 Smartphones, Apps, Help Seniors

August 2014

MIND, BODY & L SOU

H&L TECH

24

Mind, Body & Soul Inside

A Mental Health

22

Magazine

STARTING OV

eyser Joe M 0 at 10

ER

In Collaboration With:

A Publication of

SEE INSIDE

AUGUST 2014

SPECIAL

Depression

Subscription Offer

Page 31 59

5

COMMUNITY PROFILE

Far more seniors are depressed than you realize. Learn to recognize the signs and symptoms, so you can get help faster.

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HEALTHY LIVING

18 Aging Gracefully 21 Writing a Will: It’s Critical 22 Depression Too Common

Joe Meyser, a Pre-World War II pilot, Then and Now

Are we Prepared for the Next Epidemic?

Too busy and tired to eat well and exercise? Tanya’s heard it all. Cut the excuses and let her help you get healthy now!

GOLDEN YEARS

A Publication of

Tips for a Healthier Yom Tov

MEDICINE TODAY

Advertising Coordinator

GOLDEN YEARS

14

18

Advertising Director

WOMEN’S HEALTH

Associate Editor Rachel Wizenfeld Features Editor Ita Yankovich Contributing Writers:

Inflated Medical Billing

RAISING OUR CHILDREN

Moshe Klass

8

The murky swamp 8 of healthcare billing is confusing us – and overcharging us. Find out how.

ISSUES

ISSUES

INTRODUCTION

INTRODUCTION


INTRODUCTION

INTRODUCTION

GOLDEN YEARS

WOMEN’S HEALTH

RAISING OUR CHILDREN

ISSUES

28

MEDICINE TODAY

th AND

MEDICINE TODAY

The cover story of this edition of Health & Living looks at the contro26 Botox Not Just For versies surrounding the health and Wrinkles Anymore safety of our food supply, and sug27 New Heart Procedures Help gests a common-sense approach for Patients Live Longer… and Better confused consumers. 28 Pain Pills are an Easy We explore the impact of new But Dangerous - Choice technology on the doctor-patient All Care Pills vs. physical therapy: which is relationship, and ask whether the 29 Home Medical Tests: Safe? better for lasting pain relief? hours our children spend online Accurate? Or Nonsense? with social media and playing video 30 FDA Cracking Down on games is depriving them of the pa42 E-Cigarettes ✪ rental face time they need to devel31 Pharmacy Techs - The Unsung op basic social skills. Heroes Behind the Counter ✪ From the frontiers of medical research, we report on a promising 33 What’s the Worst That Could Happen? Genetic Testing for Jews ✪ new treatment for cardiac patients. We offer sound guidance for parents on issues they face raising their Cover Recipe Page children, and insights to help our seStory HEALTHY LIVING BBQ time! Get fast, 34 In Hot Pursuit of Good Nutrition niors get the most out of life by agfresh summer recipes. ing gracefully. 38 Vitamins are Good for You…Right? Whatever issue or development Living Service Marketplace44 40 Oil Pulling: The Trick for arises which impacts the health and Kids of Courage ✪ ADDICTION RECOVERY 445 Central Ave, Healthy Teeth welfare of our community, you will Suite 216, Cedarhurst, NY, 11516 Recovery Road 516.612.8844 • www.kidsoc.org 4382 Northlake Boulevard, Suite 109 An innovative, all volunteer organization dedifind it discussed here in the pages of Palm Beach Gardens, FL 33410 41 cated to improving the lives of sick children and Say Cheese! 10 Bites About this 888.899.8301 • RecoveryRoad.com their families. We offer year round programming Health & Living. Clinical excellence paired with an as well as an annual ski weekend and a medically Dairy Delight unmatched approach to treating Jewish men suffering from addiction.

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CONTENTS

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DENTISTRY

Showcase

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

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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.

May 2014


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INTRODUCTION ISSUES RAISING OUR CHILDREN WOMEN’S HEALTH

Inflated, Overpriced? American Medicine By Elisheva Stein By Leah Rothstein

H T

? he health care system in ? America is in flux right now as Obamacare increases the number ??? of insured Americans. The next frontier that we will have to deal with to keep the system functioning is to create transparency and fairness in healthcare prices. Even though the numbers of insured people are finally rising, the price of medical care is often out of control. Hospitals charge $10 for a single tablet of Tylenol. Medical bills are packed with vague items like multiple “administration fees” after a short and simple doctor’s visit. A bed frame support for a hospital bed in a North Carolina hospital came with a daily charge of $245.50, when home health equipment rental companies charge only $20 per month for the same item. If the patient is insured, insur-

ance companies may pay their fees, but the bloated system is not improving anyone’s care and is certainly not lowering their premi-

have been many complaints about insurance companies narrowing provider network options in the past few months.

ums. And what about patients who are still uninsured, or who have to go out of network for care? There

Hospital mergers are another big driver of rising costs. A key principle of the American free market system is the ability to share information about prices, so that competition keeps things balanced. Some studies have estimated that prices of health services in a region following a hospital merger rise by an average of 20%. Emergency rooms are sometimes the worst offenders, because patients turn up there in a hurry and cannot shop around for the best prices, eliminating the pressures of business competition. A tr ip to the ER to get a few stitches

HEALTHY LIVING

MEDICINE TODAY

GOLDEN YEARS

RAISING OUR CHILDREN ISSUES

SHEDDING A LIGHT ON MURKY MEDICAL COSTS Part of the reason why the pricing of health care is such a mess is that most hospitals and doctors don’t publicize what they are paid for services and how prices change depending on who is paying. It’s hard for patients to negotiate when they don’t have a price point to compare to in order to determine an appropriate amount to request. There are some resources that attempt to help, but for the most part the estimates available are only a rough guide and a starting point for negotiations. Major insurance companies offer tools to help their customers research prices, including WellPoint, UnitedHealth Group Inc, Humana, Aetna, and Cigna, but they don’t include every option. Some states are collecting databases of insurer data and various nonprofits are trying as well, including the Leapfrog Group, which is known for its hospital surveys. A website that helps price specific procedures is https://www.healthcarebluebook.com/, which also allows you to customize your results based on location. http://www.newchoicehealth.com/ allows you to get detailed no-obligation quotes from local health providers and to read other patients’ reviews, regardless of your insurance type. https://www.healthinreach.com/ lets you compare doctors.

H&L TECH COMMUNITY PROFILE

can cost between $1500 and $2230. A patient in Lansing, Michigan complained that he was charged $145.20 for “pharmacy,” which in their case was just ibuprofen and local anesthetic, as reported by the NY Times last December. The current pricing model, in which doctors are paid per service, provides incentives for doing more procedures even if they are unnecessary and wasteful. A Journal of American Medicine report said that such wasteful procedures may have cost Medicare up to $8.5 billion last year. For example, advanced imaging tests are extremely common even for run-of-the-mill lower back pain, and defensive medicine like pre-operative x-rays is often done (exposing patients to extra radiation) just in case of a lawsuit rather than for any medical benefit. Other unnecessary procedures include early elective maternal deliveries without medical necessity. The American College of Obstetricians and Gynecologists (ACOG) determined as long as 30 years ago that induced labor and caesarians were too risky without medical necessity, and have continued to advise against them, yet rates remained high. According to a report by the hospital quality watchdog The Leapfrog Group, the rates finally began to drop just after they

8

May 2014


?

H

? ?

RAISING OUR CHILDREN

???

ISSUES WOMEN’S HEALTH

cause many insurance companies have recently been eliminating many options from their provider networks, further narrowing their choices. Regardless of one’s opinions about the Affordable Care Act, we should all be able to agree that those who must pay out of their own pockets for health care have a right to know in advance what they will be charged. That will enable them to make an informed choice among providers, and make providers think twice before arbitrarily raising their prices. Greater transparency is the best way to enable patients, both insured and uninsured, to become their own advocates and not get stuck with the results of the flaws in health care.

By Elisheva Stein

INTRODUCTION

RAISING OUR CHILDREN ISSUES

Leah Rothstein lives in Elizabeth, until they have met their policy’s deductible. The consumer is at even more of a disadvantage be-

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

MEDICINE TODAY HEALTHY LIVING H&L TECH

9

COMMUNITY PROFILE

May 2014

individual details and possible complications when it comes to treating human beings. But for someone trying to choose which hospital to go to for a procedure, just try to find out the price and you will see how overcomplicated and mysterious the medical pricing system has become. For example, amniocentesis at the UCSF Medical Center costs $1600, but only $687 at California Pacific. But a bag of IV fluid at California Pacific is $137 while at USCF it costs only $16. There is a huge disparity even between similar patients’ cases: each insurance company pays for medical procedures differently than the next, differently than the government, and differently for the uninsured. Even the same insurance companies will pay different amounts for the same procedures coming from different health care providers. The expansion of health insurance coverage to millions of more Americans through the Affordable Care Act (also known as Obamacare) has not eliminated the need to encourage open pricing that would enable price competition among health care providers. Even those with insurance coverage must still pay their health providers out-of-pocket

GOLDEN YEARS

started publicizing the data on early elective maternal delivery, and the increased transparency put public pressure on hospitals and helped create real change. According to Leapfrog, 71% of hospitals that Leapfrog surveyed met their goal for reducing elective early deliveries in 2013, a vast improvement over 2012 when only 46% did so. The truth is that a lack of transparency is the biggest problem when it comes to the high price of health care. It’s easier to research the price of getting a new smartphone than it is to find out how much a surgery will cost you. Some studies have shown that private payers get charged four times as much as insurance companies. But people who pay in cash up front can get steep discounts, sometimes even more than the insurance companies get. Insurance companies have obviously not been enthusiastic about publicizing this information, but it can lead to considerable savings for individuals. Some patients prefer to pay privately for some procedures even if they are insured, when the co-pay costs more than the discounted individual full payment. No one expects a surgery to be as simple to price as a consumer product, since there are more


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

RAISING OUR CHILDREN

Declining Face Time: What is the Impact on our Children? By Dr. Joshua Weinstein

O

ur Torah tradition tells us that we parents and teachers are influential role models to our children. The rabbis of the Talmud long ago explained, for example, that a child speaks in the market square the way he heard his parents talking at home. Psychologists also tell us that the model we as parents present influences even our youngest children. In a poll conducted by The Wall Street Journal in 1999, “moral decline” was identified as the principal problem that America will face in the next twenty years. And when asked what the biggest change in American character has been since the 1950s, the leading answer was “less stable marriages and families.” That was fifteen years ago and it has taken that many years to creep into our Jewish society as well in many shapes and forms. Unfortunately, the weakening of Jewish family values has been a crucial factor in the moral decline that has been observed in a disturbingly large number of contemporary Jewish homes. This is because children learn moral values mainly within their families, and largely from their parents as role models. When society at large has such enormous problems, it is inevitable that they will impact Jewish families as well, no matter how insulated the community is. Many children may become insecure, when parents are emotionally detached, or distant, or when it becomes apparent to them that their parents are dishonest. This affects

the learning of moral values by children and greatly hinders their ability to function in school and within our society. When asked about the greatest challenge he faces, the principal of one of the largest Jewish high schools in the United States related this complaint: Parents spend thousands of dollars a year in tuition to send their children to our school where, along with calculus and chemistry, we are expected to teach some aspect of ethics. Then, on Sunday, the parents take their child to an amusement park and lie about his age in order to save five dollars on the admission fee. To save five bucks they undermine a $15,000 education. Then there is the issue of social media, video games, computers and smartphones, which are so very prevalent in our midst. According to a 2005 Kaiser Family Foundation study, American children between ages 2-17 spend more time using screen media than participating in any other chosen activity, including outside play. Granting them free access to the home computer increases the child’s total amount of screen time, resulting in decreased face-to-face interaction. Modern children just are going to the playground much less frequently because they’re busy online. These children are missing out on the social benefits of live play such as learning how to share and cooperate, which they cannot get from watching an electronic screen. This study was done ten years ago in the general population, and we know how

Technology has permeated every corner and every minute of our daily life and that of our children’s. According to a 2005 Kaiser Family Foundation study, American children between ages 2-17 spend more time using screen media than participating in any other chosen activity, including outside play. This study was done ten years ago in the general population, and we know how much more time children are now spending with laptops, iPads, iPods, iPhones, and other electronic devices in most homes today. Besides reducing face-to-face playtime duration, these computer-related interactions may alter the way in which children emotionally understand others. Many a researcher and educator has voiced concern about technological contact terminating the relationship and sensitive feedback of face-to-face communication.

Key Points

much more time children are now spending with laptops, iPads, iPods, iPhones, and other electronic devices in most homes today. Besides reducing face-to-face playtime duration, these computer-related interactions may alter the way in which children emotionally understand others. Many a researcher and educator has voiced concern about technological contact terminating the relationship and sensitive feedback of face-toface communication. So what about the Jewish community? We all know that despite many efforts. the world of social media has indeed had an effect on many of our children. Everybody with a laptop or smartphone and “followers” or “friends” on a social media site, such as Facebook and Twitter, can effortlessly spread his ideas—good and bad, meaningful and insipid—to thousands. And all that texting by our children, no less, has hit all over the spectrum of our communities. This is specifically alarming for Jewish parents trying to contain the digital world their children live in. In his book At Risk – Never Beyond Reach, Rabbi Daniel Schonbuch tells the story of a boy named Moshe who had been kicked out of three schools before his parents came to him for therapy. Frantic, tired, and on the edge of hopelessness, his parents asked Dr. Schonbuch for a “magic pill” for Moshe’s at-risk behavior. After some thought, Dr Schonbuch presented the following reply: “The magic pill for at-risk behavior is building a relationship with your child. Independent of what you are going through and how far he has gone astray, you need to go the extra mile to make sure they know you care and you will always be in their life.” To state the fact more clearly, parents and teachers alike should become more familiar with a special four-letter word which can make a great difference in their child’s futures. And that word is LOVE. It’s a simple formula that helps parents and teachers have a

10

positive approach with their children. The more relationship you have with your child, the greater impact you will have in their life. The point of this article is not to address the problems of our yeshiva system, although that is directly related to the issue of declining face time. However, what is clear is that in many yeshivas today there is a decline in face time and “ahava”. They only want to accept kids that they expect will be able to sit in large classrooms listening to one rebbe, and rely little on the teacher for their personal, intellectual, or emotional needs. The truth is that today we have a child who is raised in a whole new social atmosphere, and some homes and many yeshivas are not attuned to handle them effectively and educationally. Today, a large and growing percentage of our children don’t fit the regular mold of students our yeshivas were designed for. Many children require individual attention, smaller classrooms, lessons and homework sheets suited to their needs, and a rebbe and menahalim that care more about them than their marks. Many of our children need more personalized attention, visuallybased instruction, and rebbes who are able to compliment and bond with children. The problem is that many rebbes don’t necessarily fit the mold. And I agree with Rabbi Schonbuch when he says, “Our yeshivas mistakenly offer an education that doesn’t reflect the dictum “Chanoch lenoar lefee darcho” - to educate a child according to their way. Unfortunately, too many yeshivas maintain a “lefee darcheinu” attitude, meaning “it’s our way or the highway.” Therefore, faced with the existing problems in many homes of declining face time and lack of bonding, in addition to the rigid approach of many yeshivas to students who don’t fit the mold, a serious problem exists. Technology has permeated every corner and every minute of our daily life and that of our children’s and accelerated the pace of change in society. Furthermore,

May 2014


Joshua Weinstein has been an educa-

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MEDICINE TODAY

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GOLDEN YEARS

tor and administrator for over four decades. He holds a Ph.D., two Masters Degrees in educational administration and supervision, and an MBA in executive administration. He has been the CEO in healthcare, social services, and business corporations. He’s the president and founder of Shema Kolainu-Hear Our Voices, ICare4Autism and also Benjamin House, which advocates for families and children. He can be reached via email at jweinstein@skhov.org.

WOMEN’S HEALTH

time with their parents. Inevitably, children emulate others, and if we want them to be raised with the outlooks we would hope to express, we must not allow figures in the popular culture whose lives leave much to be desired to be their dominant influence. The Torah has been the educational primacy for Jews for thousands of years. It has effectively

inculcated in us the yearning for learning and great achievement. We are known as “the people of the book.” Torah has been an inspirational element for our people. Therefore, Torah teachings are even more significant today. Let us not consign it to the past. Quality Torah education for our children, which includes, love and attention and sufficient positive face time, must be our single highest priority.

RAISING OUR CHILDREN

creativity is often sparked by the impact of ideas from different disciplines and philosophies. The commentaries urge us as parents to keep a balanced mood in the underlying issue affecting our children, who are profoundly impressed by the things that their parents are passionate about. This applies for both good and for bad. For instance, what a child sees his parent get upset over, makes a strong impression on him. If a parent is driving, and a traffic slow- give value to these character traits down causes the parent to get irate and it will impact him as well. and put everyone’s life in danger We as parents must always know with short stops and fancy maneu- that we can’t live in vacuity. If we do not provide Torah values and vers, the child learns from that. On the other hand, if a child real- mitzvah observance to our chilizes that a parent conducts himself dren, then other moral values will with patience and self-control, then take their place. They are already the child will learn from this, and surrounded by negative influences the positive lesson will take its place in the popular media and what they9:42need is more positive face NYM-Jewish Press 10 x 7_NYM-Jewish AM Page 1 in his subconscious. The childPress will 3/26/14

ISSUES

“Unfortunately, the weakening of Jewish family values has been a crucial factor in the moral decline that has been observed in a disturbingly large number of contemporary Jewish homes. This is because children learn moral values mainly within their families, and largely from their parents as role models…”

INTRODUCTION

RAISING OUR CHILDREN

H&L TECH

11

COMMUNITY PROFILE

May 2014


INTRODUCTION ISSUES

RAISING OUR CHILDREN

Braces? Appliances? How Early Should I Start? By Dr. Chaninah Zweihorn

M

COMMUNITY PROFILE

H&L TECH

HEALTHY LIVING

MEDICINE TODAY

GOLDEN YEARS

WOMEN’S HEALTH

RAISING OUR CHILDREN

y child’s new adult teeth are crooked; does she need braces

now? Why does my son have that space between his two front teeth? Will it close on its own, or do we need early intervention? These are common concerns for parents of younger school-age children. As baby teeth are replaced by “permanent” teeth, the resulting mismatched appearance—familiar little baby teeth alongside larger, unfamiliar permanent teeth—can be a source of anxiety for parents. Fortunately, though, there is usually no need for worry. Most young children do not need orthodontic intervention. Minor spacing of the upper front teeth and somewhat crooked lower front teeth are normal and will typically improve in time as more teeth change over. Pa-

rental instincts, however, are correct in that the arrival of new permanent teeth marks an important time of transition in a child’s dental development. That is why the American Association of Orthodontists recommends that seven year olds have a first visit with an orthodontist. Subtle orthodontic problems can be picked up early and a plan of action can be formulated. In fact, when dentists refer young children for an orthodontic evaluation, it is often for issues that are not typically noticed by parents: one jaw that is somewhat too large or too small for the other; teeth that appear to be growing in the wrong direction; or back teeth arranged in a bad bite. While crowding and spacing of new permanent front teeth are easy to notice, this age is also the time when important, potentially overlooked back teeth—the “permanent first molars”—make their

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appearance. Often called “six-year molars,” these teeth first establish how the permanent teeth will fit together in the bite. Dentists looking at the fit of the first molars can detect the beginnings of a bad bite. But what can be done? Would you really put braces on a seven year old with only a few adult teeth? And if these kinds of problems are not so obvious, then how harmful could they be anyway? Let’s answer these questions by defining interceptive orthodontics. Interceptive orthodontics is the use of treatment strategies—not limited to braces alone—for preventing early problems of jaw or tooth development from becoming more severe. For example, in one type of bad bite called a functional crossbite, a child needs to shift the jaw to one side in order to get the bite to fit together. This activity over time and during periods of growth can lead to detrimental permanent changes in the jaw. While this problem might be addressed by partial braces, braces are not always needed at this early stage. An orthodontic appliance called an “expander” might be placed in the roof of the mouth for several months. Gentle expansion of the palate and upper jaw is highly successful in eliminating the bad bite and jaw shift. This type of treatment is commonly indicated for children as young as eight years of age. Expanders also have other uses related to their ability to widen the upper jaw. They can provide additional space in the jaw for adult teeth to grow. Expanders can enlarge the upper jaw to better match a significantly larger lower jaw; many children can thereby avoid severe jaw problems and surgery in their teen years. There is even some evidence that palatal expanders can improve nasal breathing. Other appliances frequently used include headgear (“night braces”) and removable appliances (sometimes called “bite plates”). Removable appliances resemble the retainers worn by older children after braces, but include small springs or other devices designed to gently move teeth into place. Removable appliances can be helpful even for six and seven year olds.

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Very often parents come to the office requesting one of these appliances, saying things like, “I want my son to have an expander - his sister had one and it made a dramatic difference.” This information is certainly useful for the practitioner, but no one appliance is a miracle cure. Something that worked perfectly for one child may be ineffective for another. A specific appliance will only be prescribed by the orthodontist when truly necessary. In fact, the most common course of action taken for young children is to simply watch and wait, with no early intervention planned. This is because some orthodontic issues, as mentioned before, will typically resolve on their own, and other problems are best addressed during adolescence. In many instances of crowding, for example, treatment should not start until most adult teeth are present. This usually means waiting until the pre-teen or teenage years. Starting treatment too early may extend treatment for many months with no added benefit. So how will a parent know if early orthodontic treatment is right for a child? And how does one find a practitioner qualified to provide interceptive treatment? Your family dentist or pediatric dentist will refer you to an orthodontist if they suspect a need for interceptive treatment, or if you express such concerns. Orthodontists have an additional two to three years of training after dental school and can recognize and address orthodontic problems in young children. Most orthodontists welcome young children to their practices, and many offer free consultations. Whether or not any interceptive treatment is recommended, you’ll be glad to have your answer after a short consultation. Dr. Chaninah Zweihorn is in private

practice in Brooklyn and Queens, and is an assistant clinical instructor at Mount Sinai Hospital. He received his Doctor of Dental Surgery degree (DDS) and subsequent orthodontic training at New York University. Dr. Zweihorn treats both children and adults with a focus on treatment planning and quality of care. He can be reached at 718.435.3393 or office@DrZweihorn.com.

May 2014


By Judy Nussbaum

T

H&L TECH COMMUNITY PROFILE

speech-language pathologist who received her Certificate of Clinical Competence (CCC) from the American SpeechLanguage-Hearing Association (ASHA). Judy also holds a Teacher of Students with Speech and Language Disabilities (TSSLD) license. Judy has extensive experience addressing speech, language, socialpragmatic, reading, stuttering and feeding difficulties in children ages 0-7 and conducts speech-language-feeding evaluations and treatment for children and adolescents throughout New York City. She can be reached at NussbaumJudy@gmail.com.

HEALTHY LIVING

13

Judy Nussbaum is a NYS-licensed

MEDICINE TODAY

forcements such as Rosetta Stone or tutoring through an ESL teacher or speech therapist. I often include both parents and caregivers my sessions with children to demonstrate to them how to carry over “homework” activities and reinforce the child’s language goals. One nanny I worked with, Jennelyn L., had accepted a position caring for twins with developmental delays. A native of Trinidad who primarily spoke Trinidadian Creole, she was forewarned about the special needs of the children and agreed this would be something she could manage. Jennelyn proactively sat in on

GOLDEN YEARS

But while bilingual exposure may be beneficial for a typical child, a child with speech delays and disorders or other special needs may suffer from a lack of modeling of their primary language. A child with special needs usually needs more reinforcement in their primary language in order to fully master it. However, the question of whether you should promote bilingualism or not is less important than how to create the most languagerich environment possible. Does it matter if your child’s nanny has “mastered” English or not? Will speaking in broken Eng-

speech therapy sessions and reinforced the language goals during her time with the children. Although her primary language is not English, she demonstrated the ability to speak exclusively in English when talking with the special-needs twins to help them both improve their ability to communicate in English. Here are some suggestions to help your caregiver facilitate language acquisition in any language: a Spend time reading! Story time enhances communication skills and memory and is a natural vocabulary builder. If you’re concerned about your nanny’s “foreign tongue” English, choose simple picture books with repetitive phrases. If she cannot read the text, encourage her to simply describe the pictures in 1-2 word phrases. a Something as simple as narrating what your child is doing (“Feed baby; Night-Night baby”, etc.), expanding on what a child says (e.g., “ball” → “ball bounce!; Throw ball!”), or narrating multistep directions (e.g., “Wake the baby up and feed her a bottle!”), is highly beneficial for language development. a Be proactive about this on YOUR time, too! Show your caregiver that you take these lessons seriously and they’ll be more inclined to practice these tactics daily, too! Provide a good model for what your expectations are. a Be realistic with your expectations. Communication and language-learning should be meaningful, enjoyable and fun for the whole family.

WOMEN’S HEALTH

May 2014

lish affect your child’s language development? As a speech and language pathologist, I find that what’s most important is a nanny or caregiver’s ability to listen to YOU and follow through with your wishes. If you are concerned about your nanny’s language skills, you can try English-language rein-

RAISING OUR CHILDREN

oday is a different century than it once was. Many parents are not given the luxury of choosing whether to work or not, especially considering the high cost of Jewish living. Time to enter the consuming world of hiring and managing childcare providers. However, what may feel like endless hours spent on background checks, interviews and checking references, all become worth it when you find a caregiver you can trust to care for your brood as they would their own. In the first few months of a baby’s life, the ability of caregivers to keep our little ones “alive,” will suffice. But soon those basic life-preservation tactics are not enough, as children begin to grow into little communicative creatures and seek out verbal interaction and engagement in their immediate surroundings. We normally expect that caregivers be trained in CPR and first aid, as they are responsible for the day-to-day safety and care of children. Shouldn’t it make sense that caregivers also receive extra training on how to best reinforce language development in a child, particularly in one who has language delays or special needs? Neural plasticity, the brain’s ability to adapt and re-circuit pathways of the brain, is at its peak during early child development. Therefore, adequate exposure to a child’s primary language is crucial to gain lifetime fluency. Bilingualism may become a necessity when one or both of the child’s parents may not be fluent in the dominant language of their country. However, for many families, bilingualism is a family choice. Many parents choose to expose their child to another language, even if they don’t speak the 2nd language themselves. Being a bilingual speaker has cognitive and academic advantages, in addition to helping promote cross-cultural communication and understanding. It can also bond a child with

the heritage and culture of their family. If parents don’t speak a second language, bilingual caregivers can provide that crucial exposure. If that’s an option for you and you hope to foster bilingualism in your child, encourage your caregiver to provide full immersion in the given language.

ISSUES

Do Bilingual Nannies Hurt or Help Our Kid’s Language Skills?

INTRODUCTION

RAISING OUR CHILDREN


INTRODUCTION ISSUES

WOMEN’S HEALTH Trim & & &Fit

Help for the Too-Busy, Unhealthy, Unfit Mom

By Tanya Rosen

HEALTHY LIVING

MEDICINE TODAY

GOLDEN YEARS

WOMEN’S HEALTH

RAISING OUR CHILDREN

“I

’m too busy to exercise and eat healthy.” Does this sound familiar? Do you hear this from people, or are you yourself guilty of this statement? As a nutritionist and trainer, I certainly hear this a lot, and I realized that: guess what? There is no such thing. Yes, there are busy people and certainly women who “juggle it all” should get credit, but nowadays any woman can find ways to fit a healthy lifestyle into a busy one. Below are some suggestions:

FITNESS FOR WORKING WOMEN:

 Many gyms offer a 30-minute lunchtime class. Check your local gyms and aim for two to three times a week to start, with the goal of eventually increasing.  If your building has stairs, aim to go up (and of course down) three flights of stairs four times a day. This can be divided throughout the day and does not have to be done all at once.  Wake up 30-45 minutes earlier and do a fitness DVD at home. Again, this does not need to be every single day. Aim for two to three times a week to start.  In warmer seasons, walk to work (at least one way).  Invest in a stability ball chair for your desk. This is a great new product that has become available. It looks like a stability ball but has a chair back to it, just like a regular chair. By sitting on this chair, you engage your core all day and burn calories at the same time.

You can do 15 minute segments at a time, for example.  Invest in a stability ball. You can sit and bounce on it while you watch your kids play, engaging your core, and burning calories. Whether you are a stay-at-home mom or a working woman, realize that while fitting exercise into your routine may seem like a burden, or even tedious, it will give you energy and you will feel great once it is done. As with anything in life, for it to work out, it has to be planned and scheduled. Do not wait for the perfect moment; create it by penciling it into your (already-packed) appointment book, or a fridge magnet reminder.

HEALTHY EATING FOR BUSY WOMEN:

 Write out a menu for the week. If you are not sure what you will be in the mood for, put in a few options but stick to the core of the plan.

 Make a shopping list in the beginning of the week based on that menu and shop on Sunday or whenever you have time, so that you will be fully stocked.  Whether you work or stay home, keep easy-to-grab healthy snacks in the refrigerator so that they are easily accessible. Some examples would be baby carrots, individual packs of hummus, string cheese, and cut-up veggies and fruits. Place these items at eye level and make them easy to reach.  If you do not have much time to cook during the week, make a pan of chicken in the beginning of the week and heat up one piece per night. When you run out, make a second pan and do the same, or make fish instead. Frozen vegetables which take just a few minutes to cook and sweet potatoes make great sides.  Always prepare the night before. When I used to take 6am clients for personal training, I would

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H&L TECH

FITNESS FOR STAY-AT-HOME MOMS:

 Take your baby or toddler along to your workout! There are many options such as groups of moms that walk with strollers, mommy and me groups that provide workouts for mom and child, and gyms that will babysit while you exercise.  Wake up earlier than the kids and do a workout DVD at home. You do not have to do it all at once.

literally put the coffee powder in the cup so that I just had to add hot water in the morning. You can cut up a salad in advance (just do not mix), toast your whole wheat bread, make a sandwich, and even peel the vegetables for tomorrow night’s dinner.  Involve the family. If your kids are old enough, give them tasks such as making a salad, making a healthy dressing, or washing some fruit. This will take some work off you, make them feel responsible, and teach them good habits. Finally, I will say that as women we tend to take care of the whole world before we take care of ourselves. If one of your kids or husband or even a coworker asked you to do any of the above for him or her, it would get done. Somehow, when it comes to ourselves, we find reasons to stick to the old, easy (and not as healthy) way. Remember that a healthy woman is a better mother, wife, and employee. Best of luck! Tanya Rosen M.S. C.A.I, C.P.T is a nu-

tritionist, personal trainer, and aerobics instructor. Tanya is the owner of Shape Fitness in Flatbush and is the creator of the Shape Fitness Kosher workout DVD series, available for ladies and teens. Tanya can be reached at tanyashape@gmail.com.

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May 2014


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INTRODUCTION ISSUES

WOMEN’S HEALTH

Massage Comes with All Types and Health Benefits By Shaindy Urman

COMMUNITY PROFILE

H&L TECH

HEALTHY LIVING

MEDICINE TODAY

GOLDEN YEARS

WOMEN’S HEALTH

RAISING OUR CHILDREN

F

or thousands of years, massages were known to be a soothing and enjoyable way to unwind and feel good. A natural and highly efficient de-stressor, massage has the ability to ease tension and relax the entire body through the soothing sense of touch and subsequent chemical release that occurs throughout the body. As everyday stresses increase in our modern society, massage has been increasing in popularity in just about every area of the world. But the benefits of massage are so much more than simply stress relief. In recent years, studies have shown that massage is instrumental in improving psychological health, alleviating pain, enhancing immunity, increasing joint flexibility, lowering depression

and anxiety, improving blood circulation, reducing spasms and cramping, relieving migraines and headaches, improving lung function and air flow, and releasing endorphins – the body’s natural painkiller. As more and more people are recognizing the health benefits of massage, it is now being utilized, either alone or in combination with another form of treatment, as a therapeutic treatment option. Here are some of the most popular types of massage:

SWEDISH MASSAGE

The most common type of massage therapy in the United States, the Swedish massage is a whole-body therapeutic massage designed to relax muscles and joints. Using long, smooth strokes, massage therapists are able to improve circulation by

bringing oxygen and other nutrients to body tissues, thereby increasing flexibility and mobility, and reducing pain and stiffness. Swedish massage can alleviate a variety of ailments, including: back pain, respiratory problems, migraines, post-injury and post surgical rehabilitation, repetitive strain injury, arthritis and other inflammatory conditions, and stress-related conditions.

DEEP TISSUE MASSAGE

Deep Tissue Massage goes further under the surface than Swedish massage, targeting the deep tissue structure of the fascia and muscles. In this method, massage therapists use slow, deliberate strokes that focus pressure on layers of tendons, muscles, or other tissues deep under the skin, stopping to concentrate on specific problem areas that are in need of some extra attention. Deep tissue massage is commonly used to help with muscle damage sustained from injuries.

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SHIATSU MASSAGE

Literally meaning “finger pressure” in Japanese, Shiatsu Massage is a form of therapeutic bodywork in Japan that was developed in the early 1900’s as a result of a resurgence of Japan’s traditional medical therapies, including acupuncture and anma massage. Shiatsu uses varied rhythmic pressure on certain precise points of the body, called acupressure points, as well as kneading, pressing, soothing, tapping and stretching techniques. Benefits of Shiatsu include: increased blood and lymph circulation throughout the body, increased immune function, improved digestion, reduced muscle and arthritis pain, increased flexibility, and increased quality of sleep.

HOT STONE MASSAGE

In this massage, hot stones are placed on acupressure points, providing deeper muscle relaxation. The hot stones expand blood vessels, which encourages blood flow

May 2014


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COMMUNITY PROFILE

that massage can benefit health and wellness in a number of ways, including psychological health, pain, immunity, joint flexibility, blood circulation, reducing spasms, cramping, migraines and headaches, improving lung function and air flow, and releasing endorphins – the body’s natural painkiller. a A number of Americans are seeking out massage: a 2013 study found 21% of women and 11% of men reported having a massage in the past 12 months. a The majority received massages for medical and health reasons, such as pain management, injury rehab or overall wellness, while 32% had a massage for relaxation and stress reduction purposes. a Eighty-eight  percent of massage consumers agree that massage can be effective in reducing pain. Source: American Massage Therapy Association

HEALTHY LIVING

Rabbinic Committee: Rabbi Yoel Bursztyn, Rabbi Asher Brander, Rabbi Moshe Dear, Rabbi Shlomo Einhorn, Rabbi Reuven Hutler, Rabbi Yakov Krause, Rabbi Dovid Loloyan, Rabbi Elazar Muskin, Rabbi Adir Posy, Rabbi Nachum Sauer, Rabbi Kalman Topp, Rabbi Avrohom Union, Rabbi Yakov Vann, Chabad Sola, Orthodox Union, Yeshivat Yavneh, Yeshivat Emek. L.A. Planning Committee: Esther Bravda, Zipporah Coronel, Roz Eschwege, Michael Feinman, M.D., Deborah Goldenberg, Ahuva Goldstein, Yaron Hassid & Oranit Hassid, Tammy Katz, Karina Mann, Steven Presser, M.D., Abby Presser, Judy Millman, Evan Schlessinger, Eva Yelloz

Shaindy Urman is a freelancer writer

a In recent years, studies have shown

May 2014

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MEDICINE TODAY

Reflexology is a form of bodywork that focuses primarily on the feet. This form of massage is based on the theory that there are certain reflex areas on the feet and hands that correspond to specific organs, glands, and other parts of the body. By applying pressure to these particular reflex areas, it is possible to promote health in the corresponding organs as well. Reflexology massage is not only a good option for those suffering from ankle injuries, toe pain, plantar fasciitis, and common forms of arthritis, but also for those interested in a

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Thai massage, dating back over 1,000 years, has been compared to yoga. In fact, many people believe that Thai massage is like doing yoga without any of the work. This form of massage takes place on a mat on the floor, with the massage therapist using thumbs, palms, forearms, elbows, feet, knees, and shins to press and stretch the body. This energizing and rigorous form of massage stretches the muscles back to their normal resting length, relieving muscle tensions and spasms and restoring joint mobility. It is also instrumental in strengthening the internal organs, increasing energy, and improving neurological function. With all the many benefits in stress management, mood, and overall health, it’s no wonder then that massage is gaining in popularity. With over 100 different types of massages to choose from and a myriad of locations, from clinics to hospitals to spas to the comfort of your own home, the possibilities for improving your quality of life are endless. Consult with your doctor before seeking out massage therapy, and make sure you are seeing a competent, experienced massage therapist.

GOLDEN YEARS

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WOMEN’S HEALTH

Aromatherapy is the use of naturally extracted aromatic essences from plants, believed to have tremendous healing powers. When combined with a massage, aromatherapy can yield amazing results, and helps manage pain, fight depression and improve blood pressure, among other things. During an aromatherapy massage, essential oils are rubbed all over the body and allowed to soak into the skin. The oil can then travel throughout the body and have a healing effect on a specific body organ or function.

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RAISING OUR CHILDREN

AROMATHERAPY MASSAGE

supplement to traditional medical treatment for sinus pain, joint pain, and digestive issues.

ISSUES

throughout the body. The sedative effect of the heat, combined with a full-body massage, ensures deep relaxation, and can also relieve chronic pain and tension created by strained and contracted muscles.

INTRODUCTION

WOMEN’S HEALTH

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INTRODUCTION ISSUES

GOLDEN YEARS

The Art and Challenge of Aging Gracefully By Yaakov Kornreich

they pass, their departure should make those loved ones who are still ging is an inexorable meta- with us all the more precious to us. bolic process in which our Rather than allowing ourselves physical and mental capabilities to become obsessed with the fear gradually deteriorate as our bodies of losing our independence or the become more fragile. That is, to be rest of our physical and mental sure, an unpleasant prospect, but capacities, aging gracefully means most people believe that it is better being determined to fully enjoy than the alternative. those that remain, while we still There are various definitions of can. In other words, we must realwhat it means to age gracefully. On ize that now is the time for us to a surface level, it involves removing stop and smell the roses. the grey from your hair and using An example of someone who Botox and plastic surgery to keep managed to defy the physical proyour face looking younger than the cess of aging longer than most was rest of your body. a baseball pitcher named Leroy On a deeper level, aging grace- “Satchel Paige.” Born in 1906, he fully means finding the determi- was the dominant pitcher in the nation to keep fighting a stubborn Negro baseball leagues, but was rear guard action against the real- well past his prime by the time Jackization that life is a battle which all ie Robinson broke the sport’s color of us must inevitably lose. bar. By the time he finally reached 1/20/14 PM Page 1 MeadowParkAd_NEW_JP_4.25x5.625_color While it is healthy to mourn old the Major10:33 Leagues as a rookie playfriends and family members as er, he was 42 years old, well past

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MEADOW PARK REHABILITATION & HEALTH CARE CENTER

cal minor league team. Before games in which he was the starting pitcher, Paige would go out on the field and sit in a rocking chair in front of the dugout. He would then go to the mound and consistently find ways to frustrate and retire the far younger opposition batters who faced him. He loved publicity and freely

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the retirement age for most players. Nevertheless, Paige managed to keep pitching successfully in professional baseball, making his final appearance in a major league game in 1965, at the age of 59. I first saw Paige near the end of his long career. I was growing up as a baseball fan in Miami Beach while he was pitching for the lo-

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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.

WOMEN’S HEALTH

Yaakov Kornreich has been working as an Anglo-

RAISING OUR CHILDREN

May 2014

vating social relationships. But we also need to be prepared for what we know lies ahead. According to psychologist Dr. Mark Frazier, “To age gracefully, one needs to anticipate the changes that are inevitable. . . If you live until you’re 95 years old, you’re probably not going to be living alone in a beautiful apartment and driving your car to the grocery store and picking up your dry cleaning and walking a mile to the park. But if you know that ahead of time, it’s much easier to manage it.” Aging gracefully can be particularly challenging for women over 50, because our culture puts so much emphasis on their physical appearance, and because many will outlive their husbands, and suddenly find themselves alone at a difficult time in their lives. Almost a decade ago, Sue Ellen Cooper, now 62, started the Red Hat Society to develop more of a sense of camaraderie among women in that age group, and help them to feel better about themselves. Today Red Hat boasts 40,000 chapters around the world, which encourage their members to dress up by donning red hats and purple dresses to attend their social outings. Another possible solution is to encourage lonely seniors to develop a mutually beneficial relationship with a young child. Studies show that many children growing up in today’s twoincome families need more adult face time than their parents can give them. In such interactions, the child benefits from the one-on-one attention they need from an adult, while the senior benefits by sharing in the child’s excitement and joy of discovery while learning more about themselves and the world around them. There is no magic bullet for extending life expectancies, but gerontologist and psychologists agree that maintaining a positive and optimistic attitude by finding new interests, remaining active by engaging in regular physical activity, and eating healthy foods can help slow the rate of decline in the physical and mental health of the elderly. On the other hand, older people who have lost interest in the future and succumb to morbid obsession over the past tend to go downhill much more quickly. To extend the length and quality of the rest of their lives, such seniors need to find a new sense of purpose and zest for living to replace what they have lost, which is the essence of aging gracefully.

ISSUES

gave pithy advice when asked by sports writers about his secrets to defying his advancing age. Most of them boiled down to maintaining a positive attitude: “I ain’t ever had a job, I just always played baseball.” “Age is a question of mind over matter. If you don’t mind, it doesn’t matter.” “How old would you be if you didn’t know how old you are?” “Work like you don’t need the money. Love like you’ve never been hurt. Dance like nobody’s watching.” Finally, and most important: “Don’t look back. Something might be gaining on you.” I always admired Paige’s spirit, and strove to incorporate his positive attitude into my own approach to growing older. To this day, when strangers ask me how old I am, I like to tell them, “I’m a 17-year-old boy trapped in a 67-year-old body,” and then watch their reaction. But part of me is sincere when saying that. Sometimes, when I first get up in the morning and look around, I wonder, “Who is that old man in the mirror?” I know that someday my children will need to take away my car keys for my own good, and will probably realize that time has come before I do. I am still preparing myself to be able to accept that decision without complaint and somehow move on. Jewish tradition defines longevity, “arichas yomim” as a blessing. In addition to venerating the wisdom that comes with age, our tradition recognizes advanced age as a sign of underlying strength. Pirkei Avos says, “Ben shmonim l’g’vurah” – “Only the strong reach the age of 80.” Some seniors who are still physically able are choosing to remain active and vigorous in order to improve their outlook on life. One example is Kirt Spradlin, a great-grandfather who took up a new hobby after his retirement from electrical engineering: mountain climbing. He and his wife Donna, both now 80 years old, have climbed Mount Whitney and Mount Kilimanjaro, and still go on weeklong backpacking trips alone in the wilderness. Kirt says that “people think we’re nuts,” but as someone who has battled prostate cancer, he is undaunted by the risks of his active lifestyle and savors every experience that life still offers him. For those who are not interested in taking up mountain climbing in their golden years, another lesson that can be taken from Spradin’s example is the importance of finding new interests after retirement. We all need to keep looking forward to accomplishing new goals, which can be any thing we take satisfaction from, whether it is mastering intellectual challenges or culti-

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Writing a Will: It’s More Critical Than You Realize

can. Debbie’s home, however, must be renovated somewhat to accommodate her home health aide and to make it more senior-

A

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a While most people think of “estate

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planning” as something that only wealthy people do, estate planning is truly critical for everyone. It refers to a process of writing a will and other documents to anticipate how to care for yourself in illness and old age, who will care for your minor children in case of tragedy, who will receive your assets and possessions, and more. a If a person dies intestate, or without a will, the state government determines the distribution of his or her assets, which often does not reflect the person’s wishes. a Executing a secular will also mitigates halachic problems which arise from the Jewish laws of inheritance.

21

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May 2014

Greenwald/Weiss Continues on Page 23 ➙

MEDICINE TODAY

n AARP survey reveals that two out of every five Americans over the age of 45 do not have a will. Studies of younger age groups understandably find an even greater percentage – three out of every four people under the age of 34 do not have a will. Admittedly, sitting down to write a will is not the most pleasant of tasks, and most of us do not anticipate needing one until age 120. We are vibrant and oh-so-busy! Who wants to take the time to think through an unpleasant scenario? So we file the entire matter into the “when I get around to it” part of our brain and try to forget about it all. Legitimate as they are, these feelings will not offer an ounce of assistance in a time of need. The ramifications of an “unplanned” departure from this world can be serious. For many, the words “estate planning” bring to mind large inheritances and estate taxes. In reality, that is not the case, as estate planning is critical for everyone, regardless of income level or net worth. Such planning simply refers to a process which should include writing a will and related documents, anticipating how to care for yourself should you become ill or incapacitated, ensuring care for minor children, purchasing insurance policies such as life and long term care (where appropriate), and more.

GOLDEN YEARS

ment determines the distribution of his or her assets according to its established “family tree.” Each state has a set order of distributees – relatives of the decedent who qualify for distribution of assets in the absence of a will. Many states (New Jersey included) provide that a surviving spouse inherits the entire estate of the deceased (at least where neither spouse had children from a different marriage). New York, however, divides the estate between the decedent’s spouse and children in all cases, with the children entitled to almost 50% of the estate in most instances. This presumably would not reflect the wishes of most individuals. Moreover, while the laws may be quite logical, they do not take into account individual circumstances that can drastically change the manner the deceased would have chosen to distribute his or her assets.

If a person dies intestate, or without a will, the state govern-

friendly. Her husband, Irwin, recently died with an estate worth one million dollars but with only one hundred thousand dollars in liquid assets. Debbie anticipated receiving that amount and using it toward her home improvement costs. Regretfully, Irwin had never gotten around to executing a will. He was a New York resident, and accordingly, New York law governed the disposition of his estate. Under those laws their son Josh would inherit about half of the estate. Josh’s wife, Sylvia, has been waiting to use this inheritance money to finally redo her kitchen. She believes that Debbie should move into a nursing home (after transferring her remaining assets to her and Josh and applying for Medicaid!), and should not spend money on

WOMEN’S HEALTH

Consider Debbie, 87, who receives home care and would like to live at home as long as she

RAISING OUR CHILDREN

YOUR ASSETS

ISSUES

Brian (Baruch) Y. Greenwald and Hillel D. Weiss Greenwald Weiss Attorneys At Law, LLC

INTRODUCTION

GOLDEN YEARS


INTRODUCTION ISSUES

GOLDEN YEARS

Seniors Need to Watch Out for Depression By Ronen Fuksbrumer nfortunately, depression is prevalent among the elderly. But contrary to popular belief, depression is not a normal part of aging. Clinical depression is a disorder that effects mood, feelings, behavior and sometimes even physical health, and is diagnosed when sadness is persistent or begins to affect a person’s ability to function normally. It is not uncommon for people of all ages to experience bouts of sadness, but amongst the elderly the results can be particularly debilitating and life threatening. Some examples of the devastating effects of depression include an increased risk for cardiac disease and a reduced ability to recover from other illnesses. Increases in the risk of mortality and feelings of hopeless-

MEDICINE TODAY

GOLDEN YEARS

WOMEN’S HEALTH

RAISING OUR CHILDREN

U

Depression is often overlooked among the elderly, because it is hard to distinguish from other conditions or treatments which cause similar symptoms. Family members should look for the following signs in their loved ones: a Sudden or increased agitation or anxiety

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for their depression in a number of ways. Medications (antidepressants) and/or psychotherapy are the preferred techniques used by professionals to successfully treat their patients with successful results. Physical activity, staying busy by keeping the mind and body occupied, and maintaining social interactions through activities and time spent with family and friends can be key to warding off serious bouts of depression.

IF YOU SUSPECT A PROBLEM, WHAT SHOULD I DO?

a Lack of attention to personal care a Sleep disturbance a Loss of interest in normally pleasurable activities a Feelings of discouragement or hopelessness

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ness may dissuade older individuals from following their proper course of treatment. Depression is the most significant risk factor for suicide, and suicide is more common among older individuals than any other age group in the U.S. The elderly make up about 13 percent of the U.S population, but they account for 20 percent of deaths by suicide, according to the National Institute of Mental Health. Fortunately, depression is highly treatable.

Roughly six million Americans over the age of 65 struggle with depression. Physical and psychological factors that often accompany the aging process may contribute to depression among our seniors. Examples are: a Social isolation and loneliness a Onset of a serious illness like Alzheimer’s, Parkinson’s, stroke or cancer a The use of certain medications (which can trigger depression or worsen existing conditions) a Stressors like the loss of a spouse or close friends a Struggling with loss of independence a Living with a chronic medical illness a A change in environment, such as moving into a new home These factors can all trigger or increase depression.

TREATMENT

Patients – both young and elderly – can be successfully treated

22

a Talk with your physician. Explain how you feel and describe what is not normal for you. a Talk to a trusted friend, family member, or spiritual advisor. a If your elderly loved one is unwilling or unable to seek helps on their own, a family or close friend should.

TALKING WITH YOUR DOCTOR

a Have a list of all medications, herbal remedies, vitamins, minerals and supplements available. a Ask questions. Take a list if necessary. a Don’t be shy or embarrassed. Explain how you feel. a Remind your doctors and pharmacist about your medical history. a Ask for advice and instructions in clear writing. a Ask for a follow-up visit if all your questions cannot be answered during your appointment. A healthy mind contributes to a healthy body. Depression is a treatable illness and physicians and family members should not mistake it as normal symptoms of aging. Ronen Fuksbrumer is a rabbi with a

Master’s degree in applied clinical psychology and education from Columbia University. He is also a certified life/executive coach. Fuksbrumer is the Executive Vice President at Homecare Services of NY (HCS), a Licensed Home Care Agency that is licensed in the five boroughs and Nassau County. Fuksbrumer can be reached at 917.238.9393 or ronen@hcshomecare.com for any questions regarding homecare.

May 2014


Greenwald/Weiss Continued from Page 21 ➙

GUARDIANSHIP OF MINORS WITHOUT A WILL

MEDICAL POWER OF ATTORNEY/HEALTH CARE PROXY

POWER OF ATTORNEY

Who will manage a person’s finances, such as paying bills

Hillel D. Weiss are the founding members of Greenwald Weiss Attorneys At Law, LLC, a NY/NJ-based law firm focused on estate planning and related matters. If you have any questions relating to this article or would like additional information regarding estate planning, please visit www.greenwaldweiss.com or contact Mr. Greenwald at 718.564.6333 or bgreenwald@greenwaldweiss.com, or Mr. Weiss at 732.526.6333 or hweiss@greenwaldweiss.com.

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It is also extremely prudent for one to appoint an agent to make decisions regarding his or her medical care when he or she is unable to make such decisions. Observant Jews often will complete a Halachic Health Care Proxy, under which

Brian (Baruch) Y. Greenwald and

WOMEN’S HEALTH

Even more importantly, if minor children (under age 18) are orphaned from both parents without a will outlining who should be their guardian, a court proceeding is necessary to appoint such a guardian. Until the court proceeding is complete, the state’s department of social services will determine temporary foster care for the children – an unpleasant, traumatic experience during an already difficult time. The time and effort – and often, frustration – associated with any court proceeding should be noted. If there is also a dispute among the family as to who should be the guardian, the case becomes even more heartrending. By executing a will, parents can plan for the care of their most precious assets – their children.

the agent is directed to make decisions regarding medical and postmortem matters in accordance with Jewish laws and customs. A rabbi or organization with whom the agent should consult can be named within this document. Committing one’s wishes to writing in the form of appropriate estate planning documents is a true act of foresight and consideration. In our next article, we will focus on items that should be addressed, as well as opportunities and concerns associated with planning your estate in today’s “digital age.” This information is for general information purposes only. It is not intended as professional counsel and should not be used as such.

RAISING OUR CHILDREN

and handling business or investment matters, at a time when the person is not in a position to do so because he or she is cognitively incapacitated? While legally competent, a person can complete a somewhat simple document known as a Power of Attorney in which an agent is appointed to act on his or her behalf if the need arises. If one did not appoint an agent prior to becoming incapacitated, his or her family members would be unable to attend to his or her finances without commencing a guardianship proceeding in the appropriate court. The proceeding is often a timeconsuming and costly process, and could have been easily circumvented by completing a Power of Attorney prior to the crisis.

ISSUES

home restorations. Had Irwin executed a valid will providing that Debbie inherit all of his assets and that Josh receive his share only at Debbie’s death, Debbie would not be in this quandary. The laws also do not account for the halachic aspects of inheritance. It is important to note that halachic authorities differ on the validity of a secular will in beis din; some halachic authorities accept it, while others do not. But without any sort of validly executed will, there is absolutely no basis in halachah for an individual’s wife and daughters to inherit a portion of his estate (other than the amount required under the kesuba). Even if the sons of the deceased individual do not choose to go to beis din to challenge the intestate distribution, serious questions of gezeilah (stealing) arise if the wife and daughters simply hold on to the assets distributed to them. While executing a secular will does not completely eliminate concerns of a challenge in beis din (for that other halachic documents are necessary, the dis-

cussion of which is beyond the scope of this article), it does mitigate the problems.

INTRODUCTION

GOLDEN YEARS


INTRODUCTION ISSUES

GOLDEN YEARS

How Technology is Changing the Doctor Patient Relationship By Mutty Burstein

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W

e live in a very fast-changing society. For many adults 60 years and above, adjusting to some of the changes have been somewhat difficult. You’ve seen them: they’re the ones who have finally adjusted to using digital flip-open cell phones and now they face the challenge of smartphones. The smartphone has become an integral part of the modern lifestyle since first introduced around 2007. Now, less than a decade later, smartphone usage and applications have infiltrated every aspect of our society. In 2013, there were over two billion smartphones in circulation and over 1.2 billion people using smartphone applications. That number is forecasted to grow to 4.4 billion users by 2017. Seniors may not be able to resist adapting to these fastmoving changes. Already, certain cell phone providers will only service smartphones. Smartphones have the opportunity to profoundly change the way we, and especially seniors, interact with our doctors. According to Manhattan Research, over 90% of doctors surveyed in 2013 use smartphones and more than 70% used tablets. Smartphones allow users a cheaper, faster way to access data. Since the apps run on the same mass market smartphones and tablets that everybody else is using, the cost of this new technology is much less than the specialized medical devices it is replacing. And the built-in capabilities of a smartphone, include a microphone, a high-resolution digital camera, and a powerful computer processor, along with new apps which have been developed for medical uses, allow it to be used as both a diagnostic tool and to store your medical records. Now you can use your phone to diagnose a rash, monitor your heart or transmit urine test results to your doctor, who can then e-mail in a prescription to your pharmacy. Your problem is diagnosed, solved and rem-

edies prescribed all without a trip across town to the doctor’s office. Doctors are feeling a time crunch as never before as they rush through appointments to see more patients and perform more procedures to make up for flat or declining reimbursements from both government and private insurers.

tient relationship, a key ingredient of good care, and may represent a missed opportunity for getting patients more actively involved in their own health. Our society wants things faster and faster. The smartphone readily accomplishes this need. Patient lab results, EKG ratings and vital signs

mation and helping to ease communications among colleagues and healthcare facilities and their patients. When used correctly, advocates say, technology can facilitate stronger patient-doctor relationships, leading to better, more cost-effective care. This will also allow the doctor to spend more

It’s not unusual for primary care doctors’ appointments to be scheduled at 15-minute intervals. Some physicians who work for hospitals say they’ve been asked to see patients every 11 minutes. And the problem may worsen as millions of consumers who gained health coverage through the Affordable Care Act begin to seek care — some of whom may have seen doctors rarely, if at all, and have a slew of untreated problems. Wouldn’t it be nice if we didn’t have to spend the two hours traveling to the doctor’s office? And how about that hour wait just to be called inside for a few minutes? By all accounts, short visits take a toll on the doctor-pa-

- just to name a few - can now be transmitted directly to the caregiver and patient via the patient’s smartphone. In the past, the patient saw the doctor, the doctor ordered the test, the test came back, etc. The whole process could take weeks. Today, it can be done electronically in a matter of minutes. As a result, the whole process of practicing medicine becomes expedited. With the Affordable Care Act (Obamacare) already in effect and implementation of key provisions impacting clinical workflows scheduled for 2014, smartphones and tablets are poised to play an even more critical role in providing convenient access to infor-

time with the patients who need it most, which will help in proper diagnosis and treatment. The first frontier of mobile health care technology is at-home patient use of software applications (apps) and peripheral hardware that plugs into or attaches to the patient’s smartphone or tablet. Some seniors, who might experience difficulties using small smartphones with sensitive touch screens, might feel more comfortable using a 7-inch or 10-inch tablet. Others might find voice recognition software easier than typing on a tiny keyboard or touching the wrong icon. Already, smartphonecompatible medical devices such

24

May 2014


cal devices, previously found only in doctor’s offices and hospitals, directly into patients’ hands. However, these devices are not meant to replace visits to a clinician. They simply make it easier to collect and

violations, disrupted clinical communication, spreading of infections by people touching the equipment without proper sterilization, social disengagement, and technology failures. Some

doctors do not see smartphone healthcare apps as a replacement for an office visit. Face-to-face contact is still crucial to having a good provider–patient relationship. In some cases, nothing can replace a doctor’s eyes and touch in diagnosing the complete patient. It should be used more to supplement the in-person visit.

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.

WOMEN’S HEALTH GOLDEN YEARS

store clinically relevant data, thus allowing clinicians to spend more time analyzing and interpreting data, counseling patients, and developing treatment plans. While these smartphonebased clinical tools have much potential, there are clear obstacles to their widespread adoption, including potential HIPAA

Mutty Burstein is the Education Out-

RAISING OUR CHILDREN

“The first frontier of mobile health care technology is at-home patient use of software applications (apps) and peripheral hardware that plugs into or attaches to the patient’s smartphone or tablet. …”

The opportunity to communicate electronically could reduce or eliminate time that is wasted through regular phone communication and cut down on unnecessary visits to the doctor or hospital. This will help in the battle to bring down health care costs, which will insure the survivability of our health care system.

ISSUES

as weight scales, blood pressure cuffs, pulse oximeters, blood sugar level meters, EKG devices, sonograms and a myriad of other patient testing equipment are making their way into patients’ homes. By providing health information and instructions for use in a userfriendly interface, smartphonesynced devices empower patients to take an active role in their own health. Unlike older generations of at-home monitoring equipment that required manual record keeping, these smartphone devices and associated apps allow patient data to be automatically recorded and stored in personalized profiles that can be transmitted securely to the patient’s doctor or hospital. They also present that data in comprehensive visual formats, such as graphs, that convey trends over time and often include explanations of appropriate ranges for that type of patient. This has the advantage of engaging and educating the patient about his or her own health, which in turn helps encourage proactive steps to better health. Smartphone compatibility has put even more powerful medi-

INTRODUCTION

GOLDEN YEARS

MEDICINE TODAY HEALTHY LIVING H&L TECH

25

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May 2014


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

MEDICINE TODAY

Botox Not Just For Wrinkles Anymore By Dr. Steven Davidowitz

B

otox (also called the botulinum toxin) is used therapeutically to reduce the strength of targeted muscle tissues. World famous for its ability to reduce and minimize skin wrinkles, Botox also has a plethora of additional therapeutic benefits in medicine and – surprisingly enough - dentistry. Botox can be used for a number of dental therapeutic procedures that can relieve pain in patients who have been searching for pain relief for years. For patients suffering from Temporomandibular Joint Disorder (TMD) and facial pain, the use of Botox can be beneficial in relieving pain. When applied to certain muscles related to facial expression and biting, Botox helps to relieve muscles stress and brings welcome relief to those who have had much prior trouble getting relief. The Temperomandibular Joint, commonly known as the TMJ, is located on both sides of the head, at the point where the jawbone meets the skull. The TMJ is used during talking, eating, swallowing, and other everyday activities. If this joint becomes displaced or is overworked through excessive teeth grinding, a person may suffer severe tension headaches, as well as sharp pain in the jaw and face. Botox relieves jaw tension by affecting the muscles’ ability to engage in the powerful and often unconscious movement of the jaw that produces headaches and pain. It is estimated that up to 80% of

adults have some form of TMJ pain or disorder and would benefit from treatment. Over the years, there have been many treatments used to

The Botox alternative treatment for TMJ disorders and jaw tension is usually quick and effective. A nonsurgical procedure, Botox injections

areas are not new. Existing literature goes back 20 years on their usage in dentistry. As more dentists use Botox for its therapeutic use in re-

treat these disorders. They ranged from the fabrication of custom night guards and the use of orthotics to psychological therapy. Drug treatments such as anti-inflammatory agents, non-narcotic and narcotic pain medications, muscle relaxants, and even antidepressants, have all been used by dentists in the never-ending search to help their patients with TMJ pain. Many other patients have turned to chiropractic therapy, massage therapy and acupuncture for relief.

are administered in a dental office and treatment requires no hospital stay. Most patients experience noticeable improvement within one or two days of their first treatment, although relief can take up to a week. The benefits of the Botox injections can last for up to four months. Only the areas injected with Botox will be relaxed. Botox treatment for TMJ therapy does not travel and will not affect anywhere else in your body. Not only will Botox relieve TMJ and jaw tension for many patients, the injections often eliminate headaches, as well, that result from teeth grinding. In addition, in cases of severe stress, it can even minimize lockjaw. Other uses of Botulinum toxin in the dental office include treatment of chronic bruxism, or grinding. Additionally, it can be used to help those geriatric patients who are having a difficult time chewing with their full dentures due to their overused, and therefore, hyperactive muscles of chewing. Botox usage in the oral and jaw

lieving facial pain, these neurotoxins will become the standard treatment option for many facial, TMJ and other oral dysfuctions that are based on musculature problems. A dentist trained in neuromuscular disorders has the knowledge and training to identify and treat facial asymmetrics caused by muscle stress and imbalance. Utilizing in-depth knowledge of the head and neck region together with aesthetic skills of symmetry and proportion, the aesthetic dentist can utilize neurotoxin treatment, and help ease some serious disorders that have been left untreated for many years.

At a Glance

Botox is renowned for its ability to reduce and minimize skin wrinkles. Yet Botox also has a plethora of additional therapeutic benefits in – surprisingly enough – dentistry! When applied to certain muscles related to facial expression and biting, Botox helps to relieve muscles stress and brings welcome relief. Botox relieves jaw tension by affecting the muscles’ ability to engage in the powerful and often unconscious movement of the jaw that produces headaches and pain. In cases of severe stress, it can even minimize lockjaw. Additionally, it can be used to help those geriatric patients who are having a difficult time chewing with their full dentures. So if you have jaw discomfort, be sure to ask your dentist about Botox!

26

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.

May 2014


New Multidisciplinary Heart Procedures Help Patients Live Longer… and Better

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27

of cardiology at New York Methodist Hospital. Patients with heart conditions who want more information about these procedures, or who would like to schedule an appointment, are advised to call 866.84.HEART (866.844.3278) for the Institute for Cardiology and Cardiac Surgery at New York Methodist Hospital, which includes the New York MethodistCornell Heart Center.

H&L TECH

May 2014

Dr. Terrence Sacchi, M.D., is the chief

HEALTHY LIVING

ways” has resulted in their steady heartbeats being replaced with intermittent or persistent quivering. This results in the loss of the heart’s ability to pump blood efficiently. The symptoms of A-fib include heart palpitations, decreased blood pressure, confusion, lightheadedness and weakness. And over time, untreated atrial fibrillation can dramatically increase the risk for stroke and heart disease. Depending on the individual, a wide range of effective treatment options are available for A-fib, including medication, electrophysi-

MEDICINE TODAY

tients, open heart surgery is simply not an option. They might be too sick, too elderly, unable to go on cardiopulmonary bypass, or have another condition that rules out an open procedure. Instead of accessing the heart through a large incision in the patient’s chest, TAVR is performed via a nickel-sized incision in the patient’s thigh. Using x-ray guidance, cardiologists and cardiothoracic surgeons who specialize in TAVR use this entry point to safely navigate a new prosthetic valve up to the heart through the blood ves-

GOLDEN YEARS

specialists are now able to perform life-saving, minimally-invasive procedures on patients who previously had no other treatment options. However, technology is just half the battle. Increasingly often, these procedures require the seamless collaboration of physicians from two distinct medical fields—cardiology and cardiothoracic surgery. It is the combination of technology and technique that makes these procedures possible, allowing patients not only to live longer, but also to live better, with higher quality of life.

I

ology and surgery. However, for those whose A-fib has persisted despite these approaches, another procedure called hybrid ablation can be a safe way to improve quality of life and reduce the risk for complications. Whereas normal heart tissue is able to conduct electrical impulses—even if that tissue is the source of the heart’s electrical malfunction—scar tissue cannot. This is why precise ablation of heart tissue can create a new, working electrical pathway and restore a healthy heartbeat. During the surgical portion of a hybrid ablation procedure, a cardiothoracic surgeon uses a specialized, fiber-optic device equipped with a camera to access and evaluate the heart through a one-inch incision in the patient’s abdomen. The surgeon then uses radiofrequency (focused heat) ablation to produce scar tissue on the heart’s surface. Next, a cardiologist specializing in electrophysiology threads an ablation catheter (tube) through an artery in the patient’s leg up to the inside of the heart, and evaluates a three-dimensional map of the heart’s electrical system to ensure that the abnormal electrical signals have been interrupted. The electrophysiologist then performs any additional ablations necessary on the interior of the heart to fine tune the new electrical pathway. Both TAVR and hybrid ablation exemplify the future of treatments for heart conditions, because they rely on convergence of both technology and technique. Cardiothoracic surgeons and cardiologists bring unique and crucial skills to the treatment of heart conditions, and with the aid of technology, they are helping to ensure that the beat goes on for their patients.

WOMEN’S HEALTH

sels, and situate it in place. Another example of this kind of multidisciplinary collaboration is minimally-invasive hybrid ablation (scar-tissue forming), which is used to treat atrial fibrillation (A-fib). For the millions of Americans with A-fib, a malfunction in the heart’s natural electrical “path-

RAISING OUR CHILDREN

n recent years, thousands of patients with potentially fatal heart conditions have been given a new lease on life. Thanks to continuing advances in medical equipment, breakthrough medical devices, and even computer software, heart

One example of this is called “transcatheter aortic valve replacement,” also known as TAVR. For patients with life-threatening aortic stenosis (narrowing of the main valve to the heart), open heart surgery to replace the failing aortic valve is the preferred course of action. However, for some pa-

ISSUES

By Dr. Terrence Sacchi

INTRODUCTION

MEDICINE TODAY


INTRODUCTION ISSUES RAISING OUR CHILDREN WOMEN’S HEALTH

Pills are an Easy – But Dangerous – Way Out of Pain By Ofir Isaac PT, MS, DPT

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ecently I was waiting in an overcrowded Brooklyn waiting room for over an hour with my father as he waited to see his family doctor. Our three o’clock appointment slowly turned closer to four o’clock. The doctor was running 10 minutes late, which in the medical lingo means: “add an hour.” As we waited, I couldn’t help but overhear the patients sharing their stories about aches and pains with each other. I heard such things as, “I always get pain right here--” while pointing vaguely to a shoulder blade, back, neck or knees. After 30 minutes of listening to these complaints of aches and pains, I found myself in conversation with a 60-something gentleman named Yossi. Suffering from neuromusculoskeletal chronic pain, Yossi told me that he was an accountant as he fiddled with his iPhone, scanning his emails up and down. He pointed to his right shoulder and

COMMUNITY PROFILE

H&L TECH

HEALTHY LIVING

MEDICINE TODAY

GOLDEN YEARS

MEDICINE TODAY

neck and said it felt tight, and that he feels shooting pain into his right arm and occasional tingling in his index finger after sitting for 20 minutes. Yossi was there for pain medication or, as he said, anything to get rid of this pain. He even took the day off from busy tax season to get this resolved. All the while Yossi was talking, I observed his

motions and posture and, naturally as a physical therapist would, I was evaluating his condition. I listened and asked questions like “How do you sit at work? What position? Where is your computer? How high is your chair?” I grabbed my sweater, rolled it up into a cylinder, and told Yossi to wedge it under his right lower back and tailbone. After Yossi sat for three minutes with my makeshift posture corrective wedge, he exclaimed, “My right arm pain is no longer there it’s a miracle! I just feel neck tightness, but that excruciating pain has disappeared. What did you do?” Before I could explain to him, the nurse called him in and he went in to see the doctor, no longer slinging his right elbow along with his left hand. It was 4:15. The nurse finally called my father to take his blood pressure when Yossi came out. He said the doctor recommended pills for the neck pain and did an X-ray. The doctor told Yossi that even though the X-ray looked normal, he may have a “pinched nerve.” The prescription was for Ultram, a strong narcotic, with two refills. Yossi whispered that the doctor never mentioned getting a physical therapy evaluation or treatment, but he still felt the relief of that new sitting posture I taught him earlier and he personally insisted on another prescription to start physical therapy. The doctor agreed and wrote it as a favor. “Truth is, it is easier for a doctor to write a prescription than to explore other effective options to combat pain,” CNN chief medical correspondent Dr. Sanjay Gupta wrote in a 2012 editorial. “And it is easier for patients to take those prescription pills than to search for alternatives themselves. Both those things must absolutely change.” “In the United States, we now prescribe enough pain pills to give every man, woman and child one every four hours, around the clock, for three weeks,” he wrote.

A HARD PILL TO SWALLOW Approximately 80% of the world’s pain pills are consumed in the United States, according to 2011 congressional testimony from the American Society of Interventional Pain Physicians. Since 1999, sales of prescription painkillers in the United States have quadrupled. So have the number of fatal poisonings from prescription painkillers.

Almost twice as many people abuse prescription drugs as the number of people abusing cocaine, heroin, hallucinogens and inhalants combined, the DEA says. Like many of you who have gone to your doctor for a yearly physical exam, it’s a routine. You don’t even think about it. Blood pressure check, body temperature check, heart rate check, respiratory rate check. Along with the ala cart menu of CBC (complete blood count), urine analysis, vision analysis, and endless choices of pill cocktails for cholesterol, sugar, blood thinning, blood clotting, digestion, the list goes on and on. Some of the medications are necessary and lifesaving, but some do more harm than good. If you could be treated without putting harmful drugs into your body, wouldn’t you want that choice or option? The same thing goes for pain control. I truly believe that when an individual learns more about the benefits of physical therapy, which doesn’t have the harm-

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ful side effects and addiction risks of pain medication, they will almost always choose it over medication.

AN OUNCE OF PREVENTION IS WORTH A POUND OF CURE

More and more studies are coming out in the last decade about the cost effectiveness of physical therapy. Outcomes with physical therapy treatment continue to be proven effective even years later, because

we teach you how to make yourself better for the future. We focus our treatment for long-term prevention, which makes us unlike any other medical profession. Not only do we have the ability to examine and treat problems now, we can also educate you about the cause of your pain so that it never returns in the future. So often we hear from patients who have tried every method to get to the root of their pain or injury, from chiropractic and acupuncture to surgery, without results. Physical therapists can solve the “unresolved” and get you back on the road to recovery and a full and active life. Ofir Isaac is the CEO of Allcare Physical

Therapy in Brooklyn, NY, which provides state-of-the-art physical therapy treatments for men and women of all ages. Through our advanced pain relief technology, diagnostic tools, and hands-on, personal care, we offer the highest-quality physical therapy services available. Contact us at 718.339.6885 or www.allcarept.com.

May 2014


Home Medical Tests: Safe? Accurate? Or Nonsense?

N

PREGNANCY TESTS

CHOLESTEROL

BLOOD PRESSURE

Most physicians recommend that patients with high blood pressure or other heart-related issues, record their numbers daily. This not only helps keep track of their heart health, but also helps in determining how much and when to take certain medications. There are different types of blood pressure testers: finger, wrist and arm are the most popular. Finger and wrist self-tests cost over $100 and are not the ideal since they are extremely sensitive to body temperature and positioning Yankovich Continues on Page 32 ➙

Come enjoy a day of Wellness & Fitness June 11th 4-8 PM

• Introduction to our Life RX Fitness Program by our Sports Medicine Physical Therapist • Nutrition and Diet Counseling (Kosher) • Yoga Training Introduction • Massage Therapist Introduction • Fitness Trainer Introduction

And for the first fifty callers that RSVP and attend you will receive: 1 Raffle for a chance to win either 1/2 hour massage or 1/2 hour fitness session Kosher refreshments

May 2014

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1213 Ave P Brooklyn, NY 11229 (one block off Coney Island Ave)

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Please call today and RSVP for you chance to win!!! (718)258-2737

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As a thank you for attending our Special Event Life Rx Fitness we will be giving away the following: For all attendess 1 Raffle: A chance to win 10 session RX Fitness package with a personal trainer

HEALTHY LIVING

We would like to invite you and a friend to enjoy the following:

MEDICINE TODAY

Allcare Physical Therapy is happy to announce Our Second Annual Wellness Day Event

GOLDEN YEARS

Most home tests (CholesTrak, HomeAccess, both under $15) just check your overall levels and do not provide a breakdown of good (lipoprotein) and bad (triglycerides) cholesterol levels. (CardioChek, which is over $100, can test for this.) The problem with home testing is that the results given do not provide an overall assessment of one’s health and risk of developing heart disease. Test results

also vary with kits and users may also get inconclusive readings if they are not vigilant about fasting prior to testing. Tests that say they are “traceable” to a program of the Centers for Disease Control and Prevention (CDC) may be more accurate than others.

WOMEN’S HEALTH

Most home pregnancy tests are equal despite price difference ($620). They all function the same by measuring hCG, human chorionic gonadotropin in urine, which is a hormone produced only when one is pregnant. This hormone increases very quickly, so if you have a 28 day menstrual cycle, a test can detect hCG in urine in just 12-15 days after ovulation. Women need to be careful since some test results can be deceptive

if the woman tests too early in her cycle and her body did not produce adequate hCG. The test may reveal a negative reading when in fact, the woman is pregnant. This home test is encouraged since early detection allows women to start prenatal care immediately and discourages potentially harmful behavior toward the baby, such as drinking or taking prescription drugs.

RAISING OUR CHILDREN

o need anymore to visit a lab to determine if you’re diabetic, anemic, pregnant, or even cancerous. Today, more and more people are just popping into their bathrooms and diagnosing themselves with over-the-counter home medical tests. With a mere drop of blood, saliva, urine, or a hair strand, consumers can now test themselves for a wide variety of ailments. Home medical tests started about 30 years ago with the invention of the popular over-the-counter pregnancy and glucose tests, and now has grown into a multibillion dollar business. With medical advancement, one can now purchase kits that test for everything from common allergies, cholesterol, blood pressure, ear infections, strep throat, hepatitis, menopause and even certain cancers.

Home test kits are gaining popularity due to their relatively low cost, convenience of avoiding a doctor’s visit, speed and privacy in acquiring medical answers. However many health care professionals worry that patients will avoid seeking medical attention and just self-diagnose their symptoms or, even worse, test incorrectly and yield false positives.

ISSUES

By Ita Yankovich

INTRODUCTION

MEDICINE TODAY


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

MEDICINE TODAY

FDA Cracking Down on E-Cigarettes

FDA Monitor

By Ita Yankovich

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he FDA is proposing new, stricter rules that would establish its authority over electronic cigarettes. Most e-cigarettes resemble regular cigarettes, while others look like small flashlights. All incorporate a battery-powered device that heats nicotine-infused liquid derived from tobacco plants into a vapor that is inhaled and exhaled like smoke. Parents, lawmakers and public health advocates have been demanding harsher legislation arguing that the product presents risks to children who may be attracted to the sweet flavors often contained in e-cigarettes. In addition, many are concerned that there are no federal age restrictions that would prevent children from obtaining e-cigarettes, nor are there any advertising restrictions. Poison centers received 2,405 calls related to e-cigarettes and 16,248 calls about cigarettes between September 2010 and February 2014, according to the report recently released by the Centers for Disease Control and Prevention. FDA Commissioner Margaret Hamburg told senators at a Congressional budget hearing that it has taken too long to move the rule forward and that she expects the proposal to be ready for release “very soon,” reports Reuters. The FDA’s proposal is currently being examined by the White House’s Office of Management and Budget, which reviews potential regulations to assess their economic impact.

O

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

There is even pressure on the White House from the American Academy of Pediatrics, the American Heart Association, and the American Cancer Society, which sent letters together with a dozen other groups urging the government to push the FDA to act.

E-cigarettes have not been fully studied so consumers currently are unaware of the potential risks, how much nicotine or other potentially harmful chemicals are being inhaled during use, or if there are any benefits associated with using these products. Additionally, it is not known if e-cigarettes may lead young people to try other tobacco products, including conventional cigarettes. Only e-cigarettes that are marketed for therapeutic purposes are currently regulated by the FDA. In 2009, the FDA tried to gain some control on this industry by concluding that e-cigarettes “were unapproved drug/device combination products,” and they even took measures to stop certain companies from importing them;

however, there was a countersuit filed and the E-cig companies won even when after the FDA appealed. Today, electronic cigarette companies fall under the jurisdiction of the Tobacco Control Act of 2009, and the FDA only has authority to regulate cigarettes, smokeless tobacco and roll-your-own tobacco. It also gave the agency the power to “deem” other tobacco products to be within its jurisdiction but it must first issue a rule to that effect. The FDA’s new proposal has already included banning the smoking of e-cigarettes indoors, and this ban is already enforced in Utah, North Dakota, Arkansas and New Jersey. Nine other states, including Colorado, New York, Tennessee and Wyoming have already placed e-cigarettes into the classification of tobacco product. E-cigarette companies believe they should be exempt from regulations because they argue it will hurt small business, and consumers who smoke their product as an alternative to nicotine cigarettes. Chris Hansen, president of the American Cancer Action Network disagrees saying, “E-cigarettes have not been scientifically shown to be effective tobacco cessation tools, yet some distributors are marketing them either directly or indirectly for that purpose.” Yearly sales of e-cigarettes are already approaching $1.7 billion. Ita Yankovch is a freelance writer for The Jewish Press and other publications. She also teaches English and Literature courses at Kingsborough and Touro College.

Say Goodbye to Summer Allergy Shots

ver 30 million Americans suffer with symptoms of nasal congestion, sneezing and watery, itchy eyes due to their allergies. Now, instead of having to run to the allergist for their yearly dose of shots, the FDA has recently approved the first ever, under-thetongue-pill, Oralair, to treat hay fever caused by certain grass pollens. The initial dose is taken in a doctor’s office so that the patient can be monitored for any harm-

ful reactions, and follow-up doses are taken at home. Patients begin taking the once-a-day tablet four months before the start of the grass pollen season and continue taking it for the duration of the season. Oralair contains a combination of freeze-dried extracts from the pollens of five grasses: Kentucky Blue Grass, Orchard, Perennial Rye, Sweet Vernal and Timothy. The tablet was tested in studies in Europe and the United States

that involved a total of about 2,500 people. Those who took Oralair had a 16 percent to 30 percent drop in symptoms and the need for allergy medications, according to the FDA. The most common side effects reported by patients taking the tablets were ear, mouth and tongue itching, swelling of the mouth and throat irritation. Oralair is made by Stallergenes S.A. of France. (HealthDayNews)

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Approvals, Recalls and Going Generic APPROVED - Topamax, the first FDA-approved drug for the prevention of migraine headaches in adolescents aged 12 to 17 years. The most common side effects included burning or prickling sensations in the extremities, upper respiratory infection, appetite loss and abdominal pain… APPROVED - Alprolix, the first treatment for adults and children dealing with Hemophilia B, designed to require less frequent injections when used to prevent or reduce the frequency of bleeding… APPROVED - Qudexy, extendedrelease capsules used to treat certain types of seizures in adults and children 10 years of age and older, and together with other medicines to treat certain types of seizures in patients aged 2 years and older… APPROVED - Eliquis, helps reduce the risk of stroke and systemic embolism in patients in certain patients who have undergone hip- or knee-replacement surgery… RECALLS - Alli - the popular over-the-counter weight loss drug is being recalled because of possible tampering. 20 tampered bottles were reported to the company by 12 customers who claim their bottles contained tablets and capsules of varying shape and color… RECALLS - Paxil- GlaxoSmithKline has recalled their anti-depressant drug after investigators found irregularities at its Co Cork plant in Ireland during an inspection. The FDA claims that drugs were contaminated with material from the plant’s pharmaceutical waste tank… RECALLS - Fresh Express - One lot of Fresh Express’s Italian Express bagged salads (product code- Ho71A11A) is being recalled after the product tested positive for listeria, a potentially dangerous food-borne bacterium. The bagged salad was distributed to retailers in multiple states. No injuries have been reported… GOING GENERIC - Actnoel (risedronate) - This slow release tablet treats and prevents osteoporosis in postmenopausal women… GOING GENERIC - Nasonex (mometasone) - is a steroid used to treat and prevent nasal symptoms such as congestion, sneezing, and runny nose caused by seasonal or year-round allergies. It accomplishes this by preventing the release of substances in the body that cause inflammation. Nasonex is also used to treat growths in the nose (nasal polyps) in adults… GOING GENERIC - Nexium (esomeprazole) - This inhibitor is used to treat symptoms of gastroesophageal reflux disease and other conditions involving excessive stomach acid. Nexium is also used to promote healing of erosive esophagitis (damage to your esophagus caused by stomach acid). This drug does not provide relief of heartburn symptoms. Taking a proton pump inhibitor such as Nexium may increase your risk of bone fracture in the hip, wrist, or spine. This effect has occurred mostly in people who have taken the medication long term or at high doses, and in those who are age 50 and older… GOING GENERIC Teveten (eprosartan) – This drug helps lower blood pressure by keeping blood vessels from narrowing. Sometimes this drug is given together with other blood pressure medications such as a water pill or diuretic to reach target blood pressure. The full effects are usually seen within three weeks.

May 2014


MIND, BODY & SOUL Treating Obsessive Compulsive Disorder

A Publication of

In Collaboration With:

A Mental Health Magazine

May 2014

The Art of Parenting Adult Children


& MIND, BODY SOUL

MIND, BODY SOUL CONTENTS &

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MAY 2014

& Further Reading MIND, BODY SOUL

RELATIONSHIPS

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PARENTING

5 6 7 8

Understanding the Challenging Child By Dr. Sara Teichman, PsyD

By Chana Kaiman, LCSW and Miriam Yerushalmi, MS

TREATMENT

The Best Parenting Tool

By Sara Pinkesz, MHC, CASAC-T

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An Ongoing Search for the Right Path By Esther Fuchs, LCSW

I Don’t Like My Kids’ Friends

Living with Obsessive Compulsive Disorder (OCD) By Dr. Pamela P. Siller, MD

THERAPY

By Mark Staum, LCSW

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Compassionate Parenting: The Secret to Healthy and Successful Children

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Attending Couple Therapy When One Partner is Absent

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Being Part of the Group

By Dvorah Levy, LCSW

By Audrey Grazi, LCSW

SELF-IMPROVEMENT

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Six Easy Steps to Foster Emotional Resilience in Retirement By Joel Verstaendig, PhD

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GRIEF

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Abandonment – When Loved Ones Pass By Marlene Greenspan, MA, LPC

DIAGNOSIS

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The Marah Shchorah: Understanding and Undoing Depression

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By Sararivka Liberman, LCSW

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

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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May 2014


& MIND, BODY SOUL

LOOKING TO LIFT YOUR SPIRITS, SOCIALIZE, LEARN NEW SKILLS, FIND EMPLOYMENT?

Dear Readers, T

here’s a core reason that most people go to therapy – to feel better. Whether it’s an addict who has hit rock bottom, someone who is suffering from anxiety or depression, a couple who feels miserable with their marriage (or their spouse), or any of the other reasons someone might seek out a therapist – they all have that same basic goal in mind. As was mentioned in past editions of this publication, people encounter problems along the way to finding the right therapist, including: identifying the real problem, finding a therapist who’s a good match, and other factors. But there’s another impediment that can get in the way of someone attaining that fundamental goal. That is, perhaps surprisingly, wanting to feel better – even wanting to see a therapist – but not really wanting to be in therapy. That’s because in order to feel better – being in therapy doesn’t always feel good. Brocha, a woman in her twenties and married for five years, came in to discuss how unhappy she was in her marriage. She and her husband have one child, and from her perspective, can’t agree on anything with regards to parenting. She was coming to seek counsel on how to handle this situation, and to deal with the fact that she was married to someone she was having such a hard time parenting with, that she couldn’t envision herself having more children with him. In talking about personal history, Brocha briefly made mention of the fact that she had had a much younger sibling who had died suddenly right before the birth of her daughter. When Brocha mentioned this, she started visibly shaking, appearing extremely anxious, but stated that that was not why she had come, that it wasn’t important to go into more details about that, and quickly changed the subject. This is just one of the many types of scenarios that take place in therapy, where someone is in a lot of pain and wants things to improve, but is hoping that they can achieve that without having to fully engage and explore everything that may be contributing to their current distress. Usually this is because really getting to the core of things will entail more pain in the short term and relief only after a significant period of time and a great deal of work. The scenario involving Brocha is one that is actually a bit easier for the clinician to help a client with, because in this case, at least one area of resistance is obvious to the therapist. In this instance, the therapist could point out what is being avoided and how, despite the person’s protests to the contrary, it might be extremely important to address. Pushing someone to go faster than they can tolerate is still not appropriate; however, when the person is willing to at least acknowledge the ”sore spot” to the ”doctor,” at the very least a conversation can ensue about what could be done, and how to deal with that spot in the least invasive, safest, or least painful way. What about cases when someone leaves out the painful subject or details altogether, not even bringing it up because it’s “something that’s not important to discuss”? Perhaps they tell themselves that it isn’t important to even mention, that it’s insignificant or irrelevant to what they sought help for, when in fact, keeping quiet is done in the service of keeping their extremely sore spot well protected. Usually, something of the core issue will eventually find its way into the treatment room. The problem is that it can get very frustrating for the client when they don’t see improvement, they’re not feeling better, and instead they feel like they are getting nowhere. From their perspective, they’re attending therapy regularly, they are participating in treatment – so why aren’t they feeling better or why aren’t things getting better? There isn’t any one answer to that question. There are a lot of possibilities as to why someone might not be finding that therapy is helping them in their lives, and not all of those possibilities fall on the shoulders of the client. However, if you as the consumer want to do your utmost to get the most out of your process, ask yourself whether you are protecting something, perhaps out of fear, embarrassment, pain, or because you figure, “it’s not really relevant here,” and try sharing it with your therapist. After all, if you want things to change, it’s important to not just go see a therapist, but to also really be in therapy.

Lisa Twerski,

May 2014

WE LC OM E TO

ALWAYS MOVING FORWARD OHEL’s Kadimah provides a warm and welcoming environment for men and women managing their mental illness COMPUTERS CULTURAL LEARNING EDUCATION T ADVANCEMEN

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& MIND, BODY SOUL

Book Review The Art of Parenting Adult Children

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their children closer to the model they desired, these parents caused a break in their relationships with their children. As a result, these children often went even further away from their parents’ ideal. Parents who justify being hard on their children by attributing it to tough love and saying that this is the only way to ensure their children become good people do not realize how counterproductive such an attitude can be. Treating children as if there is something wrong with them because of their choices and trying to figure out “what went wrong” is a damaging attitude that only sends them the message that they are not loved or accepted the way they are and that their parents cannot look past their choices to appreciate who they are as individuals. Receiving the message that they only have worth if they reach the parents’ standards is hurtful and limiting and breeds resentment. The goal should be unconditional love, not tough love. Loving your children as they grow up no matter what, regardless of religious or personal choices – that is the best way to keep relationships with your adult children stable. Because as Isay points out, adult children are now capable of leaving behind toxic relationships with parents by closing down from then emotionally, withholding details about their lives, and moving far away. What this means for parents in the Jewish community who want to remain in their children’s lives and stay close with them is that they must always show unconditional love and support. This encourages their children to feel more comfortable with them and keep them involved and up to date on their lives. When your children confide in you or share a part of their lives with you, do not pass judgment or make them regret sharing with you. One of the most crucial things is to listen, and try to understand and empathize without passing judgment or making demands or pressuring children into certain choices. When children become fully actualized adults and develop their own styles of thinking and sets of beliefs, the parents’ main job becomes to listen to what the children are trying to say and take it seriously. If your children are making personal decisions that you disapprove of, listen to them first and try to understand their motivations and their points of view in order to foster healthy, loving relationships. Fortunately, the key message of Isay’s Walking on Eggshells is a positive one. She reiterates throughout the book that no matter how many mistakes a parent may have made in raising a child, children are usually willing to reconnect and rebuild relationships when they receive the message that their parents are willing to accept them as they are and want to remain close to them.

By Hannah Rozenblat

he question of how to parent one’s children once they have grown up is a much-discussed topic in our community. Naturally, parents’ concern for their children does not stop once the children become legal adults, and if anything, increases when parents feel they are losing control over the child’s life. After investing so much effort into their children all these years, it is difficult for parents to take a step back and allow these new adults to lead their own lives and make their own decisions, particularly in the realm of religion. But although many Jewish speakers and writers declare that the parents are responsible for their children’s choices and Torah observance no matter the child’s age, that viewpoint is unsatisfactory as it denies adult children their status as fully recognized human beings who are capable of making their own decisions. I recently read Jane Isay’s Walking on Eggshells, which deals with relationships between parents and adult children in a profoundly sensitive, rational way with the goal of improving those relationships. Instead of decrying “the way young adults are today” as many unfortunately do, Isay acknowledges the reality of the relationship between parents and their adult children, focusing on how to maintain and improve the relationship instead of uselessly blaming the adult children and the society of which they are a product. Isay’s book helps parents and their adult children understand each other’s positions better so that fragile relationships can be strengthened for the benefit of both sides. Isay addresses the issue of religious differences between parents and children, encouraging parents to give adult children unconditional love and support even if their religious choices are disappointing to the parents. This is a painful issue for many in the Jewish community. After investing in their children, parents feel responsible for the outcome and take it personally when their children do not meet their religious expectations. From simple things such as modes of dress to more significant religious choices such as whether or not to be religious at all, a crucial aspect of growing up is learning to make decisions for oneself, even if those decisions may hurt one’s parents. Until parents and communities can accept this and treat young adults with respect and with the understanding that they are capable of making their own choices, these young adults are more likely to leave the community and escape from an institution that they feel is restrictive and oppressive. I know many individuals who felt driven off by their parents’ attitude. Instead of accomplishing anything or bringing

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May 2014


& MIND, BODY SOUL

By Dr. Sara Teichman, PsyD

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ost children who are brought to therapy have typical run-of-the-mill issues like low self-esteem or poor peer relations. Sometimes, however, parents bring in a really difficult, out-of-control child who is what we used to call a “problem child.” This child may be angry, moody, aggressive and undisciplined. He has difficulty learning and is unmanageable in school. Often the parents are at the end of their rope, having exhausted their bag of tricks: ignoring, consequences, punishment, and maybe therapy. Sometimes parents are optimistic, or naïve, believing that all they need are some tips to make their child behave. Parents often consult with a professional because they want “the answer.” It is quite an art for the therapist to convey that there are no simple answers for complex problems. There is no magic pill, piece of advice, strategy, bracha or segulah that can by itself adequately and comprehensively address this situation. What is needed instead is a process of trying to understand the child – his strengths and weaknesses, his needs and wants – not simply a focus on eliminating his troubling behavior. However, the difficulty, shame and embarrassment of raising a child with challenging behavior may overwhelm the parent; after all, a child is his parent’s report card. So, despite the best of intentions, the parent may fall into the trap of caring more for the behavior than the child himself. Yet a child is not his behavior. Behavior is simply the language of childhood. Challenging behavior signifies that the child is in pain; he cannot regulate his mood or impulses and he suffers the consequences of adult disapproval and peer rejection. As important as it is to teach him appropriate behavior [and that is important!], his behavior is a symptom and not the issue. The issue is his pain and helping the child deal with it is the first responsibility. It is axiomatic that children do well if they can and that no child gives more pain than he feels. More than anything, children want approval, and if they can do what is asked of them in order to get it, they will. But when the child cannot do what’s required, he both feels bad about himself and also earns the disapproval and criticism of others. Then, when he feels the pain of rejection, he acts out, or in. Neither giving him medicine nor teaching him to have derech eretz will alleviate his pain. It takes some skill and training to figure out the puzzle that is the child. There are a number of diagnostic possibilities here, from ADHD to abuse/neglect, from depression to low selfesteem, from ODD [oppositional defiant disorder] to overly permissive parenting. Because there are radically different approaches for, say, a child who is depressed or a child with ADHD,

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it is essential to determine the nature of the issues before beginning to address them. Most likely, there isn’t any one thing, but rather a combination of factors that affect the child. For example, a child with ADHD who has permissive, unstructured parents is bound to have disorganized, chaotic behavior [doing whatever he wants] which impacts negatively on his school performance. Or, a child with

the professional may suggest, like individual or family counseling, parenting classes, or special education. An evaluation for medication by a child psychiatrist may be appropriate; there are medications for depression and ADHD. However, just like antibiotics cannot cure every condition, there is no medication that addresses chutzpah or anger which are more often reactions to the child’s environment.

low self-esteem who feels disliked by his peers may have lots of feelings of anger and depression. And, though it is a consideration to give medication to a child who is depressed, there is no pill in the world that can remedy the pain of abuse or neglect. What sometimes derails the “understanding” process is that parents feel under the gun; everyone around them is urging them to do something. None of us like to be criticized, but it seems like an out-of-control child invites the well-meaning comments, suggestions, advice and perspective of others. The social pressure this engenders often propels the parent to seek a quick fix solution, rather than work at a comprehensive understanding of their child. It takes a lot of courage and stamina to work at the longterm and not the short-term, the whole child and not just his behavior, and the future – not merely the present. When the severity of the symptoms and the seriousness of their repercussions call for professional help, both the parents and the child would do well to meet with an experienced, competent mental health professional. Once there is a mutual understanding of a child and his issues, there are a number of strategies that

Last, but certainly not least, may be the need for a behavior modification program or behavior therapy. Everyone must learn appropriate behavior in order to function effectively in our families and social world. No matter what the pressure or distress, disability or challenge – correct behavior is our entry card into the world. We are derelict in our duty if we fail to provide all our children with the tools to manage their impulses and behavior so that they can be welcomed as full-fledged members of society. It is not easy being the parent of the more difficult child. It’s not something we willingly sign up for or even the cards we expect to be dealt. But when the therapist, parent and child work together on the process of figuring out those cards, that enhances the chances of playing the cards right and getting a winning hand.

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Dr. Sara Teichman, PsyD maintains a private practice

in Los Angeles, California where she specializes in individual, parenting and marital concerns. 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 lectures on parenting and a variety of clinical issues in person and by teleconference all around the United States. To contact Dr. Teichman, email sara.teichman@etta.org.

PARENTING

Understanding the Challenging Child


PARENTING

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The Best Parenting Tool By Sara Pinkesz, MHC, CASAC-T

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havy looks at her son with frustration. He has just told her that he is sick of yeshivah and wants to go to work. She wonders, why can’t he just be a “normal yeshiva boy”? Where did she go wrong? Why wasn’t she capable of passing on her beliefs to her own son? Chaim argues with his daughter who doesn’t want to go to seminary. She feels that it’s a waste of time since she’s not planning to teach. She wants to work, make some money, and possibly take some college courses. This was not the future he had envisioned for his daughter. What kind of parent is he if he can’t transmit his values to his daughter? As parents, although we have tried to do the best we could, we often look at the end product, our children, and feel that we have failed. We may blame it on ignorance, lack of patience, stress or any of the myriad of issues that decorate our lives, but we are sure we messed up. And then... the guilt sets in. How could I have said that? How could I have done that? I can’t believe I lost my temper like that. I’ve traumatized my child. I am just not a competent parent… and so on. We are eaten up with guilt for what we have done, intentionally or not, to our children. What do we do now? How can we deal with our feelings of defeat, our belief that we have destroyed the future generation, possibly even generations? The answer may surprise you. We forgive ourselves – yes, believe it or not, that will make the greatest change. No matter what we did, as terrible as it might seem, we must forgive ourselves or we are doomed to be parental failures, destined to be stuck in the rut of our dysfunctional behavior. As long as we are consumed with guilt for all the “terrible” things we have done, we cannot move forward and become better parents. Sometimes we need to apologize, depending on the child’s maturity. But whether we do or not – whether they forgive us or not – we need to forgive ourselves. We must remember, not only that we are human, but that we are part of God’s plan. Just as our parents were often a challenge to us, so are we a challenge to our children. This isn’t an excuse to be bad parents; this is a reason to forgive ourselves for our past offenses. Yes, we may have damaged our children, but teshuva does not mean being consumed by guilt. It means feeling sorry for what we’ve done and committing ourselves to avoid repeating our transgressions, whatever they may be. We cannot improve and develop our future if we haven’t let go of the past. We need to be able to move on. Moving on frees us to grow to be better parents in our interactions with our children. We can learn how to communicate effectively, discuss our conflicting viewpoints, often involving their obligations, and thrash out our differ-

ences. We also can accept our children as they are, even if they have not met our expectations, or our dreams. It means understanding that children have their own paths and we need to celebrate their own particular positive traits. It means understanding that although our parenting contributed to who they are, there are other

go, because they have no value and serve no purpose. Even if we are disappointed or hurt by their life decisions, we can more easily accept our children and their choices if we can acknowledge that it’s not our fault. Our children may want different lives, spouses, or careers than we may have planned for them,

factors that have had a great influence on them, too. Their conduct, manners, performance, aspirations and appearance are not a direct reflection of our success or failure as a parent. If we can take a step back as we learn to forgive ourselves, we can look at them without judgment. We can realize that our anger at them for not being what we expected, for not turning out the way we would have wanted, is directed more at ourselves than at them. Although we are saying: Why can’t they be like everyone else – or better?, we are actually thinking: What could I have done differently to make them be like everyone else? It’s time to let these destructive thoughts

but they still need our approval to attain true happiness. Our children need to know that we understand them and can value their struggles and the solutions that work for them. When we can reach the point that we can accept their choices, we have attained the purpose of our lives as parents: Giving our children the independence to forge their own path.

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Sara Pinkesz, MHC, CASAC-T currently works as a

Young Adult Counselor at Peaceful Home Associates. She is also in private practice dealing with troubled teens and young adults, specializing in drug addiction. She can be reached by calling 917.686.3987 or via email: spinkesz@ gmail.com.

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By Esther Fuchs, LCSW e are living in difficult and turbulent times. Never in history has it been harder or more challenging to raise children. As a result, parents of even physically and emotionally healthy children are constantly seeking guidance. Seeing and reading how much can go wrong, parents understand that they need to set the

pushes away and the right hand draws you back close), and will know how to set firm limits with an abundance of love. However, if you did not experience your own parents this way, it can leave you with “emotional baggage.” These are superfluous feelings from childhood that can weigh you down, but no matter how hard you try, they remain attached to you. You may say to yourself: “My parents did this to me, it was awful, I will never do this to

was so painful for him that, at a young age, Mordechai made a decision never to allow himself to become angry or to even express a strong personal opinion. Rivkie came from a family where they “let it all hang out.” It was a large household where there was constant drama. Anger and explosiveness were always in the air. Rivkie had internalized this as “normal.” This couple needed to learn how to regulate

right environment in their home. They want to know what kind of soil to cultivate to raise children as happy and successful human beings and ovdei Hashem. To begin, we need to realize that each child has his or her own techunos (innate characteristics), and nitiyos, (behavioral propensities). Psychological research has proven the Torah’s wisdom when it says: “Chanoch l’naar al pi darko.” Each child needs a custom-made parenting plan. What worked for Yankie might not work for Shloimie, because they are innately wired differently. So how does a parent begin? The Torah teaches us that by developing ourselves into better people, we naturally become better parents. The real challenge of parenting is transforming ourselves. “K’shot atzmicha, v’az kshot acheirim.” First fix yourself up and then you will be able to fix others. To a large degree, we learn to parent from the way we were parented. To the extent that you were fortunate to have had adequate parenting, you will likely have internalized the principle of chanoch l’naar al pi darko. It will also be more natural for you to be guided by the concept of: “Smol docha viyimin mekareves,” (the left hand

my children,” but under stress you find yourself repeating that pattern. Stress can cause unclear thinking that can cause us to go back to the default setting of our own childhoods. So what is the solution? Are you trapped? Absolutely not! The key to changing your programming is awareness. Whether through self-awareness or someone else pointing it out, you need to have the courage to accept the challenge and the willingness to change. You will need to work hard and get support and guidance to change that behavior. Parents need to make conscious changes. It is difficult to implement any of the parenting techniques you learn without being ready to work on transforming yourself. Case in point: Rivkie and Mordechai came for counseling because of problems they were having parenting their son. He was explosive at home when everything did not go his way, and had frequent meltdowns over small things. In their first session, the parents both spoke about their own childhoods. Mordechai described being a rambunctious child in need of frequent discipline. His father screamed at him whenever he misbehaved. This yelling

their emotions more effectively and to practice expressing their feelings to one another in a calm, open manner. Mordechai had been withdrawn and fearful that contradicting his wife’s opinion would cause an explosive reaction. Rivkie had been expressing her feelings in a loud and intimidating manner, and then complaining that Mordechai was emotionally unavailable. When I reflected back to them that behaviors they had learned in childhood were not working in their marriage or with their children, they were eager and motivated to change. Our sessions led to their relationship strengthening, and as a result, their son’s behavior problems disappeared. To be an effective parent we start, not by focusing on the child’s process, but on our own. Individuals who have transformed into better parents have essentially worked on transforming themselves.

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Esther Fuchs, LCSW is in private practice with over 25 years of experience providing Torah and evidence- based practice to families and children. She can be reached at 917.348.9809.

PARENTING

An Ongoing Search for the Right Path


PARENTING

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I Don’t Like My Kids’ Friends By Mark Staum, LCSW

In this example, we can see the following:  Mrs. Langford asked David what happened without immediately assigning blame to David or forbidding him to invite Charlie over ever again.  Mrs. Langford listened carefully to David and promoted a healthy dialogue without ever cutting off the lines of communication.  Mrs. Langford helped David to reflect on what had happened and think about making better choices in the future.

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onsider the following exchange between Jack and his mother: Jack: I would really like to go to Brian’s house for a sleepover. A few other kids in the class will be going as well. Mother: Well, I don’t really like Brian so much. I don’t like it when you guys are together! Jack: Why, what are you talking about? He is a really good friend of mine! Mother: It doesn’t matter, you are just not going! In the above example, we see that Jack’s mother does not approve of a specific friend, yet she doesn’t communicate the reasons for her lack of approval which, unsurprisingly, seems to make Jack very angry. The “cutting off ” statement by his mother – You are just not going! – does not seem to help the situation either. A parent recently related the following to me about not liking his child’s friends: “I know that I have control over my kid until he reaches middle school, maybe the beginning of high school. After that, there is not much I can do when I don’t like something that he does.” The above statement is very powerful because it allows us to reflect on the delicate balance between controlling our kids’ choices and empowering them to make their own choices. How does this balance work when there is something that I, the parent, really don’t approve of, but I am not quite sure whether I should raise the issue or leave it alone? This question becomes even more challenging when friendships and peer groups become a very strong part of a child’s identity. As parents, we may feel that at a certain point we almost have no right to infringe on the lives and social choices of our children. However, at every stage of child development, parents should feel that there are opportunities and ways to address any area in their child’s life that bothers or troubles them. And yes, this includes talking to children about their choice of friends. The key, however, is to communicate – utilizing communication skills to express an opinion, but still listening and valuing your child’s opinion. Your child needs to sense that you get it, and that even though you may disapprove of a specific peer interaction, you also fully understand why this particular friend or this peer group is important to him/her. Your validation does not necessarily need to stand in the way of setting firm guidelines and/or consequences, but it needs to be clear to your child that you value their feelings and input as well, even if you disagree. Consider the example of Mrs. Langford who gets a call from a parent that her son Jonathan and his best friend Charlie were bullying David on the bus: Mrs. Langford: Jonathan, I received a call from David’s mother today that you and Charlie were teasing him on the bus. Can you tell me what happened? Jonathan: I was sitting next to Charlie on the bus and all of a sudden, he started to make fun of David’s clothes. I thought that it was kind of funny so I sort of joined in! Mrs. Langford: Okay, thanks for being honest about what happened. Don’t you remember that we had a talk about Charlie’s behavior last week? Remember the time that he came over to the house and started using foul language in the backyard? Do you remember the talk we had about having fun without using that type of language? Jonathan: Yes, I remember. Mrs. Langford: I am becoming a little concerned about your friendship with Charlie. It is probably very difficult to make good choices when others around you are not, but making good choices is something that we discuss at home all of the time. In this situation, do you think that you could have done anything differently? Jonathan: Well, I could have told Charlie to leave David alone or maybe tried to make a joke to change the conversation away from David’s clothes. Mrs. Langford: Yes! Those are very good ideas. Maybe you should give some thought to whether Charlie is a real good friend if he seems to always be picking fights, bullying kids and using bad language.

When assessing a situation of “I don’t like my kids’ friends,” here is a list of important questions to ask ourselves:  Did I communicate to my child the specific issue that is bothering me about this friend?  Did I also listen and give proper time and consideration to my child’s feelings?  Did I validate and show understanding that this friendship is important to him?  Did I teach or give insight to my child to make better choices in the future? Of course, there are situations that may demand consequences or more firm guidelines relating to harmful social interactions. Our role as parents when it comes to our kids’ friends does not only need to be one of control. Instilling values, communicating, and listening respectfully are invaluable “seeds” that we plant inside our children to help them make positive choices throughout their lives. Mark Staum, LCSW is the school therapist for the PTACH program @ MTA, special-

izing in child and family mental health. In the past, Mark has developed social skills groups for both elementary and middle school aged children, as well as many different workshops related to the social and emotional development of children and adolescents. To learn more, please visit his website, www.markstaum.com, or email: mstaumlcsw@ gmail.com.

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Abandonment – When Loved Ones Pass By Marlene Greenspan, MA, LPC

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Recommended Reading: Angel, M. 1997. The Orphaned Adult. New York: Jason Aaronson Fumia, M. 2003. Safe Passages. York Beach: Conari Press Lamm, M. 2004. Consolation. Philadelphia: Jewish Publication Society Lamm, M. 2006. The Jewish Way in Death and Mourning, revised and expanded. New York: Jonathan David

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needs. An adult is basically self-sufficient physically, although he may have emotional needs that cannot be discerned immediately and that need tending. The feeling of being abandoned exerts itself gradually and steadily. Judaism prepares individuals to heal the grief within slowly, in five stages, from the time between death and burial to the first three days of shivah, to the rest of shivah, to shloshim, and to the end of the first year. For those who need more help, psychologists have found that the rawest part of grieving takes 3 to 5 years. It does not take away the scar of loss, but that time period strengthens healing feelings. While it is not possible for this loss to be reversed, there are many things an individual can do to mitigate the pain. One comfort is that, as

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time goes on, the pain dulls and good memories come to the surface. Laughter and warm feelings in those stories come to replace the pain because those memories remain as long as an individual chooses to keep them. As long as an individual has a purpose, his/her life continues. One thing to remember is that these experiences occurred in the past and cannot be repeated. Time moves on and so must individuals. It does not hurt to remember, as long as one does not stay locked in the past. People who have lost children, spouses, siblings or parents sometimes set up regular donations or foundations to fund research into devastating illnesses or traumatic and unexpected accidents. In this way, they can enjoy memories of their loved one and move on into the future without sentencing themselves to be trapped in a very sad past. Of course, adults understand (for the most part) that they are not abandoned by choice when someone passes from illness, trauma, or in the natural end of their days. It is just that mourners have neither expected to be in that position so soon nor thought they would feel the loss as such wrenching pain. There are many different places that one can receive assistance in getting balanced again once a loved one has passed, and many therapists specialize in helping people get past the hardest part of their grief. One man tells the story of how as his last day of shivah came to a close, he had a dream of his wife giving him an important message: “Jack, look at this road that I’m showing you. It’s the path I have to take now. I’ll come back from time to time to see how you are doing, but this is where I have to go right now.” Although the man felt very lonely, he understood that he had his own path to follow from then on. For everyone whose time has not yet come, it is just a matter of learning to cope with the greatest challenge of all. Help is available for those who want it. Marlene Greenspan, MA, LPC is currently in private

practice and the director of Counseling for Better Living. Formerly in the yeshiva system for many years, she has taught, created social skills programs, written weekly Counseling Corner articles, given workshops, and published professional articles for Nefesh, ACA, ASCA, and the OU, among others. She can be reached at counselingforbetterliving@gmail.com.

GRIEF

eath, at any age, means painful finality. Whether the deceased was a friend, spouse, sibling, parent or child, the loss of this dear person is permanent and the ones left behind feel abandoned and alone. There is no further opportunity to share thoughts, experiences, ideas and apologies. No further opportunity to be companions along the way. The loved person is here no longer and that conclusiveness is all-encompassing. This realization of finality usually surfaces after all the other feelings that come with dealing with death have been expressed, including denial, anger, and so on. There is a certain helplessness and hopelessness to feeling abandoned that seems to stretch on into a dismal future. When that loved person leaves, there is a big hole left in one’s heart. And the longer the relationship with the departed was, the deeper the pain. No matter how old an individual is when a parent passes, the child still feels forsaken and deserted. In most instances, young children will be able to adapt to the absence of a parent, depending on how the person’s life continues. At first the pain is very great and extremely difficult to contemplate. “Where is Mommy?” “Why isn’t Daddy coming home?” are heard frequently among young children. If the child is fortunate, there is another parent and positive family or hired helpers to keep the children’s lives going as smoothly as possible. On the other end of the spectrum, if the child is not as fortunate, the family is broken up and the child is raised by cold, sometimes even hurtful, individuals. Then it is strength of mind and heartfelt courage that somehow help the child grow up until he can support himself. Of course, the age of the child when the parent

passes determines a lot of what follows in his/ her life and choices. What about the older child? Is it easier when a parent dies when the child is almost an adult, or already an older adult? These people are considered old enough to cope, yet inside they may be suffering even more than younger children, who frequently accept the parent’s loss and go on with their experiences as part of healing.A big difference between younger and older people in dealing with loss has to do with helplessness. A young child is helpless and depends on the adults around him to take care of him and his


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The Marah Shchorah: Understanding and Undoing Depression By Sararivka Liberman, LCSW

DIAGNOSIS

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nce known as “the common cold of mental illness,” depression has been recognized throughout history. Dovid was summoned to the court of Shaul to alleviate the king’s depression with music. The Rambam, himself a physician, provides an explicit treatment for depression. In his writings, Rav Nachman of Bratzlav offers support and encouragement to anyone suffering from the low self-esteem – “falling in one’s own eyes,” in his words – and the despair that so many of us experience during depressive episodes. In the U.S., an estimated 5–12% of men and twice as many women will experience a diagnosable depression during their lifetime. In any given month, an estimated 5% of all Americans meet the criteria for a Major Depressive Disorder, a severe form of the condition. In short, depression is likely to touch our lives through our own struggles, or by affecting those close to us. Depression is considered a mood disorder. Indeed, depressed people often feel sad, unhappy, apathetic, irritable, hopeless, desperate, and/or resigned. But depression involves many aspects of our lives: It affects our physical selves, often causing a loss of appetite or overeating, insomnia or sleeping too much, fatigue and low energy. It can change our thinking, interfering with normal memory and concentration as it increases negativity, guilt, worthlessness, and pessimism. Motivation plummets, and functioning is impaired; even simple tasks may seem overwhelming. Depression costs us dearly in terms of human misery, troubled relationships, lost productivity, and even suicidal thinking and behavior. This painful and widespread problem demands a thoughtful response. Is depression an illness? The American Psychiatric Association says so. New York City’s Department of Health and Mental Hygiene says so. Pharmaceutical companies say so. But not everyone agrees. Experts concur that there are certain advantages to a medical model of depression: It reduces self-blame, and increases the likelihood that those suffering will seek appropriate help. (If I have a sore throat, I don’t think of it as a sign of personal weakness or failure. I call my doctor for a throat culture, and take the antibiotics he prescribes.) However, the disease model may not be completely accurate. While biological predispositions, hormonal influences, and other physiological factors clearly play a role in some cases of depression; no simple, clear causal relationship has been proven. While certain levels of neurotransmitters, naturally occurring chemical messengers in the brain, tend to be abnormally low in depressed individuals; we

don’t know whether the low levels cause the depression, or whether depression lowers the levels: It’s the old “chicken and egg” question. The best predictor of depression is a stressful life event, such as the death of a loved one or job loss. What does that have to do with biochemistry? And certain forms of psychotherapy have been demonstrated to produce the same changes in neurotransmitter levels that antide-

“Depression involves many aspects of our lives: It affects our physical selves, often causing a loss of appetite or overeating, insomnia or sleeping too much, fatigue and low energy…”

the behaviors they choose in response to their moods, and how these behaviors, in turn, affect their moods. They focus on experimenting and discovering what behaviors bring them closer to the results they want. Rochel* was strongly affected by her husband’s death. While she went back to work right after shivah and maintained relationships with family and friends, months afterwards she was clearly depressed. Fortunately, she became aware of her condition, and put a behavioral activation approach in place. She made only two changes: She took a walk for exercise at least five days a week, and did something enjoyable (or something that she thought might be enjoyable, or that she would have enjoyed before she felt depressed) once a week. She continued to

pressant medications do. A realistic picture of depression, then, seems to be more complex. Perhaps depression is best understood as an interactive process involving many aspects of our experience – our environments, our bodies, our feelings, our behaviors, our thoughts, and our relationships. This more sophisticated view of depression makes sense to many mental health professionals, and opens up a number of possibilities for effective intervention. So what’s the good news about depression? In three letters, it’s EBT: Evidence-based treatment. The growing trend in mental health is to help people using proven methods. Scientific research demonstrates that these treatments work well and work better than standard (or nonspecific) approaches. Most EBT’s work on a shortterm basis. Participants often make significant progress and are sometimes able to successfully complete therapy after 10 to 16 sessions. Here’s what research tells us works to undo depression: Behavioral Activation This approach sees the basic problem with depression as “shutting down.” In a misguided attempt to feel better, or with the mistaken belief that they shouldn’t or can’t do what they don’t feel like doing, depressed people often avoid activity, including social activity. They avoid the very behaviors that might give them a sense of pleasure, accomplishment, mastery, or problem-solving. The key to behavioral activation is to help depressed people re-engage with life. Participants collect information on

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mourn her husband, but her depression lifted within two to three months. Behavioral activation has been proven to be effective in both overcoming depression and preventing future relapse. An excellent selfhelp book on this method is Addis and Martell’s Overcoming Depression One Step at a Time.

Cognitive Therapy

exchange she’d had with her daughter, and said that she’d be better off dead. “She said: ‘You have no friends! You have no life!’ and it’s true. I don’t.” We examined the beliefs that fueled Adina’s painful feelings: I pointed out that Adina was alive, so, by definition, she had a life. “Oh, you know what I mean!” she argued. We considered her specific experience. Taking a more comprehensive view, we agreed that there were some aspects of her life, such as being a mother and earning a living by holding down a steady job, that pleased her, while others, such as her depression, anxiety, and being divorced that were painful. Adina also acknowledged that she was doing something about these problems – getting therapy, going to the gym, and working with shadchanim – and that she could possibly do more to enjoy a richer, fuller, more joyful life. I also pointed out that Adina had mentioned a number of friends, and asked how that fit with her belief of having none. As many depressed people do, Adina disqualified the positive. She told me that she hadn’t had much contact with one friend in quite a while, and that she thinks another only gets in touch when she wants something from her. She said that other people have more and better friends, and are more active cultivating those friendships. (The unofficial term for this is “comparisonitis,” and it’s a shortcut to depression!) We agreed that a more accurate idea was that she had some measure of enjoyment and support in her friendships, although they weren’t all she’d like them to be, and that she could choose to work on developing more and better connections with others. By challenging her perfectionistic, allor-nothing thinking and recognizing “shades of grey,” Adina arrived at a more realistic, useful, and compassionate view of herself and her situation. Her mood improved, and hope replaced her suicidal thinking. Cognitive therapy takes a while to learn, but is well worth the effort. It has been proven to treat depression and to prevent relapse. Greenberger and Padesky’s Mind Over Mood is an excellent self-help manual on this approach and the book that I recommend to my clients more than any other.

Interpersonal Psychotherapy

As the name implies, IPT emphasizes the importance of interpersonal relationships on our wellbeing and focuses on improving a depressed person’s relationships with significant others. IPT recognizes how relational difficulties can contribute to depression and how depression, in turn, frequently characterized by social withdrawal and low levels of functioning, often leads to further relational problems. Specifically, IPT focuses on one or more of the following problem areas: Role disputes (conLiberman Continues on Page 12 ➙

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DIAGNOSIS

Cognitive therapy emphasizes that humans are meaning makers: We always interpret our experience. I learned this from my Tanach teacher, the great Nechama Leibowitz, z’l, who defined parshanut as attributing meaning to sensory data. What does it mean, for example, if I lift my hand? How you feel and what you do in response both depend on how you interpret it. You may decide that I’m waving in greeting, or that I’m motioning you to come over. You may decide that I’m simply stretching my arm to get

out the kinks. You may think that I’m indicating that you should stop, slow down, or lower your voice. Maybe you think that I’m about to shake your hand. Maybe you think I’m about to hit you. Do you see how the meaning you give it changes your experience? According to most cognitive therapists, except on a level of reflex, we humans rarely react directly to our environment. Instead, our reactions are mediated by our cognitions – our thoughts, beliefs, and interpretations of the world. Al regel achat, the idea behind cognitive therapy is that you feel the way you think. Your thinking causes you to feel the way you do. And when you’re depressed, your thinking tends to be negativistic and distorted. The focus of cognitive therapy is on identifying and changing distorted thinking. Adina* struggled with severe depression since her divorce. She once described a heated


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DIAGNOSIS

Liberman Continued from Page 11 ➙

flicting expectations about role behavior in a particular relationship,) role transitions (changing roles when, for example, we get married or divorced, have a child, move to a new community, enter or retire from the workforce, get a promotion, or go back to school,) unresolved mourning, and deficits in social skills. Research suggests that since women’s self-concepts tend to be inextricably linked to their important relationships, the IPT approach may be particularly useful for them. Debbie* stated that her husband, Yehudah*, caused her depression. When I met with the two of them, I noticed that almost all of their communication took the form of quoting rules to each other, and criticizing each other for not following them. “You’re the husband! You’re supposed to support me financially!” Debbie would say. “You’re the wife! You’re supposed to have a home-made meal ready for me when I come home every day!” Yehudah would respond. Their conflict, a classic case of role disputes, was making them both very unhappy. As they focused on improving their relationship, they developed alternative ways of communicating – actively listening, expressing ap-

preciation, asking for what they wanted instead of demanding or blaming, negotiating their differences – and they grew closer. Debbie was pleased with her improved mood, and surprised by her increase in energy. “Our marriage is not problem-free,” she said, “but we catch ourselves when we get into destructive patterns. We know what doesn’t work, we know how to do what does work, and, most of all, we’re working as partners: Now we’re on the same team.” IPT is demonstrated not only to reduce depression, but also to improve social functioning.

Acceptance and Commitment Therapy

Given how much they suffer, depressed people often struggle long and hard to eliminate or at least reduce their symptoms. They also frequently also avoid situations and activities that they believe may trigger depression. From the perspective of Acceptance and Commitment Therapy (ACT), this attempted “solution,” while understandable, is a big part of the problem. We all experience a range of inner experiences, including painful feelings, troubling thoughts, uncomfortable physical sensations and reactions, unwanted, intrusive memories, and problematic urges. That’s part of being hu-

12

man. To a large degree, this is inevitable, and beyond our control. Not only can we not win the struggle, but the struggle – or the avoidance – takes our focus, attention, energy, and investment away from what really matters: the life we want to lead. ACT promotes a dual approach to

“ACT has been proven to be an effective treatment for depression that sometimes produces additional benefits after therapy is completed. …” reducing depressive suffering: Accept the inner experience: You don’t have to want it or like it, and you also don’t have to involve yourself with it, identify with it, fight it, or push it away. Then clarify your values and commit to acting on them. Use your resources to move toward a rich, full, meaningful life. Karen* struggled with depression for years, and it worsened after she relocated to a new community following a painful break-up. She criticized herself for her weight and her single status, as well as for not having met her vocational and financial goals. She wanted to help herself, and eventually identified some coping strategies that decreased her symptoms, but found that they did not do so consistently over time. When they didn’t work or when she didn’t use them, she’d blame herself and feel more depressed. ACT proved to be revolutionary for Karen. She concluded that she might never extricate herself from depressive thoughts and feelings, but that she need not entangle herself in them, either. Instead of revolving her life around managing or controlling her depression, she made a conscious and deliberate choice to focus on what was truly important to her. She appreciated and nurtured mutually supportive friendships. She started a job search for a position that offered more creativity and reward. She consulted with a nutritionist and developed an eating plan that left her feeling more satisfied and energized. She rediscovered her interest in art and resumed painting. She acknowledged her deep and genuine spirituality and sought and found a shul to whose rav and members she related. She spent more time outdoors appreciating nature. She realized her value of chesed through volunteer work. Her depression became less impactful as she cultivated her expanding and increasingly fulfilling life.

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ACT has been proven to be an effective treatment for depression that sometimes produces additional benefits after therapy is completed. The Mindfulness and Acceptance Workbook for Depression by the husband-and-wife team of Strosahl and Robinson is an excellent resource on this approach.

Medication

May 2014

Exercise

Aerobic exercise has been demonstrated to be an effective antidepressant. (There was once a psychiatrist who was so impressed with the research findings on aerobic exercise in decreasing both depression and anxiety, that he started conducting all of his sessions while running with his patients! Of course, aerobic exercise has other important benefits as well, especially in enhancing cardiovascular health.) There is some research that suggests that other forms of exercise, including strength training, also decrease depression. (Again, there are many physical advantages of strength training, especially for women over age 35.) Do all cases of depression require professional help? I believe that depression requires intervention. Some people, like Rochel in the example above, are able to undo depression by implementing their own self-help strategies. However, this can be hard to do because of the nature of depression: It decreases mo-

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tivation, energy, and hopefulness. It increases pessimism, discouragement, and helplessness. It interferes with thinking and creative problem-solving. It causes people to withdraw from their support network instead of engaging it. Also, in cases where depression leads to suicidal risk or severely impaired daily functioning, self-help may simply not suffice, or may not work quickly enough, and more intensive treatment may be needed. For these and other reasons, professional help may be the best option. To get the most out of therapy, you may wish to read Preson, Varzos, and Liebert’s short, practical book, Make Every Session Count: Getting the Most Out of Your Brief Therapy. *All identifying information has been altered, and case examples are composites of a number of different individuals. Sararivka Liberman, LCSW-R, has been a psychother-

apist for 30 years. For the past 20 years, she has provided supervision and training to mental health professionals. She currently serves as a Master Trainer in EvidenceBased Practice at the Jewish Board of Family and Children’s Services and an Administrative Supervisor at the agency’s Boro Park counseling center. She also maintains a private practice for adults in Flatbush. Contact information: 718.393.7750; sliberman@jbfcs.org.

DIAGNOSIS

There are a number of safe, effective medication options for many depressed individuals. As a non-prescribing psychotherapist, I strongly urge anyone considering antidepressant medication to consult with an expert in psychopharmacology – a psychiatrist or a specialized nurse practitioner – and to openly share their symptoms and questions. Many people deny themselves effective medical treatment because of unfounded fears of side effects and/or addiction. A responsible practitioner will discuss the benefits and risks of medication with you, and address your concerns clearly and honestly. A good clinician will include you as an important member of your treatment team. Because medication affects body chemistry, it may be just as important to communicate with your provider about stopping medication as start-

ing it; it is not safe to abruptly stop taking certain medications. Both Adina and Debbie, in the examples above, benefited from a combination of medication and evidence-based psychotherapy.


& MIND, BODY SOUL

Compassionate Parenting: The Secret to Healthy and Successful Children By Chana Kaiman, LCSW and Miriam Yerushalmi, MS

T

he quality of our closest relationships profoundly affects how we feel about ourselves. Our relationships have real and measurable consequences on our lives and those around us. The way we communicate both verbally and non-verbally affects the emotional, cognitive and physical development of our children, as well as our physical and mental health. Child-rearing is complex. Any parent can attest to the many rewards and equally distressing moments. Volumes of theories and practical approaches will not suffice to adequately explain parenting. Don’t we wish there was a manual? Each child is a unique, dynamic individual who changes almost daily. For parents to properly guide their children, it is important to consider the environment that the parents create at home. We primarily focus on the communication style between the adults, which is the template for the children’s present and future relationships. Chanie Geisinsky, a respected Rebbetzin, describes successful childrearing as 50 percent consistent chinuch (Jewish education) and 50 percent shalom bayis (atmosphere in the home). A healthy relationship between you and your spouse is critical to the success of every aspect of your child’s healthy development, both physical and spiritual. Treating your spouse positively in front of your children is paramount. Why are relationships one of the most challenging aspects of the human condition? The Torah teaches us that no element of life is devoid of meaning and purpose, and we believe that every interaction is divinely designed. So too, relationships are an important process that leads to completion (shleimus). We as human beings have a variety of emotions

and personality styles that impact the way we think and feel about the people in our life. In the midst of a contentious moment, it is difficult to grasp the higher purpose of elevating one’s soul to a more peaceful and unified state. Realize that provocations with your spouse, child or other, are all meant to result in you being more patient, enduring, understanding and tolerant. No one gets it right all of the time or even half of the time. Dr. Wile, originator of the Collaborative Couples Therapy model, states: “Solve the moment rather than the problem.” Perfecting relationships is a lifetime journey, one interaction at a time. When husband and wife get along and demonstrate respect for each other, it helps the children get along better, and also lays a foundation for children to respect their parents. It is acceptable to occasionally express disagreements amicably in front of children. According to Tina B. Tessina, author and psychotherapist, couples should definitely discuss many issues in the presence of their children. It teaches the children how relationships work. However, never let your children hear the two of you argue in a state of rage or anger; this is toxic! Seeing parents in such a state makes children feel terrified, unsafe, and heartbroken. In addition, when one parent yells and shames the other parent, the children witnessing these events feel ashamed as well. Our Sages teach that the greatest suffering is shame, and this is especially true in the case of children. Shame may cause a child such distress that eventually his life becomes unbearable and he may have little energy to achieve his potential. Even when one spouse may think the other needs to improve his/her communication, they should refrain from criticizing the other. It is better for a child to receive some overly strict discipline than to see parents fighting over this issue. Instead, after such an episode, when the spouse is not present, tell the children, “Tatty/ Mommy may speak very strongly to you, but know that we both love you and mean well.” When the situation has calmed down, the parents can work together on reducing the amount of stress in the home, making the other aware when they speak aggressively or act tense. Bringing up the topic in a calm atmosphere, which is particularly important if the spouse is sensitive to criticism, can help them reflect on their own behavior and be more open to change. For instance, a parent may say, “I think that we can both work on decreasing the stress in this home. Let’s help each other act more calmly in front of the children, especially when we have to discipline them.” By preparing a strategy in advance, a person can prevent many conflicts. If you cannot come up with an amicable solution, ask the advice of a Rav or a spiritual advisor who knows your spouse. New research has revealed that exposure to common family problems during childhood and early adolescence affects brain development, which could lead to mental health issues in later life. The study led by Dr. Nicholas Walsh, lecturer in developmental psychology at the University of East Anglia, used brain imaging technology to scan teenagers aged 17-19. He found that those who experienced mild to moderate family difficulties between birth and 11 years of age had developed a smaller cerebellum, an area of the brain associated with skill learning, stress regulation and sensory-motor control. The researchers also suggest that a smaller cerebellum may be a risk indicator of psychiatric disease later in life, as it is consistently found to be smaller in virtually all psychiatric illnesses. Dr. Walsh said: “These findings are important because exposure to adversities in childhood and adolescence is the biggest risk factor for later psychiatric disease.” Also, psychiatric illnesses are a huge public health problem and the biggest cause of disability in the world. Fighting is an indication that your communication isn’t working. When one or both parents are tired or stressed, an occasional

RELATIONSHIPS

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dispute is understandable. However, ongoing conflicts are cause for concern and need to be addressed seriously.

Action Plan to Avoid Fighting in Front of the Child

May 2014

preparing his people in the desert as they were going to be involved in the mundane life, to get accustomed to sacrifice perfectionism and be at peace with the process of becoming complete. Shalom – making peace with inadequacies. Visualize Yourself

“Each child is a unique, dynamic individual who changes almost daily…”

Points for Practical Reflection

your children come home, consider that they may have had many “muddy moments” before coming through your door. Treat them with compassion. Do your best to help them feel better. At the very least, do not throw more mud at them. Following are some important points that can help dramatically improve the way you relate to your family.

Deactivate Your Ego When It Threatens to Upset Your Family

Take note when you allow your ego to get in the way of dealing with family issues. One way to break that habit is to pay attention to body signals that can warn you when you are about to lose control. For instance, before you raise your voice to yell, does your stomach tie itself into knots, does your nose flare, or does your face get hot? These body signals are warning you to take a deep breath and, if need be, walk away until you calm down.

Affirmations

Repeat the following affirmations throughout the day, even before a challenging situation arises: “I want to unite, not to win.” “I want peace, not victory.” “Making peace is the greatest victory.” “My goal is to give peace of mind, not pieces of my mind.” “Shalom bayis is the surest path to raising emotionally healthy children.” “My efforts to become a positive role model will maximize my success as a parent.” Let’s keep in mind that beyond all the pragmatic benefits of improved relationships, shalom bayis is a mitzvah for the purpose of perfecting the soul. The reason why the Jewish people gave the peace offering (korbon shlomim) soon after matan Torah was because they had reached a spiritual state of elevation. Hashem was symbolically

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Not Criticizing Your Family Members

They are the most precious part of your life. Picture yourself refraining when feeling the impulse to act unkindly.  Cultivating an attitude of gratitude helps give your partner a feeling of security, which in turn brings peace and harmony to a home.  Helping your spouse selflessly benefits you spiritually and physically, because acting generously enhances your health and longevity.  In order to promote peace in your home, heal your relationship to money, whether you spend too much or too little.  Raising your voice in anger, speaking sarcastically, or otherwise belittling your spouse or children, indicates that your animal soul has taken over.  When one spouse expresses patience, perseverance, and a deep commitment to the marriage, amazing turnarounds can be achieved, even when the partner is the chief cause of the problems.  When a spouse helps their partner feel confident and self-accepting, they will treat one another as equals and even as superior.  A parent must model the qualities of thoughtfulness, sensitivity, and generosity that will set the standards for the children.  Professional counseling that is sensitive to Torah ethics and values may be useful in helping you achieve healthier perspectives on your marriage.  A spouse should strive to be the partner’s cheerleader rather than being an adversary. Miriam Yerushalmi holds an MS in Psychology and

Family Therapy. She was trained at Pepperdine University and is uniquely skilled at combining behavioral and humanistic approaches to address a wide spectrum of psychopathology. Miriam works in private practice with families and children, restoring healthy functioning through multisensory systems approach. 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 needy to access appropriate Mental Health care. Chana Kaiman, LCSW is a psychotherapist, lecturer and author whose specialty is in working with children, adolescents and families. She earned her degree at Wurzweiler School of Social Work. Chana has background training in the Interpersonal/Relational model and applies psychodynamic strategies for stabilizing crisis cases at IDCC. She brings a unique approach to collaboration of supports in treatment. Chana can be reached at chanat01@aol.com.

RELATIONSHIPS

V Turn around and walk away if you think you’ll have a hard time dealing with your urge to fight. Recognize that when you don’t walk away, you are putting your need to vent ahead of their well-being and peace of mind. V After you walk away, write down everything you’re thinking and feeling, so you can discuss it later when the children aren’t around. V If you’re going to have a discussion, take it somewhere private. Deal with your spouse closely and personally to minimize distractions and interruptions. Express your needs to your partner; they may not know what those needs are. Be articulate, state what you need, plainly and specifically. Remain calm. V Work out the problem. Cooperation, not competition, is needed to find a solution to the issue. V Share a moment of peace, and verbalize your feeling of resolution like saying: “I’m glad we talked” to reaffirm your bond once a decision has been reached. A teacher moved to a town and began giving a shiur, which quickly became popular. One of the established teachers thought that the teachings were cultish, so he slandered the new teacher and urged people not to attend his shiur. One rainy day, as this teacher was walking down the street, he saw the new teacher slip and fall in the mud. The teacher hurried over to him. He bent down as if to help the fallen man, but instead picked up some mud and threw it at him, hissing disgustedly: “You deserve it!” then he walked off. The new teacher got up and ran after the other man. “Wait, teacher, please!” he called out. The teacher continued walking, but the mud-stained teacher called out again: “Please wait!” The teacher slowed down slightly. “Please, teacher,” the new teacher gasped, “please, accept my apologies. I do not know exactly how I have hurt you, but the pain I caused you must have been great for you to hate me.” Both men stopped walking. The new teacher asked humbly: “Please tell me, what I have done to you? I must know so that I can do teshuvah properly.” The other teacher was taken aback. For a moment, he doubted the new teacher’s sincerity, but searching the man’s mud-streaked face, he only saw true humility. Astonished and ashamed, he thought to himself: “This is a G-dly man before me!” He embraced the new teacher and said, “It is I who must do teshuvah.” After that, the relationship between the two men improved. They began studying together and became close friends.

This sort of self-reflection is especially important in regard to your relationship with your children. When they behave disrespectfully to you, stop and think to yourself: “What have I done to cause them to be in this mood?” There is a second lesson to glean from this story. Every day children are under pressure from parents, teachers, bus drivers and siblings. They “fall in the mud” many times over the course of the day. When


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Living with Obsessive Compulsive Disorder (OCD) By Dr. Pamela P. Siller, MD

TREATMENT

I

do not have OCD. I just need to work on my middos... Many people are familiar with the publicized symptoms of OCD (Obsessive Compulsive Disorder). These stereotyped symptoms generally include excessive hand washing and turning lights on and off multiple times. Although this is correct, these are not the only ways that OCD can manifest itself. Bracha entered into my office reluctantly, stating that she came because she needed to work on her middos. When asked to elaborate, she explained that she was always worried that she was not as popular as her sisters, and that her children will not be as well-liked either. She described these thoughts as bothersome, and difficult to accept. She reported that she found it very difficult to distract herself when these thoughts began, and when she tried to think of a diversion, she became increasingly uncomfortable. She found herself counting all of her friends’ names in her head in order to count how many people “liked” her. If she said a name out of order, she had to start over. In order to deal with these thoughts, she began to learn Pirkei Avos (Ethics of our Fathers), and concluded that she needed to be happy with who she is, as “one who is rich is happy with what he has.” She decided to seek treatment when she became increasingly frustrated with her inability to “become a better person.” She began to lose sleep because of these thoughts, and food began to lose its appeal. Concentration suffered as these worries became increasingly overwhelming. After careful questioning and explanations, she was able to understand that this was not indicative of a character flaw. Rather, this was a symptom of a psychiatric condition on the anxiety disorder spectrum. Obsessive Compulsive Disorder consists of obsessions, defined as “unwanted intrusive thoughts,” and compulsions, which are “actions performed to ward off the obsessions.” These obsessive thoughts could range from the thought to physically hurt somebody, (voiced by a mild mannered, docile older female), to the fear of contamination and germs which was thought to lead to immediate death if a doorknob was touched by the bare hand. These thoughts usually cause great

distress to the person, which may further confound the diagnosis, as secondary depression (with the associated symptoms of change in sleep, appetite, energy level, and concentration), may occur. Compulsions are usually bothersome as well, as the person feels that they cannot control these actions and they do not make sense, yet they cause a significant feeling of discomfort and anxiety when they are not immediately indulged upon. They often are linked directly to the obsession, such as hand washing excessively when the obsession involves germs, but at times they do not correlate directly, such as the need to put on the right sock six times. Treatment for OCD can consist of both therapy and medication management. Both can be helpful if done properly. The mainstay of medication management consists of using an antidepressant, such as Zoloft, Prozac, Paxil, Celexa or Lexapro. The most efficacious of this category includes the lesser known Luvox and Anafranil. Usually the dosages effective for OCD are higher than utilized for depression or anxiety. Therapy for OCD is often cognitive-behavioral, which includes exposure and response prevention. The premise of response prevention is exposing the person to the feared stimulus for increasingly longer periods of time, before the compulsion is allowed to be performed. The cognitive portion includes recognizing and dealing with the catastrophic thoughts and/or exaggerated sense of responsibility. Usually this therapy is short-term, and is often very successful. Education regarding the origins of anxiety and OCD is often very beneficial as the stigma and fear can be overwhelming. It is imperative to understand that this is a medical/psychiatric condition that does not reflect on one’s character traits and value/worth as a person. Rather, it needs to be treated as one would any medical anomaly, so as to restore, a happy, healthy and productive lifestyle.

“Compulsions are usually bothersome as well, as the person feels that they cannot control these actions and they do not make sense, yet they cause a significant feeling of discomfort and anxiety when they are not immediately indulged upon…”

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Pamela P. Siller, MD is a Board Certified Child, Ado-

lescent and Adult Psychiatrist who provides medication management as well as individual and family therapy to children and adults. She maintains a private practice in Great Neck, New York. Dr. Siller is also an Assistant Professor of Psychiatry at Westchester Medical Center, where she is the Division Chief of the Child and Adolescent Psychiatry Division and is a staff psychiatrist at Interborough’s mental health center in Brooklyn.

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Attending Couple Therapy When One Partner is Absent By Dvorah Levy, LCSW

I

May 2014

Dvorah Levy, LCSW is a psychotherapist in private

practice working with individuals and couples and specializing in relationship issues: marriage, parenting and dating. She maintains offices in Hewlett and Flatbush. Dvorah is trained in Emotionally Focused Couple and Gestalt therapies. She can be reached at 516.660.7157.

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Therapy

deally, for a couple to work on their marriage, it is best to have both partners come in to therapy. Unfortunately though, that doesn’t always happen. Many times one spouse cannot convince his/her partner to join him/her, and that’s when one partner ends up in my office alone. What happens then? Can couple therapy actually work with just one partner? Sara felt very criticized by her husband. He tended to point out the very thing that hadn’t been done yet or wasn’t done right when he came home from work at the end of the day. He was quick to comment negatively on her driving, and just about anything else she did. Her patience for tolerating this much criticism was wearing thin, and she found herself snapping at him and then withdrawing into a cold silence. Sara was becoming increasingly dissatisfied with her marriage, and we could assume that her husband shared a similar experience. However, he was not willing to come into couple therapy. In our first session, Sara asked if therapy would help if she comes in alone. The answer came with time. Sara now knows that her individual therapy sessions have helped, both individually and in her marriage. Couples engage in cycles of interaction. Interactions that feel good become positive cycles; interactions that are conflictual and leave partners feeling distant are often self-perpetuating negative cycles. How we hear or perceive our partner determines what we think, which influences what we feel. And what we feel often determines what we do. A couple’s interaction can be likened to a dance. Dance steps are determined by music, which in the case of relationships, are one’s emotions. We feel something, then we do something. A common cycle in relationships begins when we perceive hurt, which is then followed with instinctive attack or withdrawal, two knee- jerk reactions that ensure distance rather than closeness and perpetuates a cycle of hurt and misunderstanding. The power to change a negative cycle lies in changing how we hear and understand our partner, and how we respond when we feel hurt. This is what couple therapy targets. In session, Sara was able to identify why her husband spoke to her so critically. In this particular case, she understood it was his anxiety. Working hard and balancing the financial needs of the family was a huge strain, and when her

husband anticipated waste, carelessness or ineffectiveness, he was triggered to feel anxiety. We would have helped her husband describe his experience if he were coming to sessions but since he wasn’t, Sara intuited what she thought may be going on for him. Sara developed a new lens from which to hear and understand what her husband was saying when he sounded critical. The thought that it was not that she was doing something wrong when he spoke to her critically, but rather was experiencing his own distress, enabled her to feel compassion. After all, they were in the same financial boat, and his caring and hard work was something from which she benefited. This more compassionate and understanding thinking created an alternative response. No longer did she require her knee-jerk protective stance of defending herself by verbally attacking or withdrawing, now she was more likely to respond with: “I know this upsets you. I will try to stop,” or with problem solving: “If the mess in the house is unnerving to you then we can…” (whatever that solution may look like.) Once Sara showed understanding as to where her husband was coming from and began to respond to him more sensitively, his response to her changed. He was soothed, felt calmer, and this translated into his being less critical. In a dance, when one person changes their steps, the other is forced to follow or toes end up getting stubbed. So too in the marriage “dance.” As one person works on him or herself and subsequently grows and changes their reactions, it is likely that the other spouse will also change his or her sequence of reacting and responding. To work on a marriage, it is preferable that couples come in to therapy together. Hopefully, they can then work on gaining insights into their cycle of interaction, into themselves and their partner. Emotional safety, connection and intimacy are enhanced through understanding the layers of actions and reactions, that “dance” that goes on between couples. However, for those times when only one partner is ready to come in, it is possible to be in couple therapy alone and improve one’s marriage.


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Being Part of the Group

TAFKID

assists families whose children have been diagnosed with a variety of disabilities and special needs.

Services provided by TAFKID include:

D Family Support Services & Information D Educational Advocacy D Individual Case Consultation D Referrals to Doctors, Therapists, Schools and Government Programs

D Parent Matching D Family Recreation Programs D Parent Training and Meetings D Guest Lecturers D Community Sensitivity and Training D Informational Publications D Pediatric Equipment Lending Program D Tape/Video Lending

Therapy

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 Audrey Grazi, LCSW

A

s a graduate social work student in 2008, my vision for helping people was exhilarating and somewhat idealistic. My favorite part of the school semester was going to the NYU bookstore to purchase the required books for my classes and browse through some of the other sections to see what the future would bring for the other courses that would be coming my way. I didnâ&#x20AC;&#x2122;t know what to expect from the group therapy course I was about to begin, but from the looks of the big fat books I was purchasing, it seemed I had a whole bunch of information to learn. As with all the knowledge that I gained in graduate school, my hope was always to bring it back to my community as a way to help others. And, as it turns out, group therapy has tremendous potential to help people on their road to recovery. Groups vary in style, structure and content. Whether it is a support group, self-help group, psychotherapy group, open-ended or closed group, confidentiality remains the central premise for helping groups succeed and be used as an important intervention. Group therapy programs are becoming a growing modality for community mental health centers and for private practitioners, as it can be cost effective and have lasting and satisfactory results. Group therapy has the potential to help people in various ways that individual therapy cannot. Social group work requires leaders to bring hidden and underlying issues and feelings to the surface, in a public way. Many times this can be a deviation from societal norms, as well as a crossing of boundaries that clients think are taboo. However, it lies within the skill of the group leader to be able to break through individualsâ&#x20AC;&#x2122; inhibitions and facilitate the group in a way that allows the client to examine and grapple with all positions and options involved, which will make the process a success. The leader can be vulnerable and flexible, but at the same time, be able to take and give control in ways that benefit the group and the individual at the same time. The group interaction becomes valuable for reflection and understanding by members. When members are experiencing similar situations, they can effectively come together to provide each other with acceptance, reassurance and encouragement. This decreases isolation and stigma, promotes problem solving, accesses strengths, develops common interests, provides information and education, facilitates mutual aid, changes attitudes and behaviors and allows clients to find new ways of relating to others. Regularly talking and listening to others can be a helpful way of putting your problems in perspective. When hearing others speak about similar experiences and issues, group members feel some relief knowing that they are not alone.

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Being part of a group offers diversity from people with different personalities and different backgrounds, which helps to see things from a new lens. By understanding how other people tackle problems and make positive changes, members can discover a whole range of strategies for facing their own concerns. Group therapy allows for an expert facilitator, as well as group members, to help contribute to learning many ways of coping with anxiety, depression, trauma, bereavement and emotion dysregulation. When choosing a group, one thing to consider is whether it is an open or closed group. An open group allows for new members to join at any time, while a closed group is when all the

members join the group at the same time. Like most things, both have their advantages and disadvantages. An open group means you can join at any time, but it also means there may be an adjustment period for a newcomer to be part of an existing group. Closed groups will only contain the same members you started the cycle with, but it may mean having to wait for the next group to start. Another thing to take into account is how many members are in the group. Small groups may allow for more individual attention, but larger groups offer more diversity and variety of opinions from more of its members. It is common for people to participate in both individual and group therapy as methods of treatment. With the support of both, one can boost his/her chances of making lasting and valuable changes. Group therapy may enhance personal growth when progress in individual therapy has been stalled. Open and honest communication and confidentiality make for good, solid groups. The bond formed from a group of people who are at first strangers, can be amazingly strong, supportive and healing. Audrey Grazi, LCSW currently has a private practice

providing individual and group therapy. DBT group forming now, Dialectical Behavioral Therapy groups help individuals regulate emotions using effective coping skills. For more information, email agrazi48@gmail.com.

May 2014


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Six Easy Steps to Foster Emotional Resilience in Retirement By Joel Verstaendig, PhD

“D

May 2014

Dr. Joel Verstaendig, a “Baby Boomer,” is a psychologist

with over 30 years of clinical experience. He is an engaging public speaker whose presentations are informative, educational,and entertaining. He can be reached at: drjoelv@aol.com or 516.933.6196. Visit his website, at www. drjoelvpsychology.com.

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Serena Wieder, Ph.D.

CLINICAL PSYCHOLOGIST Co-Creator of the DIR Model

Is pleased to announce the opening of her New York practice for Autistic Spectrum, Sensory Processing and related emotional and learning disorders at all ages. Co-Author of The Child with Special Needs, Engaging Autism and Visual Spatial Portals to Thinking, Feeling & Movement

575 West End Ave (88th Street) Ground Floor A New York, New York 10024 Phone: 240-423-3673 E-Mail: serenawieder@gmail.com

Self-Improvement

on’t trust anyone over 30!” This was one of the battle cries of the “Baby Boomer” generation during the 1960’s. It is sobering to realize that these same people have reached or will soon reach the age of retirement. While the media is saturated with information and recommendations for the baby boomers regarding the need for an adequate retirement income, little or no thought is given to the emotional needs and challenges of the retiree. This is unfortunate as there certainly are many stressors related to retirement. Consider the following vignette: Several years ago, my brother-in-law and I were watching a group of children playing together at a neighborhood birthday party. At one point, he pointed to one particular child and said: “That child needs treatment.” I was bewildered. At that time I had been a practicing psychologist for almost 25 years and I had known that child for many years, yet I had never been cognizant of any emotional issues. Furthermore, my brother-in-law is not a mental health professional. What was he noticing in a brief observation that I had not discerned over the years? Finally, with some trepidation and embarrassment I asked what he had seen. “Look at that overbite!” he exclaimed. My brother-in-law, you see, is an orthodontist. We were both watching the same child, but from our respective professional perspectives. Yes, our jobs and professions not only help us define how we view ourselves, but to a large extent they can affect the way we view the world. It is, therefore, understandable that retiring can lead to an emotional upheaval, resulting in a loss of selfesteem and a depletion in one’s sense of purpose. In 1996, Fortune Magazine published an article about Lee Lococca, the man who brought Chrysler back from the brink of bankruptcy in the 1980’s. He had retired for about three years, but then returned to work. He stated that his three years of retirement were more stressful than his 47 years in the auto business. He said that he missed his old friends and the structure of his job. In that article he wrote: “You can plan everything in life and then the roof caves in on you because you haven’t done enough thinking about who you are and what you should do with the rest of your life.” Examples of retirement stressors are many. For example, after one retires, one may begin to miss the workplace challenges, and the camaraderie that was shared with co-workers. The relationship between spouses can deteriorate. For example, if a retiree was an administrator at work, he/she might now decide to exercise his/ her administrative authority in the home. If a

retiree is not engaged in fulfilling activities, the lack of meaning in his/her life can lead to boredom and depression. Most important, one might feel distressed facing the fleeting nature of time. Most of us go through life rarely considering our mortality, and we conduct our lives as if we have an unlimited amount of time for living. Retirement represents a hard to ignore wakeup call for the retiree that he/she is in the final stage of life. So what can one do to foster emotional resilience in retirement? Here are six steps that can assist us in this endeavor: V Recognize that retirement has its own set of challenges. The first step in dealing with any problem is to recognize it and define it. Conduct an honest assessment of your retirement stressors and acknowledge them. Once this is done you can strategize and develop a plan to address them. V Evaluate your life up to the present, and explore what you would have liked to do, but did not. Consider what prevented you from engaging in these activities. Can you do them now? What has to be accomplished in order to initiate the process? V Take the time to face the fact that life is transient. Life can be so much richer if we accept this hard cold fact and focus on the things in life that are truly important rather than waste time and energy obsessing over silly concerns. Warren Zevon was interviewed on the Late Show with David Letterman following his having been diagnosed with terminal lung cancer. Letterman asked Zevon if there was anything he understood now, facing his own mortality, that he didn’t before. Zevon replied: “Just how much you’re supposed to enjoy every sandwich.” V Increase your sense of gratitude by taking the time to acknowledge all of the good things in your life. Research has shown that making an effort to actively appreciate all of our blessings, the minor ones as well as the major ones, is strongly correlated with a sense of optimism, satisfaction, and contentment. V Resolve to live a life of self-compassion and dispute your self-limiting beliefs, laugh more, and live life in a mindful manner. V Eat well and exercise as appropriate. A healthy diet and physical exercise are essential for a sense of well-being. The retirement years can be the best years of your life. Using the above six steps as guideposts will help enrich them with fulfillment and meaning.


July 31, 2014


Pharmacy Techs – The Unsung Heroes Behind the Pharmacy Counter

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Among the responsibilities of pharmacy technicians are to make sure the information on incoming prescriptions is correct, keep track of drug inventory, answer basic phone inquiries (although they are technically not allowed to advise patients – that is the pharmacist’s job), update patient profiles, and verify that whatever was ordered was received in the correct quantity. Additionally, whatever medication pharmacy technicians dispense to patients is first reviewed by the pharmacists. Many become pharmacy technicians in hopes that the experience working in such a setting will give them an advantage for getting into

macy Technician. City College of New York offers a 75-hour course that prepares students to pass the Physician Technician Certification Examination. Passing the PTCE would likely give job-seekers in New York an edge as well as provide many more out-of-state employment options, according to V-Tecs.org, a site that features a directory of pharmacy technician programs throughout the country. Dionne Bishop is a pharmacy technician at Rite Aid on Kings Highway in Brooklyn, NY. She started her career working as a store clerk but decided that she would enjoy working with the pharmacists more. Although she

or when they discover that the medication they want conflicts with another medication they are taking. “They don’t want to hear it,” Bishop says. “When they want their medication, they want their medication.” Even so, she says she is much happier as a pharmacy technician than she was as a clerk. For someone who has interest in becoming a pharmacist, needs flexible hours, or enjoys helping others, becoming a pharmacy technician is an option to explore.

GOLDEN YEARS

acknowledges that New York State does not require her to have certification, Rite Aid puts its pharmacy technicians through a rigorous training program as a condition of employment. Furthermore, she says that hospitals – which pay more than pharmacies – often require certification. Yet she loves her job. Granted, she has her share of customers who get upset when the medication comes in late, or when they find out that their insurance does not cover their drugs,

WOMEN’S HEALTH MEDICINE TODAY COMMUNITY PROFILE

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

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Barry Katz is a college administrator

HEALTHY LIVING

May 2014

pharmacy school. Others have no such aspirations but are interested in the health care field, enjoy the interaction with patients, and appreciate the flexibility that comes with pharmacy hours, which are often much longer than 9 to 5. Despite New York being one of the few states that do not require certification to become a pharmacy technician, some colleges in the state offer programs in the field. For instance, Monroe College offers an Associate Degree in Phar-

RAISING OUR CHILDREN

esidents of Windsor, Canada are thankful to a pharmacy technician for discovering an important error that may have saved some patients’ lives. Online newspaper Our Windsor reported on April 2, 2014 that Craig Woudsma, a pharmacy technician at a nearby hospital, noticed a discrepancy in some of the chemotherapy medication that had been delivered. Upon further investigation, it was discovered that one of the shipments contained watered-down medication. This individual shows how pharmacy techs play an important role in dispensing drugs. Pharmacy technicians – sometimes called pharmacy assistants – are the people you see behind the counter at a retail pharmacy giving customers their medication, but they also work at pharmacies in hospitals, long-term care facilities, and at mail-order pharmaceutical warehouses. Although some might mistake them for pharmacists – especially because many wear white coats similar to the ones that pharmacists wear – there is a great difference between the two positions: Pharmacists must go through a great deal of schooling to get their licensure and certification. As an illustration, the prerequisite courses at Touro College’s pharmacy school include biology, organic chemistry, physiology, and calculus. Once in the pharmacy school, students take many more science courses. On the other hand, pharmacy technicians often do not need to have taken any college courses. The requirements to become a pharmacy technician vary from state to state. Although most states do not require a college degree, some require pharmacy technicians go through a training program to become certified. Other states, however, have no such requirements. New York, for example, does not require any sort of training or degree to become a pharmacy technician. Thus, some job listings ask for applicants to

have either a high school diploma or a GED certificate. The U.S. News and World Report ranks pharmacy technicians at #83 in their annual list of the 100 best jobs. According to the U.S. Dept. of Labor’s Bureau of Labor Statistics, the field is expected to grow 20 percent over the next 10 years, which is faster than average. This is due to the country’s aging population. The median pay in 2012 was $14.10 per hour, or $29,320 a year.

ISSUES

By Barry Katz

Positions in Health Care

INTRODUCTION

MEDICINE TODAY


INTRODUCTION ISSUES RAISING OUR CHILDREN WOMEN’S HEALTH GOLDEN YEARS

Yankovich Continued from Page 29 ➙

(although wrist tests are good for obese patients). Arm testing, ranging from $17-130 is the best option since it receives the most accurate results, being closer to the heart. To ensure you’re using a quality blood pressure monitor, check that the label has a statement which says the device has been validated in a human study and that measurements obtained by the blood pressure monitor are equivalent to those obtained by a trained observer using a cuff and stethoscope.

UTI AND YEAST INFECTION

Users who suspect having a urinary tract infection can urinate on a test strip such as AZO or Consumer Choice System ($10) that checks for nitrates, protein and white blood cells.

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way, most doctors will want you to come to their office before prescribing medication. The most popular tests for yeast infection are Vagisil and Fem-V, both about $8. These tests detect infection by measuring the pH of one’s vaginal discharge. If levels are

FERTILITY

Urinating on a fertility tester on the third day of menstruation can reveal levels of follicle-stimulating hormone (FSH), an indicator of one’s ability to produce viable eggs. These tests are misleading since a single check of FSH doesn’t reliably tell you whether you have a healthy egg supply. These home kits are not recommended since infertility is a complex problem that requires users to meet with a specialist for diagnosis and to start treatments no matter what the test reveals.

Most people attribute vaginal burning and pain during urination to a urinary tract infection, but if there are other symptoms such as fever, chills or back pain, then it could be something more serious like kidney damage. Either

Give a baby gift before they even think about having a baby.

A simple, affordable, at home test for Jewish genetic diseases.

A present for the future.

ologist for follow-up and further screening such as colonoscopy.

LATEST ADVANCEMENTS

The newest tests on the market can test DNA. These are good for checking one’s risk of certain genetic abnormalities or health issues, however, they cannot predict with certainty that a person will suffer from a specific illness or condition and this doesn’t take into account health issues that are acquired or not genetic explains Dr. Muhammad Mirza, medical director at Allied Medical & Diagnostic in Clifton, NJ.

TESTING ERROR

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MEDICINE TODAY

Visit JScreen.org to learn more, or call us at 404-778-8640

in the normal range, this may indicate a yeast infection, which can be safely treated with an over-thecounter medication, but if the pH levels are elevated, this may indicate a vaginosis or parasitic infection. Dr. Marina Gefanovich, a primary care physician in Upper East Side with her own practice, doesn’t recommend over-the-counter yeast infections kits since many variables can alter the vaginal Ph, yielding inaccurate results.

COLON CANCER

The two promising tests for colon cancer are The Reveal Colon Disease Test ($15.99) and The EZ Detect ($9.95), which both detect blood in the stool in very small quantities. The test is very easy to follow: users drop a testing tissue into the toilet after a bowel movement and receive results within 2 minutes once the pad turns bluishgreen if blood is detected. The test requires no lab processing or any modification from one’s diet prior to the testing. A result card is also provided to record your results and send to your physician. Stool blood can be attributed to bleeding ulcers, hemorrhoids, polyps, colitis, diverticulitis, and fissures or cancer of the colon. Consumers need to be aware that certain drugs like aspirin or anti-inflammation drugs may produce gastrointestinal bleeding that may yield positive results. If the test is positive immediately contact your physician or a gastroenter-

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Users may get an error or incorrect reading if instructions were not followed properly, or if there was a misuse of the specimen collection (the sample was held too long or exposed to severe temperature changes). Timing is also important for accuracy. Some blood samples need to be taken after fasting, while others after a meal. Some tests recommend using morning urine, which is more concentrated and unaffected by consumed foods.

NEED TO KNOW

The first thing to look for when buying any test is whether the test has been approved by a major medical organization, explains Dr. Gefanovich. “If you need a home blood pressure monitor, look for one that is approved by the American Heart Association.” All this information is usually easily located on the product’s packaging. To ensure accuracy, it’s best to choose a test approved by the FDA. Consumers are advised to check out www.fda.gov/oc/buyonline/ to verify the kit they purchased and also to check on a particular OTC test. From a medical standpoint there are some advantages to taking these tests since they are more affordable than seeing a doctor if someone doesn’t have medical coverage and they’re fairly safe to use. They can also be a useful step that a person takes which encourages them to seek medical help. Dr. Mirza clarifies: “It’s when patients avoid seeing a doctor and rely solely on these at-home tests that there’s cause for concern.” Ita Yankovch is a freelance writer for The

Jewish Press and other publications. She also teaches English and Literature courses at Kingsborough and Touro College.

May 2014


By Hillary Kener

“A

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nator for the JScreen initiative for Emory University’s School of Medicine. Kener received her Bachelor’s degree at the University of Florida and then attended business school at Johns Hopkins University, where she earned her Master’s degree. Her concentration on marketing and experience working with global media and healthcare firms enables her to foster awareness for the importance of genetic screening around the country.

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Hillary Kener is the outreach coordi-

MEDICINE TODAY

“The more information you have, the more choices you have. This is about expanding your options,” she said. According to Dr. Spencer, the risk of getting your genes screened is discovering you are a carrier, forcing you to work with your doctor to assess that risk and then make an informed decision that will increase the chances of having a healthy child. However, the risks associated with not undergoing genetic screening are much more drastic, ultimately leaving open a greater possibility of having a child that is affected by a potentially debilitating or life-threatening hereditary condition. “This is why screening is so important,” said Dr. Spencer. “It gives you choices. You don’t have to accept that risk.” Genetic screening doesn’t need to wait until you’re ready to have a child either. According to Dr. Spencer, it can equip you with that important knowledge about your carrier status, and can also help your extended family understand

GOLDEN YEARS

The Heyman family from (L) to (R): Lyons, Scott, Jared, Carly, Lady (their family pet) and Gail.

One person hoping people choose to get screened is Gail Heyman, parent of a child with Fragile X syndrome, a genetic condition involving the X chromosome and causing mental disability. “Our entire family is affected by the Fragile X gene,” said Heyman. “I have brothers and sisters and nieces that are premutation carriers and two nephews that are affected by the condition.” Since her son, Scott, was diagnosed with Fragile X at the age of 9, Heyman co-founded and remains the president of the Fragile X Association of Georgia. Heyman’s daughter, Carly, is a carrier and advocate, while her other son, Jared, started an internet company called CrowdMed for early diagnosis of rare diseases. At this point in time, the Heyman family has become strengthened by Scott’s Fragile X diagnosis, though Gail Heyman says that wasn’t always the case. “It was devastating when we first found out. It was such an unknown. After the shock that it was

what they’re at risk for. If one sibling is a carrier, they can tell others to get screened as well. “There’s no reason you can’t do it way ahead of starting your family,” said Spencer. “The screens we have today are so much better than the ones we had 10 years ago.” At-home genetic tests, like JScreen, are an easy and convenient way to screen oneself. Led by Emory University’s Department of Human Genetics, JScreen is a nonprofit at-home genetic testing program that allows you to provide a saliva sample and discover your carrier status for over 80 different genetic diseases, 19+ of which are predominant among people of Ashkenazi Jewish ancestry. JScreen can be ordered via their website, www.jscreen.org. The kit is directly mailed to you at your home and, after providing your saliva sample, you send the kit to JScreen’s testing lab which will analyze your sample and report their findings. If a person or couple’s risk is elevated, a certified genetic counselor from Emory University will contact you to discuss your results and your options. JScreen also offers a genetic sequencing option, which will detect an even higher percentage of carriers than the traditional test. “Everyone has to be aware of their carrier status,” said Heyman. “When it comes to relationships, there are lots of books written about emotional understanding, but the books also need chapters on genetics. Genetics need to be part of the conversation. People need to start saying, ‘Let’s share. Let’s get screened. Let’s get to know things. And let’s prepare ourselves for our future in a good way.’”

WOMEN’S HEALTH

May 2014

permanent and wouldn’t go away, the next step was to get all the information we could,” Heyman said. That initial push for information led to the family’s advocacy work on behalf of Fragile X and their involvement encouraging people to undergo screening to discover if they are carriers before they start or expand their families. For those that might be scared of discovering their carrier status, Dr. Spencer says knowledge is power.

RAISING OUR CHILDREN

re there any positive tests today?” It’s the first thing Dr. Jessica Spencer asks when she walks into work every morning at the Emory University Reproductive Center in Atlanta. If she’s lucky, she gets to inform a hopeful woman that she is carrying a baby, finally starting the family she’s been dreaming of. “The possibility that I might get to share that news with somebody is what gets me up in the morning,” said Spencer. “It’s why I chose to specialize in reproductive endocrinology and infertility in the first place.” When Dr. Spencer was first exposed to assisted reproduction in school, she felt a strong connection to the idea of promoting reproductive choice—helping people get pregnant when they decide the time is right and ensuring they have all the correct information so they can make decisions to help them have a healthy child. Soon after deciding on her specialty, she learned there are many misconceptions about getting pregnant. While there are misconceptions about the availability, cost and efficacy of infertility treatments, there are also misconceptions about genetic screening. Some may think genetic screening is an invasive procedure (hint: it doesn’t have to be), while others may not understand why genetic screening might be particularly important for them to consider because of their ancestry (Ashkenazi Jews, for example). And, for some, the possibility of finding out they are a carrier is scary. To those people, out of sight means out of mind. Simply because you’re not thinking about it, though, doesn’t mean the threat isn’t there. In fact, 1 in 4 people of Ashkenazi Jewish descent is a carrier of at least one of 19+ “Jewish genetic diseases” that they could potentially pass onto their children. Moreover, 80 percent of children born with hereditary diseases are born to parents with no known family history of that disease. “People who have at least one

grandparent that is genetically Jewish are more at risk of being a carrier for one of these diseases,” said Dr. Spencer. “You don’t have to consider yourself Jewish, but if you have a Jewish ancestor, you could be at a greater risk. I recommend that everybody at least consider carrier screening. The reality is that the choice to get screened can drastically reduce the chance that you’re faced with tougher choices in the future.”

THE GENETIC FRONTIER

ISSUES

What’s the Worst That Could Happen? Genetic Testing for Jews

INTRODUCTION

MEDICINE TODAY


INTRODUCTION ISSUES

HEALTHY LIVING

Cover Story

Nutrition and Food What are we really eating?

In Hot Pursuit of Good Nutrition

COMMUNITY PROFILE

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HEALTHY LIVING

MEDICINE TODAY

GOLDEN YEARS

WOMEN’S HEALTH

RAISING OUR CHILDREN

By Yaakov Kornreich

N

utritionists like to tell us that “we are what we eat,” and undoubtedly that’s true. It is a concept so fundamental that we take it for granted. How often do we stop to think about the miraculous powers of our body? It efficiently extracts the energy and nutrients it needs from the various kinds of food that we eat to sustain us throughout the day and to regenerate the billions of cells which make up our organs, blood and tissues and which must be constantly replaced. We tend to think of nutrition in scientific terms. The food that we eat is a complex mixture of naturally occurring proteins, fats, carbohydrates and water, and, to an increasing extent in processed foods, a mysterious brew of manmade additives intended to improve the food’s appearance, texture, taste, storage properties and nutritional content. We also know that not all of these additives are there for our benefit. Some are cheaper or more convenient substitutes for natural ingredients that have been removed to save their manufacturers time and money. Some have been added to make the food more attractive, but not necessarily more healthy, for consumers. Others are intended to replace some of the nutrients which were lost in the processing which made it possible to extend the food’s shelf life or shorten its preparation time in the kitchen. We have been assured by the food industry and the federal government that these ingredients have been scientifically tested and found to be safe. But every once in a while we read in the newspaper that one of these ingredients, which we had been told would not hurt us, had indeed been found to be dangerous. In some cases, the danger was so clear that the government ordered the food industry to stop

using the ingredient. In other cases, consumers had to band together to make it clear that they would no longer buy foods with that ingredient before food man-

ufacturers realized that they had to remove it from their products to protect their market share. For example, partially hydrogenated oils and shortenings containing trans fats were first introduced

around 1910. Their desirable cooking and baking properties quickly made them standard ingredients in commercially-produced baked foods and snacks. But after research in the 1990’s showed that consuming trans fats was a major risk factor for heart disease, consumer pressure forced U.S. food manufacturers to virtually eliminate trans fats from their products, years before the FDA finally declared them to be unsafe in 2013. That is why the shelves in our supermarkets now routinely contain alternative versions of familiar processed foods which claim to be low-fat, low-sodium, gluten-free, sugar-free, reduced calorie or “lite” versions of the original. However, savvy consumers are learning that just because an offending ingredient has been removed does not mean that the version of the product made with a substitute is necessarily healthier for us. For example, the artificial sweetener or high fructose corn syrup that often

is substituted in the sugar-free version of a product may have side effects that are more harmful to our health than the sugar it replaced. In recent years, advocates for healthier foods started looking beyond the ingredients and nutrients listed on the package label to examine how the underlying natural food was produced. They claim that in many cases, the natural food has been altered by modern food technology in ways which make it less healthy, and which are not apparent from the label. Some of these changes originally grew out of research to find ways to make farmers and livestock producers around the world more productive, in order to make enough food to support the growth in population and avoid mass starvation. They came up with more effective fertilizers to grow food faster, pesticides to keep food from being attacked in the fields, and mechanized agricultural techniques that drastically increased the yield per

MACRO VS. MICRO NUTRITION Macronutrients are the major nutrients that provide us with calories or energy. The three macronutrients are: a Carbohydrate a Protein a Fat The amount of calories that each one provides varies: a Carbohydrates provides four calories per gram. a Protein provides four calories per gram. a Fat provides nine calories per gram. There is an additional substance that provides calories: alcohol. But while alcohol provides seven calories per gram, it is not a macronutrient because we do not need it for survival. Just as critical as macronutrients are micronutrients, comprised of vitamins and minerals that support growth, metabolism and bodily function. Vitamins are essential organic nutrients that are mainly obtained through food. Without adequate vitamin intake, deficiencies and disorders develop. Although vitamins are only present and required in minute quantities, compared to macronutrients, they are just as crucial to health and wellbeing. There are 13 currently recognized vitamins today, including vitamin A, provitamin A (Betacarotene), vitamin B1, vitamin B2, vitamin B6, vitamin B12, biotin, vitamin C, vitamin D, vitamin E, folic acid, vitamin K, niacin and pantothenic acid. Whereas vitamins are organic substances (made by plants or animals), minerals are inorganic elements that come from the soil and water and are absorbed by plants or eaten by animals. Your body needs larger amounts of some minerals, such as calcium, magnesium, potassium and sodium, to

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grow and stay healthy. Other minerals are called trace minerals (including copper, iodine, iron, manganese, selenium and zinc) because you only need very small amounts of them each day. No single food contains all of the vitamins and minerals we need, which is why a balanced diet is so necessary. A good rule for optimum health is to aim for the most micronutrients per gram of macronutrient. That means for each gram of carbohydrate, protein or fat that you consume, you should be getting the most micronutrients possible, or the most bang for your buck. You can also think of this in calories. Per calorie, you want to get the most vitamins and minerals possible. For example, when choosing between a bag of potato chips or several slices of whole-grain bread, while they may contain the same amount of carbohydrates (the bread may even have more), the potato chips are virtually absent of vitamins and minerals – micronutrients – while the bread is rife with them. There are many factors that affect the micronutrients in food, including the ripeness of fruits and vegetables (ripe is usually more nutrient-rich), processing (nutrients are often lost), or exposure to heat (nutrients are usually lost, with tomatoes being a notable exception – a key phytochemical, lycopene, increases with cooking). However eating a lessthan-ideal fruit or vegetable is always a more nutrient-rich option than ice cream or pizza. Just weigh those micro versus macronutrients and you’ll be well on your way to toasting good health (just not with alcohol, of course!) Sources: Mckinley Health Center, DSM

May 2014


Nutrition and Food food crops have not been adequately tested for long-term safety and may present hidden dangers. The rebellion against them started with the organic food movement. It grew out of the realization that the residue of pesticides which were used to protect fruits and veg-

MEDICINE TODAY

etables in the fields from attacks by insects and other predators remained on the outer skin, and were not easy to wash off. They could be dangerous when eaten, especially by young children and other people in delicate health. The same was true for some of the artificial ingredients in commercial fertilizers absorbed by the fruits and vegetables, and the chemical additives and preservatives used in the packaging process. Consumers began demanding organically grown fruits and vegetables as well as organic eggs, produced by chickens whose feed was grown without the use of pesticides or synthetic fertilizers, preservatives and additives. Organically-grown animals are not given antibiotics to prevent disease or hormones to promote growth. There is a raging controversy over the safety of giving antibiotics and growth hormones to dairy cattle. Some claim that the antibiotics and hormones get into the milk produced by these cattle,

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Kornreich Continues on Page 36 ➙

GOLDEN YEARS

such as wheat and rice, which were genetically engineered to be easier for farmers to grow and more naturally resistant to common diseases and predators. They made farmers much more productive, but at the cost of changing the nature of the food itself. The new, high-yield versions did not have the same nutritional value, flavor and gluten content of the natural varieties of wheat and ricewhich they replaced throughout the world. They were cheaper and more plentiful, but they were not necessarily more nutritious and tasty. Similar changes were made, through crossbreeding or chemical processing, to develop “improved” varieties of traditional fruits and vegetables, such as seedless watermelons and tangerines, and tomatoes which are always bright red. Natural food advocates argue that these human-altered, genetically-modified strains of staple

spread availability of gluten-free foods in mainstream supermarkets and grocery stores as well as specialty stores. Their popularity was initially caused by the increasing number of people who have been diagnosed with a sensitivity to gluten in their diet, as well as testimonials by parents who say that switching to a gluten-free diet improved the behavior of their autistic child. Others are buying gluten-free products because they have found that they simply

WOMEN’S HEALTH

“In recent years, advocates for healthier foods started looking beyond the ingredients and nutrients listed on the package label to examine how the underlying natural food was produced. They claim that in many cases, the natural food has been altered by modern food technology in ways which make it less healthy, and which are not apparent from the label…”

and pose a health risk to children who drink it. There are strict USDA government standards on what can be labeled as an organic food to protect consumers in one of the fastest-growing segments of the U.S. food marketplace. However, published scientific studies have yet to show clear health benefits for those people who eat organic rather than conventionally produced foods. While they do show that that organic foods reduce the exposure to pesticide residues and antibiotic resistant bacteria, these differences have been judged to be minimal and there is no strong evidence that organic foods are significantly more nutritious. Running a close second is the gluten-free food craze, which has had explosive growth in the past few years and fueled the wide-

RAISING OUR CHILDREN

acre of planted farmland. These major food technology breakthroughs of the 20th century are known as the “Green Revolution.” The biggest gains in productivity came when agricultural scientists developed “high-yield versions” of typical cereal grains,

ISSUES

What are we really eating?

INTRODUCTION

HEALTHY LIVING


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

Nutrition and Food What are we really eating? Kornreich Continued from Page 35 ➙

feel better when they reduce the amount of gluten they consume. Natural food advocates also argue that the changes made to the way that cattle and poultry are raised by large commercial operators, in the name of efficiency and productivity, have changed the nature of the food being produced. Cattle who are force-fed grain in feed lots are not as healthy as grass-fed cattle free to graze on open land. The feed-lot cattle do put on weight more quickly than the grass-fed, which makes them more profitable to raise, but they are less healthy. Their meat has more fat, and according to some, a different taste. Consumers who are aware of these concerns face a choice. They can buy “healthier” varieties of staple foods, such as organic fruits,

vegetables and eggs, gluten-free baked goods, grass fed beef, and

organic varieties will also spoil faster and may not look as “per-

“We are often unaware that we are consuming too much of these things because we don’t bother to stop and read the ingredients and nutritional label on processed foods before we buy them…” antibiotic-free milk, but they will have to pay substantially more for them than for the standard commercial versions of the same food. Because they do not contain preservatives and food colorings, the

fect” as conventional produce. Is it worth the extra price? That’s a judgement call, and requires a good deal of research in order to make an intelligent choice. For example, there are certain fruits and vegetables which retain more pesticide and fertilizer residues, and for which the extra cost of the organic version would seem to be worthwhile, as opposed to others in which the objectionable residues are largely confined to the inedible or usually discarded outer peel. In many cases, there is no consensus answer from the medical community, leaving consumers to make up their own minds, often on the basis of trial and error.

A GROWING HEALTH CRISIS

Public health experts agree that the raging epidemics of obesity, Type 2 diabetes and high blood

pressure we face today can be traced to the imbalances in the typical American diet, which contains too much sugar, too much salt, and too many nutritionally empty calories. We are often unaware that we are consuming too much of these things because we don’t bother to stop and read the ingredients and nutritional label on processed foods before we buy them. Is it worth the extra effort? Sure. Taking a few more moments in order to make more intelligent choices in the supermarket aisle will help extend your life expectancy and that of the rest of the people who you are shopping for. In 1993, the Journal of the American Medical Association published a study of the “Actual Causes of Death in the United States,” by doctors J. Michael McGinnis and William Foege, focusing on heart disease, cancer, and stroke. It concluded that half of the annual deaths due to those diseases were premature, and could have been prevented by modifying

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suming fewer calories, and contain more nutrition than more highly processed foods. When reading the label, look for foods with a shorter list of ingredients, all of which you can identify without having to look them up in a dictionary or a biochemistry textbook. The larger the number of multi-word ingredients, the more cause there is for caution. Read the nutritional summary on the label in addition to the ingredients list. Calories are not the whole story here. Beware of foods which get too high a percentage of their calories from fat and sugars, and pay attention to the serving size. Another key to healthier living is to follow the Rambam’s advice: Everything, including food, is best taken in moderation. A little healthy skepticism is necessary in evaluating dramatic new claims in the media. There are no quick and easy diets that work and are healthy and satisfying for everyone. Anybody who says otherwise is trying to sell you something. Discuss any significant changes in your diet or lifestyle with your doctor before you make them. New foods could have dangerous interactions with your prescription medications or existing health conditions. Switching to a more healthy diet consisting of simpler, more natural foods isn’t as cheap or simple in today’s food marketplace as one might expect. It requires the willpower to pass up the sweet treats and the heavily promoted snack foods filled with empty calories and unhealthy additives. It also requires extra time, money and effort, but most people find that the benefits to their health are more than worth it.

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

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.

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COMMUNITY PROFILE

May 2014

ISSUES

or eliminating unhealthy behavior. Specifically, smoking, poor eating habits and a lack of exercise were responsible for 700,000 premature deaths a year. A 2004 study published in the same journal by scientists at the CDC came to the same conclusion, except that the number of those dying prematurely due to the epidemic of obesity and diabetes increased sharply. Another study by CDC scientists published last summer analyzed the medical records of more than 23,000 German adults who had been asked four questions: Are you eating well? Are you at a healthy weight? Are you physically active? Do you smoke? Those who responded that they are active, eat well, have a BMI (body mass index) below 30, and do not smoke, were 80 percent less likely to suffer from a major chronic disease than those who admitted to a less healthy lifestyle. Their good health seemed to flow from following simple guidelines for what some would call “clean living,” which does not require eating only organic foods or making other radical changes to their normal diets. Beyond those four recommendations, someone wanting to follow a simple “common sense” diet might prefer to buy whole or minimally processed foods which contain the least amount of additives, colorings, flavorings, sweeteners, preservatives and hormones. Simpler foods will also tend to satisfy your hunger quicker, after con-

INTRODUCTION

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INTRODUCTION ISSUES RAISING OUR CHILDREN WOMEN’S HEALTH GOLDEN YEARS

Nutrition and Food

Vitamins are Good for You…Right?

What are we really eating? By Leah Lebel-Wolofsky

I

f you are taking vitamins or dietary supplements, which basically include any vitamin, mineral, herb or extract sold to enhance health, you are not alone. Currently over half of Americans take some form of dietary supplements and spend over $25 billion a year on vitamin and supplement products. Most Americans take a multivitamin to make up for dietary shortcomings, while others take isolated supplements hoping for some health or energy benefit or disease prevention or cure. But do people really need vitamins or supplements? Which are best? And are there any health risks from supplements? As a nutritionist, I can tell you that vitamins and supplements are unnecessary for most healthy people. A healthy and varied diet should provide all the vitamins, minerals and nutrients needed throughout the day. An adequate intake of fruits, veggies, protein, carbs, and fats gives you everything you can ever need to get and

stay healthy. Supplements are designed to supplement the diet, not replace proper eating. You can’t just pop pills and expect to become as healthy as someone eating the right things. That said, supplements definitely have their place in society. If you have a penchant for certain foods, and only those foods, then go with a vitamin if you cannot see yourself changing your habits any time soon. Prenatal vitamins are useful for pregnant and lactating women who need more iron and folate than most diets contain. Certain vitamins come in handy for infants (who often need vitamin D), people who are lactose intolerant and can’t get enough calcium, and in dieters who may not eat enough food to meet their nutrient needs. Newborns require vitamin K because their gut cannot synthesize it. Vitamins are also quite useful in the elderly who may choose poor diets, have trouble chewing, have bad absorption of vitamins, or who are simply not getting their vitamin D supply because they are

immobile and cannot go outside. They are also necessary for those on certain medications that inhibit vitamin absorption or interfere with the body’s use of a vitamin, and needed for those recovering from things like surgery, burns or other illness. Strict vegetarians often need vitamin B12, iron and zinc, as do people coping with physical stress. But for the average consumer, vitamins are not only useless, they can actually be quite harmful if overdone. When you eat foods, there’s hardly any risk of a nutrient imbalance because you would have to eat a lot of the food to reach the danger zone. With a pill, however, it’s all too easy to pop in one too many and overdose on iron, zinc, or niacin. One man I read about arrived in an emergency room with dangerously low blood pressure after taking 11 grams of niacin, because a website falsely claimed it was an effective therapy. The tolerable upper limit for niacin is 35 milligrams (a milligram is 1/1000th of a gram).

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MEDICINE TODAY

HEALTHY LIVING

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Vitamins can also provide a false sense of security, leading people to make poor food choices. However, a vitamin can cover a surface deficiency. For example, if can give you the B12 and B6 you need, but it will not give you the fiber and other phytochemicals that come with choosing a wholesome whole grain product. In fact, even if you were to take a fiber supplement along with your vitamin, the benefits would not be as good as eating fiber in a fiber-rich natural product. You can’t just take isolated protein and vitamin D and calcium and have it replace milk. The whole is greater than the sum of its parts. Many argue that the food supply today is watered down, so to speak, and not rich in nutrients like it was in yesteryear—and that may be so—but the nutrient recommendations made by the government are based off of today’s foods, not yesterday’s. Ironically, study after study demonstrates that it’s not those at risk for deficiency, but well-nourished people who are the ones taking supplements. The people who are eating too little or unhealthfully are the ones not taking supplements, either. History has been chock-full of instances of disease where people simply fell short of their nutrient needs. Times were tough, and through long voyages, limited refrigeration, and seasonal foods not always available, vitamins were a sure bet to fill these needs. But today, in an environment where food is plentiful, it makes little sense to reach for these synthetic pills in place of good, wholesome choices. Are all supplements safe? The FDA recently identified products labeled as natural alternatives that contained drugs such as steroid hormones and stimulants and toxins like heavy metals and bacteria. Many contain caffeine, taurine, and alcohol to produce positive benefits. One brand of melatonin supplements, a supplement that is supposed to put people to sleep, was found to have ethanol, or alcohol, which also causes drowsiness.

May 2014


example, should be wary of anything containing vitamin K, which assists in blood clotting. A high dose of vitamin K may undo the effects the blood thinner was meant for.

What are we really eating? should not be the same person selling you the vitamins, and pay close attention to labels. Also, pay attention to the foods you’re eating to make sure you aren’t getting a high dose from your foods which a supplement will push over the limit. There are a few measures of vitamin amounts to pay attention to. The RDA of a vitamin is the amount of a given vitamin or nutrient you should be getting, and the upper tolerable limit is the ceiling above which there’s risk with a vitamin. Never take more than the upper limit of a vitamin or mineral unless instructed by a healthcare professional, and remember the golden rule of nutrition: everything in moderation. in private practice. She can be contacted at leah_lebel@yahoo.com or by phone at 718.877.4937.

GOLDEN YEARS

Leah Lebel-Wolofsky is a nutritionist

WOMEN’S HEALTH

When choosing vitamins, always choose a high-quality, reputable manufacturer. Preferably, the person giving you recommendations for which vitamins to take

Nutrition and Food

RAISING OUR CHILDREN

Recently, a new market sprouted for wholesome vitamin-rich products like vitamin-muffins and vitamin-water. These supplements aren’t any better for you than taking a mul-

tivitamin and should not be overdone. Drinking more than one vitamin water product a day can carry the same repercussions as taking too many vitamins.

ISSUES

Also, many multivitamins contain more of the vitamin than is shown on the label. Supplements are not closely regulated by the FDA. The FDA regulates food and drugs. Supplements are neither a drug nor a food item, and hence not regulated. Thus, claims can be misleading and be supported by little evidence, if at all. When taking multiple vitamins at once, the body may not be able to take in everything. Many vitamins share absorbing mechanisms. For example, zinc and copper cannot be absorbed at once, yet they are found frequently in the same supplement. Other vitamins enhance each other’s function. It’s just hard to know how taking vitamins will affect absorption of foods eaten and if doing so will be harmful in some way or another. Other people, like people with kidney disease, or those on any medication should stare clear of any vitamin or mineral supplements without first consulting with their doctor, as there may be terrible ramifications if a vitamin and necessary medicine interact. A patient on a blood thinner, for

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MEDICINE TODAY HEALTHY LIVING H&L TECH

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

HEALTHY LIVING Trim & & &Fit

By Esther Hornstein

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hen my patient, Rachel, emailed me about this thing that “I had to try,” I was skeptical. What was she raving about? This ayurvedic practice is alleged to keep your teeth clean, breath fresh, remove bacteria, cure allergies, and drain phlegm from your sinuses. What is this magical thing? It is called oil pulling. As the name suggests, oil pulling is the method of swishing oil in one’s mouth for a long period of time, ideally ten to twenty minutes. Traditionally, sesame oil is used. Lately people are experimenting with sunflower oil or coconut oil too. Strangely enough there is some research on this Indian-based routine. Patients were tested daily for bacterial levels in the mouth. The group that did oil pulling tested as having much lower levels of oral bacteria than the control group. After 40 days of oil pulling, oral bacterial levels were down 20%. Sesame oil has an effect on certain bacteria such as streptococcus mutans in the mouth. My initial impression was “ewww!” However, I have changed my attitude since I’ve tried it! I happen to be sensitive to sesame – it makes my throat itch – so I went for coconut oil. Coconut oil becomes solid at room temperature or cooler, so initially it has a buttery consistency. Take a teaspoon full and put it in your mouth. Use your tongue to “pull” it along all your teeth and once it becomes liquefied, swish it throughout your mouth. These oils have antibacterial properties. As the lipids (fats) in the oil mix with saliva, toxins, bacteria and other undesirables get trapped in the oil as it makes its way around your mouth. Due to the toxins trapped in the oil, one needs to be careful not to swallow any oil or let it get to the throat. Gargling or swallowing the oil is counterintuitive to the process because it would expose the germs to the digestive and sinus avenues

Oil Pulling: The “New-Old” Trick for Healthy Teeth of the body. Additionally the oil should be spit out after 20 minutes or less to prevent toxins from reabsorbing into the mouth. The oil should be spat into the toilet or garbage can, not the sink drain as some oils may congeal in narrow pipes and cause clogging. The mouth should be rinsed out

is pain free. Due to a bad orthodontic experience, I have a few teeth that always get cavities. I was pleasantly surprised at my last dental check up confirming no more cavities! I attribute this to oil pulling and I am no longer grossed out. Daily oil pulling is safe and recommended to keep your teeth

Z Stops bleeding gums Z Possible holistic treatment of TMJ and soreness in the jaw Due to the detoxifying effect of oil pulling many enthusiasts infer that this technique strengthens the immune system as well. Some purport that oil pulling can then treat seasonal allergies, migraines, sinus

with water to make sure all the oil is out and it is suggested to drink a glass of water. The trickiest part by far is communicating with family members during the ten to twenty minutes of no talking. Start slowly by trying it for five minutes at a time and work up to longer periods of time. I tend to have sensitive teeth and bleeding gums even with a very diligent brushing and flossing routine. Since starting oil pulling my mouth

healthy. Check with your dentist if you have any dental apparatus to make sure consistent oil pulling won’t damage artificial structures. ON THE WHOLE, BENEFITS REPORTED ARE: Z Prevention of gingivitis, gum disease and cavities Z Treatment of bad breath Z Strengthening of teeth, gums and jaw Z Preventing dryness of mouth, throat and lips,

pressure and more, but there is no research on that yet. You can find suitable oil at your local grocery or health food store. Enjoy!

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Esther Hornstein is a New York State-

licensed acupuncturist practicing since 2007. She founded 2nd Nature Acupuncture in Brooklyn, NY. Acupuncture is an alternative medical process helpful for almost all ailments and people of all ages. For more information visit www.2ndNatureAcu.com.

May 2014


Say Cheese! 10 Bites About this Dairy Delight

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ith Shavuos springing upon us, many have our sights set on the dairy aisle, eagerly anticipating a new lasagna or cheese-based recipe. From cottage cheese to farmer cheese to cream cheese, we’ve come to depend on this staple for all of our dairy dishes. Here are a few things you probably didn’t know about your favorite dish add-in, and hopefully something you’ll appreciate the next time you choose to “say cheese!”

Americans ate an average of  In33 2012, pounds of cheese per person. The

cheese is produced, manufacturers are left with 1/10th the  After volume of cheese as the milk it came from. That means it takes 10

pounds of milk to get just one pound of cheese! The first step in cheesemaking is known as curdling. Milk must be separated into two components, the solid curds and the whey, by adding rennet or some form of acid or bacteria. The solid curds are for cheese and the whey is—you guessed it—the same whey protein found in whey protein shakes. the curds can take a few different  Next, routes. They can be drained, salted, and

are over 500 recognized varieties of cheese, categorized by tex There ture as hard, soft, semisoft or semihard, or by milk content, such as

cow or goat’s milk. Cheese can also be categorized as a lower-fat or highfat cheese. What has become known as “American cheese” isn’t really a type of cheese at all. Instead, it’s processed from other cheeses and may be made either from a single cheese or a blend of cheeses, milled and filled into molds to make uniform slices. American cheese was invented by J. L. Kraft, the founder of Kraft foods, as a longer shelf-life alternative to traditional cheese.

varieties. If you’re buying freshly sliced cheese, ask the counterperson how long the cheese’s shelf life is. Most cheeses last about 4 weeks whole or 2 weeks if grated. Also, be sure to pay attention to the three C’s of cheese handling. Keep it Clean, as cheese absorbs other flavors and bacteria very easily, you want to keep it separate from other foods. Next, keep it Cold, between 34 to 38 degrees Fahrenheit. Finally, keep it Covered in tightly wrapped plastic wrap or parchment paper and trim off any dry edges before serving cheese.

word “cheese” comes from the Latin word caseus, which means  The “cheese.” The word caseus is also the source of the word casien,

cheesemonger, a specialist or a seller of cheese. Cheesemongers are usually employed in supermarkets, restaurants and specialty shops and are responsible for selecting the cheese menu and purchasing, storing, taking care of the cheese, and helping customers select just the right cheese for their dish. Becoming a cheesemonger requires lots of tasting and handson experience, kind of like becoming a wine expert.

May 2014

Leah Lebel-Wolofsky runs a private nutrition practice in Brooklyn, NY. She can be contacted at 718.877.4937.

COMMUNITY PROFILE

in a career working with cheese? Believe it or not, you can  Interested go through several years of training to become what’s known as a

can be used in a number of different recipes and dishes. Pizza  Cheese Hut alone uses 300 million pounds of cheese per year to produce its

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which is the protein found in milk and a very versatile item found as a food additive and even as an additive to glue. It also is thought to come from the Indo-European word “Kwat,” which means to ferment or make sour. The Old English word “cese” and the West-Germanic “case” is the more recent source of cheese and the root of the word kais, which is Yiddish for cheese.

HEALTHY LIVING

choosing cheeses, be sure to pay attention to the stamped ex When piration dates on packages which can be quite short in some cheese

MEDICINE TODAY

packaged to form a few varieties of soft cheeses, or alternatively heated to produce a drier and harder cheese. The curd can be stretched and kneaded in hot water to developing a stringy, fibrous body for things like mozzarella or provolone cheese. It can be “Cheddared,” or the slang term for dried and mixed, which produces the texture familiar in cheddar cheese. Or it can undergo a washing with warm water, lowering the acidity and producing the more milky flavor of edam cheese. Some cheeses also undergo a ripening process which can lasts several weeks, months, or even years to develop their flavors.

GOLDEN YEARS

most popular cheese eaten in America today is the famous mozzarella, used in everything from pasta to pizza. Mozzarella beat cheddar in 2005 as the most popular cheese, and cheddar is still America’s second most eaten cheese. The most easily recognized cheese is none other than Swiss, famous for its holes which are caused by gas during the period which Swiss cheese is ripened. Perhaps unbelievably, cream cheese is also an actual type of cheese, infamous for its high fat content.

WOMEN’S HEALTH

others are very high in saturated fat. High saturated fat cheeses should be limited because they can contribute to heart disease. Choosing lower-fat cheeses like mozzarella and cottage cheese is a good idea for those wanting to decrease their risk of heart disease. That said, cheese should not be avoided altogether because it is a rich source of calcium, vitamin D and protein, and is shown to have positive benefits including protecting tooth enamel and helping people fall asleep.

searchers have found what appears to be the remains of cheese in Egyptian tombs dating over 4,000 years ago! One theory says that cheese was invented as merchants transported milk in the stomachs of animals, which has rennet, an agent causing milk to curdle. Rennet found in calf stomachs is still the most common curdling agent today because it’s the easiest source of obtaining the chemicals that will effectively and efficiently curdle milk into cheese. However, milk can also be curdled to cheese by using acids such as vinegar or lemon juice.

RAISING OUR CHILDREN

historians have studied cheese’s origins, no one is quite sure  Like the actual varieties of cheese, the nutritional content of cheeses vary widely. Some cheeses are lower in fat and high in protein while  Though how long cheese has been in existence or how it got invented. Re-

ISSUES

By Leah Lebel-Wolofsky, MS, CNC

INTRODUCTION

HEALTHY LIVING

pizza. Other more nonconventional uses of cheese include cheese for spa treatments. Dr. Oz’s skincare specialist, Dr. Marmur, recommends pineapple and cottage cheese applied to the face for relief of rosacea symptoms. Cottage cheese can also ease dark undereye circles and a cream cheese face mask is great for dry skin.

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Recipe Box

Get Your Grills On!

By Elizabeth Kurtz

COMMUNITY PROFILE

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HEALTHY LIVING

MEDICINE TODAY

GOLDEN YEARS

WOMEN’S HEALTH

RAISING OUR CHILDREN

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rilling season is upon us and I am ready! Bring on the sunny skies, smoky briquettes, and fabulous flavors of BBQ! I make everything on the BBQ from basic grilled chicken to grilled breads and fruits. With the right techniques, anyone can be a grill master. Not only will you

produce great meals that are cooked in a flash, the cleanup is minimal, too. Try these recipes for starters, and check out others online at www. gourmetkoshercooking.com. Feel free to write me at ekurtz@gourmetkosherocoking.com with any grilling questions so you too, can have a great grilling season.

THE ULTIMATE GRILLED CHICKEN WITH STONE FRUIT SLAW GRILLED CHICKEN Serves 8 This is the moistest, juiciest, most flavorful grilled chicken ever, due to the super flavorful marinade. Ingredients: 2 cloves garlic, chopped 2 shallots, chopped 2 teaspoons Dijon mustard ¼ cup red wine vinegar 1 head roasted garlic, squeezed out 2 teaspoons chopped fresh rosemary ¾ cup olive oil Kosher salt Ground black pepper 8 chicken cutlets, pounded to an even thickness Directions: In a small bowl, whisk together garlic, shallots, Dijon mustard, red wine vinegar, roasted garlic, and rosemary. Slowly whisk in the olive oil until fully emulsified (I like to do it with an immersion blender to get a smooth consistency and a thick dressing). In a resealable plastic bag, pour marinade over chicken Cover and chill for at least 4 hours and up to overnight. Heat a gas grill or a grill pan over high heat. When the grill gets to an internal temperature of about 375-450 degrees, reduce the burners to medium heat. Place chicken on the grill. Cover and cook for 4 -5 minutes. Open the grill and turn flip them over and cook for an additional 4 minutes (overall cooking time is 8 – 12 minutes). The chicken should have an internal temperature of 160 degrees.

STONE FRUIT SLAW Serves 6 Jazz up any grilled chicken or meat with this summer slaw. Ingredients: 1 tablespoon grated peeled fresh ginger 1 tablespoon rice vinegar 1 tablespoon vegetable or peanut oil 2 teaspoons brown sugar ¼ teaspoon curry powder ¼ teaspoon crushed red pepper (to taste, or optional) 1-½ pounds assorted firm stone fruit (about 5, such as plums, nectarines, peaches, all julienned) 2 scallions, thinly sliced Kosher salt Directions: Whisk the first 6 ingredients in a medium bowl. Add fruit and scallions, toss gently to coast. Season to taste with salt.

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May 2014


CEDAR PLANKED SALMON WITH DILL SAUCE

COFFEE RUBBED STEAKS WITH CHIMICHURRI SAUCE

CEDAR PLANKED SALMON Serves 5 The planks help give this salmon awesome smoky flavor without the fish sticking to the grill.

DILL SAUCE

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Ingredients: 1 cup mayonnaise 1 tablespoon ketchup 3 tablespoons grated apple 2 pickles, chopped 1/3 cup chopped onion ¼ cup fresh dill 1 tablespoon sugar

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Directions: Process all ingredients in a food processor to desired consistency.

May 2014

HEALTHY LIVING

For chimichurri sauce: In a medium bowl, whisk vinegars with olive oil and sugar. Stir in shallot, parsley, cilantro, chives and oregano. Season with salt and pepper.

MEDICINE TODAY

Directions: For the steak: In a small bowl, mix coffee beans, cocoa, chile powder, brown sugar, paprika, cumin and salt. Pat steaks all over with coffee-chile rub and let stand at room temperature for 30 minutes to 2 hours. Light a grill or heat a grill pan. Grill over moderate heat, turning once, until nicely charred and medium-rare, about 11-13 minutes. Let it rest for 10 minutes and slice.

GOLDEN YEARS

Directions: Chimichurri Sauce 2 tablespoons white wine vinegar 2 tablespoons balsamic vinegar ¼ red wine vinegar 3 tablespoons olive oil 1 teaspoon sugar 1 shallot, minced ¼ cup flat-leaf parsley, chopped 1 tablespoon finely chopped cilantro 1 tablespoon finely chopped chives 1 teaspoon dried oregano Kosher salt and pepper to taste

WOMEN’S HEALTH

Directions: Soak the plank in water for 30 minutes. Put the salmon on the cedar plank. Season with salt and pepper, drizzle the honey, lemon juice and olive oil on top of the salmon. Heat the grill. Place the salmon on the plank on top of the warm grill. Cover the grill and cook for about 15 minutes or to desired doneness. Serve with dill sauce.

RAISING OUR CHILDREN

Ingredients: 2 tablespoons finely ground coffee beans or instant coffee granules 1 tablespoons cocoa powder 2 tablespoons chili powder 2 tablespoons dark brown sugar 1 tablespoons smoked paprika or regular paprika 1 ½ teaspoons cumin 1 tablespoon kosher salt 4 10-ounce filet steaks or 1 (3 lb) minute steak, split into two pieces

Ingredients: 1 cedar plank (available at Williams Sonoma and Costco) ½ side of salmon fillet 4 tablespoons honey 1 tablespoon lemon juice 1 tablespoon olive oil Kosher salt and pepper

ISSUES

Serves 8 You can use the chimichurri sauce below or my honey-mustard sauce. Any type of grilling steak works. I use sirloin, minute steak, skirt steak or thin cut London broil. Coffee, cocoa and chili powder give great depth of flavor.

INTRODUCTION

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INTRODUCTION ISSUES RAISING OUR CHILDREN WOMEN’S HEALTH GOLDEN YEARS

“Smart Watches” from Samsung Just Got Smarter

Tech Support

By Shimon Lewin

R

ecently Samsung unveiled its next generation of “smart watches.” For those of you who aren’t familiar with the term, these are watches that can do a whole lot more than your average watch, including receive phone calls, play music, monitor your heart rate and more. The new generation of smart watches has some significant upgrades and improvements from the older models. The older Samsung watches ran on Android while the new ones run on Samsung’s own operating system, called Tizen. The old generation came in just one version. The new smart watches come in three models: The Samsung Gear 2, Samsung Gear Neo, and Samsung Gear Fit. The Samsung Gear 2 ($299) is the most expensive and comes with a built-in 2 megapixel camera to

take pictures from your watch. The design has significantly improved, moving the camera from the watchband to the watch itself. Many people complained that having the watch on the wristband restricted them to using only one type of band, which is now no longer the case. The Samsung Gear Neo ($199) comes with almost everything that the Samsung Gear 2 has, except the camera. Many people have no use for the camera and consider it an extra weight and unnecessary and costly feature. In addition, there could be privacy issues with having the camera in certain situations. The third model, the Samsung Gear Fit ($199), is geared towards the exercise enthusiast and is very different in screen size and design. It’s designed like a bracelet and includes several additional fitness-related features, and does not include a camera.

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Each of these watches have a builtin heart monitor that will measure and log your pulse rate, and a pedometer to help keep track of your steps and how many calories you are burning. You can set your own goals (or use the preconfigured ones) and track your fitness progress. These major improvements make the next generation smart

knowledge navigator and intelligent personal assistant. You can view your photo gallery, listen to music and control your media player and even some TVs by using your watch as a remote (with the built-in infrared signal). The watch even tells you the weather and can help you find your phone if you misplaced it (as

watches a must-have. I still can’t help but wonder why they were not released with the first generation. And just like the old generation of smart watches, with these new ones you can make and receive calls from your watch (as long as it’s connected via Bluetooth to your Samsung smartphone). It also lets you see your call logs, contacts and calendar, and can notify you of new email, voice mails, calls, tweets, and other customizable alerts. There’s a built-in vibration feature so alerts can be discreet. Apps on the watch let you monitor and keep track of your sleep. You can also control your phone with the sound of your voice by using the S Voice feature, Samsung’s

long as your phone is within Bluetooth range). One note of caution: According to Samsung, their smart watches are not compatible with all of their phones, so please check if your phone is compatible before going out and purchasing one. I have personally been using the Samsung Gear 2 Neo and overall it’s been a great experience. One downside is the band design. I have found that the neo clip from the band digs into my skin at times. Another frustration is that it is a little too easy to delete messages. Other than that, however, this is definitely a good watch.

The Therapy Resource for Families & Professionals!

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Sensory Integration • Early Learning •

225 Arlington Street Framingham, MA 01702 Tel: (800) 257-5376 Fax: (800) 268-6624 www.therapro.com

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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.

May 2014


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Heads-up Taste Buds! The Kosher Market is Bubbling with Healthy (and Tasty!) New Products

n recent years, it’s become very clear that the kosher Jewish market isn’t what it used to be. With new and innovative food lines cropping up every day all over the world, it’s easy to find products that are healthy, delicious, affordable, accessible… and kosher. Whether you’re trying to be more health-conscious in general or you follow a strict diet – whatever kind that may be – numerous food items are now available to fit your lifestyle.

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ne company that caters to those on a restricted diet is Breads from Anna, which was founded on the belief that those living on a restricted diet can enjoy both delicious and nutritious foods. When Anna, the founder, had to begin living on a gluten-free diet for medical reasons, she also needed to keep sugar low and make sure she was getting important nutrients for her body. Unfortunately, she found that many of the gluten-free alternatives on the market are made with low-nutrient starches and fillers, and the cardboard taste that generally accompanied the glutenfree foods didn’t make things any better. Additionally, in order to make the products tasty, the manufacturers often add a lot of sugar, which isn’t healthy either. Anna set out to offer delicious tasting, nutritious, and safe gluten- and allergen-free

foods. The moist and rich texture in Anna’s mixes comes from a unique blend of all-natural bean and chia flours and herbs, sweetened with only maple or honey. She offers 12 mixes which provide a good source of protein, fiber, vitamins and minerals, are safely free from the top 8 food allergens, and have no artificial ingredients, flavor enhancers, or stabilizers. A great example of her approach is with the Black Bean Brownie Mix, which is the only one of its kind on the market, and is her newest product to the line-up and one of her fastest selling. It has amazing texture and flavor and is incredibly nutritious. It is used not only by Celiac and Food Allergy sufferers, but also by diabetics and athletes. Anna’s products are sold in all 50 states nationally, and internationally. All mixes are kosher certified and GMO free certified.

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eitan, a meat alternative which is vegan, high in protein, and has zero cholesterol, has been around for centuries. Taft Foodmasters took it upon themselves to also make it taste delicious. Whether you are vegan, vegetarian, or simply interested in incporating more plant-based proteins into your diet, Taft Foodmasters Seasoned Seitan offers quick and delicious meat alternatives. Their products are completely began, kosher, pareve, non-GMO lab tested, made in the USA, and free of chemicals and preservatives. Look out for their products at your local natural food store, and on veganstore.com.

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nother natural bread product in the kosher market is Tribes-A-Dozen. A certified Women’s Business Enterprise, Tribes-A-Dozen is the first to sell an all-natural and kosher (OU) line of three Voilà! Hallah Egg Bread Mixes – Traditional, Whole Wheat and Simply Spelt. Products are unique and versatile, allowing home bakers to bake with ease and simplicity a variety of traditional European breads and pastries, such as hallah/brioche, coffee cakes, doughnuts, etc. The goal of Tribes-A-Dozen was to redefine the kosher product using premium all natural and organic ingredients. Thus, the list of ingredients is minimal, just what a home

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baker would use to bake traditional breads. Products are now selling around the country at Walmart’s kosher stores (over 750 stores) and other supermarkets and specialty and organic food markets. For more information about Tribes-A-Dozen products, visit tribesadozen.com, or find them on Facebook.

May 2014


Showcase

Putting the "SOUL" Back Into Food

Join the Kosher, Raw, Organic Movement with Living Tree Community

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Grapeseed Oil Extra Virgin Olive Oil Balsamic Vinegar of Modena Red & White Wine Vinegar

COMMUNITY PROFILE

contributing to the decline of real food. Living Tree Community Foods is a company dedicated to encouraging this new movement. We manufacture organic and kosher nut butters, oils and chocolates. Wherever possible we source our ingredients from California family farmers. We invite you to visit our website, livingtreecommunity.com, to learn more about our fabulous products and approach to good health, and see the wonderful feedback we receive from our satisfied customers.

H&L TECH

any kosher consumers are no longer willing to settle for traditional Jewish cuisine that originated in Eastern Europe, with its emphasis on fatty foods and carbs. (Potato kugel or kishke, anyone?) A growing number of discerning eaters are choosing a way of wholeness and simplicity in their food. They have come to the realization that food today is not like it was, that heavily processed, pesticide- and chemicalladen food products are a leading cause of serious illness. The growing use of GMOs is further

May 2014

HEALTHY LIVING

relatively new company, De La Rosa Real Foods & Vineyards offers a kosher and organic line of Grapeseed Oil, Extra Virgin Olive Oil, Balsamic Vinegar of Modena, and Red & White Wine Vinegar. Ensuring the best and healthiest products possible for Jewish consumers, their products are GMO-free, never from concentrate, with no preservatives, sugar, or sulfites added. For more information, visit their website: delarosa613.com.

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E-mail us at: sales@ jewishpress.com

MEDICINE TODAY

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Do you have a product or service that you would like us to feature?

GOLDEN YEARS

which is when people are allergic to the protein in different types of milk and cannot eat any cheese at all. But many cheeses, including goat cheese, contain little to no lactose; if you are indeed lactose-intolerant and not allergic to milk, goat cheese, which contains shorter fat molecules, can be easier to digest. Goat cheese is also significantly lower in fat and calories than cheese from cow’s milk, is higher in calcium, and is a wonderful source of important nutrients and vitamins. Anderson International Foods aims to produce high-quality kosher cheeses, including goat cheese, and sells to kosher markets, supermarkets, restaurants, and industrial clients. Products are sold under three labels: “Natural and Kosher” (cholov Yisrael), “Les Petites Fermieres” (cholov stam), and “Organic and Kosher” (cholov stam).

WOMEN’S HEALTH

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or those who are lactose-intolerant, the abundance of kosher cheese available nowadays may seem completely irrelevant and a luxury food item they can never indulge in. However, according to Rabbi Moshe Vogel from Anderson International Foods (AIF), most people who are lactose-intolerant can, in fact, eat goat cheese. People commonly confuse lactose-intolerance with milk allergies,

kosher supermarkets in New York. For more information, visit mattsmunchies.com.

RAISING OUR CHILDREN

f you’re looking for a healthy and completely organic alternative to traditional snacks, try out Matt’s Munchies Premium Fruit Snacks line, which won Best New Sweet Snack at Kosherfest. Less than 100 calories, this delicious kosher snack is pareve, gluten-free, vegan, free of nuts, eggs, and dairy products, with no added sugar, oil, salt and non-GMO. The ingredients are very straightforward and simple to understand, so that there are absolutely no surprises. Products are available at Fairway Market, Westside Market, and large

ISSUES

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INTRODUCTION

H&L TECH


Community Profile Forging a Chain of Support for Those Facing Breast Cancer

ISSUES

INTRODUCTION

COMMUNITY PROFILE

COMMUNITY PROFILE

H&L TECH

HEALTHY LIVING

MEDICINE TODAY

GOLDEN YEARS

WOMEN’S HEALTH

RAISING OUR CHILDREN

By Sandy Eller

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t was November of 2001 when Rochelle Shoretz, a law clerk to United States Supreme Court Judge Ruth Bader Ginsberg, found herself part of a club that she never asked to join: women with breast cancer. At just 28, Shoretz was truly in the minority, because typically more than 95 percent of all cases of breast cancer diagnosed in the United States occur in women over 40. She quickly recognized that younger women who were dealing with a breast cancer diagnosis might be in the process of dating, marrying, or having children, and had different needs than their older counterparts. Additionally, with statistics showing that Jewish women of Eastern European descent having an increased genetic risk for developing breast cancer, there was a clear need for a support group that would be culturally sensitive to young Jewish women. What began as a group of young women with breast cancer who gathered at Shoretz’s dining room table to offer each other support, grew into Sharsheret. Sharsheret’s goal is to offer support to young Jewish women from all across the religious spectrum who face breast cancer, as well as their family members. “Ashkenazi women are at a ten times higher risk for hereditary breast cancer and ovarian cancer,” explained Elana Silber, director of operations at Sharsheret, told the Jewish Press. “We are the Jewish response to breast cancer.” According to Susan G. Komen, the largest breast cancer organization in the United States, younger women with breast cancer face unique challenges, as their cancers tend to be faster growing, higher grade and more difficult to detect. Sharsheret prides itself on offering as much personal support as possible to each and every person who reaches out to them.

“Everything we do is tailored to the caller,” said Silber. “We give each woman personal direction at every point of the continuum of care, from before diagnosis, through treatment and beyond. We customize our support to meet the needs of the women and families we serve.” The name Sharsheret, which literally means “chain” in Hebrew, is an apt metaphor for the organization, which connects callers with a network of peers, medical professionals and other related resources. Each one becomes a link in an easily accessible chain of services designed for women who have been diagnosed with breast cancer, or are at an increased genetic risk for the disease. A not-for-profit organization that offers its confidential services at no cost, Sharsheret has evolved over the years to become a national organization. Shoretz, a Teaneck mother of two, currently serves as Sharsheret’s executive director. “We might be based in New Jersey, but our programs are available to anyone, whether they live in Teaneck, Miami or Los Angeles,” explained Silber. “The last thing we want to hear from someone is ‘I wish I had known that I could have called you.’” Sharsheret offers a wide variety of programs that are open to both men and women, addressing the many facets of breast cancer. An ovarian cancer program was added to Sharsheret’s list of offerings five years ago, offering specialized support to those facing both early and later stages of ovarian cancer. Sharsheret’s Genetics for Life program is a full service program that addresses hereditary breast and ovarian cancer for those who have a strong family history of these cancers, with experienced counselors on hand to discuss their family history, concerns about genetic testing and other concerns. Thriving Again helps women triumph over breast cancer by offering them the emotional and mental support they need to view themselves as

survivors who will one day emerge victorious from their fight with breast cancer and helps women in all stages of breast cancer create a personal plan which will guide take them through their medical journey. Understanding that it is the support of their peers that can often provide women with the resolve to soldier on, Sharsheret’s Peer Support Network connects women with cancer survivors, offering them crucial support via phone and email. Other innovative programs address the needs of family members and younger children whose mothers are diagnosed with breast cancer and a unique program called Best Face Forward helps women deal with side effects of their treatment that affect their appearance with cosmetic products, makeup tips and practical advice for those who are dealing with hair loss. Community members have embraced Sharsheret and over the years other programs have evolved, allowing the general population to show their support for Sharsheret. Working hand in hand with young adults who want to incorporate a meaningful component into their Bar or Bat Mitzvah, Sharsheret has partnered with many boys and girls who have used their special celebration as a means to raise awareness for breast cancer with dance-a-thons, basketball games, challah baking, fashion shows and other teen oriented activities. Sharsheret’s annual Pink Day, which began in 2010, now spans 100 schools in both America and Israel, with both boys and girls showing their solidarity by dressing in pink. “Breast cancer is not a Jewish women’s issue, it is a Jewish community issue,” said Silber. “Everyone knows someone touched by breast cancer and young adults want to make a difference. They share information and help to spread the word so that if someone is diagnosed or at risk they know they can turn to Sharsheret for support and

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information to guide them.” Pink Day is actually a springboard for the future, explained Silber, as those same high school students move on to college and beyond. “We have a college program called ‘Have the Talk’, which is a social media-based educational campaign. We train student leaders on campus to educate their peers about the increased risk for cancer among Jewish families. They also share information about Sharsheret’s free programs so that if anyone has questions about their family history, they know we are here for them. These students identify with Sharsheret and when they go out into the professional world, becoming community leaders, doctors, lawyers, nurses and parents, they take that information with them, educating both themselves and their community, knowing that we are there to help them every step of the way.” Over 600 men and women turned out for Sharsheret’s recent luncheon, held on May 4th at the Marriot Glenpointe in Teaneck. A celebration of Sharsheret’s own Bat Mitzvah, the luncheon shone the spotlight on Sharsheret’s twelve years of community service. “Just as we are reaching this important milestone, we have had over 100 bnei mitzvah who have included Sharsheret in their own celebrations,” said Silber. “We understand what it is like to have breast cancer and our programs help thousands of women and families. Anyone can call at any time and there is staff available to speak to them, connecting them with programs that will help.” To find out more about Sharsheret, visit them online at www. sharsheret.org or contact them at 866.474.2774. Sandy Eller is a freelance writer who

writes for numerous 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.

May 2014


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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COMMUNITY PROFILE

May 2014

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.

H&L TECH

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 75th 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).

ISSUES

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

INTRODUCTION

COMMUNITY PROFILE


Community Provider Bulletin Medstar: A Lifeline of Medical Support

ISSUES

INTRODUCTION

COMMUNITY PROFILE

COMMUNITY PROFILE

H&L TECH

HEALTHY LIVING

MEDICINE TODAY

GOLDEN YEARS

WOMEN’S HEALTH

RAISING OUR CHILDREN

I

f you or a loved one have undergone a medical crisis, you know how critical it is to have access to the best care. Luckily, a lifeline of support can be found with Medstar. The Medstar Medical Services Division helps patients navigate the complexities of the health care system by providing referrals to top physicians along with cutting edge and comprehensive guidance. It started over 25 years ago when Sephardic Bikur Holim, a respected social services agency, reached out to help save a life. A five-year-old boy had been hit by a car and put into a coma for ten days. His mother was also injured in the accident, leaving his father distraught and unsure how to get his son the proper treatment. Sephardic Bikur Holim was able to bring in an outside pediatric neurologist, and

within 24 hours, the young boy was awake and transferred to NYU Hospital. After just this one case, it became clear that the power of networking and support during a medical difficulty can literally save lives. Today, they are a leading, globally recognized medical care organization, with liaisons to every major hospital and doctor in the tri-state area. In 2013, Medstar received over 120 calls per week! Their knowledgeable and professional staff and volunteers go above and beyond to see that questions are answered, treatments obtained, needs met, and families cared for. The health of community members is their top priority. Whether you need a simple doctor’s check-up, need to undergo surgery, or have been diagnosed with an illness, Medstar is here to put your health first.

Online Fertility Support and Care

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ou are not alone on your journey to your dream family. From working with your physician and insurance company to delivering medications to your door, BesScription will be with you every step of the way, providing support and guiding you in all aspects of your reproductive health. BesScription is a licensed pharmacy dedicated to providing fertility medications, responsive customer service, and compassionate personalized support to people dealing with conception problems. In addition to our

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online services, we also operate a pharmacy in Sea Cliff, New York. Staffed by caring professional pharmacists and nurses, we are committed to responding to your questions and needs in a timely manner. BesScription’s mission is to give support and assistance to couples who want to experience parenthood, but are having difficulty conceiving. Call us at 866.237.9419 or visit us online at www.BesScription. com. We are here 24/7 for you!

New York Methodist Hospital’s Sports Surgeons Add Breakthrough Procedures

rthopedic surgeons at New York Methodist Hospital (NYM) have recently added several breakthrough procedures for cartilage repair, giving athletes with formerly career-ending injuries a new lease on their sporting lives. Where once articular cartilage damage meant that a patient’s years as an athlete would grind to a halt, advanced osteochondral autograft or allograft transplantation (OATS) procedures performed at NYM are enabling a high percentage of athletes to reach peak levels again.
 During an autograft procedure, healthy cartilage tissue is taken from an area of a patient’s bone that does not carry weight, and is not susceptible to the negative effects of cartilage damage. The healthy tissue is then matched to the surface of the damaged joint and solidified in place, restor-

ing a smooth and undamaged cartilage surface. While autograft procedures are ideal for the repair of smaller damaged areas in the joint, a different
procedure called an allograft may be more beneficial for larger defects. Allografts involve using larger sections of tissue taken from a donor. As with autografts, the tissue is shaped to fit the exact contour of the damaged tissue. The number of patients who come to us for cartilage repair and restoration procedures continues to increase,” said Henry Tischler, M.D., chief of orthopedic surgery at NYM. “That is because our goal isn’t just to treat athletes who have sustained injuries, but to help those athletes return to top performance again. We’re at the ‘razor’s edge’ of this field, and that’s where we plan to stay.”

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Matthew Wert, M.D., director of sports medicine at NYM.

May 2014


COMMUNITY CALENDAR Yachad West Coast Family Shabbaton Where: Sheraton Agoura Hills 30100 Agoura Rd. Agoura Hills, CA 91301 For more info: please contact Batya Jacob at 551.404.4447 or batyaj@ou.org

ISSUES

Understanding Our Zeideys:- Father’s Day Walking Tour Where: Museum at Eldridge Street 12 Eldridge St. New York, NY Time: 11am-12:30pm Bring the men you love and most admire and discover the fascinating history of the Jewish Lower East Side. We’ll provide a light father’s day brunch, explore Lower East Side landmarks of yesterday day and today, and uncover lore about gangsters, sportsmen, political activists, businessmen and other machers of the area. Tour takes approximately 1 1/2 hours.

RAISING OUR CHILDREN

JUNE 2014

June

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Digging Up Family Roots with DNA Testing Where: 15 W 86th St. New York, NY 10024 Time: 3:30-5:00 pm More info: 212.213.1002 or info@citycongregation.org Max Blankfeld, the Managing Partner and VP of Operations of Gene By Gene, a Houston-based biotech company, will explore challenges and opportunities specific to Jewish genealogical research and various matters in Jewish DNA testing.

June

1

June

13

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Where: Jewish Home at Rockleigh 10 Link Drive Northvale, NJ 07647 Time: 7:00 AM - 12:00 PM Register at www.ridetofighthunger.org or call 201.837.9090 JFS is looking for the entire community to join the fun and participate in the annual Wheels for Meals event offering 25 and 50 mile rides for advanced cyclists and shorter routes of 10 and 3 miles for less experienced riders. For those who prefer not to cycle, there is the option of a 3 mile walk.

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Empowering Ethical Elders Where: New York Society for Ethical Culture 2 West 64th St. @ Central Park West New York, NY Time: 6pm – 8pm (monthly on the 3rd Thursday for 12 times) Free presentation on the benefits of technology for seniors.

GOLDEN YEARS

Parkinson’s Disease: Practical Tools for Rehab Management Where: Hotel Pennsylvania 401 Seventh Avenue New York, NY For more info email: tsi@therapeuticservices.org or call 718.692.1929 This course will educate therapists on practical approaches to providing comprehensive, evidence-based evaluation and treatment strategies for individuals with Parkinson’s disease.

MEDICINE TODAY

First Things First for Eating Disorders Workshop for Those Affected by an Eating Disorder Where: 19 West 34 St. 3rd floor, Suite 301, New York, NY Time: 7:30pm More info: 917.692.8193 or SkerkerPsychotherapy@icloud.com Group program developed by veteran psychotherapist and eating disorders specialist William Skerker, LCSW, LRSW, and Ellen Schieren, who provide personalized phone help and support for attendees dealing with this issue. There is no charge or obligation. A one-time email or phone registration allows you to attend multiple meetings.

June

June

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Suspected Apraxia and Early Intervention: Designing Effective Therapy for our Youngest Clients Where: Edison, NJ More info: 732.632.1570 or mmohary@jfkhealth.org This one-day seminar is packed full of clinically relevant ideas and activities to fine-tune therapy sessions for young children with suspected Childhood Apraxia of Speech. June

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June

22

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JULY 2014

July

1-3

N’Shei CARES Birthing Tour for Couples Where: Maimonides Hospital Administration Building, Room 2C To register call: 718.283.7614

July

Uncovering your Family History: Researching Vital Records and the Census Where: NY Public Library- Stephen A. Schwarzman Building, South Court Classrooms Fifth Avenue and 42nd Street. Time: 3:15-4pm Discover genealogical resources at the New York Public Library. Uncovering your Family History, Part I explores vital records and the census in documenting your genealogy.

June

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AUGUST 2014 Team Sharsheret NYC Triathlon Register at athletes@sharsheret.org Our individual and relay team athletes will swim in the Hudson River, bike along Manhattan’s West Side Highway, and run through Central Park to the finish line. Individual and relay slots are available. Sharsheret will fly you to NY from anywhere in the continental U.S.

August

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COMMUNITY PROFILE

May 2014

Shalom Baby The Louise D. & Morton J. Macks Center for Jewish Education Where: 5708 Park Heights Ave.-Baltimore, MD 21215 Time: 9:30pm Contact Melissa Berman at meberman@cjebaltimore.org Childbirth Classes with a Jewish twist Cost $100

H&L TECH

1, 8, 15, 22

ICare4Autism International Autism Conference Where: New York’s Hotel Pennsylvania 401 Seventh Avenue (at 33rd St.)New York, N.Y. 10001-2062 More info: 212.537.9087

HEALTHY LIVING

Rofeh Cholim Golf/Tennis Tournament Where: Cold Springs Country Club, East Gate, Huntington, NY 11743 More info: 718.722.2002 Rofeh Cholim Cancer Society (RCCS) has assisted thousands of cancer patients by helping them maintain their individual or family health insurance policies, resulting in the best possible medical care. Join us in a day to support cancer patients and their families.

June

9

Jewish Family Services Fights Hunger

June

WOMEN’S HEALTH

Affordable Care Act (ACA) In-Person Assistance Program Where: Sunset Park Library- 5108 4th Ave. Time: 10am-6pm More info: 718.567.2806 Find information about qualified health insurance plans, check eligibility for subsidies and government insurance programs, and get enrollment assistance from trained certified navigators.

June

June

INTRODUCTION

COMMUNITY PROFILE


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

COMMUNITY PROFILE

Health AND Living Service Marketplace To Advertise in the next Marketplace section, E-mail: sales@jewishpress.com

ADDICTION RECOVERY

Genesights: The Jewish Genetics

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

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.

ASSISTED LIVING

COMMUNITY SUPPORT

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

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

Lakewood Courtyard

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.

Safe Foundation

Ateret Avot

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.

The New Nautilus

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.

Prospect Park Residence

One Prospect Park West, Brooklyn, NY 11215 718.622.8400 • www.prospectparkresidence.com Quality senior living. Community within a community.

Regency Home Health Care

Aleh Foundation USA

Chai Lifeline

Chayim Aruchim

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.

Chesed 24/7

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

Hand in Hand Family Services

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.

390 Kings Highway #1, Brooklyn, NY 11223 718.336.6073 · www.HIHFS.org TSC – After School Program · Weekend & Holiday Program · Yad B’Yad - Day Hab · Medicaid Service Coordinator · Evaluations · At Home Respite & Res-Hab

CHIROPRACTIC CARE

JCC of Greater Coney Island

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.

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

OHEL Bais Ezra Sibshops

Dr. Christopher Tabick

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

COMMUNITY SERVICES

OHEL Family Caregiver Support Group

718.745.8177

Counterforce

COMMUNITY PROFILE

Online Educational Series

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

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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.

May 2014


Health AND Living? Service Marketplace 800.603.OHEL · www.ohelfamily.org Have a disability, and looking to become more selfconfident and engaging with others? Join OHEL’s Morris Pinsky Simcha Program!

Yitzchak Weissman

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

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.

ELDERCARE ADVOCATES

Yad HaChazakah

ElderCare Advocates, Inc.

Yad v’Ezer

ELDER LAW ATTORNEYS

FELDMAN & FELDMAN, Counselors at Law 590 Madison Ave., Suite 1800, NY, NY 10022 800.702.8677

Goldberg, Sager & Associates

Zicharon Memory Loss

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

DENTISTRY

86-16 Queens Boulevard, Elmhurst, NY 11373 800.483.2175

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

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.

Dr. Steven Davidowitz: Brooklyn: 1714 E. 23rd Street, Bklyn., NY 11229 718.376.1606 Manhattan: 328 E. 75th Street, New York, NY 10021 212.759.7535 • www.luxurydentistrynycblog.com

Zweihorn Orthodontics

DIALYSIS

Gateway Dialysis Center

May 2014

BesScription/ New York Fertility Services

866.237.9419 · www.besscription.com New York Fertility Services is proud to work with BesScription, a premier fertility pharmacy. Part of Compassion Care & GO Direct Program.

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.

Jscreen

404.778.8640 · JScreen.org A simple, affordable, at home test for Jewish genetic diseases.

53

COMMUNITY PROFILE

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.

FAMILY HEALTH

H&L TECH

Brooklyn: 718.435.3393 · 4119 13th Avenue Queens: 718.969.9234 · 150-25 Union Turnpike Comprehensive Orthodontic treatment for children and adults. Sunday & Evening Hours Available.

Solomon Blum Heymann LLP

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

HEALTHY LIVING

Luxury Dentistry

Law Office of Amy Posner

20 Vessey Street, New York, NY 10007 212.385.1951

MEDICINE TODAY

Joseph Lichter D.D.S

Gross & Levin, L.L.P.

GOLDEN YEARS

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.

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

WOMEN’S HEALTH

646.723.3955 • www.yadempowers.org The Jewish disability empowerment center provides coaching and mentoring, advocacy, and resource information, led by Jews with disabilities.

ElderCare Advocates

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

RAISING OUR CHILDREN

Rofeh Cholim Cancer Society

ELDER LAW

ISSUES

OHEL Morris Pinsky Simcha Program!

INTRODUCTION

COMMUNITY PROFILE


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

COMMUNITY PROFILE

Health AND Living Service Marketplace 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.

H&L TECH

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

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

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.

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

HOME HEALTHCARE

MEDICAL SUPPLIES

Noobi3fitness

1213 Avenue P, Brooklyn, NY 11229 718.258.2737

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

Shape Fitness

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

FITNESS

917.842.8490 • www.noobi3fitness.com Chaim Friedman: chaim@noobi3fitness.com Fitness made simple 718.338.8700 • www.shapefitnessgym.com The fitness DVD you’ve been waiting for. Order now!

HEALTHY EATING

Baum’s Gluten Free Delights

www.baumsglutenfree.com Full line of yummy, gluten free products, now at your local health shops.

Breads from Anna

877.354.3886 · breadsfromanna.com Gluten and allergen-free baking mixes perfect for your family’s favorite traditional recipes.

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.

Fiber Gourmet

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

Kosher in the Kitch

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

COMMUNITY PROFILE

NU Café

4709 New Utrecht Avenue, Brooklyn, NY

Living Tree Community Foods

www.livingtreecommunity.com Organic and Kosher almond butter. Almonds grown by California Family Farmers.

Allcare Physical Therapy

Americare CSS

Caring Professionals, Inc.

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.

HamaspikCare

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

HCS Home Health Care Services of NY 1650 Coney Island Avenue, Brooklyn, NY 11230 718.336.7110 · www.hcshomecare.com Superior Home Care · Dedicated to Patient Service · Quality Home Attendants · Serving all of New York City & Nassau County · Staff Support for Payment Alternatives

Preferred Home Care of New York

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

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.

54

American Discount Medical

Surgical Sock Shop

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

Shabbos Stairlift

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

MEDICAL PRACTICE Dr. Lawrence Levitan

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

Dr. Masha (Friedman) Lewin

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.

Dr. Andrea S. Wolf,

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.

May 2014


Health AND Living Service Marketplace

MENTAL HEALTH SERVICES Counterforce Therapy Program

NEFESH International

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

OHEL Kadimah Clubhouse

Project Innocent Heart

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

Sovri Helpline

Tikvah at OHEL

800.603.OHEL • www.ohelfamily.org

Professional out-patient services by dedicated and caring team of highly specialized psychiatric specialists.

Gluten-Free Savonnerie SkinCare & Soaps

No dyes, soy, peanuts, corn or casein. Fragrance-free, allergen-specific, paraben- free soaps, hair care and skin care for the entire family. Full disclosure of all ingredients used. Vegan and biodegradable. 888.643.7627 · www.GFSoap.com

Esther Hornstein L.Ac., Dipl. www.2ndNatureAcu.com • AcupuncturEsther@gmail.com

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.

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

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.

J Drugs II

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.

COMMUNITY PROFILE

55

H&L TECH

May 2014

Kosher Vitamins

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

Start your healing now and be ready for Summer!

Our founder Esther Hornstein will be practicing in Israel starting July

HEALTHY LIVING

MEDICAL SPA

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.

917-414-3831

MEDICINE TODAY

888.613.1613 Emotional support for Orthodox victims of sexual abuse.

Bluebonnet Nutrition

for the

Quality of your life

GOLDEN YEARS

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

NUTRITIONAL SUPPLEMENTS

Quality acupuncture

WOMEN’S HEALTH

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

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.

RAISING OUR CHILDREN

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.

ISSUES

Women’s Contemporary Care Associates

INTRODUCTION

COMMUNITY PROFILE


INTRODUCTION ISSUES

COMMUNITY PROFILE

Health AND Living Service Marketplace HOSPITALITY ROOMS 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.

MEDICINE TODAY

GOLDEN YEARS

WOMEN’S HEALTH

RAISING OUR CHILDREN

Calvary Hospital (Bronx)

3rd Floor, off the Family Lounge

Catskill Regional Medical Center (Harris Hospital) Main Building, 4th Fl, #455

Columbia University Medical Center Babies and Children’s Hospital 6th Floor Lobby, Room #662

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

Ellenville Regional Hospital Radiology Waiting Room

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

Good Samaritan Hospital (Suffern) Main Lobby

Hackensack University Medical Center

5th Floor West - Women Building, Room #121

Hospital for Special Surgery 2nd Floor, Room 252 West

Lenox Hill Hospital

4th Fl (off waiting room)

Memorial Sloan Kettering Hospital 1st Floor Room C-170

Montefiore Medical Center

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

HEALTHY LIVING H&L TECH

REFERAL 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

Boro Park Center for Rehabilitation and Healthcare

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.

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

SOCIAL SERVICES

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

Ideal Medicine

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

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

Valley Hospital

Mother Baby Unit, B3224

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

Fort Tryon Center for Rehabilitation & Nursing

Parker Jewish Institute for Health Care and Rehabilitation

2nd Floor North, Room #107 Tel. in Room: 212-746-7335

Agudath Israel of America Community Services, Inc.

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

New York Hospital Cornell Medical Center

Guggenheim Pavilion, 2nd Floor, near the shul

SENIOR CENTERS

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

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

Mount Sinai Hospital

COMMUNITY PROFILE

New Age Pharmacy

2918 Avenue J, Brooklyn, NY 11210 718.253.1700

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

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

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.

Sephardic Nursing & Rehabilitation

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

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.

56

Mount Sinai Doctors Urgent Care

May 2014


Health AND Living Service Marketplace Care Coordinator for Bklyn pediatric office.

Com Hab Trainers

After School Hours positions for Com Hab trainers w/exp w/special needs children/adults. P/T afternoon/ evening hrs, also Sat/Sun Crown Hts, BP, Flatbush & Queens. E-mail: Shanie@otsar.org

Community Habilitation Supervisor

Medical Biller

Medical Biller

Direct Care Staff

certified wanted F/T for Multi-Specialty Medical Center. Candidate must be detail oriented, organized & knowledgeable in CPT & ICD coding requirements. F/T position with benefits. Please fax to 718.686.2098 or E-mail: hr@ezramedical.org

for Brooklyn social services agency. FT/PT, different shifts, including weekends, available. Please E-mail: brooklynjobs2014@gmail.com

Early Intervention Service Coordinator

Education Directors

for Queens & Bklyn Preschools. Must be certified B-2, minimum 2 years classroom experience & one year supervisory experience. Strong written, oral & verbal skills. Full time. Please send resume to: beaboveteachers@gmail.com

Medicaid Service Coordinator

Work with individuals who have developmental disabilities and their families. Responsibilities include referral and advocacy, regular meetings with individuals and families, and assisting families with needs of the disabled child. Must have an Associates degree in a health or human services field plus at least one year working with persons with developmental disabilities. Computer literacy, valid driver’s license, and own car required. For more information, please contact OHEL Bais Ezra: 718.686.3102 or E-mail your resume to: resumes@ohelfamily.org

Service Coordinator

P/T, F/T. Work w/special needs population. BA in Human Services required. Car necessary. Experienced. E-mail: Shanie@otsar.org

SLPs, OTs & PTs

For CHALLENGE Early Intervention Center NYS Lic & DOH Approval as EI Provider, Birth-3 Home-Based Cases, Brooklyn, Queens, Staten Island Fax Resume: 718.972.0696 or E-mail: Ibel.Challenge@thejnet.com

Speech Therapist

P/T working with individuals with intellectual disabilities in a clinic setting. Call Shaina 718.535.1977 or E-mail resume to: srosenfeld@hasccenter.org

COMMUNITY PROFILE

57

Service Coordinator

F/T for Challenge Early Intervention Center Bklyn & Queens positions available. Work with families of children with developmental delays. BA in Human Services or related field. Competitive compensation package. Great working environment. Queens office: Russian/Hebrew speaking preferred. An Equal Opportunity Employer Bklyn: Fax resume: 718.972.0693 or E-mail: HR@Challenge-ei.com Queens: Fax resume : 718.261.3702 or E-mail: Cara.challenge2@thejnet.com

H&L TECH

Must have BA in Human Services related field. Yiddish, Spanish & Hebrew a plus. Resume to HR@skhov.org or fax 718.686.6161

Medical Coder

SEIT Supervisor

F/T for Queens agency. Must be SAS or SBL certified. E-mail: Preschoolagency@gmail.com

HEALTHY LIVING

Counselors

Receptionist

for dental office, exper preferred. P/T. Diversified duties, good communication & computer skills. Call 718.338.0388

MEDICINE TODAY

wanted F/T for Multi-Specialty Medical Center. Candidate must be detail oriented & able to communicate effectively w/insurance companies. Some exper in medical billing reqd. F/T position w/benefits. Please fax to: 718.686.2098 or E-mail: hr@ezramedical.org

Medical company needs exp biller/coder, Flatbush. E-mail: medicalbillingjobopening@gmail.com

to work in homes for individuals with intellectual disabilities (Shabbos). Male and Female, Boro Park and Flatbush. Good pay. Exp/AMAP a plus. E-mail: cgrossman@jbfcs.org or fax: 718.438.2099 Attn: Carole

May 2014

Medical Assistant

for busy doctor’s office in Boro Park to do EKGs & to draw blood. Exper nec. Must speak English & Russian or Yiddish. Mon & Wed 10-5, Tues & Thurs 12-7. Fax: 718.258.2456

Physical Therapist

P/T working with individuals with intellectual disabilities in a clinic setting. Call Shaina 718.535.1977, or E-mail resume to: srosenfeld@hasccenter.org

GOLDEN YEARS

Seeking well organized and professional individual for our Community Habilitation Program to hire, supervise and train direct care staff working independently in and out of the homes of children and/ or adults with developmental disabilities. Experience working with individuals who have disabilities required. Management experience and BA preferred. Excellent opportunity for professional growth. Valid driver’s license and own car a must. For more information, please call Bais Ezra: 718.686.3102 or E-mail your resume: resumes@ohelfamily.org

HR Assist

for agency for children with disabilities. Degree and experience preferred. Resume to HR@skhov.org or fax 718.686.6161

NYC EI Service Coordinator

Needed F/T to function as a resource & liaison btwn families, their children & a multidisciplinary team, as the families pursue the supports avail to them under the NYC EI program. Must possess 1 yr of exper working w/children/families & a Bachelor’s degree. Competitive compensation package. E-mail res: recruit@omnirehab.com w/code JP.EISC.5/14

WOMEN’S HEALTH

Com-Hab

Dept. at HASC Center looking for M/F to work 1-on-1 with individuals with disabilities in and around their homes. Good pay. Please contact Penina: 718.535.1987, psauber@hasccenter.org

NYC DOE Employed SLP’s

Did you know that you can supplement your income by working for Early Intervention? Create your own schedule after hours or on Sundays. Immediate positions avail for home-based, Yiddish A+. E-mail resume to info@eislaasois.org. Fax 718.303.9499

RAISING OUR CHILDREN

F/T. Resp self-starter, multitask, work well under pressure. Exp w/med office inventory mgmt, ordering med supplies, liaison patients/providers, med forms, pre-authorizations. Long term only. E-mail: brooklynmed@gmail.com

End of Summer Positions

Looking for a fun and exciting way to end your summer? Come join Ohel Bais Ezra’s exciting end of summer sleep-a-way camp programs! Enjoy swimming, sports, karate, yoga, zumba, music, carnivals, dance, gorgeous outdoor campgrounds, and much more, all while making a difference in the life of a child or teen with a developmental disability. Positions available include Group Leaders, Counselors, Lifeguards, Dining Room staff, Nurse and Specialty Staff (music, art, sensory integration, dance, zumba, karate, sports, and more). Boys Sleep Away Camp at Camp Kaylie: 8/20/148/28/14. Girls Sleep Away Camp at Camp Nageela: 8/20/14-8/28/14. For more information please contact Isabel: 718.686.3475 or camps@ohelfamily.org

ISSUES

HELP WANTED

INTRODUCTION

COMMUNITY PROFILE


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

COMMUNITY PROFILE From the Doctors Desk

Based upon an interview with Dr. Henry Hasson by Yaakov Kornreich

A

common neurological complaint in children is headaches. A parent’s natural reaction is to fear the worst, but fortunately, the vast majority of such headaches are not a sign of serious problems. Nevertheless, they still need to be evaluated by a doctor performing a thorough clinical and physical exam. A child’s headaches may be a sign of something more serious if they get progressively worse, or more severe when they lay down. The most frequent contributing factors to headaches in children are unhealthy items in a child’s diet, disturbed sleep patterns or a family history of frequent headaches. High levels of ingested MSG, caffeine and nitrites and nitrates (a preservative found in deli meats) can trigger headaches in some children. Eliminating MSG from a child’s diet can be difficult. It is a common ingredient all kinds of processed foods. Caffeine is also found in many foods, in addition to coffee, tea and carbonated beverages. While the health effects of caffeine remain controversial, it is well known that adults who consume large amounts of caffeinated coffee are subject to headaches without it. That is why a child who is prone to headaches should avoid beverages or snack foods containing caffeine. Irregular sleep patterns can often cause headaches in children. Continuity of sleep is often more important than the total number of hours slept. That also applies to students who get up in the middle of the night to cram for an exam. Frequent headaches can run in families, but there is no need for parents in such families to assume that they or their child simply have to suffer with them. For routine headaches, over-the-counter analgesics such as acetaminophen (Tylenol), ibuprofen (Motrin) or naproxen (Aleve) are often effective. There are also effective prescription medicines for migraine headaches.

Protecting Our Children’s Neurological Health To reduce the incidence of headaches, a child’s diet should be able to provide an adequate amount of riboflavin, also known as vitamin B2. Two non-prescription herbal extracts, butterbur and feverfew, can also help to prevent migraine headaches. Besides headaches, another common concern for parents is the condition known as ADD/ADHD (attention deficit or attention defi-

cases are misdiagnosed. A child who is daydreaming in class could just be bored, and in need of more intellectual challenge. The child could also be suffering from mini seizures due an undiagnosed case of epilepsy. The most accurate way to make a diagnosis is for an experienced pediatric neurologist or psychiatrist to spend some time examining the child. This in com-

cit hyperactivity disorder), which some say has been over-diagnosed in children who are disruptive or inattentive in normal classroom settings. Sometimes this behavior is wrongly identified as a sign of learning disabilities, with the child then assigned to Special Education. In other cases, the problem is ignored, and the underperforming student is left back a grade, with devastating consequences to their self esteem. It appears that some of these

bination of reports from parents and schools is very important in diagnosis. In addition several objective measures of ADHD have been developed and are very helpful in supporting the diagnosis. Having the child examined with these computer tests in the office is very helpful. For years, children diagnosed with ADD/ADHD were treated with the prescription drug Ritalin, which is known to have often-serious side effects. There are newer,

58

more effective drugs, with fewer side effects, but unfortunately, many insurance companies still will not pay for them. As a result, Ritalin is still being prescribed in cases where another drug would be more effective and have fewer side effects. Studies show that vigorous exercise seems to improve the ability of these children to concentrate, as it does for most other children. Epilepsy is common in children and often can go undiagnosed as it can simply present as daydreaming or staring. In children who stare off it may be important to have an evaluation with a neurologist who is trained to diagnose epilepsy. Sometimes a simple EEG test that detects the child’s brain waves can help explain why the child seems to “space out” so often. Parents should ask for the cooperation of their yeshiva in protecting their child’s neurological health. Every student should start his or her school day by eating a healthy breakfast. Students also need a regular program of regular exercise, as well as breaks during the school day to get them up and moving to enhance their ability to concentrate in class. To help prevent headaches, yeshivas should ban students from consuming any caffeine-containing beverages and remove snack foods containing caffeine or MSG from vending machines. The good news is that we can now diagnose and treat our children’s neurological problems more accurately and effectively than ever before. By taking a few simple, preventive steps, we can also significantly reduce one of the most common complaints: childhood headaches. Dr. Henry Hasson is a board certified

neurologist with special qualifications in child neurology. He is an Assistant Professor of Neurology and Pediatrics at the Albert Einstein Medical College of Yeshiva University, where he received his medical training and completed his fellowship. He is also affiliated with Maimonides Hospital, and is an ordained rabbi. His office, at 2769 Coney Island Ave, Brooklyn NY 11235, can be contacted at 718.785.9828. For more info., visit www.hassonmd.com.

May 2014


NOT JUST PURE. Providing the purest, most wholesome dietary supplements on the market is the power behind Bluebonnet Nutrition. Ever since Bluebonnet was founded 22 years ago, we’ve never strayed from our roots – investing in the finest natural ingredients, state-of-the-art manufacturing, rigorous quality controls, and innovative formulas free of allergens like gluten and dairy. But for us, there is no higher power than Kashrus. Bluebonnet is one of the few vitamin companies that actually makes its own supplements. Our company

KOSHER P URE. built a pharmaceutical-grade manufacturing facility that not only employs cutting-edge systems to ensure superior quality, it has met the demanding kosher standards of world-renowned KOF-K Supervision.* We do this because we believe there is a proper way to make vitamins. Because clean, healthy living is one of our fundamental company values. And because we will always make sure that Bluebonnet nutritional supplements exceed the typical standards of purity… through Kashrus. * Only those Bluebonnet products bearing

are kosher-certified.

Women and men are very different beings. That’s why Bluebonnet developed kosher-certified Targeted Multiples.® These innovative multivitamins are scientifically formulated to meet women and men’s specific and changing nutritional needs as they age – even if they’re vegetarians. Each gluten-free formula not only supplies more than 25 crucial vitamins, minerals and antioxidants, but also delivers powerful fruit and vegetable phytonutrients to enhance your general health and well-being.u

Bluebonnet. Nutrition to the Fifth Power. NATURE · SCIENCE · QUALITY · TRUTH · KNOWLEDGE

Available in natural food and specialty kosher stores u

These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease.

BBKosherTMAd-CON_jan2014.indd 1

For additional information on Bluebonnet nutritional supplements, please log on to www.bluebonnetnutrition.com, or write: Bluebonnet Nutrition Corporation, 12915 Dairy Ashford, Sugar Land, TX 77478.

1/16/14 9:49 AM


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