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CONTENTS MAY 2015 ISSUES Supplement Publisher

4 5

Moshe Klass

Doctor-Patient Relationship is in Danger

6

Yaakov Kornreich

Amy Dubitsky Avigayil Perry Leah Rothstien Ita Yankovich

Heshy Korenblit

Advertising Sales

Arthur Klass David Hoppenwasser Leah Postelnik

Alana White SUBMISSION INFORMATION

Concierge Medicine

22 Down Syndrome Mimics Key

RAISING OUR CHILDREN 6

24 10 Facts About

Ovarian Cancer and Jewish Women

Mysterious Mushrooms

25 What’s the Worry About GMOs? ✪ 26 Meals from Around the World, Part 2 ✪

Get Vitamin D

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29

Showcase

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COVERY STOR

30 Zicharon: Helping Jewish 14

14 Sunshine Destinations for the Sunshine Years

31 Medical Profile 32 Community Calendar 33 Community Provider Bulletin 34 Health and Living Service Marketplace

18 Helping Seniors and Caregivers

38 Interview with Dr. Don Bandari

19 Keeping Active and Mobile to

Bond through Motion Age 90 and Beyond 3

✪ Featured Columns

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GOLDEN YEARS

Alzheimer’s Patients & Caregivers

HEALTHY LIVING

May 2015

HEALTHY LIVING

10 All About Hormone Therapy 12 Losing Your Baby Weight 13 How Modestly Dressed Women

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.

23 Genetic Testing for Sephardi and Mizrahi ✪

What is the EI?

WOMEN’S HEALTH 8

Alzheimer’s Symptom

MEDICINE TODAY

Design

20 FDA Monitor ✪ 21 The Pros and Cons of

GOLDEN YEARS

Advertising Director

MEDICINE TODAY

WOMEN’S HEALTH

Associate Editor Rachel Wizenfeld Features Editor Ita Yankovich Contributing Writers:

RAISING OUR CHILDREN

Senior Editor

23

Measles Vaccine Has Even More Benefits

ISSUES

A publication of the Jewish Press, publishing since 1960

INTRODUCTION

INTRODUCTION


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

RAISING OUR CHILDREN ISSUES

? General Disease Risk Measles Vaccine Lowers

T H By ?

he results of a new study published in the journal ? Science indicate that children who ? come down with the measles suffer lasting damage to their immune ??? systems, making them vulnerable to other potentially deadly infections to which they had previously developed immunity. The study shows that historically, large-scale measles vaccination of populations of children resulted in a reduced rate of childhood deaths, even from infections that are unrelated to measles, for up to three years. It had already been shown that measles and some other diseases, such as cancer, can temporarily weaken the body’s immune system for a period lasting from a few weeks to several months. The phenomenon is called immune system amnesia. The body’s immune system seems to forget how to fight off infections that it has overcome in the past. The new study by Michael Mina, an evolutionary biologist at Princeton University, and his colleagues applied a new mathematical model to analyze the reports of childhood deaths in the U.S. and the United Kingdom during the 1960s and in Denmark during in the 1980’s, before, during and after widespread measles vaccination was first carried out in those countries. It found that once measles infections were reduced, so were the death rates from other childhood diseases for an average period of 27 months. The researchers wrote, “Our results show that when measles was common, measles virus infections could have been implicated in as many as half of all childhood deaths from infectious disease. The reduction of measles virus infections was the main factor in reducing overall childhood infectious disease mortality after the introduction of vaccination.” Measles seems to be unique with respect to its long-term power to depress the immune system. When

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the researchers looked at childhood death rates following the first widespread vaccinations for pertussis (whooping cough), they didn’t see the same effect. Today, the MMR vaccine against measles includes protection against mumps and rubella (German measles) as well. A discredited research paper published in England by Dr. Andrew Wakefield in 1998 claimed to have found a link between the MMR vaccine and autism and bowel disease. The mainstream medical and scientific community now rejects that finding, and accuses Wakefield of using unethical research methods and falsifying his results. However, Wakefield still defends his research, and some anti-vaccination advocates still give credence to his warnings about the dangers of the MMR vaccine. The findings of the new study, that preventing a child from getting measles significantly reduces its risk of death from other infections, further strengthens the argument of the many doctors and public health experts who support a public policy of mandatory universal MMR childhood vaccination.

May 2015


? The Doctor-Patient Relationship is in Critical Condition

est growing type of primary care in America today. Ironically the foibles of the current primary care mess are the driving force behind this movement to restore the doctor-patient relationship to the trusting, caring, mutually respectful bond that has been all but forgotten.

WOMEN’S HEALTH

Dr. Werzberger is an internist who

GOLDEN YEARS

rimary care in America is in ??? transition to a new system that is incredibly distant from the one most people are used to and expect. There are many factors in play which have disrupted forever the primary care model of yesteryear. Internet healthcare and advice, smart-phone technology, coupled with a new breed of nondoctors capable of prescribing and practicing medicine have given the care-seeker a myriad of options for care heretofore nonexistent. Not all of them healthy. The pitiful, stagnant compensation, equating commercial reimbursement with Medicaid rates, has shifted the practice dynamic. Private insurance compensation is no longer lucrative compared to

RAISING OUR CHILDREN

H P

fall of patronage from established patients who are stepping out on their physician. The private practice of medicine, the traditional doctor-patient relationship based on compensation solely from insurance companies and copays, is dead. Private physicians have no economic choice but to turn their practice and you, the patient, over to one of the competing hospitals in the local healthcare market. Ultimately, the doctor has no choice but to become an employee of a large healthcare bureaucracy. He will see some patients as directed by the hospital administration, but primarily his role will be to supervise from a distance the nondoctors who will provide the bulk of hands-on, personal care. However, for a select minority of patients there is a choice. Private practice arrangements are the fast-

the patient on public assistance. Patients have embraced convenience over a quality, caring, long term relationship with their doctor. The fidelity of the doctor patient relationship has been violated and replaced by any-care by anyone, anywhere. The result is an exacerbation of wait time, difficulty in getting timely appointments, increased stress for all, and systemically fractured non-continuity of care. Patients feel empowered to seek care anywhere their whim or Google takes them, as they have full confidence that their regular physician will take them back and incorporate this self-directed care choice without reprimand or consequence. The unintended results of this behavior is that mature private medical practices are seeing the need to attract new patients continually to make up for the short-

ISSUES

By ? Excerpted from an open letter from Dr. Murray J. Werzberger to ? his patients. ?

INTRODUCTION

RAISING OUR CHILDREN ISSUES

has been practicing medicine for 29 years and maintains an office in the Midwood section of Brooklyn.

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he specialists at the New York Methodist-Cornell Heart Center offer a full range of heart care services in the most modern cardiac center in Brooklyn. They provide the newest procedures and technology for diagnosis and treatment, including groundbreaking transcatheter aortic valve replacement (TAVR) for treatment of aortic stenosis, as well as medical management, balloon angioplasty stent placement, and minimally invasive and traditional cardiac surgery – all performed by exceptional specialists and surgeons.

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RAISING OUR CHILDREN

What is the Early Intervention Program? By Shoni Eidlisz

C

hildren grow quickly and have much to learn. Most pass a set of predictable developmental milestones along the way. Some, however, need extra help. In these circumstances, early intervention can be a tremendous benefit in the growth and development of our children. As noted by the New York State Department of Health, the mission of the Early Intervention Program is to identify and evaluate as early as possible those infants and toddlers whose healthy development is compromised and provide for appropriate intervention to improve child and family development. WHAT IS EARLY INTERVENTION? Early Intervention is a public program for children under the age of three who are either sus-

pected of having or are at risk for developmental delays or disabilities. New York State’s definition of developmental delay “means that a child has not attained developmental milestones expected for the child’s age adjusted for prematurity in one or more of the following areas of development: cognitive, physical (including vision and hearing), communication, social-emotional, or adaptive development. For the purposes of the Early Intervention Program, a developmental delay is a delay that has been measured by qualified personnel using informed clinical opinion, appropriate diagnostic procedures, and/or instruments.” Potentially eligible children must be referred to the program to receive early intervention services. The Early Intervention program is funded by New York State and

county governments. All early intervention services are provided at no cost to parents. Health insurance may be used for approved services. A child’s eligibility for the program can be determined only by state- approved evaluators under contract and all services must be authorized by the county. Early intervention services are aimed at meeting children’s developmental needs and helping parents take care of their children. These services can include: ❦ Assistive technology services and devices. ❦ Audiology. ❦ Family training, counseling, home visits, and parent support groups. ❦ Medical services only for diagnostic or evaluation purposes. ❦ Nursing services. ❦ Nutrition services

Checklist for Growing Children

Are you concerned that your child may be developmentally delayed? Use these broad guidelines as you observe your own child to check for developmentally appropriate behavior:

AT 3 MONTHS OF AGE—MOST CHILDREN CAN: ❏ Turn their heads toward bright colors and lights ❏ Move both eyes in the same direction together ❏ Recognize bottle or breast ❏ Respond to their mother’s voice ❏ Make cooing sounds

❏ Bring their hands together ❏ Wiggle and kick with arms and legs ❏ Lift head when on stomach ❏ Become quiet in response to sound ❏ Smile

AT 6 MONTHS OF AGE—MOST CHILDREN CAN: ❏ Follow moving objects with their eyes ❏ Turn toward the source of normal sound ❏ Reach for objects and pick them up ❏ Switch toys from one hand to the other ❏ Respond to soft sounds, especially talking

❏ Help hold the bottle during feeding ❏ Recognize familiar faces ❏ Imitate speech sounds ❏ Play with their toes ❏ Roll over

AT 12 MONTHS OF AGE—MOST CHILDREN CAN: ❏ Get to a sitting position ❏ Pull to a standing position ❏ Stand briefly without support ❏ Crawl ❏ Imitate adults using a cup or telephone

❏ Play peek-a-boo and patty cake ❏ Wave bye-bye ❏ Put objects in a container ❏ Say at least one word ❏ Make “ma-ma” or “da-da” sounds

Taken from the New York State Department of Health Website: www. health.state.ny.us If your child is having trouble doing some of the above, it may put your

AT 18 MONTHS OF AGE— MOST CHILDREN CAN: ❏ Push and pull objects ❏ Follow simple directions (“bring the ball”) ❏ Pull off their shoes, socks and mittens ❏ Can point to a picture that you name in a book ❏ Point, make sounds, or try to use words to ask for things ❏ Feed themselves ❏ Make marks on paper with crayons ❏ Walk without help ❏ Walk backwards ❏ Say at least six words

AT 2-3 YEARS OF AGE— MOST CHILDREN CAN:

❏ Identify hair, eyes, ears, and nose by pointing ❏ Use two- to three-word sentences ❏ Say about 50 words ❏ Recognize familiar pictures ❏ Kick a ball forward ❏ Feed themselves with a spoon ❏ Turn two or three pages together ❏ Like to imitate their parent ❏ Build a tower of four blocks ❏ Show affection

mind to rest to talk to your pediatrician or your local early intervention program. Early help does make a difference!

6

May 2015


cognitive and language skills develop. ❦ High quality early intervention services can change a child’s developmental trajectory and improve outcomes for children, families, and communities. ❦ Intervention is likely to be more effective and less costly when it is provided earlier in life rather than later.”

Shoni Eidlisz, LMSW is the director of

the Brooklyn office of HTA of New York. HTA of New York is a special needs provider agency consisting of a New York State-approved, fully accredited team of infant and student special need professionals. Please contact HTA Brooklyn at 718.564.6128 to arrange for a free individual assessment of your needs, for help navigating the early intervention process, or for information about HTA’s full range of services.

RAISING OUR CHILDREN

❦ Persistent “toxic” stress, such as extreme poverty, abuse and neglect, or severe maternal depression can damage the developing brain, leading to lifelong problems in learning, behavior, and physical and mental health. ❦ The brain is strengthened by positive early experiences, especially stable relationships with caring and responsive adults, safe and supportive environments, and appropriate nutrition. ❦ Early social/ emotional development and physical health provide the foundation upon which

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INTRODUCTION

RAISING OUR CHILDREN

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INTRODUCTION ISSUES

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Think Beyond Pink: Ovarian Cancer Gets Increasing Focus By Amy A. Dubitsky

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GOLDEN YEARS

WOMEN’S HEALTH

RAISING OUR CHILDREN

T

eal is quite a trendy color this year, showing up in clothing, home furnishings, and even cars. However teal also has a more serious connotation; it’s the symbolic color of ovarian cancer. Pink has long been well-recognized as the symbolic color of breast cancer, but while ovarian cancer is often a more lethal disease than breast cancer, it still tends to get less publicity. Myrna Cohen is one woman who was forced to deal with this devastating disease. Cohen had to contend with fibroid tumors on her left ovary for years, and while she found them annoying, they were never dangerous. She had a yearly ultrasound to monitor the fibroid tumors, which ultimately saved her life. In 2010 she reported to her doctors that she wasn’t feeling right, and they ordered an ultrasound. Although that ultrasound came out clear, an ultrasound Cohen took six months later revealed a golf ball-sized tumor in her ovary. The forty-eight-year-old pointed out that, “an ovary is usually the size of an almond and I’m lucky I had something to compare it to… it’s really important to know your body.” She added that, “Many people think a Pap smear tests for ovarian cancer but it doesn’t.” In fact, while Pap smears screen for cervical cancer and mammograms screen for breast cancer, there really is no good screening process for ovarian cancer. The symptoms of ovarian cancer can be mild, such as abdominal pain, bloating, upset stomach or heartburn, which can often be attributed to other medical issues or what someone ate for lunch. Cohen became concerned by occasional and sporadic small twinges of pain that were becoming worse. Soon after the abnormal ultrasound, her doctor performed surgery- removing the tumor. “I was very lucky as the cancer was completely enclosed in the mass and nowhere else,” explained Cohen. She had an aggressive form of ovarian cancer but caught it in

stage one. After six rounds of chemotherapy, Cohen is considered cancer free. She stressed that if someone suspects cancer, seeing a gynecologist oncologist can greatly increase the chance of survival. She still follows up with her gynecologic oncologist every four months. Through acquaintances, Cohen

diagnosed but are worried about their cancer risk and protective measures can be matched up with another woman who has had a very similar experience. “Sharsheret found me the perfect link.” said Cohen. “Knowing someone that has already walked in your shoes really helps.”

found out about a support organization called Sharsheret, a national breast cancer organization with a program for women and families facing ovarian cancer. According to Elana Silber, director of operations, “Sharsheret provides individualized, culturally-relevant, psychosocial support that Jewish women can’t find anywhere else. All of our programs are free, confidential, and open to all women and men. Our goal is for every Jewish family to know that Sharsheret is here for them, should they ever need us.” Available by phone, email, text, or even live chat 24/7 on their website, Sharsheret is always available to help and answer questions from women and their families. One of their primary services is their Link program, which provides women with peer support. Women diagnosed with breast or ovarian cancer or even women who are un-

Aside from servicing Jewish women of all backgrounds facing ovarian and breast cancer, Silber stated that one of Sharsheret’s priorities is to educate the Jewish community about their increased risk of these hereditary diseases. Some of their educational programs include a Sharsheret Teal Shabbat in September, Ovarian Cancer Awareness Month, and college campus outreach throughout the year. So what is the correlation between ovarian cancer and Jewish women? Chani Wiesman, MS, CGC is a genetic counselor at Montefiore Medical Center where she specializes in reproductive and cancer genetics. She also works with the Program for Jewish Genetic Health where she focuses on research and community education. Wiesman said that 10-15% of ovarian cancer has a hereditary basis, mostly due to a BRCA1 / BRCA2 gene muta-

8

tion or to hereditary non-polyposis colon cancer (HNPCC), also known as Lynch Syndrome. “Women with BRCA mutations have up to a 44% risk of getting ovarian cancer. Someone with the BRCA1 mutation has a higher risk for ovarian cancer than someone with the BRCA2 mutation. Risk of breast cancer in someone with a BRCA gene mutation could be as high as 87%,” she explained. This is important for Jewish women, since while approximately one in 350 people in the general population carry a BRCA gene mutation, approximately one in 40 people of Jewish Ashkenazi decent carry the same mutation. This increases the risk of not only breast and ovarian cancers, but also pancreatic, prostate, and melanoma. Wiesman recommends genetic testing for any person that has or had any of those cancers, to determine if it was caused by a genetic mutation. In addition, if a first degree family member (child, sibling, parent) or second degree family member (aunt, uncle, grandparent, or grandchild) has breast, ovarian or pancreatic cancer, Wiesman recommends genetic testing for all other family members - especially if the patient has a genetic mutation or if the patient was never tested. It’s also important to be aware that if someone has a BRCA gene mutation and they do get cancer, it may not be the same cancer as the other member(s) of their family. Survival of ovarian cancer is poor because there is currently no reliable screening method, so it is often detected in an advanced stage, Weisman said. The symptoms can be fairly innocuous, like back pain and weight gain or loss and are often ignored. Because of this, many medical professionals recommend an oophorectomy – removal of the ovaries -- for someone with a BRCA gene mutation when they are done having children, usually in their late 30s or early 40s. Not only is it the best way to reduce the risk of ovarian cancer, but if done before menopause it can also greatly reduce the risk of breast

May 2015


fects the kids, life is not that little pixel-perfect picture. The picture is much larger and even the bad things that happen are for the good – even being able to share this, if it helps one person, it’s for the good. A lot of bracha has come from this seemingly horrible thing.” Cohen and Lange shared their very personal stories in hope of educating the community about the signs and risks of ovarian cancer, and the importance of education about the BRCA gene mutation. Be color-conscious about both pink and teal and be sure to talk to your doctor about any risk factors you may have at your next appointment. For information about subsidized testing as part of a research initiative, visit: brcacommunitystudy.einstein.yu.edu. For questions, support and information regarding breast or ovarian cancer or hosting an educational event in your community, visit: www.sharsheret.org or call: 866.474.2774. communications professional living in Phoenix, AZ.

– Sara B.

HEALTHY LIVING

“My husband Yossel, of blessed memory, endured countless surgeries. The result was severe wounds that just would not heal. We grew more discouraged every day as we desperately travelled far and wide from our home in Borough Park, visiting the finest medical facilities in the New York metropolitan area. No one was able to accommodate his needs. Then we visited Calvary Hospital’s Center for Curative and Palliative Wound Care. First, the expert doctors and nurses relieved our stress with comforting encouragement and hope. Then they began their expert clinical process of providing relief. Ultimately they cured his advanced wounds that no other medical facility could heal and respected our Orthodox faith. It was the answer to our prayers. We thank G-d for Calvary Hospital.”

MEDICINE TODAY

“We prayed for a miracle to heal Yossel’s severe wounds. Divine intervention brought us to Calvary.”

GOLDEN YEARS

Amy Dubitsky is a freelance writer and

WOMEN’S HEALTH

then followed up with oncologist Professor Nathan Cherny for six rounds of chemotherapy. About 10 months after finishing chemotherapy, in November 2014, the cancer returned and was found in her liver and chest. The news was devastating, and the outlook was disconcerting. It was at this time that she officially changed her name to Ahava Emunah and, along with the prayers from people around the world, began four rounds of chemotherapy accompanied by bone marrow stimulators which put her cancer back into remission. Lange is now in a clinical trial for PARPS inhibitors, which may be a way to maintain remission for BRCA cancers. She returns to Shaarei Zedek every month for blood work and has a PET scan every 8 weeks. While Lange doesn’t know if she is receiving the actual drug or the placebo for the trial, she has a positive attitude. “My life perspective has changed. I always felt that I had the perfect life: five kids, great community, married to the man of my dreams. But I realized that even though sometimes I get depressed and of course, sometimes it af-

RAISING OUR CHILDREN

and had some extremely depressive thoughts. I went to my family doctor a number of times and even though I told her about my family history of breast cancer – no red flags went off and she didn’t think to send me to my Ob-Gyn,” Lange said. The Lange’s youngest child was two at the time and Ahava thought she was going to feel like an old person for the rest of her life, when one day she experienced bleeding mid-cycle and knew something was wrong. Trained as a physical therapist, Ahava was well aware of how her anatomy should look and feel, and after a self-exam of her abdomen, she knew there were tumors. The following Sunday she went to the Ob-Gyn who sent her to the emergency room, where she received her dreadful diagnosis. A friend of her father referred her to Professor Uzi Beller at Shaarei Zedek medical center in Jerusalem, who, after seeing her CT scan showing that her cancer had already spread, scheduled Ahava for surgery just a few days later, on his day off. “He successfully removed all visible signs of the cancer – he saved my life,” Lange said. She

ISSUES

cancer by up to 62%. (While having a preemptive mastectomy can reduce the risk of breast cancer by 90%, because breast cancer has better screening and treatment processes, many women opt not to be as aggressive. Angelina Jolie, who is BRCA gene positive and made headlines a few years ago when she opted for a preemptive double mastectomy, recently had a prophylactic oophorectomy as well.) While some women may be nervous to do genetic testing at a young age, Wiesman recommends that those with a family history of ovarian cancer talk to their physician and come up with a screening plan, such as a vaginal ultrasound and a CA125 blood test every six months, until they do the genetic testing and possibly prove that they are not in that high-risk category. Ahava Emunah Lange of Beit Shemesh, Israel, found out she was positive for a BRCA gene mutation after she had become ill with ovarian cancer at the age of 36, and now encourages every woman to be aware of her genetic risks. “Before I was diagnosed, I was very tired, bloated, felt full quickly,

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For more information call 718-576-2714 or visit www.calvaryhospital.org

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May 2015

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Is Hormone Therapy Right For You? By Avigayil Perry

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GOLDEN YEARS

WOMEN’S HEALTH

RAISING OUR CHILDREN

W

hile many women glide through menopause, a significant number experience difficult symptoms including night sweats, sleep disturbances and hot flashes, which are sudden feelings of feverish heat throughout the entire body. These symptoms are due to the ever-decreasing levels of estrogen in a woman approaching menopause – and when these symptoms interfere with daily life and become too challenging, hormone therapy (HT) is an option to consider, though it has been subject to some controversy. Typically menopause, defined as the cessation of menstrual periods, takes place in a woman’s life between the ages of 45 and 55. Hormone therapy consists of medications that contain estrogen and progesterone in various forms such as a pill, skin patch, gel, cream, or spray, all approved by the FDA. Besides alleviating the night sweats, hot flashes and other menopausal symptoms, hormone therapy can also help stave off bone loss, which may lead to osteoporosis. It has also been shown to decrease risk of endometrial cancer. However, the jury is still out on hormone therapy because some studies have found it to increase the risk of breast cancer, heart disease, and stroke. In years past, hormone therapy used to be the standard treatment for difficult menopause symptoms and prevention of osteoporosis. But that all changed in 2001 when the Women’s Health Initiative (WHI) conducted a randomized, clinical study to see if it reduced the chance of heart attacks. Women tend to get heart attacks ten years after men, and the WHI wanted to see if this is due to women taking hormone therapy upon the onset of menopause. However, shockingly, the study showed evidence that a combination of estrogen and progestin can increase, rather than decrease, coronary heart disease which lead to heart attacks. As a result of this study, women stopped showing interest in hor-

mone therapy and doctors stopped prescribing it. In fact, Yael Swica, a doctor in private practice specializing in menopause, reproductive health and gynecology in New York, did not even learn about hormone therapy in residency and instead studied it later in a fellowship

These women could have already had coronary heart disease prior to participating in this study, and it remains unclear if a direct causal link exists between coronary heart disease and HT. “A black cloud moved over hormone therapy after the WHI study,”

with an endocrinologist. However, before jumping to conclusions about the potentially harmful nature of hormone therapy, keep in mind the WHI’s flaws in carrying out this study: For instance, most of the participants started taking HT a long time after the onset of menopause, i.e. ages 60 and older.

said Dr. Swica. “The findings of the WHI study were very important but complex. Unfortunately those findings were disseminated by the media without any nuance. The only message that women and their doctors heard was that HT is unsafe, when in fact the data clearly showed that HT is very safe to

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use for women up to age 60.” Geoffrey Redmond, MD, director of the Hormone Center in New York, agreed. “Hormone therapy is not without risk, but the risks are smaller than the media portrayal,” he said. He also noted that women have a less than 1% increase per year in breast cancer when taking HT. If experiencing a difficult menopause, one can weigh the slight risk against the difficult daily challenges. “Persistent hot flashes can wreak havoc in a woman’s life,” explained Dr. Swica. In addition, “if night sweats interfere with her ability to sleep, she can become chronically exhausted and irritable.” So before dismissing hormone therapy as a potentially viable option, “the smartest thing women can do is to find an expert in the field who can really put their individual risks, benefits and concerns into perspective,” explained Dr. Tara Allmen, an OB/GYN at the Center for Menopause, Hormonal Disorders and Women’s Health in New York. She noted that menopause often catches women by surprise, and while one should not belittle the importance of exercise and nutrition, ultimately very little can be done to prevent the possibility of a challenging menopause. Therefore, it is essential that women educate themselves, and know what available options exist. “By the time women get to me, they feel desperate for expert advice and real relief,” Dr. Allmen said. “Since I am able to explain the risks and benefits of hormone therapy in easy-to-understand language, they always feel relieved.” In summary, as long as hormone therapy is used responsibly and with a doctor’s guidance, it can be helpful to many women. To learn more about HT and menopause in general, check out the North American Menopause Society (NAMS) site: www.menopause.org. Avigayil Perry lives in Norfolk, VA with her family and contributes to various Jewish publications.

May 2015


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INTRODUCTION ISSUES

WOMEN’S HEALTH Trim & & &Fit

By Tanya Rosen

COMMUNITY PROFILE

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HEALTHY LIVING

MEDICINE TODAY

GOLDEN YEARS

WOMEN’S HEALTH

RAISING OUR CHILDREN

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ver meet a woman who excuses her extra weight by saying: “I had a baby… thirty years ago!” We all do it, whether our baby is an infant, or old enough to have one. We use childbirth as an excuse for all the extra pounds. Now before I get attacked for saying having a child is not a reason to gain weight, I’ll clarify: Pregnancy is a reason (and a very good one) to gain weight, but once that’s over it no longer works as an excuse. Put it this way: if all you are left with after each child is just five pounds, and you multiply that by the average five pregnancies that many frum women will have, that’s 25 extra pounds (and almost three dress sizes!). And that’s assuming that all you gained was five pounds (don’t we wish it was such a low number?). As I write this article, I have my newborn sitting right next to me, so this is a topic I am just as concerned and fascinated with as you, the reader, are. When I was pregnant with my first child, I completely let myself loose and gained more weight than I want to

Losing Your Baby Weight share publically. With my future pregnancies however, armed with knowledge, I managed to gain the bare minimum weight and lose it all pretty quickly. My number one piece of advice is not to gain too much weight to begin with. I’ll restate the obvious: the more you gain, the more you’ll have to lose. So even if you are pregnant (no matter how far along), start your healthy eating and exercising NOW. Here are my top tips for losing your baby weight, whether it’s 5 pounds, or 50+ pounds.  Do NOT wear maternity clothing a day longer than you have to. Just like you put your winter clothing away in the summer and your summer clothing away in the winter, think of pregnancy as a season. Once the “season” is over, change your wardrobe. By wearing (or trying to fit into) your regular clothing, you’ll have a more realistic view of where you’re holding.  Nursing is NOT a reason to “eat for two” again. Nursing moms require an average of an extra 500 calories a day. That’s 500 extra healthy calories, and not more.  Change your attitude, and the number on the scale will change too. So often, I hear women saying they don’t think they can ever look the way they did before the baby, at their wedding, etc. My response to that is “Why not?” ANYONE at any stage or age can be in shape. In fact, many of my clients will say they look and feel BETTER than they did before their baby.  Monitor, monitor, monitor. In order to succeed, you MUST have a system of tracking progress in place. Some examples of monitoring include a weekly weigh-in, monthly measuring of inches and body fat, tracking food in a journal, or ideally all three.

 Stop waiting for it to come off “on its own” or “melt away.” Have you noticed that it’s not going to happen? Ok, there are VERY few lucky people that it will happen to. Chances are, you (and not me either) are not one of them. There are no shortcuts or magic tricks to getting in shape.  Don’t forget exercise. Dieting is important, and if you are eating right you will see the results on the scale. However, if you want your “old body” (or an even better one),, exercise is the key. Strength training, weight lifting, and Pilates are examples of work-

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outs that will firm you up, help you lose inches, and get rid of that unwanted flab. Mazal tov to you on the birth of your baby (no matter how old). I’m sure you are doing a great job taking care of him or her. Make sure to take some time to take care of yourself. A healthy and fit mommy is a happy one. Tanya Rosen is a nutritionist, personal

trainer, and aerobic instructor. Tanya is also the co-owner of Shape Fitness Gym and the creator of the Shape Fitness Kosher Workout DVD series for women and girls. Tanya can be reached at 917.913.1523 or tanyashape@gmail.com.

May 2015


The Vitamin D Challenge for Modestly Dressed Women

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only need about 30 minutes of sunshine twice a week on exposed skin (no sunscreen) that incudes face, arms, neck and legs. All skin exposure is equivalent (arms and face vs. back and legs), however the only factor that might cause a restriction is pigmentation. The more pigmentation in areas, the less UVB absorbed, says Cohen. Your body can make 20,000 units of vitamin D after only 20 minutes of summer sun. You can get the required amounts in the privacy of your own home by laying out in the sun in a secluded porch, rooftop or even under a skylight, but make sure the window is opened since sun rays can-

He says that in his practice, he has not seen a discernible difference in the Vitamin D levels of patients who are modestly dressed vs. those who are not. This is because the exposure to the sun does not promote sufficient levels of Vitamin D, (even to Floridians) who have maximum sun exposure, and everyone needs to supplement from other sources, such as food or vitamins. Regardless, how can we be certain of getting sufficient vitamin D intake through sunshine when we have lifestyle restrictions? Make an effort to eat foods that are good sources of vitamin D such as egg yolks, dried shiitake mushrooms and fatty fish like salmon,

working in NY, recommends taking a supplement with vitamin D, especially when you take into consideration geography, climate, sun sensitivity, eating habits, and our busy lives. “I look for a supplement that has 400 IU for kids and 1000 IU for adults. I like alternaVites because not only does it have a lot of Vitamin D which is certified kosher and vegetarian sourced in both its children and adult formulas, but it has a lot of other nutrients as well,” she says.

GOLDEN YEARS

tuna, sardines, herring and mackerel. Purchase milk, orange juice, cheese, yogurt, and cereals fortified with vitamin D. Keep in mind that only about 10% of vitamin D intake comes from food, so it is nearly impossible to get adequate amounts solely from diet. The next step is talking to your doctor about which and how much supplements you should be taking. Ilyse Schapiro, a registered dietician, nutritionist and author

WOMEN’S HEALTH MEDICINE TODAY COMMUNITY PROFILE

also teaches English and Literature courses at Kingsborough and Touro College.

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Ita Yankovich is a freelance writer. She

HEALTHY LIVING

May 2015

not penetrate glass to generate vitamin D in your skin. Some doctors downplay the effects of modesty on vitamin D levels. One South Florida cardiologist, Dr. Adam Splaver, says that even Floridians, who are bathed in sunlight all year, are struggling to maintain optimum levels of vitamin D, “and as an Orthodox Jew, I can also tell you that modesty, or lack of it, does not have a major impact.”

RAISING OUR CHILDREN

ow that winter has finally retired, we can put away those heavy boots and coats, bring out the sandals and light clothes, and get some sunlight on our pasty, white skin. For a long time the sun was a public enemy blamed for causing serious problems such as skin cancer, but now we know that some sunshine is actually beneficial to our overall health, especially with regard to our daily vitamin D intake. This can present a challenge to many Orthodox Jews who devote most of their daylight time to indoor activities and study, and especially to women who practice modest dressing. In fact, a 2001 study cited in Pediatrics confirmed that Brooklyn’s ultra-Orthodox Jewish children are vitamin D deficient, as are 30% – 50% of those living a religious lifestyle involving modest dress. So how can we get adequate vitamin D when our attire may restrict it? Vitamin D is our body’s only source of calcitrol, which we need in order to absorb and utilize calcium, which keeps bones and teeth strong and is essential for normal blood clotting and muscle and nerve function. Studies confirm that sun exposure has numerous other health benefits, such as: treating skin diseases like psoriasis, vitiligo, atopic dermatitis, and scleroderma. UV radiation also enhances skin barrier functions, neonatal jaundice, treats season mood disorder, enhancing mood and energy through the release of endorphins. How exactly does sunshine get converted to a vitamin? Dr. Dana Cohen, a NY-based general practitioner, explains that when the skin is exposed to UV radiation, a chemical reaction occurs in the epidermis of the skin that converts pre-vitamin D (technically called 7-dehydrocholesterol) into provitamin D or cholecalciferol. From there it gets metabolized in the liver into 25 hydroxy vitamin D. This is typically what is measured and indicative of your vitamin D levels. From there it goes through

one more process, called hydroxylation, and gets converted to the active form of vitamin D to be utilized by the tissues in your body, including the colon, brain, breast and heart. The only way to know if your levels are optimum is through a simple blood test and a consult with your doctor. However, there is no need to stress if you dress modestly and cannot sunbathe. Experts say you

ISSUES

By Ita Yankovich

INTRODUCTION

WOMEN’S HEALTH


INTRODUCTION

GOLDEN YEARS

ISSUES

COVERY STOR By Yaakov Kornreich

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HEALTHY LIVING

MEDICINE TODAY

GOLDEN YEARS

WOMEN’S HEALTH

RAISING OUR CHILDREN

F

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Sunshine Destinations for the Sunshine Years

or those approaching the age of retirement, or for those who are into their retirement years and who yearn to live or spend more of their time in a more comfortable climate, there is a wide new world of residential and tourist options from which to choose without having to sacrifice or compromise on Jewish observances and lifestyle. Over the past generation, it has become much more common for senior members of Jewish families to move to homes and communities that have been designed specifically for the convenience and comfort of retirees. Some of these communities are in the Northeast, not far from their lifelong homes, and are preferred by retirees who desire to maintain convenient access to their lifelong friends and family members. For seniors who would prefer to spend their leisure years basking in a more comfortable year-round climate, there also more options for Jewish retirement living in the sun today than ever before. Retirees with the financial means may choose to live as “snowbirds,” splitting their time between life in the Jewish community where they have lived most of their lives and a second vacation home in one of several vibrant

Jewish communities in South Florida, or near their adult children who have moved to Israel. Other retirees have chosen to stay in place in their longtime homes and communities, but have allotted the time and money necessary to satisfy their wanderlust, escaping for a while to a more comfortable climate in foreign or exotic places while remaining true to their Jewish lifestyle. Today, active seniors have a broader choice than ever of kosher travel options, enabling them to fully enjoy the experience of visiting the most famous and popular tourist sites in the world, with all of their personal and Jewish needs provided in comfort and style. Kosher Cruises Kosher cruises are among the most elegant of kosher travel experiences, with the cruise ship serving as your leisurely and comfortable mode of transportation as well as your luxury hotel at its ports of call. Kosherica offers a broad choice of cruising destinations around the world, including the Mediterranean, Alaska, the Baltics and the Carribean. Delicious, gourmet quality glatt kosher meals are prepared under strict rabbinical supervision and served in the most elegant setting. The kosher cruises also include compelling Jewish programming.

While at sea, there is a wide variety of recreational options and scheduled social activities aboard ship. Guided tours are available at the ports of call, and participants can just spend their time relaxing and exploring at their leisure. There is a much wider choice of traditional guided kosher tours to scenic locations in North America and around the world than ever before. Each tour follows a fixed itinerary and is run at specific times during the year. They generally include ground transportation via chartered bus, hotel and kosher food accommodations, knowledgeable local guides and site admission at each point of interest. They may or may not include discount charted air transportation from the New York area to the tour’s starting point. The Value of an Experienced Travel Agent An experienced travel agent can save his or her clients money and effort by putting together a customized travel package including air travel and hotel accommodations to specific destinations and optional activities that will significantly enhance the experience. Such a package can include joining up with one of the organized kosher tours during the trip. Experienced kosher travelers may prefer to make their own arrangements using one of the many booking sites on line. Even if they have visited the area before, a certain amount of research is highly recommended. In choosing a hotel, don’t go by the ad alone. Look for recognized quality ratings from travel organizations, such as the AAA, and look for the comments of travelers who have stayed there recently at sites like www.tripadvisor.com. Trip Cancellation Insurance Trips to popular destinations during peak periods, such as Israel during the summer months and holiday seasons, often must be booked and paid for months in advance. Trip cancelation insur-

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ance for such trips can be a wise investment, especially for seniors. Health problems or family events can come up unexpectedly, forcing the cancellation of travel plans which have already been largely paid for. Refunds may not be available, especially for discount rate airline tickets. Trip cancellation insurance is designed to eliminate much of that financial risk, but it is important to read the policy carefully, paying special attention to any coverage exclusions. These policies typically offer additional options such as health insurance coverage at your destination, or a low cost collision damage waiver for a rental car. Some policies offer unique options, such as guaranteed return of your body home should you die while abroad, which is available from the Divers Alert Network. Available options will also vary depending upon your home state’s insurance regulations. Frequent travelers typically prefer to use a particular airline and/ or credit card in order to take full advantage of the perks which come with frequent flyer miles. These include free tickets or seat upgrades, access to comfortable airport lounges before flights and increased baggage allowances. Travelers should also be aware of any discounts on auto rental, hotel rooms and site admissions to which they may be entitled due to their membership in organizations such as the AAA auto clubs and the AARP, or their premium level credit card. Do-It-Yourself Travel Planning Finding travel bargains online is more of an art than a science, but there are some great deals to be found by those willing to spend the time to regularly check their favorite travel sites. Dr. Stan Goldstein, a Brooklyn podiatrist who has made finding travel deals into his hobby, has visited many of the leading tourist sites around the world in recent years, and has solid recommendations

May 2015


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Kornreich Continues on Next Page

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The Centro Israelita Synagogue (Orthodox) and Jewish community center in San Jose is the heart of the country’s Jewish community. Security is tight, and tourists must clear their visit to the shul at

are available in both Honolulu and on Maui. For those who have enough time (at least 10 days) and money to visit destinations across the Pacific, Goldstein recommends Hong Kong and Singapore. Because it is summer in the Southern Hemisphere during winter months in North America, another sunny destination at that time is Englishspeaking Australia, with its large Jewish communities in Melbourne and Sydney. A Kosher Bargain in Central America One of Goldstein’s more surprising recommended kosher travel destinations is Costa Rica, in Central America. Joe Jacobwitz of Kesher Tours agrees with Goldstein. Kesher has been running kosher tours to Costa Rica for the past several years, and Joe reports that his clients have been very pleased. Costa Rica is located just north of Panama. It offers beautiful beaches on both its Caribbean and Pacific coasts, cultural institutions, volcanoes and a protected tropical rain forest filled with diverse wild life. Glatt kosher food is available from the Costa Rica Kosher Center, located in the capital city of San Jose. The center operates a sit down fleishig restaurant, a takeout deli and kosher bakery. Arrangements can also be made in advance for delivery of kosher food to your hotel.

WOMEN’S HEALTH

May 2015

CO STO VER RY

ISSUES

for kosher travelers looking for safe, convenient and enjoyable fair weather destinations. Many competing travel sites offer online bargains. Goldstein’s favorites are Kayak (www.kayak.com) and Best Travel Store International (www. bt-store.com), but that is not to the exclusion of other popular sites, as well as travel agents who specialize in kosher travel arrangements. In planning foreign travel, Goldstein’s first consideration is safety, because tourists in some countries have become the targets of criminals and terrorists. In Third World areas, Goldstein is more comfortable visiting military dictatorships which place a high priority on protecting their tourists, for economic reasons. It is also important to be aware at all times of what is happening around you whenever you are in another country. The growing number of antiSemitic incidents across northern Europe has caused Dr. Goldstein to cross most off those popular tourist destinations from his recommended list. However, he feels that it is still safe for Jewish tourists to visit Spain, including the Canary Islands, and Italy. Like other Eurozone destinations, visiting these countries has recently become more affordable because of the increased buying power of the U.S. dollar. Finding KosherFriendly Destinations When considering a tourist destination that does not have a large Jewish community, in the U.S. and abroad, Dr. Goldstein recommends checking the list of Chabad centers, whose presence generally assures local access to at least a minyan on Shabbos and kosher food. In the Caribbean, Goldstein’s preferred Jewish travel destinations are St. Marteens, in the Netherlands Antilles, Puerto Rico and the Dominican Republic. Goldstein recommends that whenever touring in a non-English speaking country, carrying a book of matches or other souvenir imprinted with the address of your hotel that you can give to a local taxi driver whenever you need to get back there. The Hawaiian Islands are almost the same distance from New York by air as Israel. Jewish facilities, including Chabad centers,

INTRODUCTION

GOLDEN YEARS


INTRODUCTION ISSUES RAISING OUR CHILDREN WOMEN’S HEALTH GOLDEN YEARS

GOLDEN YEARS option for Americans looking to retire on their Social Security benefits. Retirement Planning R E Retirement planning is much V CO Y more difficult task than vacation R STO planning, because it must take into account many other considerations. These include the retiree’s long-term finances, their desire to remain close to children and other Kornreich Continued from Previous Page family members, and, of course, The U.S. dollar goes a long way in health considerations. Costa Rica. There are many highly- After World War II, Miami rated hotels and villas throughout the Beach became the most popular country at very reasonable prices. retirement destination for Ameri For premium class kosher tour- can Jews. To meet the continued ists, Kosher Casas (www.kosher- demand, huge new retirement vilcasas.com) offers a choice of more lages were built up along the Atthan 80 deluxe villas across Costa lantic coast to the north, leading to Rica. Weekly rental fees vary the creation of vibrant new Orthowidely, starting from $3,100 to dox communities, such as Deerseveral times that amount. The fee field Beach and Boca Raton. includes kashering of all the villa’s But South Florida living is not cooking facilities by mashgichim ideal for everyone. The cost of livfrom the central shul, all needed ing, including mortgage, maintekosher utensils, and a refrigera- nance and taxes, can be too high tor fully stocked with kosher food. for some seniors to afford in the Personal chefs are also available to long term if they do not have sigprepare kosher meals on site. nificant financial resources in Kesher’s Jacobwitz says that Costa addition to their Social Security Rica’s low cost of living and other benefits. Others may not be able MeadowParkAd_NEW_JP_4.25x5.625_color 1/20/14 10:33 PM Page 1 advantages have made it a popular to adapt to South Florida’s humid,

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subtropical climate, especially during the summer months. Retiring in Israel Israel is another increasingly popular retirement option, but it presents its own set of issues which require careful preparation before making a commitment. One of the primary resources for Americans considering retiring to Israel is an organization known as Nefesh B’Nefesh (www.nbn.org.il). It has been designated by the Israeli government and the Jewish Agency as the primary provider of pre-Aliyah guidance, planning, financial advice and peer support to Americans of all ages considering Aliyah. Nefesh B’Nefesh programs include heavily subsidized pilot trips for those preparing to make Aliyah. Participants can see where they will be living, find suitable housing, seek employment and make other necessary living arrangements in advance of their Aliyah. Nefesh B’Nefesh will also inform potential olim of the various financial and other one-time benefits provided to them by the Israeli government, and advise them on how to qualify and navigate the often frustrating Israeli government bureaucracy. In many instances, those considering making Aliyah upon retiring are doing so to be near their children and other family members living in Israel. However, if they anticipate needing to make frequent visits back to the U.S. for business or family reasons, that considerable expense should be added into their Aliyah calculations. Hebrew language proficiency is also a consideration. There are several large religious communities in Israel where English is widely spoken, but because of supply and demand, those areas also tend to be much more expensive places to rent or buy a home.

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High Costs and Tax Issues The cost of housing in the most desirable areas of Jerusalem, in particular, has been bid up by wealthy Americans seeking apartments to serve as second homes to visit for Yom Tov with their families and during the summer vacation season. Less expensive housing can still be found in some of the newest religious communities, located some distance from the main centers, as well as in the north or south, where English is not as widely spoken as in central Israel, but real estate prices and rents are at historic highs nationwide. Nefesh B’Nefesh estimates the average cost of living for a newly arrived retired couple in a rented apartment to be between $2300$4500 a month, depending upon where in Israel they choose to lived. Dual U.S.-Israeli citizenships for American olim are common. You can still vote by absentee ballot in American elections while living in Israel. But the tax regulations for retired Americans living in Israel primarily on their Social Security benefits can be very complicated. Retiring couples considering Aliyah should consult with an expert in both sets of tax laws about their particular situation. A vital consideration for seniors is arranging for their medical care in Israel. Health coverage is generally very good and much less expensive in Israel than in the U.S., for those who qualify for Bituach Leumi, Israel’s national health insurance system. Private health coverage can be much more difficult for seniors to obtain. Nefesh B’Nefesh recommends that older olim make sure that they have qualified for Bituach Leumi by the time

May 2015


CO STO VER RY

RAISING OUR CHILDREN 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.

GOLDEN YEARS

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ing and living costs than the Jewish communities in South Florida. However, Jacksonville is 350 miles north of Miami, and is much closer (about 2 hours by car) to the Jewish resources available in Orlando and Savannah, Georgia. Other towns on the affordable retirement list which offer at least the services of a Chabad center to Jewish retirees include Little Rock, Arkansas (which has a “traditional� shul), as well as Albuquerque, New Mexico, Columbia and Greenville, South Carolina, Chattanooga and Knoxville, Tennessee, and Augusta, Georgia. Each of them also has at least one non-Orthodox synagogue. Checking Out a Retirement Community If you are interested in exploring the possibility of retiring in one of these communities, you should become very familiar with the area before making a long-term commitment. Much information about life in these cities is available online, but there is no substitute for visiting in person, ideally over a Shabbos, to get a real sense of the Jewish community. Contact a local rabbi or Orthodox shul officer and ask them for help arranging for your visit. Small Jewish communities are always interested in attracting new members. They will be happy to refer you to a local real estate agent who will show you the available housing within your budget. If you have any doubts, it is best to start by renting a home or apartment short term and living in the community for a while. Delay buying until you are sure that you will be happy there. Life in a smaller, more isolated Jewish community is not for everyone, especially those who will miss frequent visits with newly distant family members, or who have grown accustomed to the wide variety of conveniences available in large Orthodox communities. But today, many Jewish essentials not available locally in such towns, including kosher food items, Torah seforim and shiurim, as well as live video chats with children and grandchildren, are just a mouse click away. Life in small Jewish communities has its own rewards, especially for those with an adventurous spirit, who are strong in their faith, and who don’t mind putting up with small inconveniences. For Jewish retirees living on a small,

ISSUES

they move to Israel permanently. Owning and operating a car in Israel is very expensive, but may not be necessary, because Israel’ public transportation systems are efficient and inexpensive, especially for seniors. Retiring to Israel requires a great deal of advance planning. Another organization which provides valuable resources and services for English speaking North Americans olim is the Association of Americans and Canadians in Israel (www.aaci.org.il) Viable Sunbelt Retirement Cities American Jewish seniors on a restricted budget who are interested in retiring to a warmer clime have many other options, beyond Florida and Israel. There are a number of thriving sunbelt Orthodox Jewish communities, located in the South or Southwest, which are attractive for year-round retirement living, but those relying primarily on their Social Security benefits may find many of them to be too expensive. Over the past several years, U.S. News and World Report has run annual surveys on the most desirable locations in the country for seniors seeking to retire on their Social Security income, and little more. Lower Cost Options Eliminating those locations with cold winters, there are eleven cities across the Southern U.S. with at least a Chabad house to provide basic Jewish services. In addition to affordable housing and living expenses, these communities offer various other amenities for retired seniors, such as reduced rate college credit tuition. Four of the listed cities, Austin and San Antonio, Texas; Tucson, Arizona and Jacksonville, Florida. have at least one other Orthodox shul in addition to a Chabad center. Other Jewish amenities include day schools and access to kosher food. Of the four, Tucson has the best-developed Orthodox Jewish community and services. Austin and San Antonio have smaller but still viable Orthodox communities, while Jacksonville has the smallest religious community, with more limited local access to kosher food. On the other hand, Jacksonville is on the Atlantic Coast, and offers a genuine year-round Florida climate, with much lower hous-

INTRODUCTION

GOLDEN YEARS


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

GOLDEN YEARS

Helping Seniors and Caregivers Bond through Motion By Ayala Shapira, Beni Kelner and Orit Raz

“I

’ll begin by saying, Mother had been a very social, assertive and active woman. She swam twice a week and managed her house expertly. Until she got sick. Today, the situation is completely different. Mother barely leaves the house. At home, the entire burden lies upon us, her daughters. We take care of the shopping, food, etc. Most of the day, Mother sits on the couch or sleeps. As a result, she has gained weight and tires quickly every time she does leave the house. This is when the “Bonding through Motion” program entered our lives. “I was afraid that Mother would resist, but, to my great surprise, she was very excited, on the condition that I “exercise” together with her. Mother surprised us and had a lot of fun. We turned an hour of sitting on the couch to activity time, accompanied by laughter and joy.” “Later, the grandchildren and great-grandchildren, who came to visit, quickly noticed the ball and rubber bands for muscle strengthening and wanted to join in the fun. Visiting hour became more significant with purpose and pleasure for everyone…”

This is one of many testimonials of the benefits of the “Bonding Through Motion” program, created by Israeli organizations Ezer Mizion and ESHEL to facilitate positive connections between the elderly person confined to his house and the family members caring for him, while maintaining the senior’s daily level of functioning. This goal is achieved by infusing significant and enjoyable content into recreation time and by providing caregivers with knowledge and skills in the fields of both interpersonal communications and physical activity. For family members caring for parents, a training program is offered which utilizes the format of a workshop consisting of five meetings, each meeting 3.5 hours long. In this workshop, they acquire knowledge on aging and its manifestations, interpersonal communications skills and a series of physical activity exercises which are adapted for elderly people with decreased mobility. Every meeting consists of a theoretical portion which includes a lecture in addition to experimentation participation, a workshop for learning activity skills and a home practice assignment. The first meeting is dedicated to an introduction to the world of the

home-bound elderly person, and to teaching family members how to convince the elderly person to join in and participate in the project. Participants also learn exercises for strengthening the lower limbs. The second meeting focuses on training family members in how to deal with emotional and practical issues which arise when caring for the elderly. In addition, participants are given exercises to improve balance and guidance, in how to walk properly with an elderly person. The third meeting focuses on communication skills with the elderly person, ways to increase mobility around the house while using various aids and adapting the home environment to the elderly person’s level of functioning. In the fourth meeting, the required conditions for implementing the plan at home are taught, workshop participants receive an activation kit including aids, an instruction film, a book of exercises and a summary of what was covered in previous meetings plus guidance in the practice of what was taught so far. The fifth meeting is held individually with each participant at the home of the elderly person. Participants receive focused instruction suited to the condition of

the elderly. At the end of the workshop, participants continue to implement the program independently, while the program’s team continues to accompany them with instruction and follow-up and is available for telephone consultations. The program’s goals are to decrease the caregiver’s emotional pressure by providing emotional support, maintain – and even improve – the physical abilities of the elderly, as well as their functioning levels in daily life, and improve the communication between the elderly person and the family member. “Bonding Through Motion” is a project

that was created and implemented by the professional staff at Malka Hager Fitness Center, a department of Ezer Mizion’s Geriatric Services Division. Project expansion and dissemination was made possible through funding from JDC/Eshel. This article was written by Ayala Shapira, Beni Kelner, Orit Raz of Ezer Mizion, a highly respected Israel-based NGO that helps the cancer patient, the developmentally delayed, the mentally ill and the elderly with a broad spectrum of professional and volunteer services for themselves and their families and Achinoam Ben Akiva, Dror Rotem of ESHEL, the Association for the Planning and Development of Services for the Elderly in Israel – A joint venture of the American Jewish Joint Distribution Committee Organization and the Government of Israel.

Overweight Elderly Found Less Susceptible to Dementia

A

15-year study of the health records of nearly 2 million British seniors has led to the unexpected finding that those over age 55 who were overweight or obese were 30% less likely to develop dementia, and that underweight seniors were 34% more likely to suffer dementia symptoms. The study found that 45,500 of those who were studied developed dementia. The associations between weight and dementia held up even after the researchers took into account when the participants were born or their age at diagnosis. It also corrected for known risk factors for dementia, such as drinking and smoking, the researchers added. Dr. Nawab Qizilbash, of Madrid,

Spain, the lead researcher for the study, whose results were published in the British journal Lancet, said that his findings did not suggest any specific cause and effect mechanism to explain the association between weight and the risk of developing Alzheimer’s. “We don’t have a biological explanation for the association we observed,” he said. The study also showed an increased risk of premature death for seniors who are overweight or obese. Dr. Qizilbash warned that people shouldn’t take his study’s preliminary findings as a license to gain weight in hopes that it will prevent dementia. “Even if there were to be a protective effect on dementia from being overweight or obese, you may

not live long enough to get the benefit,” Dr. Qizilbash said. Calling for further research to confirm and explain his findings, Dr. Qizibash said, “Our results should open new avenues for research for protective factors for dementia. They may be used to provide insight to looking for a mechanism and developing new treatments for dementia. In addition, doctors, public health scientists and policy makers may need to rethink how to identify who is at high risk for dementia.” Dr. Malaz Boustani, a professor of medicine at the Indiana University School of Medicine who is associated with the American Federation for Aging Research, suggested that “if a biological mechanism can

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be found to support these findings, it might lead to new ways of treating or preventing dementia.” But Deborah Gustafson, a professor of neurology at SUNY Downstate Medical Center in New York City, questioned the study’s methods. She questioned whether weight measured at age 55 could predict the risk of developing dementia 15 years later. Since there are genetic components to both weight and dementia, the role of weight by itself isn’t clear, she added. “Despite the high number of participants [in the study], it is not the final word, given the methodological questions,” Gustafson said. “More research is needed, as well as clarification of these results.”

May 2015


Keeping Active and Mobile to Age 90 and Beyond

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COMMUNITY PROFILE

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.

H&L TECH

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Yaakov Kornreich has been working as

HEALTHY LIVING

nior falls are a signal event. They’re often part of a larger geriatric syndrome, which means the fall itself may represent other things that have long been going on. . . “[While a fall can] certainly lead to a decline in functional ability and even death, [it] can also result from medical problems that cause the fall in the first place.” These include balance issues, poor nutrition, poorly controlled diabetes or poor coordination. Impaired thinking could also create confusion, causing an older person to trip and fall. But there is a positive aspect to the results of these recent studies as well. Professor Gell emphasizes that “while falls may be [a] leading cause of death. . . that does not mean that most falls result in death. An important takeaway from the CDC study is the concerted need for fall-prevention efforts. [This] may include an individual fall-risk assessment, home environment assessment, and participation in fallprevention exercise, such as balance and strengthening exercise.” Hip Replacement Still an Option at Age 90+ The studies show that no matter

MEDICINE TODAY

tion systems. Over the past few years, these features have become more available, and many new car models now include some of them as standard equipment. Together, they can help compensate for the slowed reflexes of older drivers and correct for some of their most common driving mistakes. Within limits, they can help seniors to remain safely behind the wheel of their cars and maintain the independence that gives them to age 85 and beyond. The greatest safety risk to seniors is not from automobile accidents, but rather injuries due to falls. According to Centers for Disease Control (CDC), about one-third of Americans over 65 fall every year. The number of seniors who die annually as the result of falls has nearly doubled since 2000. Nationwide, falls account for 55% of the 90,000 deaths of the elderly each year due to accidental injuries. Car accidents are the second leading cause, accounting for 6,000 (14%) senior deaths each year, followed by suffocation (8%), accidental poisoning (4%), and fire (2%). The likelihood of death from unintentional injuries due to all causes in-

GOLDEN YEARS

“[While a fall can] certainly lead to a decline in functional ability and even death, [it] can also result from medical problems that cause the fall in the first place.”

how careful a senior may be, sooner or later they are likely to suffer a serious injury from a fall. But that does not necessarily mean that their active lifestyle must come to an end. One of the most serious injuries for an older person from a fall is a broken hip. According to Dr. Alexander Miric, an orthopedic surgeon at Kaiser Permanente in Los Angeles, “someone who has fallen and broken their hip [has lost] the ability to walk, the ability to do tasks, to live their lives independently. That’s important to all of us, but particularly to people of that age. . . because the mortality of broken hip without surgery is extremely high.” Recovery from an operation to repair a broken hip in an elderly patient often takes months, so Dr. Miric says that a better choice may be a full surgical hip replacement, after which the patient can often get up and start walking again the day after surgery. His study of 43,000 hip replacement operations performed over the past decade found 183 cases in which the patients were past the age of 90. Their outcomes were much better than one might expect. While they required slightly longer hospital stays and had higher readmission rates, their surgical risk factors and post-operative complications were generally no worse than in younger patients. Dr. Miric attributes this to improved today’s surgical and anesthetic techniques and better medications. He concludes that for those seniors who are “lucky enough to reach the age of 90” in reasonably good health, even suffering a broken hip from a fall does not necessarily mean the end of their life, or even their active life style.

WOMEN’S HEALTH

May 2015

creases sharply after the age of 85. The Importance of Avoiding Falls Dr. Lauren Gleason, a geriatric medicine specialist at Beth Israel Deaconess Medical Center in Boston, said, “people are living longer. And there’s also more community knowledge about the risk of falling, which might have led to a greater acceptance of [mobility] devices.” She added that such deaths “are not usually just about the fall. Se-

RAISING OUR CHILDREN

s more members of the Baby Boom generation pass what used to be called retirement age, modern medicine is finding new ways to help them to remain active and healthy for another two decades and longer. The very definition of old age has changed, and is no longer generally applied to those under age 70. Today, the elderly are divided into two categories: the “young elderly” under the age of 85, and the “oldelderly” above that age. Doctors are studying those populations to determine the equipment and medical treatments which can best help them to maintain a healthy and active lifestyle even past the age of 90. A study of 7,600 Medicare beneficiaries published in the Journal of the American Geriatrics Society reveals that the percentage who regularly using canes, walkers and other mobility aids increased from 16 to 24 percent between 2004 and 2012. An estimated 8.5 million American seniors use mobility devices today. The most common is the cane, used by 16 percent of seniors. Just 2 percent use more expensive electric scooters. Nearly 10 percent of those interviewed regularly used more than one mobility device, changing off between them based upon the immediate needs of their situation. Nancy Gell, a professor of rehabilitation at the University of Vermont, was the lead author of the study. She said that as recently as a decade ago, many seniors who needed canes, walkers, wheel chairs or motorized scooters did not want to use them because they were seen as a sign that their age was catching up with them. That opposition is breaking down due to a combination of factors. These include the increased number of public places which have become wheelchair accessible, and the fact that they have become more socially acceptable as the general population has aged. Also, rather than going to live in nursing homes, more seniors today

are choosing to stay in their communities, for which they need to retain their mobility. Senior-Friendly New Car Safety Features A new class of mobility aids for seniors are the safety features available on many new cars today. These include automatic lanekeeping, adaptive cruise control, crash avoidance systems, backup cameras, blind spot alerts and GPS-guided turn-by-turn naviga-

ISSUES

By Yaakov Kornreich

INTRODUCTION

GOLDEN YEARS


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

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

FDA Monitor

ISSUES

INTRODUCTION

MEDICINE TODAY

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Approvals, Recalls & Going Generic Approved - Bactrim -is used to treat ear infections, urinary tract infections, bronchitis, traveler’s diarrhea, shigellosis, and Pneumocystis jiroveci pneumonia. You should not use Bactrim if you have severe liver or kidney disease, anemia caused by folic acid deficiency, or a history of low blood platelets caused by taking trimethoprim or any sulfa drug…

FDA Taking on Chin Fat

ometimes the face is the hardest part of the body to lose fat. But no longer will struggling individuals have to “take it on the chin,” since the FDA recently approved Kybella (deoxycholic acid), also known as ATX- 101, as a treatment for adults with moderate-tosevere fat below the chin. Kybella helps the body absorb fats after it is injected into tissue and then destroys the fat cells. Patients may receive up to 50 injections in a single treatment, with up to six single treatments administered no less than one month apart. Kybella is being provided in single patient use vials and should not be diluted or mixed with any other compounds. The safety and effectiveness of Kybella for treatment of submental fat were established in two clinical trials which enrolled 1,022 adult participants

Approved - Corlanor - approved for use in certain people who have chronic heart failure caused by the lower-left part of their heart not contracting properly. This drug is for patients who have symptoms of heart failure that are stable, a normal heartbeat with a resting heart rate of at least 70 beats per minute and are also taking beta blockers at the highest dose they can tolerate…

with moderate or severe submental fat. Participants were randomly assigned to receive Kybella or a placebo for up to six treatments. The results showed that reductions in submental fat were observed more frequently in participants who received the drug versus placebo. “It is important to remember that Kybella is only approved for the treatment of fat occurring below the chin, and it is not known if Kybella is safe or effective for treatment outside of this area,” reports Amy G. Egan, M.D., M.P.H., deputy director of the Office of Drug Evaluation III in the FDA’s Center for Drug Evaluation and Research. Kybella can cause serious side effects, including nerve injury in the jaw that can cause an uneven smile or facial muscle weakness, and trouble swallowing.

Approved - Kamra - a device implanted in the cornea of one eye is approved to improve near vision in certain patients with presbyopia. It is the first implantable device for correction of near vision in patients 45 to 60 years old who have not had cataract surgery and are unable to focus clearly on near objects or small print… Approved - Stivarga - approved as a cancer medication that interferes with the growth and spread of cancer cells in the body. Stivarga is used to treat colorectal cancer and a rare type of tumor that can affect the esophagus, stomach, or intestines. It is usually given after other cancer medications have been tried without success… Recall - Allergy Alert on Undeclared Milk in Ossie’s Herring in Sour Cream, Pickled Lox Dairy and Undeclared Eggs Pickled Lox & Cream Products-SM Fish Corp. of Far Rockaway, NY is recalling their 8 ounce containers of OSSIE’S HERRING IN SOURCREAM and OSSIE’S PICKLED LOX DAIRY because of undeclared milk.. These products were distributed to retail stores in the NY and NJ area. OSSIE’S HERRING IN SOURCREAM contain the UPC code 739885114174 and date code 06/08/15 (represents expiration date) located on the bottom of the tub. OSSIE’S PICKLED LOX DAIRY has the UPC code 739885114136 and date code 06/08/15. OSSIE’S PICKLED LOX & CREAM is also being recalled due to undeclared eggs. It bears the UPC code 739885104113 and date code 06/04/15… Recall - Whole Foods Market Voluntarily Recalls Packaged Raw Macadamia Nuts Due To Possible Salmonella - The product was labeled as “Whole Foods Market Raw Macadamia Nuts” and was packaged in 11 oz. plastic tubs. There is a possibility these nuts may be contaminated with salmonella. The recalled product has a best-by date of Feb. 4, 2016 and a UPC code of 7695862059-1. Recalled items were sold in AR, AZ, CA, CO, HI, KS, LA, NM, NV, OK, TX, and UT at Whole Foods Market Stores…

FDA Enforces New Drug Safety Labeling for Pregnant Women

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tarting June 30th, the first revision of the traditional A-X grading system for prescription drugs will go into effect. This marks a radical change in the information available to doctors when prescribing medications to their female patients especially the ones that are pregnant. Labeling drugs efficiently is vital since many women have chronic medical conditions, such as high blood pressure or asthma, and need to continue taking prescription drugs to treat those conditions even while trying to get pregnant, pregnant and breastfeeding. Other pregnant women may need to take medicines for new conditions that develop during pregnancy or for health problems that

worsen during pregnancy. The current grading system has been in effect since 1979. A grade of A indicates the drug is considered benign when it comes to adverse effects in fetal development, while an X means it’s off limits to expectant mothers. The lettered system will be replaced with three detailed subsections -- “Pregnancy,” “Lactation” and “Females and Males of Reproductive Potential.” The new labeling system will provide up-to-date technical information based on quantities of medicine as it relates to adverse effects on the fetus, breast-feeding and fertility. Older drugs will have their labels changed more gradually, the FDA said.

Going Generic -Aggrenox (dipyridamole) - is used to reduce the risk of stroke in people who had blood clots or a mini stroke… Going Generic - Gleevec (imatinib) treats certain types of cancers such as acute lymphoblastic leukemia, chronic myeloid leukemia, gastrointestinal stromal cancer and myelodysplastic/myeloproliferative diseases by stopping or slowing down the growth of tumor cells… Going Generic - Intuniv (guanfacine extended release tablets) is used to treat ADHD, as part of a total treatment plan including psychological, educational, and social measures. Unlike other drugs used to treat ADHD, this drug is not a stimulant… Going Generic – Pulmozyme (dornasa alpha inhalation solution) improves breathing and reduces the risk of lung infections in people with cystic fibrosis. It works in the airways by decreasing stickiness/thickness of mucus so that it can be cleared from the lungs more easily. Medication is inhaled into the lungs using special breathing equipment, usually once or twice daily or as directed by your doctor… Going Generic - Travatan Z (Travoporst ophthalmic solution) is used to treat pressure in the eye by reducing pressure through increasing the amount of fluid that drains from the eye…

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May 2015


So I Don’t Have to Spend Hours in the Waiting Room? The Pros and Cons of Concierge Medicine

ISSUES

By Rachel Wizenfeld

J

HEALTHY LIVING H&L TECH

Rachel Wizenfeld is the associate editor

of this publication and a frequent contributor to many Jewish publications. She is also a healthy food enthusiast and experiments weekly with new tricks to keep costs down while feeding her growing family.

COMMUNITY PROFILE

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tors and nurses. All the care is paid for out-ofpocket. “I don’t deal with insurances,” Karnaby said. “I’m giving topnotch service. Our services are so elite that if I bill insurances, my quality goes down.” “It’s not for everyone, it’s definitely for the affluent customer,” he added. “We’re trying to be the Barneys of pharmacies.” While Cedra is representative of a more elite concierge service, of the estimated 5,500 concierge practices nationwide in 2013, about two-thirds charged less than $135 a month on average, according to Concierge Medicine Today. People with deductibles of $5,000 or more should think about how many times a year they typically see the doctor and for what price, keeping in mind that annual checkups are free. If doctor visits typically cost $150 and the patient has six appointments a year, a concierge practice offering the same services for $40 or $50 a month might be cheaper. Those interested in finding a local concierge medical practice can visit http://privatephysicians.com for a searchable directory.

MEDICINE TODAY

One of their centers is on the cusp of Harlem and the west side of Manhattan, drawing a range of working professionals who are both lower-income and uppermiddle class. “These are busy working people, they don’t have time to get to the doctor and they’re younger, not as sick, so they’re never going to reach their deductibles,” he said. This shift towards “retail health care,” as Katz called it, is natural as people are busy, doctors are never open at convenient times, and patients don’t want to lose a day of work just to go to an overcrowded primary care facility to get a physical. Mazen Karnaby, founder and CEO of Cedra Pharmacy, has created his own unique pharmacy concierge service, which focuses on wellbeing and preventative healthcare for affluent patients. Through a tiered membership program, Cedra provides a range of home-based services like sending nurses to your home to check blood glucose levels for diabetics, pharmacists to deliver and explain medications, and chefs to teach you how to cook healthfully or even accompany you to the supermarket. For cancer patients, Cedra makes available extra nursing and support groups to help during an active chemo phase. While Cedra doesn’t provide primary care services, they work in conjunction with a patient’s primary care doc-

GOLDEN YEARS

patient’s insurance for the extra services. And some other practices merely operate as traditional medical offices, billing insurance as usual, but charge a concierge fee for extra services such as same-day appointments, after-hours access to doctors, and more. Elan Katz, CEO of CURE Urgent Care which is soon opening its third urgent care facility with a concierge option in New York City, has found with Obamacare that people are paying more and more out of pocket, even with insurance. Since a lot of insurance plans have high deductibles, “by the time you reach your deductible, you’re paying more out of pocket than if you signed up for membership, when you and your kid could go in at anytime,” he said. CURE Urgent Care facilities operate as traditional for-profit urgent care centers, working with all major insurance plans including Medicaid (Katz said they are currently the only urgent care facility in Manhattan to accept Medicaid), but they also offer annual membership plans ranging from $399 for four visits to $599 for unlimited visits. Currently only 5-8% of his population utilizes the membership option, but Katz anticipates that to grow in response to rising deductibles. He said that 15% of his clientele are already paying for their services completely in cash, using no insurance whatsoever.

WOMEN’S HEALTH

May 2015

RAISING OUR CHILDREN

ust as the Affordable Care Act came along and made sure almost all Americans had insurance, a new crop of doctors, pharmacists and other medical professionals are going private –meaning not working with insurance companies barely at all. Long considered a service for the wealthy, concierge medicine, as this privatized medical model is called, is now becoming more available to the middle and lower class through a growing number of practices. How does it work? At its most basic form, a patient pays a concierge practice – usually a primary care or family medicine practice - a monthly fee, and in return gets to make an appointment any time and be seen by the doctor for no additional cost. Needed services, such as blood work or x-rays are either paid for in cash (at more reasonable prices than in typical medical practices) or billed to insurance. The Wall Street Journal reported in 2013 that eliminating insurance billing cuts as much as 40% of medical practices’ overhead expenses, When doctors are no longer at the beck and call of insurance companies and their set reimbursements, they have the freedom to design their practice so they can see fewer patients per day and make themselves available through phone calls, emails, and text message. Patients enjoy spending less time in the waiting room and having more face-time with their doctors, and doctors report feeling less stress and burnout, and practicing medicine in the way that they desire. Concierge practices vary in the way they work with insurance companies. Some avoid them entirely, and require patients to pay with cash for vaccinations, lab work, x-rays and other services, or they’ll send them to a lab, but often for a more reasonable fee than typical cash arrangements. Other practices might charge a retainer for basic services such as appointments and check-ups, and bill a

INTRODUCTION

MEDICINE TODAY


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

MEDICINE TODAY

Down Syndrome Mimics Key Alzheimer’s Symptom

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t has long been known that people with Down syndrome are at higher risk for developing Alzheimer’s disease at a relatively early age. New research suggests that people with Down syndrome develop plaques made up of amyloid proteins that are visible on brain scans and similar to similar accumulations found in the brains of Alzheimer’s victims. The hope is that if the underlying physical mechanism responsible creating amyloid plaque in Down syndrome patients could be found, it might lead to promising avenues for research and treatments that could delay or prevent Alzheimer’s. A statement by Dr. Eric Reiman, executive director of Banner Alzheimer’s Institute, who led the research team said, “We and other researchers have been interested in detecting and tracking Alzheimer’s, starting before the onset of cognitive [thinking] impairment in individuals at genetic risk for the disease. We have used this approach to help launch Alzheimer’s prevention trials in people with other genetic risk factors, and we hope that the same approach can help empower people with Down syndrome in the fight against this disease.” Recent medical advancements have significantly extended the life expectancy of people with Down syndrome. As more of them began to live longer, researchers realized that they faced an 80 percent risk of developing Alzheimer’s disease, much higher than the risk facing the rest of the aging population, Dr. Reiman’s statement noted. People with Down syndrome suffer from a birth defect which gives them three copies of chromosome 21, which carries a gene for the so-called amyloid precursor protein. This presence of the gene leads to the overproduction of amyloid, a protein strongly linked to Alzheimer’s disease. Reiman’s research team found that PET brain scans of people with Down syndrome showed the accumulation of amyloid proteins and reductions of brain activity usually

associated with Alzheimer’s beginning around the ages of 35 to 40, which is decades earlier than most cases of Alzheimer’s. “The number of people with Down syndrome who go on to Alzheimer’s symptoms has tripled in the last 20 years,” said Marwan Sabbagh, the lead researcher of Banner Sun Health Research Institute. “There is a growing need to find interventions to treat and prevent Alzheimer’s in these individuals, and there is an opportunity to do so in a way that could help find effective Alzheimer’s prevention therapies for everyone.” The study was conducted on a

small sample involving five people with Down syndrome who had already developed symptoms of Alzheimer’s, 12 people with Down syndrome who had no symptoms of Alzheimer’s, and nine “control” participants who did not have Down syndrome or symptoms of Alzheimer’s disease. In addition to PET scans, researchers also used MRI scans to measure the volume of “gray matter” in the participants’ brains. The people with Down syndrome and Alzheimer’s symptoms showed a much greater buildup of beta-amyloid, reduced brain activity, and smaller gray matter volumes than subjects from

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the other two groups. In addition, the people with Down syndrome who had not yet develop Alzheimer’s symptoms had more amyloid protein in their brains than the control group. Researchers have long believed that the amyloid buildup begins long before memory and cognitive symptoms become detectable, but it is hard to identify subject to test for the earliest stages of amyloid buildup. The new findings suggest that people with Down syndrome might be suitable trial subjects for testing the effectiveness of new drugs aimed at preventing the onset of Alzheimer’s symptoms.

May 2015


By Estie Rose

F

H&L TECH COMMUNITY PROFILE

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

HEALTHY LIVING

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Estie Rose, MS, CGC, is a genetic

MEDICINE TODAY

participation was sub-optimal. My colleagues and I wanted to get to the bottom of this. We decided to do some of our own research into the matter with the help of Yeshiva University and Stern’s Sephardic Community Program leader, Rabbi Moshe Tessone. Rabbi Tessone invited us to join one of his classes at Stern to have a candid conversation with his Sephardic/Mizrachi students. What we learned is that, in their communities, there is a general lack of knowledge that these conditions exist (or maybe a denial), a fear of stigma, and an emphasis on keeping medical issues private. The en-

GOLDEN YEARS

mal dominant, which means that having just one mutation puts one (meaning the parent or the child) at risk for developing the disease. On top of that, many of these conditions are adult-onset, and one with the mutation is not guaranteed to even develop the disease at all. We wonder if screening for such diseases is appropriate for preconception/premarital testing, because we would be identifying conditions possible in the parents themselves. Finally, we questioned whether there was enough of a Sephardic/ Mizrahi community interest in preconception carrier screening. In 2009, a genetics team at Cedars-

couraging points that we took away were that (a) if educational sessions were to precede testing, then people may be more receptive to getting tested, and (b) the younger, second generation Americans, may be more responsive to using preconception genetic testing as a resource for family planning. So what’s new in 2015 that can help move this forward? We and others are now able to offer genetic testing to our Sephardi and Mizrahi patients. The panels we use are not country of origin-specific, but instead include diseases that are more common in Jews of multiple different countries (which is particularly applicable for those with mixed ancestry). More appropriate and comprehensive testing panels are in the process of being developed, and our hope is that with the availability of these better tools, we’ll be able to better serve the entire Jewish community. Once the genetics professionals can establish more effective testing panels, it will be up to us and other community organizations to spread awareness and to promote genetic testing. Beyond this, many have suggested we try to better understand the communities and their genetic health issues with the help of medical and rabbinic leaders who already are trusted within their communities. I am very optimistic about the future of genetic awareness and testing for the Sephardi and Mizrahi community. With some more education in the right context and with better testing panels, we are almost there. You can check for updates on our Jewish carrier screening initiatives at PJGHtesting.com.

WOMEN’S HEALTH

May 2015

Sinai Medical Center piloted a genetic screening program for 1,000 members of Los Angeles’s Iranian community. The program was very successful in that it identified 288 carriers, ten carrier couples, and another ten individuals who were affected (but not symptomatic) with a disease. Since this program, there have been efforts to expand to other Sephardi and Mizrahi sects, and to duplicate this initiative in other parts of the country with the help of local organizations, such as New York’s Sephardic Health Organization for Referral and Education (SHORE). Expansion, however, proved to be difficult, since

RAISING OUR CHILDREN

or years, genetics professionals and matchmaking groups have spoken about the importance of preconception carrier screening for Ashkenazim. Tay-Sachs testing on the community level began in the 1970s and has since expanded to a much more comprehensive testing panel, ranging from diseases that are fatal in infancy to those that are compatible with life, but nonetheless chronic and debilitating. Ashkenazi Jewish carrier screening has arguably been one of the most successful public health initiatives in the Jewish community since it has almost eradicated Tay-Sachs and other common conditions. However, carrier status for these common Ashkenazi conditions will continue to be prevalent and we will have the need for carrier screening in every generation. When my Program for Jewish Genetic Health hosted an Ashkenazi Jewish screening event at Yeshiva University in November 2013, we got many inquiries from Sephardic and Mizrahi students about why they weren’t “invited.” Some students felt left out and others felt proud (“We don’t have these diseases!”). At the time, the answer was simple: there was no readily available testing panel for Sephardis and Mizrahis, so we had nothing to offer. But this answer was not satisfying to us, since we as genetic professionals know that there indeed are genetic diseases that occur in these populations. So we started to think about why there were no testing panels available, like there are for their Ashkenazi classmates. The first reason relates to population genetics--unlike Ashkenazi Jews, the Sephardi and Mizrahi Jewish populations are not a homogenous group. Their genetic variations are country of originspecific, and therefore, they cannot be grouped into one entity. For example, there are four wellknown conditions common to Iranian Jews, specifically Mashadis, but none of these conditions are known to be common in Moroc-

can Jews. Why, then, would labs develop expensive testing panels for such unique sub-populations? The second reason we speculated was more of a medical one. The nature of some of the known Sephardi and Mizrahi diseases is not comparable to that of the established Ashkenazi ones for which we offer testing. Those Ashkenazi Jewish diseases are all transmitted in an autosomal recessive manner, which means that offspring are affected when both parents are carriers of a mutation for the same disease, and both pass down their mutations. Some of the Sephardi and Mizrahi diseases are autoso-

THE GENETIC FRONTIER

ISSUES

Is There Genetic Testing for Sephardi and Mizrahi Communities?

INTRODUCTION

MEDICINE TODAY


INTRODUCTION ISSUES

By Leah Lebel

HEALTHY LIVING

MEDICINE TODAY

GOLDEN YEARS

WOMEN’S HEALTH

RAISING OUR CHILDREN

HEALTHY LIVING

More Than Just Fungus: 10 Facts About Mysterious Mushrooms

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ushrooms are unique fungi that are useful for a range of things from decomposing wood to medicinal uses, as well as a tasty add-in for thousands of dishes from pizza to pasta. Here are a few fun facts about mushrooms that will sprout up in your mind the next time you bite into a ‘shroom. average per capita mushroom consumption in the U.S today is 4  While most plants get their energy from the sun, mushrooms are grown without the help of sunlight in a cold, wet, and indoor envi The pounds, a far cry from the average per capita consumption in China

(22 pounds per person) or Japan (26 pounds per person). there are thousands of  Although varieties available, 87% of mush-

rooms consumed are the familiar white button mushrooms; 11% of consumption is from potabella and crimini mushrooms; and the other 2 percent come from assorted varieties like oyster and shitake mushrooms. Though you’ll only find about 20 varieties of mushrooms in the supermarket, there are 200 edible mushroom species cultivated today. There is even an edible mushroom that grows in the wild called laetiporus that tastes nearly identical to fried chicken! all mushrooms grow in farmed compost beds. Some varieties  Not of mushrooms, such as shitake and oyster mushrooms, grow on

logs, which farms can simulate. However, farms have to keep these logs constantly moist to replicate the natural conditions of a rainforest, where these mushrooms would normally grow. round top of a mushroom is known as the cap, which is attached  The to the mushroom stem. The thin tissue connecting the mushroom

H&L TECH

are very nutritious. They are the only food in the pro Mushrooms duce isle that contains vitamin D, and they are rich in many B vita-

mins and copper and potassium as well. In fact, a single portobello mushroom contains more potassium than a whole banana. Mushroom are also immunomodulators, meaning they can help regulate the immune system. They can enhance immune function when fighting infection, or reduce it to protect from autoimmune conditions, such as allergies and arthritis.

sure which mushroom to use? White button mushrooms are great  Not as pizza toppers, canned and in stir-fry recipes. Portobellos have a

meaty, mushroom-like flavor that are great as a meat substitute for vegetarians. Shitake mushrooms are earthy, smokey, and woody, and their texture is firm and chewy. They are often used in Asian cooking.

cap to the stem is known as the veil. As a mushroom matures, its veil will pull away from its stem, exposing the brown stringy material known as the gills of the mushroom underneath. Mushrooms do not produce seeds to reproduce, but instead have spores which are attached to its gills. Each mushroom contains about 16 billion spores. Farmers plant spores in compost beds, allowing fungus to grow, and mushrooms to develop out of this fungus. 92% of a mushroom is made up of water. species of mushrooms, the Maitake mushroom, also nicknamed  One the “hen of the woods” is noted by the American Cancer Society

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ronment. Like humans, they also have the ability to make vitamin D in the presence of sunlight.

mushrooms grow on their own and are often dangerous to hu Wild mans. Amanitas mushrooms are famous for their amanitin, a toxin

that kills people by shutting down the liver and kidneys. Little brown mushrooms, which are found almost everywhere, contain amatoxins that can also make humans sick. Jack o’lantern mushrooms, which glow in the dark, contain muscarine, which causes diarrhea and severe cramps. Some warning signs of poisonous mushrooms include patches on the cap, a bulbous “bulge” at the mushroom’s stem, white gills, or gills that don’t easily separate from the cap.

(cancer.org) for its supposed anti-cancer properties. There is no conclusive evidence that these mushrooms prevent or cure cancer, but research has shown that it boosts the immune system and may lessen or alleviate some common chemotherapy symptoms, such as hair loss, pain, and nausea. This mushroom may also help with blood sugar and blood pressure control, but further evidence is needed to discover this mushroom’s extensive beneficial properties.

.

Technically, mushrooms are not plants because they contain no clorophyl.

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

Nontheless, they are useful and as you can see, have many amazing functions.

you can differentiate which mushrooms are poisonous and  Unless which are safe for consumption, it’s best to avoid eating wild mush-

rooms. Despite common assumption, no amount of cooking can “destroy” the poisonous properties of deadly mushrooms, nor can you assume that if a bug is eating it, it must be okay. Remember that Roman Emperors Tiberius and Claudius, Tsar Alexander I of Russia, Charles V of France and Pope Clement VII all died of mushroom poisoning.

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May 2015


What’s the Controversy About Genetically Modified Foods?

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HEALTHY LIVING H&L TECH

Rachel Wizenfeld is the associate editor of this publication and a frequent contributor to many Jewish publications. She is also a healthy food enthusiast and experiments weekly with new tricks to keep costs down while feeding her growing family.

COMMUNITY PROFILE

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MEDICINE TODAY

lion pounds as a result of GMO cultivation. This and other evidence suggest that GMO crops are fueling an escalating arms race with weeds and insects.” But while the verdict on the safety of GMO foods may still be uncertain, another battleground has heated up – the movement to label GMO foods, giving consumers the option of avoiding them if they so desire. Currently more than 90% of corn, canola, soybean and sugar beet crops in the U.S. are genetically modified. Most of the produce Americans consume directly isn’t GMO, but the above crops are used to produce common ingredients like corn syrup, soy lecithin and more than half of the sugar consumed in the U.S.—plus the feed consumed by most of the nation’s livestock.

GOLDEN YEARS

biases, such as an overriding desire for things that are natural, which means a preference for food that does not involve additives, processing or human intervention. And a 2013 article by Maria Konnikova for NewYorker.com discussed three things that stand in the way of a logical risk assessment of new technologies: Our level of dread, our degree of familiarity (or lack thereof), and the number of people we believe the technology will affect. GMOs are at the extreme of that scale, high in dread and possible impact, while being low in familiarity.” Consumer groups deny that their opposition to GMO foods has anything to do with gut feelings or hysteria. “Virtually all commercially produced GMOs are engineered to withstand direct application

Because GMO ingredients are so prevalent, being forced to label GMO foods (70% of supermarket products, by some estimates) would represent a burden for food companies, who are quick to say that doing so would lead to higher food prices for consumers. In 2014, General Mills eliminated all GMOs from its Cheerios brand, but said it didn’t result in increased sales. That same year, shareholders struck down a proposal to eliminate GMOs from all of its products, saying that GMOs were proven to be safe and consumers could buy organic products if they wanted to (products labeled to be organic are forbidden by law to contain GMO ingredients). But while consumers still seem to be uncertain whether they want to shell out more money for GMO-free products, they overwhelmingly support labeling. A 2014 Consumer Reports survey noted that a whopping 92% of consumers support required labeling of GMO foods. To date, more than 70 bills have been introduced in over 30 states to require GE labeling or prohibiting genetically engineered foods, according to the Center for Food Safety, but none have conclusively passed. (Maine, Vermont and Connecticut have each passed GMO labeling laws, but they only go into affect once nearby states adopt the law as well.) Monsanto has threatened to sue states that adopt these measures, and along with food industry groups has poured money into campaigns to derail labeling attempts, which so far haven’t been successful. Time will tell if the GMO-labeling initiatives actually come to fruition, but it’s clear that things look headed that way.

WOMEN’S HEALTH

May 2015

of herbicide and/or to produce an insecticide,” Caroline Kinsman, communications manager for The Non-GMO Project, said in an email as to why her group opposes GMO. “Despite biotech industry promises, none of the GMO traits currently on the market offer increased yield, drought tolerance, enhanced nutrition, or any other consumer benefit. Meanwhile, a growing body of evidence connects GMOs with health problems, environmental damage, and violations of farmers’ and consumers’ rights.” Chipotle echoed that with its online statement that, “One recent study by researchers at Washington State University estimated that between 1996 and 2011, pesticide and herbicide use increased by more than 400 mil-

RAISING OUR CHILDREN

f you read the news, you’ve probably come across some heated debate about genetically modified foods, commonly known as GMOs, or genetically modified organisms. Are there risks to consuming GMOs or are they safe to eat? Should they be labeled or should they not be labeled? Adding fuel to the debate last month was popular restaurant chain Chipotle Mexican Grill’s announcement that they are eliminating all GMO ingredients from their food. In a statement on their website, Chipotle said, “In our quest to serve the best ingredients, we decided to remove the few GMOs in our food so that our customers who choose to avoid them can enjoy eating at Chipotle.” Many writers and pundits decried the decision, saying it was based on consumer hysteria and disregard for scientific evidence. “Chipotle…and those who follow their examples are doing real social harm. They are polluting public discourse on scientific matters,” wrote Michael Gerson in the Washington Post. USA Today opined, “[They] say they’re doing the right thing for consumers. What they’re really doing is validating ignorance and hysteria.” At stake in this debate, of course, is lots and lots of money, both in the multi-billion dollar food industry, which faces increasing pressure to be more transparent and use ingredients that shoppers perceive as healthy, and for companies like Monsanto and DuPont, which sell genetically engineered seeds and pesticides. A key objective for developing GMO crops and seeds is to improve crop protection, according to the World Health Organization (WHO). Through tweaking the genetics of a fruit or vegetable, scientists can make it more resistant to plant diseases caused by insects or viruses, or through increased tolerance towards herbicides. But while the scientific commu-

nity mostly agrees that GMO food has been proven to be safe, critics say that most of the studies have been short-term and funded by companies like Monsanto, who are obviously biased. There is a large divide between the scientific and corporate community and American consumers regarding GMOs. A Pew research study in January of this year reported that while 88% of scientists say that genetically modified food is generally safe, only 37% of Americans said that it is. 57% of Americans believe that GMOs are unsafe. Why the large discrepancy? According to a paper recently published in the science journal Trends in Plant Science and quoted by NPR, it’s because opposition to GMOs taps into deep cognitive

ISSUES

By Rachel Wizenfeld

INTRODUCTION

HEALTHY LIVING


INTRODUCTION ISSUES

HEALTHY LIVING

Around the World Part 2 By Elizabeth Kurtz, Gourmet Kosher Cooking

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’m continuing my virtual travels through the Middle East, Asia, and Morocco, so you can enjoy the dynamic flavors, incredible scents and cuisines of these cultures. The ingredients and flavor combinations are consistent through the generations, and recipes are passed down from mothers to daughters. Take a trip to China, Morocco, Tunisia, and Israel and enjoy these new recipes and flavors.

RAISING OUR CHILDREN

Tunisian Spiced Chicken and Chickpeas Serves 6

WOMEN’S HEALTH

1/2 cup Tofutti sour cream or mayonnaise 1/3 cup coarse harissa* or 3 tablespoons Sriracha sauce 1 tablespoon lemon juice 1 teaspoon kosher salt Pepper, to taste 2 lbs. chicken pieces, bone-in, skin-on, about 1 whole chicken 1 can (15 oz.) chickpeas, drained and rinsed 1 large red onion, halved lengthwise and thinly sliced into half-moons 1 pound carrots, peeled and sliced on the diagonal about 1/4 in. thick 1/3 cup coarsely chopped cilantro or parsley

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H&L TECH

HEALTHY LIVING

MEDICINE TODAY

GOLDEN YEARS

 In a bowl, whisk sour cream, harissa, lemon juice, salt, and several grinds of pepper. Add chicken; turn to coat. Chill, covered, 4 to 8 hours. Remove from refrigerator 30 minutes before cooking.  Preheat oven to 425° with a rack set in upper third. In a bowl, combine chickpeas, onion, and carrots. Season lightly with salt and toss to blend. Place vegetables in a 9- by 13-in. baking dish. With a rubber spatula, redistribute marinade so it evenly covers both sides of chicken. Set chicken and any marinade on vegetables, skin side up. Bake until chicken is deeply browned, about 45 minutes.  Sprinkle with cilantro. *Find harissa, a Tunisian chile-and-spice paste, at well-stocked grocery stores, made by Sabra and other international brands.

Moroccan Spiced Turkey  Meanwhile, preheat the oven to 400°. Serves 8-10 One 12-pound turkey, patted dry Kosher salt and pepper, to taste 1 lemon, quartered 4 sage sprigs, plus 1 1/2 teaspoons finely chopped sage leaves 1 head of garlic, halved crosswise 1/3 cup fresh grapefruit juice 1/4 cup fresh orange juice 2 tablespoons fresh lemon juice 2 tablespoons fresh lime juice 2 tablespoons Ras el hanout, available by McCormick or Pereg (see note) Store-bought chutney or onion jam, for serving  Put the turkey on the rack of a roasting pan. Season the turkey cavity with salt and pepper and stuff the lemon quarters and sage sprigs inside. Tie the legs together, season the turkey all over with salt and pepper and let stand at room temperature for about 1 hour.

Wrap the garlic in foil and roast for 1 hour, until very tender. Let cool completely, then squeeze the cloves into a medium bowl. Whisk in the citrus juices along with the Ras el hanout and chopped sage.  Brush the turkey all over with the citrus-garlic mixture. Roast in the lower third of the oven for 30 minutes, then baste with the citrus-garlic mixture. Reduce the oven temperature to 325° and continue to roast, basting every 30 minutes, for 2 hours and 15 minutes longer, until an instant-read thermometer inserted in an inner thigh registers 165°. Transfer the turkey to a board; let rest for at least 30 minutes or up to 1 hour. Carve the turkey, drizzle with any pan juices and serve with chutney. Note: Ras-el-hanout: Blend of cardamom, cinnamon, cloves, turmeric and coriander. It’s a North African spice blend and is amazing sprinkled on lamb before grilling or roasting, adds warm flavor to rice pilaf or couscous, and is delicious added to cholent.

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May 2015


Chinese Orange Beef And Broccolini

INTRODUCTION

HEALTHY LIVING Serves 4

Israeli Chocolate Tahini Truffles

HEALTHY LIVING

Makes 20

H&L TECH

3 ounces bittersweet chocolate, melted ½ cup tahini 2 tablespoons sugar ½ teaspoon cinnamon 1 teaspoon kosher salt, plus more 1 teaspoon vegetable oil ¼ cup toasted sesame seeds, or crystallized coarse sugar or confectioners’ sugar  Place a parchment-lined baking sheet in the refrigerator to chill. Mix chocolate, tahini, sugar, cinnamon, and 1 tsp. salt in a medium bowl with a rubber spatula; chill until firm, about 15 minutes.

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COMMUNITY PROFILE

 Scoop chocolate mixture by the heaping teaspoonful and roll into balls. Place on chilled baking sheet. Chill 5 minutes, then roll in toasted sesame, or crystallized coarse sugar to fully coat. Or sprinkle with confectioners’ sugar. Chill 10 minutes. Can be prepared a day or two ahead of time and stored in refrigerator until ready to serve.

May 2015

MEDICINE TODAY

 In a large sauté pan, heat oil, over medium heat. Add ginger and orange strips. Cook for 1 minute or until golden. Increase heat. Remove meat from marinade (reserving marinade). Add meat and chiles to pan and stir-fry until almost cooked through, about 4 minutes. Add garlic and onions and cook an additional 2 minutes. Add broccolini, vinegar, and reserved marinade and cook for 2 minutes or until heated through. Sauce should bubble and thicken slightly. Serve with steamed rice.

GOLDEN YEARS

 In a 12-inch sauté pan, heat ½-inch of water to a boil. Add broccolini, cover and cook, until tender, 4 minutes. Drain and rinse with cold water.

WOMEN’S HEALTH

 Place 2 inches of water into a small saucepan. Bring to a boil. Scrape out pulp and pith from orange peels. Add cleaned peels to water and cook, covered for 2 minutes. Drain and cut into long ½ -inch wide strips, discard stems.

RAISING OUR CHILDREN

 Juice orange into a large bowl, yielding about 1/3 cup. Reserve peels. Whisk in cornstarch, sugar, wine and soy sauce. Add beef and chiles and marinate for 30 minutes.

ISSUES

1 large orange 1 tablespoon cornstarch 1 ½ tablespoons sugar 2 tablespoons red wine ¼ cup soy sauce 2 lbs. pepper steak or sliced minute steak, sliced very thinly crosswise 5 – 10 dried hot chiles 12 ounces broccolini, cut into 3-inch pieces, stalks split to make them ½ inch thick 5 tablespoons canola oil 2 tablespoons matchstick slices of ginger 1 tablespoon minced garlic 4 green onions, sliced into 1-inch pieces 2 tablespoons distilled white vinegar Steamed rice, for serving


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fun muffins come in a pack of six and are 1oz each. They are gluten-free, dairy free, nut free, low calories, high fiber, rich in whole grains, and certified kosher under the Star-K. Garden Lites produces delicious veggie-based soufflés, dishes, and muffins since 2008, aiming to deliver full flavor without sacrificing taste or health. For more information or to find out where you can purchase products, please visit www.GardenLites.com or call 718.439.0200.

RAISING OUR CHILDREN WOMEN’S HEALTH

arden Lites Muffins, a Queens, New York-based company, recently launched new kid-friendly snacking options with the help of two popular Nickelodeon characters: Garden Lites Teenage Mutant Ninja Turtle Power Muffins and Garden Lites Sponge Bob Square Pants Chocolate Krabby Square Muffins. These new products allow parents to leverage their child’s adoration of Nickelodeon characters while reinforcing healthier eating habits. These

ISSUES

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Garden Lites Launches New Kid-Friendly Snacking Options

Health Benefits to De La Rosa’s Organic Grape Juice

No Time to Work Out? TruTrainer Brings the Trainer to You you access to a personal trainer through your smartphone. All personal trainers are certified with

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ness questions you might have. You can log your workout results as you train so your personal trainer can review your progress and adjust your training plan to suit your fitness levels. Trainer subscriptions are monthly and cost $49.99 per month, about the typical cost of one session with a personal trainer. For more information, search TruTrainer on the app store.

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multiple certifications and you simply need to subscribe to one via the app to have him or her become your own personal trainer. He or she will build a training plan for you to follow via the TruTrainer application, and you can work out either in the gym or at home. The trainer will provide the motivation and encouragement you need to stay on track and answer any fit-

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ou know you should exercise more, but you just don’t have the time or motivation. You tried going running with a workout buddy, but he flaked. You want to try using a personal trainer, but they’re so much money and how can you justify the expense? TruTrainer attempts to solve all these problems by offering a lowcost membership option giving

May 2015

HEALTHY LIVING

Y

family, owners of De La Rosa. WOW! This Is It is De La Rosa’s grape juice that is kosher for Passover and all year round to the strictest religious standards. It is available for immediate shipping from their warehouses in the U.S. or from their vineyards in Austria. Other products brewing and stewing at De La Rosa Real Food and Vineyards include organic and conventional oils, organic and conventional vinegars, organic tahini, organic sesame oils and organic wine vinegars. For more information, please visit: www.delarosa613.com or call 718.333.0333 or 855.252.5613. You can also see De La Rosa in action at the Fancy Food Show on June 28-30 at the Javitz Center in New York City, booth 4859.

MEDICINE TODAY

ed grape juice has long been proven to have many health benefits, like flushing out harmful toxins and helping to purify the blood. The antioxidants present in red grape juice are purported to boost the immune system, and studies have shown that it helps to prevent cancer and heart attacks, can raise the level of good cholesterol, and can even be used as a home remedy to cure headaches and migraines. Some studies have also shown that drinking red grape juice can help burn fat, resulting in weight loss. De La Rosa’s organic grape juice is intended to provide these benefits without the toxins or pesticides of conventional grape juice. “Our mission at De La Rosa is to ‘Put Heavenly Sparks Back Into Food,’” explains the Girshberg

GOLDEN YEARS

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INTRODUCTION

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

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Community Profile Zicharon: Dealing with Alzheimer’s in the Jewish Community

By Sandy Eller

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housands of support groups, programs and resources exist to enhance care and support for caregivers of those who have Alzheimer’s and other forms of dementia, but until recently, none catered to the unique needs of the Orthodox Jewish community. Zicharon was founded in 2012 to bridge that gap and provide a support network for members of the Jewish community who are dealing with a loved one suffering memory loss. “It all started with one man, who prefers to remain anonymous, who had a neighbor who suffered from dementia,” said Leah Horowitz, director of Zicharon. Checking in frequently with the neighbor’s husband, it became apparent that the couple had no outside help and no Medicaid. Those they had turned to for practical guidance could not understand the particular issues of an Orthodox caregiver since they weren’t familiar with the nuances of Judaism that are so integral to daily life. The man contacted Horowitz who had become well known in Brooklyn’s Jewish community for her experience in home care, a result of many years of work at Revival Home Health Care and caring for her own critically-ill father. “He wanted me to start something for people who were caring for those with memory loss,” said Horowitz. “I told him it would never work, that people would never be willing to publicly talk about something like this, but he wouldn’t take no for an answer.” The two began making appointments with top-of-the-line geriatric psychiatrists and neurologists. “The more we went out there the more we realized that there was so much that people weren’t even aware of,” remarked Horowitz. “We spent six months educating ourselves.” Zicharon held its inaugural event in May 2012 in Boro Park. Horowitz recalled walking in, seeing 300 chairs set up and contemplating removing half the seats to avoid potential

embarrassment when just a handful of people showed up. Instead, participants came in droves to hear Dr. Gary Kennedy, head of geriatric psychiatry in Montefiore Hospital and Jedd Levine, president of the American Alzheimer’s Association. “It was standing room only,” said Horowitz. “There were people standing on the steps and the men were standing outside. We were floored, and after that the phone calls started coming in with people begging for help.” Since that time Zicharon has been providing caregivers with hands on tips and practical advice. “We offer a lot of guidance on safety issues, like getting a GPS for those who wander,” said Horowitz. “Sometime it is the simple solutions, like installing a Shabbos lock backwards for someone who tends to leave the house. Because the combination is on the inside, the patient can’t get out and family members can go to sleep at night knowing that the patient isn’t walking out the door.” Zicharon also offers comprehensive information on homecare, medical and psychiatric referrals and advice on filling out Medicaid applications. When it came to starting support groups for caregivers, Horowitz admitted that she had reservations. “I figured in our community no one would come,” said Horowitz. “No one wants to say ‘I am fed up with my mother,’ but we are packed every week.” While Zicharon’s support groups offered encouragement, advice and guidance it soon became apparent that communication was a serious problem. “The first thing that goes in an Alzheimer’s patient is the sense of reasoning,” noted Horowitz. “A patient will insist that it is Shabbos when the caregiver knows that it isn’t. The best way to handle a situation like that is by diversion. Change the subject and talk about something safe and the patient will forget that they were fixated on Shabbos.” While the American Alzheimer’s Association offered a valuable

communications skills training workshop for caregivers, Horowitz longed for a course tailored to the Jewish community’s needs. Her early calls to the American Alzheimer’s Association were disappointing but one day Horowitz got the call she had been waiting for, something she describes as “siyata dishmaya.” “They asked me to do a training for their department heads on issues unique to the Jewish community,” said Horowitz. “I felt like Hillel standing on one foot trying to decide what to say.” Among the topics that Horowitz addressed were Shabbos, Yom Tov, kashrus and davening. “Women whose husbands have dementia can hear many times a day, ‘I need to daven mincha,’ and they will say, ‘You just did.’” These men could want to go to mincha ten times a day.” Holocaust survivors presented other challenges. “There are huge issues,” noted Horowitz. “Hospital situations are a nightmare. Many Holocaust survivors won’t take showers because they have a horrible connotation to them.” One week later the American Alzheimer’s Association informed Horowitz that they would create the course she requested. The ten-hour classes are given in Boro Park with groups kept small to encourage more discussion between participants. “We are extremely grateful to the American Alzheimers Association,” said Horowitz. “One woman told me that those workshops changed her life.” Having a mother who lives in Los Angeles and suffers from Alzheimer’s has been trying for Queens resident Rivkah Engelson. A veteran of both Zicharon’s caregivers course and its support groups, Engelson noted that Horowitz always goes the extra mile, finding contacts and offering advice, guidance and emotional support. “It doesn’t matter where in the country you live, Leah is there for you,” said Engleson. “Zicharon is a lifesaver in more ways than one.” Debbie Green*, whose husband

30

suffers from Alzheimer’s, described his diagnosis as devastating. “I think of Alzheimer’s as an avalanche that destroys the foundations of a home,” said Green. “I had to learn the difficult task of putting it back together. I read whatever I could find on the internet and checked out countless books from the library which I didn’t have time to read. Zicharon filled the gaps in my education...whenever I have a question about aides or finances or any of the countless issues we deal with Leah is there to answer it.” Green draws strength from a Zicharon support group. “The support group is a haven where we can express our deepest emotions and receive practical advice,” said Green. Even more important is a weekly Zicharon social group that Green’s husband attends. “I bless Zicharon and Dr. Shindler for the men’s social group on Wednesdays,” remarked Green. “My husband returns home with a happy contented look on his face.” In a life turned upside down by her husband’s illness, Zicharon has been a lifesaver for Green. “I had tried so hard and approached many organizations, sent letters to elected officials, and only Zicharon heard my pleas,” said Green. “We blundered a great deal at the onset of my husband’s illness due to ignorance and misinformation. Thankfully now Zicharon is there to hold your hand and lessen the pain as you deal with a chronic and devastating illness.” Horowitz estimated that Zicharon, which is privately funded by an anonymous donor, sees several hundred cases each year. To find out more about Zicharon, visit them online at www.zicharon or contact them at 718.534.1008. *Name changed for reasons of privacy

Sandy Eller is a freelance writer who writes for numerous websites, newspapers, magazines and many private clients. She can be contacted at sandyeller1@gmail.com.

May 2015


RAISING OUR CHILDREN

Hal Gerstein, MD

Cancer Institute of Long Island 225 Community Drive, Suite 160 Great Neck, NY 11021 516.482.4790 www.cancer-li.com

DR. ABDELRAHMAN SALEM DPT

DR. JACQUES DOUECK

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

31

COMMUNITY PROFILE

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

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

MEDICINE TODAY

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.

GOLDEN YEARS

Chaninah Zweihorn, DDS

Zweihorn Orthodontics Queens: Brooklyn: 150-25 Union Turnpike 4119 13th Avenue Flushing, NY 11367 Brooklyn, NY 11219 718.969.9234 718.435.3393 Dr. Chaninah Zweihorn is a specialist in orthodontics and treats both children and adults. He attended New York University College of Dentistry on a full-merit scholarship, receiving his DDS in 2003 with several honors and awards, including the American Association of Oral Biologists Award. Dr. Zweihorn completed residency at the Mount Sinai Hospital in Manhattan, returning to NYU for specialty training and certification in orthodontics. He has taught pediatric-dentistry residents at Mount Sinai. Dr. Zweihorn is excited to provide the highest quality treatment to the community and to continually implement the most effective and innovative techniques in orthodontics. Dr. Zweihorn is a member of the American Association of Orthodontists, the American Dental Association, and the New York State Dental Association.

WOMEN’S HEALTH

Pulmonary Rehabilitation Specialist Integrated Rehab & Physical Therapy P.C. 2657 Batchelder Street Brooklyn, NY 11235 718.332.3401 Dr. Abdelrahman Salem has worked for more than 20 years with pulmonary rehab patients. He has helped wean many patients off supplemental oxygen, helping them to lead more normal and healthy lives. Dr. Salem taught chest physical therapy at the university level for seven years. He was invited to join the American College for Chest Physicians based on his tremendous work and successful research with chest patients. Dr. Salem received his Doctorate in physical therapy from Stony Brook University and continues to stay updated with the latest innovations in physical therapy.

Dr. Hal Gerstein was a member of the exclusive Biomedical Research Program at the Rensselaer Polytechnic Institute in Troy, NY and the Albany Medical College in Albany, NY where he earned both a Bachelor of Science degree and a Doctor of Medicine degree in. While earning his degree, He was awarded the Mosby Award for Outstanding Research in the field of virology. He is board-certified in both Internal Medicine and Medical Oncology by the American Board of Internal Medicine and is a Senior Attending Physician on the staff of both the North Shore University Hospital in Manhasset and the Long Island Jewish Hospital in New Hyde Park. He has held teaching positions at the NYU School of Medicine and the Cornell School of Medicine. He brings over 30 years of clinical expertise to his patients, focusing on providing the latest therapies for cancer treatment, including chemotherapy, hormone therapy, immunotherapy, and selective hyperthermia as well as vitamin and mineral infusions in a comfortable, modern, private setting.

May 2015

ISSUES

Medical Profile

INTRODUCTION

COMMUNITY PROFILE


COMMUNITY CALENDAR

ISSUES

INTRODUCTION

COMMUNITY PROFILE

JUNE 2015

June

5

GOLDEN YEARS

WOMEN’S HEALTH

RAISING OUR CHILDREN

All-Summer - Nature on the Go! Where: Auduban Center at Prospect Park, near the Lincoln Road and

Ocean Avenue entrance of the park, Brooklyn, NY 11225 When: Sundays from 1-2pm and 3-4pm Contact: 718.287.3400 A naturalist will lead children to places where they can play games that relate to the local flora and fauna, whether it’s animal charades or imitating a bat chasing a moth. Families can also take a walk accompanied by a naturalist to look for animals and observe their habitats. June

3

MEDICINE TODAY HEALTHY LIVING H&L TECH

5

June

3

Westchester College Event “What Are Students Facing Today on Campus?” Where: JCC of Mid-Westchester-999 Wilmot Rd. Scarsdale, NY 10583 When: 7-9:30pm Contact: Pam Goldstein at pam@wjcouncil.org

June

10

June

11

Annual Elder Abuse Conference Where: The New School - 66 West 12th St. New York, NY 10011 When: 8:30am-4:30pm Contact: MPollack@jasa.org or 718.286.1540

June

11

Health & Wellness Seminar Where: Lubavitch Yeshiva - 570 Crown St. Brooklyn, NY 11213 When: 7:30-9:45 pm Contact: Mike Friedman at 216.214.2668

4

June

14

A Day of Professional Learning at Museum of Jewish Heritage Where: 36 Battery Place New York, NY 10280 When: 8:30am-3pm

Join us for a day of free professional learning. During the morning session, a museum historian will lecture. In the afternoon, participants will discover way to help students make connections to the past using Echoes and Reflections, a multimedia Holocaust education. June

4

June

19

Better Sleep in Survivorship Where: Rockefeller Research Laboratories-

5

West Hartford, CT 06117 When: 3:30-5:30pm

CAD Computer Class Training Where: Englewood Public Library- 231 Eagle St. Englewood, NJ When: 6:45-8:45pm Contact: 201.568.2215 or www.englewoodlibrary.org

15th Annual Partners for Life Gala Where: Grand Hyatt, New York, NY When: 6-10 pm Contact: gala@giftoflife.org

Jews, Liquor, and Life in Eastern Europe Where: Center for Jewish History

15 West 16th St. (between 5th and 6th Avenues), New York, NY When: 2pm Contact: info@jgsny.org JGS members are free; guests pay $5 at the door

Finding Peace During Times of Transition Where: Elmont Library, 700 Hempstead Turnpike Elmont, NJ 11003 When: 12:30-2pm Contact: (516) 354-5280

Listen to a free seminar and explore how life’s transitions - both the predictable and the unforeseen - can become the gateway to peace, harmony and happiness. Topics include everyday practices to reduce stress, techniques to simplify chaotic lifestyles, and a spiritual appreciation for life’s transitions. Registration required.

430 East 67th Street - Room RRL-101, New York, NY 10065 When: 5:30– 7:00 PM Contact: 646.888.8106 or email RLAC@mskcc.org Sleep disorders, including insomnia and excessive sleepiness, affect a significant proportion of cancer survivors, often in combination with fatigue, anxiety, and depression. Improvements in sleep lead to improvements in energy, mood, and quality of life. This program will provide screening, diagnosis, and management recommendations for sleep disorders in survivors. You must register to attend this program. June

Hebrew Health Care Senior Day Center Open House Where: Hebrew Health Care, 1 Abrahms Boulevard,

Gift of Life will introduce donors with their recipients for the first time!

Attend a health seminar conducted by one of the industry’s leaders, Brian Clement, director of Hippocrates Health Institute, a renowned wellness center. Event is free but registration is required. June

65+ Program: Preventing Falls at Home Workshop Where: Zucker Research Center-

A CAD expert will teach “Introduction to CAD (Computer-Aided Drafting)” in a free class.

JASA C sponsors the NYC abuse conference, an interdisciplinary conference bringing together over 300 professionals and government partners.

3

Learn the correct Tai Chi walk, movement and breathing techniques for health, balance and well-being

417 East 68th St. Room ZRC-105 New York, NY 10065 When: 10:30am-12pm Contact: 646.888.8106 or email RLAC@mskcc.org. There are many health conditions that can increase the risk of falls at home such as dizziness and imbalance. In this program physical and occupational therapists will review the underlying causes of these conditions and present strategies for reducing risk of falls. Learn exercises to improve balance and home set-up recommendations to maximize safety. You must register to attend this program.

The events on campus, as well as around the world, compel us to convene the Westchester community for a program focused on confronting anti-semitism and anti-Israel sentiment on campus. The details of the event are being finalized. We are planning to show the movie “Crossing The Line 2” followed by a panel discussion with experts in the field, and separate breakout sessions for parents and young adults.

June

COMMUNITY PROFILE

June

Tai Chi for Adults Where: Poe Park-Grand Concourse Bronx, NY 10468 When: 11:30am

JULY 2015 July

6

Therapeutic Chair YogaHealing Yoga for Osteoporosis, Chronic Pain and Stress Relief

New Dimensions Physical Therapy75 Plandome Road, Manhasset, NY 11030 10-10:50 am Contact: 516.304.5373 Therapeutic yoga practice helps in developing the awareness to relax chronically stressed and shortened muscles and to strengthen overstretched weak muscles. This class will help you to recognize good alignment and muscle imbalances so you can gradually restore the natural curves of a healthy and supportive spine. It also incorporates gentle weight bearing exercises to ensure muscle and bone health.

Health Presentation from NORC Where: Kings Bay Library 3650 Nostrand Ave. When: 10am

Participating health presentations on various topics such as nutrition, emotional wellbeing, and Medicare and followed by stay well exercises for older adults.

32

May 2015


INTRODUCTION

COMMUNITY PROFILE

Community Provider Bulletin he specialists at the New York Methodist-Cornell Heart Center offer a full range of heart care services in the most modern cardiac center in Brooklyn. They provide the newest procedures and technology for diagnosis and treatment, including groundbreaking transcatheter aortic valve replacement (TAVR) for treatment of aortic stenosis, as well as medical management, balloon angioplasty stent placement, invasive traditionalin cardiac surgery – underway earlierand minimally patients haveandpoured from children all performed by exceptional specialists and surgeons.

F

6

SEPTEMBER 2015

The Suffolk County Diabetes Prevention Program Where: Good Samaritan Hospital, Breast Cancer Health, Inc.

32 Park Avenue, Bay Shore, NY 11706 Contact: Debora at 845.853.2928 The Suffolk County Department of Health Services offers a free Diabetes Prevention Program (DPP) to all Suffolk County residents at risk. The program is led by a trained lifestyle coach. The sessions cover healthy eating, physical activity, and lifestyle changes to help participants achieve the goals that lead to the prevention or delay of a diabetes diagnosis. Registration required July

1

September

20

Team Sharsheret 2015 Panasonic NYC Triathlon

Team Sharsheret is an official charity partner of the 2015 Panasonic NYC Triathlon. 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. To apply for a slot, email athletes@sharsheret.org

May 2015

AARP Smart Driving Course Where: Jay-Harama Senior Center

2600 Ocean Avenue, Brooklyn, NY 11229 When: 4 pm Contact: Arlene Punnett at 718.891.1110

33

COMMUNITY PROFILE

13

UJA Federation Summer Not Done Aqua Run Where: Town of Oyster Bay’s Tobay Beach Massapequa, New York When: 8:30 AM Contact: Mindy Perlmutter at or 516.677.1856

The Aqua Run features an 800-meter swim in South Oyster Bay and an eclectic three-mile run through Tobay Beach Bird and Game Sanctuary. Participate in the race on your own or be part of a two-person relay team. Don’t want to get wet? Participate in our three-mile run. All levels welcome.

AUGUST 2015

August

CONTINUED

W. 23rd St and West Side Highway, New York, NY 10011 When: 8:30-11pm Contact: 212.354.8801 or national@acsz.org

H&L TECH

19

September

Shaare Zedek College Bowl-A-Thon Where: Bowlmor Chelsea Piers Pier 60,

HEALTHY LIVING

July

2/17/15 3:

MEDICINE TODAY

COMMUNITY CALENDAR

GOLDEN YEARS

NYM_EXCEPTIONAL_AD-2 Jewish Press.indd 1

WOMEN’S HEALTH

estivities for this year’s National Nurses Week were and family members alike. this month at New York Methodist Hospital (NYM). The annual cel- Six other New York Methodist staff members received NYM’s top awards ebration began on May 6 and concluded on May 12, and gives NYM an op- for Nurses Week. portunity to recognize the one thousand nurses and nursing “One out of every four New York Methodist employees associates who serve on the Hospital’s staff. is a nurse—that’s what always makes National Nurses Week Central to National Nurses Week activities at NYM are such a high point at this Hospital,” said Rebecca Flood, R.N., the Nurse Recognition Awards, in which outstanding, peerNYM’s senior vice president for nursing. “They collectively nominated New York Methodist staff members are chosen to represent the culture of patient-centered care that reflects receive special accolades. For 2015, seven were singled out New York Methodist Hospital’s mission. for chief honors. “But at NYM, National Nurses Week is about more than Diane Bonet, R.N., of the hospital’s pediatrics unit, rejust the nurses in our Hospital,” continued Ms. Flood. “The ceived the 2015 Registered Nurse of Distinction Award, the millions of nurses across America form the backbone of inpatient care. It’s in that spirit that we’re celebrating not just highest accolade conveyed during National Nurses Week at Helping Brooklyn Thrive nym.org • 866-84-HEART New York Methodist’s staff members, but every man and NYM. Ms. Bonet resides in the Midwood neighborhood of woman across the country that has chosen the profession of Brooklyn, and has worked at the hospital for more than 15 years. Throughout her tenure, rave reviews of Ms. Bonet’s care for pediatric nursing. We’re proud of the role that we play, every day.”

RAISING OUR CHILDREN

Honors Nurses for T National Nurses Week

ISSUES

E X C E P T I O N A L New York Methodist H E A R THospital


Health AND Living Service Marketplace ADDICTION RECOVERY

ISSUES

INTRODUCTION

COMMUNITY PROFILE

Safe Foundation

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

RAISING OUR CHILDREN

ASSISTED LIVING Ateret Avot

WOMEN’S HEALTH

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

Lakewood Courtyard

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

GOLDEN YEARS

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.

CHIROPRACTIC CARE

COMMUNITY SUPPORT Aleh Foundation USA

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

Bikur Cholim Chesed Organization

718.438.2020 Bikur Cholim offers a 9-part workshop series for caregivers, available on CD, covering many aspects on caring for a relative with Alzheimer’s/dementia.

Chai Lifeline

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.

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.

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

Dr. Christopher Tabick

COMMUNITY SERVICES

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

COMMUNITY PROFILE

H&L TECH

MEDICINE TODAY

Chesed 24/7

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

HEALTHY LIVING

Dr. Melinda Keller

Participation involves 2-3 sessions. No cost evaluation and compensation are provided. E-mail: CSC.ARP@nyumc.org

718.745.8177

Counterforce

To Advertise in the Marketplace Call Ettie at 718.330.1100 Ext. 373 or E-mail: ettie@jewishpress.com

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

Genesights: The Jewish Genetics Online Educational Series

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

NYU Child Study Center

at NYU Langone Medical Center Currently conducting brain research study and looking for children between 18 and 40 months to participate.

34

Hand in Hand Family Services

OHEL Bais Ezra Sibshops

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

OHEL Family Caregiver Support Group

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 2015


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!

Yad v’Ezer

Zicharon Memory Loss

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

Luxury Dentistry

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

ELDER LAW

Yitzchak Weissman

ELDERCARE ADVOCATES ElderCare Advocates

May 2015

Solomon Blum Heymann LLP

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

FAMILY HEALTH

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.

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.

Fitness

Noobi3fitness

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

35

COMMUNITY PROFILE

155 W 20th St #1, New York, NY 10011 718.252.2580 • www.agingstrategies.com 1309 Avenue I, Brooklyn, NY 11230 718.252.2580 • www.agingstrategies.com

Law Office of Amy Posner

20 Vessey Street, New York, NY 10007 212.385.1951

H&L TECH

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

Gross & Levin, L.L.P.

86-16 Queens Boulevard, Elmhurst, NY 11373 800.483.2175

HEALTHY LIVING

Zweihorn Orthodontics

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.

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

MEDICINE TODAY

DENTISTRY

Goldberg, Sager & Associates

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.

590 Madison Ave., Suite 1800, NY, NY 10022 800.702.8677

WOMEN’S HEALTH

Yad HaChazakah

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

FELDMAN & FELDMAN, Counselors at Law

RAISING OUR CHILDREN

Rofeh Cholim Cancer Society

762 Bedford Avenue, 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.

ELDER LAW ATTORNEYS

ISSUES

OHEL Morris Pinsky Simcha Program!

INTRODUCTION

COMMUNITY PROFILE


INTRODUCTION

COMMUNITY PROFILE

ISSUES

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

Health AND Living Service Marketplace Shape Fitness

HOME HEALTHCARE

MEDICAL SUPPLIES

HEALTHY EATING

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

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

COMMUNITY PROFILE

H&L TECH

HEALTHY LIVING

MEDICINE TODAY

GOLDEN YEARS

WOMEN’S HEALTH

RAISING OUR CHILDREN

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.

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.

American Discount Medical

Shabbos Stairlift

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

MEDICAL PRACTICE

Dr. Masha (Friedman) Lewin

718.333.0333 · www.DeLaRosa613.com Real foods for real people. Find in your local markets or on Amazon.com.

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

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.

Diet Fantasy

HCS Home Health Care Services of NY

Women’s Contemporary Care Associates

De La Rosa Real Foods & Vineyards

855.995.DIET • www.thedietfantasy.com Free menus, discounts, weight loss tips. Nutritionist with PHD on staff.

Fiber Gourmet

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

HamaspikCare

1650 Coney Island Avenue, Brooklyn, NY 11230 855.239.CARE (2273) · 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

www.gourmetkoshercooking.com The premier place online for kosher recipes, products, and so much more.

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

Kosher in the Kitch

Reliable Community Care, Inc.

Gourmet Kosher Cooking

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

Living Tree Community Foods

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

NU Café

4709 New Utrecht Avenue, Brooklyn, NY

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

Taft Foodmasters

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

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

Revival Home Health Care

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

INSURANCE

Adam Pearlman & Associates

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

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.

Mental Health Services Counterforce Therapy Program 718.787.4412 Frum professional staff. Some insurances accepted. Sliding scale.

NEFESH International

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

OHEL Kadimah PROS

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

Sovri Helpline

888.613.1613 Emotional support for Orthodox victims of sexual abuse.

Tikvah at OHEL

800.603.OHEL • www.ohelfamily.org

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

MEDICAL SPA

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

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May 2015


Health AND Living Service Marketplace REHABILITATION CENTERS

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

1213 Avenue P, Brooklyn, NY 11229 718.258.2737

Bluebonnet Nutrition

PHARMACIES New Age Pharmacy

REFERAL SERVICES Medstar

URGENT CARE

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

718.591.8300 Ext. 201 - mprcare.com Queen’s premiere glatt kosher rehabilitation and health care facility. Professional chef on staff for an exquisite dining experience.

MedRite

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

Mount Sinai Doctors Urgent Care

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

GOLDEN YEARS

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.

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

Join Us for Our August 2015 Issue A Publication of

MEDICINE TODAY

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WOMEN’S HEALTH

2918 Avenue J, Brooklyn, NY 11210 718.253.1700

Fort Tryon Center for Rehabilitation & Nursing

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.

RAISING OUR CHILDREN

Kosher Vitamins

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

Allcare Physical Therapy

SOCIAL SERVICES

ISSUES

NUTRITIONAL SUPPLEMENTS

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

By Dr. Don Bandari As told to Yaakov Kornreich

C

holesterol is a topic over which nutritionists have differed and opinions have changed over the years. Since the 19th century, scientists have realized that the plaque that clogged arteries consists mostly of cholesterol. There have been high priority warnings about the dangers of cholesterol in the American diet since 1962, issued first by the American Heart Association and later by the federal government. These warnings have helped shift eating habits, reducing per capita egg consumption by about 30 percent, and harming egg farmers. However, scientists at that time did not realize how complicated the interaction between cholesterol and heart disease really is. The body creates cholesterol in amounts larger than their diets provide. The body regulates how much cholesterol there is in the blood. There is both good and bad cholesterol, and people react differently to it. Scientists say that about 25 percent of people appear to be more vulnerable to cholesterol-rich diets than others. In addition to the problem of obesity, about half a million people die every year due to disease related to poor eating habits. Recently, the nation’s top nutrition advisory panel dropped its caution about eating cholesterol-laden food, threatening to undo 40 years of government warnings about cholesterol consumption. The group believes that cholesterol is no longer a “nutrition of concern.” Many nutritionists have changed their views and now believe that eating foods in high cholesterol may not significantly affect the level of cholesterol in the blood or increase the risk of heart disease. They believe that the greatest danger is not from products such as eggs, which are high in cholesterol, but from too many servings of foods heavy with saturated fats, such as fatty meats, whole milk,

To Eat or Not to Eat Eggs? and butter. The new view on cholesterol does not reverse the warning about high levels of “bad cholesterol” in the blood, which has been linked to heart disease. While Americans are used to the constant change of dietary warnings, this change in the recommendation about cholesterol comes from the influential Dietary Guidelines Advisory Committee.

for reams of diet advice. As recently as 2013, the American College of Cardiology and the American Heart Association organized a task force to look at dietary cholesterol studies. The group found that there was “insufficient evidence” to make a recommendation because the existing studies are too broad to single out the effects of cholesterol in the diet.

The group provides the scientific aspect of the “Dietary Guidelines,” an influential federal publication that helps determine the content for school lunches, affects how food manufacturers advertise their wares, and serves as the foundation

Therefore, the national guidelines on cholesterol intake are inconclusive regarding egg consumption. Each egg has about 186 milligrams of cholesterol, all found in the yolk. According to federal figures, American adult men on av-

38

erage ingest about 340 milligrams of cholesterol a day. Major studies claim that eating an egg a day does not raise the chances of heart disease for a healthy person. In fact, some studies have shown that eating one egg a day may actually prevent some types of strokes and can be part of a healthy diet. However, to prevent food-borne illnesses, it is necessary to store eggs in the fridge and cook them until the whites and yolk are firm. This advice does not apply to a diabetic person, who is more at risk. Seven eggs a week will significantly raise their risk of heart disease. In the Nurses’ Health Study and Health Professional’s Follow-Up Study, heart disease did increase among men and women with diabetes who ate one or more eggs a day. Also people who have difficulty controlling their total and LDL cholesterol may want to eat only the egg white, which has no cholesterol, or use cholesterolfree egg substitutes. In conclusion, the 2006 AHA dietary recommendations, as well as the 2013 update, advises that instead of worrying about which foods not to eat, to focus on real food and healthy food choices, such as a diet rich with fruits, vegetables, whole grains, fish, legumes and low-fat dairy. Based upon the recommendations in the scientific report of the advisory committee, the 2015 Dietary Guidelines for Americans, published by the Dietary Advisory Guidelines Committee, is expected to be very different than the past ones. It is no longer going to advise to limit the intake of cholesterol, which has been the main focus of recommendations since 1961. They believe that cholesterol is no longer a “nutrition for concern” for the American public. Don Bandari, M.D., is an assistant professor of medicine in the department of cardiovascular medicine at Downstate University Hospital in Brooklyn. His private office is located at 1664 East 14th Street in Brooklyn.

May 2015


Not Just Pure. Providing the purest, most wholesome dietary supplements on the market is the power behind Bluebonnet Nutrition. Ever since Bluebonnet was founded 24 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 built a cGMP - compliant manufacturing facility that not only

Kosher Pure. 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.

the ground up. ® eas emerge from tified* Super Earth id t ea gr es im et er -c Som bonnet’s kosher ee caplets – Introducing Bluetiple – in both iron and iron-fr zymes and ul SingleDaily M sential vitamins, minerals, en s the Earth which provide ese of the best plant super food munealso deliver somese include adaptogenic and imnutrienthas to offer. Th from the garden, greens from lycopene boosting herbs chlorella and chlorophyll, and dants from dense spirulina, Plus, it provides potent antioxi♦ from tomatoes. uit and sprout phytonutrients. ss in just a pomegranate fr lesome goodne SingleDaily ho w r fo g in ch ar So, if you are seok to Bluebonnet’s Super Earth single caplet, lo e it’s truly ONE-of-a-kind! Multiple becaus

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.

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.


Family & Friends Helping Each Other. The CDPAP program allows the consumer/designated representative to administer and assume responsibility for his or her own care. Independently recruit, hire, train and supervise your own Personal Assistants. You can now manage and direct your own Plan of Care. Preferred Home Care can be there to provide guidance and support for you or your loved one. No prior training is required!

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