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HEALTH

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living

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A Publication of

NOVEMBER 2016

I S ES

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SEE INSIDE

Inside this issue...

HEALTH INSURANCE – OPEN ENROLLMENT GUIDE See Page 8

CPAP FOR SLEEP APNEA See Page 18

WHEN “END OF LIFE” ISN’T REALLY THE END See Page 19


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contents November 2016

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12

18

Assessing Your Child’s Development

Unmasking CPAP’s Benefits

COLUMNS

5 Election Challenges in the 21st Century

22 Diagnosis at a Glance 24 Trim & Fit 25 Top 10 Facts - Nuts 26 Recipe Page 27 Showcase 28 Community Provider Bulletin 28 Community Calendar 30 Digest 34 Health & Living

6 A Financial Bridge to Nowhere: New York City Tolls

8 Medicare Open Enrollment Understanding Your Choices

12 Assessing Your Child’s

Development: When Should You Start to Worry?

16 Medicine Today 18 Unmasking CPAP’s Benefits 19 When End of Life Isn’t Really

the End

20 What You Need to Know

21 Chiropractic and Chronic Pain 23 Screening for the Breast and

Ovarian Cancer Gene

Top 10 Facts – Nuts

26 Keeping Your Fridge Stocked with Healthy Food

38

Service Marketplace

37 Community Profile 38 From the Doctor’s Desk -

About Cellulitis

25

An Interview with Dr. David Fishman

From the Doctor’s Desk An Interview with Dr. David Fishman

A publication of the Jewish Press, publishing since 1960

Supplement Publisher Moshe Klass | Senior Editor Yaakov Kornreich | Associate Editor Ellen Appelbaum | Features Editor Ita Yankovich | Contributing Writers Sandy Eller, Mendy Hecht, Barry Katz, Leah Lebel-Wolofsky, Tanya Rosen, Rochelle Rothman, Shaindy Urman, Ita Yankovich | Advertising Director Heshy Korenblit | Advertising Sales Arthur Klass, David Hoppenwasser, Leah Postelnik | Design Alana White SUBMISSION INFORMATION:

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

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| November 2016


Yaakov Kornreich

Updating the U.S. Electoral System ISSUES for the 21st Century D

uring the final weeks of the presidential campaign, nowPresident-elect Donald Trump warned his supporters that the electoral system in this country was “rigged” against him. While Trump’s political opponents dismissed the charge, many of his supporters took it seriously, based on abundant evidence that the selection process in this year’s presidential election had indeed been tampered with. For example, supporters of Senator Bernie Sanders, along with Iowa’s largest newspaper, the Des Moines Register, complained that Hillary Clinton’s razor-thin victory in the February 1 Iowa Democrat caucuses had been rigged by state party officials, who then covered up their actions by refusing to release the actual numbers of caucus participants who had voted for each candidate. In July, hacked emails released by WikiLeaks revealed that staff members of the Democratic National Committee (DNC) actively conspired throughout the primary campaign to help Mrs. Clinton win the nomination. The resulting uproar forced DNC chair, Congresswoman Debbie Wasserman Schultz, to resign in disgrace on the eve of the Democratic National Convention. In October, 17 federal intelligence agencies warned that hackers working for Russia were systematically infiltrating politically sensitive American computer systems in an attempt to influence the outcome of the presidential election. Some Democrats also said that the Russians were trying to help Donald Trump win the presidency. States across the country changed their voting procedures to avoid a repeat of the “hanging chad” controversy which had clouded Florida’s results in the 2000 presidential election, and which ultimately determined whether Al Gore or George W. Bush would be president. Paper-based and mechanical voting systems were replaced with electronic and computer-based

voting equipment which was more accurate, but which proved to be extremely vulnerable to hackers. Some states have upgraded to systems that are less vulnerable and which provide paper backups to double-check the results, but it will take years and a lots of money to install systems across the country that are more-resistant to hackers. There are no signs that hackers influenced the vote count in the November 8 election. Nevertheless, some Hillary Clinton supporters refuse to accept Donald Trump’s victory because she won a majority of the popular vote, nationwide. Trump was declared the victor because he won a majority of the votes in the Electoral College, as specified in the U.S. Constitution. The system was designed for situations like this election, when one candidate, Hillary Clinton, ran up huge majorities in a small number of big states such as New York and California. Nevertheless, the system awarded the victory to Donald Trump because he won narrower voter majorities in most of the smaller states across the country, entitling him to all of the Electoral College delegates of those states, enough to give him the majority. This outcome was not unique. Four times before in American history — most recently in the 2000 election — the candidate who received fewer popular votes won by virtue of his majority in the Electoral College. This year, as was the case after the 2000 election, angry and disappointed Democrats across the country have demanded the replacement of the Electoral College with a system which would award the presidency to the winner of the popular vote nationwide. One scheme to make such a change takes advantage of the fact that the Constitution leaves the delegate selection process up to each state. The National Popular Vote Interstate Compact calls upon each state to pass an identical law that would automatically assign its Electoral College delegates to the win-

ner of the national popular vote, instead of the current state-by-state winner-take-all system. The new system would not go into effect until it is adopted by states which have a combined total of at least 270 Electoral College votes, enough to determine the winner of a presidential election. So far, the National Popular Vote proposal has been adopted by 11 states (including New York, California, Illinois and New Jersey) and the District of Columbia. They represent 165 combined electoral votes, still 105 votes short of the total needed for the system to go into effect. While the Electoral College is likely to survive because it is so hard to change the Constitution, the nationwide electoral system is evolving. Changes include the widespread institution of early voting,

which was used to cast 46 million votes in this election. In the states of Washington, Colorado and Oregon, all votes are cast by mail ballot. Maine and Nebraska assign some Electoral College votes by congressional district instead of by the statewide winner-take-all system. As new voting technology is developed, we can expect to see the introduction of systems that enable voters to cast their ballots online using their computers or smartphones, as well other changes to eliminate vulnerabilities and make the process more secure, convenient and responsive to American voters. Yaakov Kornreich has been an Anglo-

Jewish journalist for more than 40 years. He is the Senior Editor of Building Blocks and the Health & Living supplement of the Jewish Press.

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Mendy Hecht

ISSUES

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ith 2017 less than two months W away, it’s time for another dreaded but seemingly inevitable

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| November 2016

Of course, the remaining $13.3 billion can be explained away with ongoing costs of operating thousands of subway cars, buses and trains, plus a total of thousands of stations and stops—never mind hundreds of miles of subway tunnel—that all need constant maintenance and repair. But the system isn’t constantly growing in any major way. No

new subway line has opened since 1937 (though a new subway station, extending Manhattan’s Number 7 line, opened at 34th St. and Hudson Yards in Sept. of 2015)— and never mind the 2nd Avenue line, which they’ve been working on since 1972 and still aren’t done. So here’s one explanation: Pensions. Given the MTA’s sizable employee body and the fact that hundreds

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facet of living in the Five Boroughs: another MTA fare hike. According to a July 2013 report in the New York Daily News, the New York Metropolitan Transit Authority (MTA) will raise fares in 2015 and 2017. Well, 2015 came and went—and the 2015 fare hike came but didn’t “went.” According to the MTA’s July Financial Plan 2017-2020, the bloated bureaucracy that runs our local bridges, tunnels and subways is on track (no pun intended) to raise tolls and fares by four percent come 2017. And that leads to the basic question: Why do fares and tolls keep going up, but infrastructure doesn’t improve? When the Triborough Bridge opened in 1936, it cost 25 cents to cross. It costs $8 today. When the vital Verrazano Bridge connected Brooklyn and Staten Island in 1964, its toll was 50 cents. Its toll today is $16. But while tolls on bridges (and tunnels) in and out of our fair city have exploded over the past 50 years and more, New York City has not opened a new bridge or tunnel in over a half-century. Traffic and backups on our city’s bridges and tunnels, and the backups, are worse than ever. Inflation only explains some of it. If it were inflation alone, then, the RFK Bridge should cost about $4.50 today. And the Verrazano should cost about $4.00. So why do fares and tolls keep going up? And where’s all that extra

money going? To understand this, we have to take a look at the organization that runs the city’s seven bridges and two tunnels, MTA Bridges and Tunnels, an affiliate agency of the Metropolitan Transportation Authority (MTA), which also runs our subways. (The Brooklyn, Manhattan and Williamsburg Bridges spanning the East River are maintained by the New York City Dept. of Transportation (DOT). On the other hand, er, side, the critical George Washington Bridge, plus the Lincoln and Holland Tunnels, are kept by the New York/New Jersey Port Authority. Being non-MTA entities, these are outside this article’s scope.) In terms of traffic volume, according to a 2013 report, the MTA is “the largest bridge and tunnel toll agency in the United States, serving more than a million people each day.” According to the MTA’s newest annual toll revenue review, published this past April, Year 2015 toll revenues at the agency’s bridges and tunnel were $1.8 billion—an increase of 7.9 percent over 2014, “primarily due to the March 2015 toll increase.” (The report also cites “relatively low gas prices” and “a continued moderate recovery in the economy,” both of which many New Yorkers somehow haven’t been noticing.) But an intake of $1.8 billion a year at its bridges and tunnels doesn’t quite square with a reported total 2016 operating budget of $15.1 billion spanning an agency of over 68,000 employees. You don’t need to be a mathematician to see that something isn’t lining up.

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retire each year, the retirement fund that active employees regularly pay into, and regularly draw from upon leaving the MTA’s ranks, adds more than a bit. That money must come from somewhere. In a January 2016 financial report on the MTA’s Defined Benefit Pension Plan by accounting powerhouse Deloitte, we learn that “benefits paid to participants increased by 8.6% from $176.0 million in 2013 to $191.1 million in 2014.” That roughly jives with increases in tolls, plus ongoing technological upgrades to quite a few subway trains and stations including such modern novelties like Wi-Fi and phone charging stations. At the same time, rising tolls keep taking larger and larger bites out of commuters’ wallets. While not much day-to-day, they do add up to sizable sums each year—making personal finance an even bigger headache to those (most?) of us “working poor” whose incomes barely cover budgets that include school tuitions, kosher food and other costs of Jewish living. For example, frum Staten Island

commuters hitting the Verrazano on Sunday, March 22, 2016—the date of its last toll hike—found themselves staring at up to another dollar per crossing. While the already-minimal resident carpool toll was hiked to a minimal $3.08, still, crossing five workdays a week, times the 52 weeks of the year, does add up—and all the more so when cash-paying customers doing the same number of crossings were now looking at another $260 a year. To sum up: This article makes no concrete cause-and-effect claims as to the direct reason(s) for chronic toll hikes. But given inflation, plus a vast overhead of maintenance, repair and wages, the aforementioned handful of relatively small but not insignificant modernizations, and costly pensions on top of all that, one gets a fuzzy picture of expenses equaling income. But the real elephant in the room, in terms of explaining what’s really been happening for decades, is far likelier the fact that the MTA took over the TBTA in 1968. To preface: New York City’s bridges and tunnels, for the most

part, were run by an organization called the Triborough Bridge and Tunnel Authority (TBTA), led by legendary city planner Robert Moses. Under Moses, toll revenues on TBTA crossings were used as collateral for bonds which financed the construction of new bridges and tunnels. The tolls eventually paid off the bonds, and provided capital for new bridges and tunnels as needed for the city’s ever-growing automobile traffic. However, upon the MTA absorbing the TBTA in 1968, Moses’ efficient infrastructure development process screeched to a halt. Tolls collected at bridges and tunnels formerly part of the TBTA were now used entirely to help offset the huge deficit of running the MTA’s buses and subways. In short, with the MTA never having been designed from the ground up as an automobile-friendly entity, it’s never quite embraced the millions of cars and trucks using its adopted bridges and tunnels. While it spends the minimum required to maintain them, it is far friendlier to the bus and subway systems that are its original and still-primary purview.

ISSUES “This hostility to private vehicle owners has helped to drive the middle class out of the city and hurt all city businesses which rely on private transportation,” opines Health & Living editor Yaakov Kornreich. Bottom line? We’re left with a bottom line that apparently leaves over precious little for serious infrastructure expansion on the scale of a new bridge or tunnel—and this despite Gov. Cuomo’s cost-cutting and otherwise laudable ongoing transition from manned tollbooths to fully “EZPassed” cashless crossings. As they say: “Follow the money.” Mendy Hecht is the editor of Hamaspik Gazette, satire columnist and writer for Hamodia, and an occasional contributor to the Jewish Press, Ami and Mishpacha magazines and others. The views are those of the author and don’t reflect the opinion of Health & Living.

November 2016 |

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Yaakov Kornreich

Medicare Open Enrollment

Understanding Your Choices D

ecember 7 — save the date. If you are one of the 44.9 million Americans now receiving Medicare benefits, you need to know that this is the end date of the current open enrollment period for coverage starting in January, 2017. The choices you make will affect your health coverage and your pocketbook, so it is important to set aside time to

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study, analyze and understand the options. The default choice is traditional Medicare coverage, which consists of Part A, which includes up to 60 days of hospitalization coverage, and Part B, which provides for other medical expenses, including doctors and outpatient procedures, but not prescription drugs. Unlike Part A, Part B requires a monthly premi-

| November 2016

um, expected to be $107.60 for most people who receive Social Security retirement benefits, and greater for those with higher incomes. Part B pays only 80 percent of covered medical expenses, with the patient paying the other 20 percent out-of-pocket. Recipients must also pay certain deductible hospital and medical charges out-of-pocket before coverage takes effect.

It goes without saying that these co-pays and deductibles can quickly add up to a major expense. So, many people buy a Medigap plan — a Medicare-approved private insurance policy, whose monthly premiums vary, based on the benefits provided — to help cover health care expenses Medicare doesn’t pay for. It’s reassuring to know that all Medigap policies offer extended


hospitalization benefits and coverage for at least some of the co-pays associated with Part B. To make comparisons easier, Medicare divides the Medigap plans into 10 categories according to the type of benefits they offer, such as coverage for nursing home stays and foreign travel emergencies. Since 2006, Medicare offers a prescription drug benefit, known as Part D. Recipients choose among Medicare-subsidized plans offered by private insurance companies, which compete on the basis of cost and the specific prescription drugs they cover (listed in the plan’s formulary). To complete their coverage, most recipients of traditional Medicare who can afford it buy the Medigap and Part D insurance plans that best suit their needs and budget. In Brooklyn, monthly premiums for Part D

plans range from $17 to $83, with an average of about $40. There is greater variation in the pricing of Medigap policies, even among those offering the same category of coverage. Monthly premiums for the Medigap A and B category plans, which offer basic coverage of Medicare deductibles, range from $130 to $400. Lower-cost options are the highdeductible F class plans and 50 percent coverage K category plans, whose premiums range from $50 to $175 monthly. Higher-end plans offering foreign travel services or excess charges coverage (categories C, D, F, G and M) range from $200-$550.

Additional Benefits

(Free Gym Memberships, Transportation, Dental, etc.)

Some Medicare Advantage Plans

Medicare Advantage

Medicare Advantage, also called Medicare Part C, is an alternative to traditional Medicare. It offers the equivalent of Medicare Parts A and B, and, optionally, Part D drug coverage. Some 16.2 million Medicare recipients

If You Will Soon Turn 65:

Most Americans become eligible at age 65 for valuable health coverage under the federal Medicare system, and need to educate themselves to make the right choices. The initial enrollment period for Medicare begins three months before your 65th birthday and continues for 7 months. If you currently receive Social Security benefits, you don’t need to do anything. You will be automatically enrolled in traditional Medicare effective the month you turn 65. If you currently have insurance from an employer, you need to check some months before you turn 65 to find out whether you have the option to continue your current coverage. In many cases, employer-provided health insurance will be automatically canceled when you turn 65, and you will have to choose among the options in Medicare coverage described in this article.

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November 2016 |

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Skilled Nursing Coverage

Compatible with Employer Provided Retirement Health Benefits or Medicaid

Traditional Medicare +

Medigap Policy D, F, G, M, N

Traditional Medicare

Medicare Advantage Plans

Offering Skilled Nursing Coverage

have chosen Medicare Advantage. Various Medicare Advantage plans are offered by private health insurers and subsidized by Medicare. They offer tradeoffs between cost and coverage, permitting Medicare recipients to choose the plan that best fits their needs. All Medicare recipients must pay the Part B monthly premium, but some Medicare Advantage plans do not require an additional premium for drug coverage. Subscribers must receive all their covered medical needs from providers in their plan’s network, including hospitals, doctors and pharmacies. (Exceptions are emergency rooms, urgent care facilities and some preventive care.) Plans with lower costs typically have narrower provider networks and cover fewer prescription drugs. Higher-cost plans offer a wider selection of providers and drugs, and may also offer extra health benefits. When considering a specific Medicare Advantage plan, it is important to confirm that it covers your current doctors, prescription medications, and other preferred providers, as well as any new medical costs you anticipate over the next year.

It is up to each senior to select the right combination of Medicare coverage options, based upon their own personal health needs and finances. The first choice to be made is between traditional Medicare, optionally supplemented with Medigap and Part D coverage, or one of the Medicare Advantage plans. Traditional Medicare is best for those who want the broadest choice of medical providers and specialists. It is also best for those who travel frequently to other parts of the country, since most Medicare Advantage provider networks are limited to specific geographic regions, whereas traditional Medicare is good everywhere. Traditional Medicare is best for people who qualify for Medicaid, or those whose employersponsored medical or retirement benefits are designed to supplement traditional Medicare. Medicare Advantage premiums are usually much cheaper than the monthly cost of traditional Medicare supplemented by Medigap and Part D plans. Another positive feature of Medicare Advantage plans is that they limit a subscriber’s total out-of-pocket medi-

Snowbird Coverage – at Home & at Vacation Home

Minimum Monthly Cost with Capped Out of Pocket Costs

Traditional Medicare

10 |

What Is Best for Me?

(Plus Medicare Part B Premium)

Medicare Plans Offering “Passport” Coverage in Vacation Home

Traditional Medicare + Medigap Policy F - High Deductible

| November 2016

All Medicare Advantage Plans

Foreign Travel Emergency Coverage

Traditional Medicare +

Medigap Policy C, D, F, G, M, N

cal costs (in 2017, no greater than $6,700). In contrast, traditional Medicare has no ceiling on noncovered health costs. Many Medicare Advantage plans also offer extra health-related services, such as free gym memberships, transportation to doctors’ offices and at-home wellness checkups. However, Medicare Advantage can be very expensive if a subscriber uses an out-of-network provider. It’s of great importance that Medicare Advantage subscribers make sure that every provider from whom they receive medical services in a hospital or during surgery is in their plan’s network and/or has been approved by the insurer; otherwise they may be billed directly by the provider at full price.

Some Strategies for Picking the Best Coverage

The best place to start the selection process is the Medicare website, www.medicare.gov. There, seniors can directly compare the basic costs and benefits of the competing Medigap, Part D and Medicare Advantage plans in their area. They can also determine which plans cover their current prescription drugs. Most metropolitan areas have

Broadest Geographical Coverage/ Choice of Providers

Traditional Medicare

Medicare Advantage (Nationwide) Regional PPO Plans

No Deductibles

Traditional Medicare + Medigap Policy C&F

Some Medicare Advantage Plans

Including Drug Coverage

many competing plans. For Brooklyn’s 11230 zip code, for example, 14 different companies offer Medigap plans, and there are 19 competing Part D drug plans. Those who prefer Medicare Advantage can choose among 30 competing plans. Once you have found the plans that seem to best meet your needs, compare the quality ratings for each plan on the medicare.gov website. Also confirm that your doctors and prescription drugs are covered by the plans you are considering by checking their own websites or by calling their toll-free information numbers, before making a final selection.

And If You Do Nothing?

Medicare recipients who do not choose a new plan during open enrollment will have their current coverage automatically renewed for 2017. Since the costs and benefits of private plans change from year to year, it pays to check one’s current plan, before December 7, to make sure that it will still meet the needs of 2017. Yaakov Kornreich has been an Anglo-Jewish journalist for more than 40 years. He is the Senior Editor of Building Blocks and the Health & Living supplement of the Jewish Press.

Minimum Monthly Costs

(Plus Medicare Part B Premium)

Traditional Medicare

Medicare Advantage Plans Offering $0 Monthly Premium


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Assessing Your Child’s Development: When Should You Start to Worry? F

rom the moment a couple welcomes their first child into the world, their mindset shifts into parent mode. Even the most carefree husband and wife will suddenly find themselves worrying endlessly about their new arrival, but as time goes by and their selfconfidence in their new role grows, most parents still find themselves plagued by one nagging thought: Is my child developing normally? For decades, parents considered Dr. Benjamin Spock’s Baby and Child Care, originally published in 1946, to be the bible on raising healthy children. The book, which was printed in 42 languages, sold more than 50 million copies, reported CNN. Dr. Spock advised parents to trust their instincts, not to worry about less-than-helpful comments from well-meaning friends and relatives, and empowered parents to accept the fact that

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babies don’t come with instruction manuals and rarely stick to a strict timetable. The fact that both babies and children are notoriously unpredictable often has many parents worried as she fails to achieve particular milestones exactly on schedule. Should a parent worry if their four-monthold baby doesn’t smile? Is there a problem if a child hasn’t taken a single step by his first birthday? And just how worried should a parent be if their three-year-old doesn’t know his colors yet? There are no one-size-fits-all answers when it comes to child development, explains Karen Cherney Zaltz, chief operating officer of HTA of New York, which evaluates and provides therapy and special education services to children of all ages. “Every child masters their own skills within their own time period,” Cherney Zaltz told Health & Living.

| November 2016

The first step in determining if a child is developmentally delayed is to understand typical child development and realizing that children achieve particular milestones not at an exact age but rather at an age range that can span a period of several months. That lack of definition can be particularly difficult for first-time parents who have little basis for comparison and don’t always appreciate that there are no hard and fast rules when it comes to child development. “Most children will walk between the ages of nine to fifteen months, which is a very long period of time,” explained Cherney Zaltz. “If you are in a Mommy and Me group and your neighbor’s kid is walking at ten months, you might start to get nervous. But there is no reason to, because every child is unique and does things in a certain way.” More productive than worrying

about why your child isn’t walking is to focus on what they are doing. If a child is exhibiting behaviors that lead up to walking, including crawling and trying to pull themselves up, then they are displaying the precursor skills to walking, a good sign that parents need to engage in patience instead of panic. Cherney Zaltz also suggested that couples speak to their parents and in-laws to find out about their own development as children. “When your child is two-anda-half and still not talking, it is fascinating to find out that your husband didn’t start talking until he was three,” said Cherney Zaltz. “Just hearing that alone can help allay parents’ fears, because genetic makeup plays a huge part in child development.” Environmental factors also play a major role in a child’s physical development. Because doctors


• CO now advise against putting babies to sleep on their stomachs, babies spend less time pushing up on their arms — which aids in gross motor development — and therefore they may lag somewhat in certain skills. And babies who spend significant amounts of time watching videos on a parent’s iPad will be far less interested in walking because they are being provided with entertainment that doesn’t require any movement. While Cherney Zaltz feels it is important to maintain a balance between being hyper-vigilant and cautiously optimistic, she notes that developmental red flags should never be ignored. “If you are making noise and your child doesn’t turn around, that should trigger a red flag,” noted Cherney Zaltz. “If your child consistently speaks in a very low voice or an extremely loud voice, then those are both red flags that your child may have a hearing problem.” Additional warning signs may pop up in other areas including fine motor, gross motor, language, cognitive, social/emotional and

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• CO self-help develVER opment. When it STO comes to behavioral deRY • velopment, seeing that your child doesn’t make eye contact, can’t pay attention or stay focused, or demonstrates atypical frustration or aggression can indicate that some kind of intervention is in order. Cherney Zaltz recommends spending two weeks taking notes on any behaviors that are cause for concern. “Write down any time you notice a behavior of interest,” said Cherney Zaltz. “What is it that happened? When did it happen? What happened before or after? Often when you look back at the data you see a specific pattern starting to emerge. If you see that a certain behavior is happening and it goes away when you give your child a snack, you may realize that your child has difficulty communicating when they are hungry.” Cherney Zaltz has found that pediatricians are more receptive to parents who come to a visit armed with hard data on their child’s behavior. “A physician’s knee-jerk reaction may be that new parents tend to be

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nervous and overreact. But when you come in having charted specific behavior they pay more attention, I

think,” said Cherney Zaltz. Your child’s teacher can also be a particularly useful source of information. “Teachers see a ton of children and probably have more of an immediate ability to know when something is significantly different,” said Cherney Zaltz. What to do if a potential problem is identified? Take a deep breath and relax. After that, parents should take advantage of free state-funded programs and have their child evaluated, advised Cherney Zaltz. Early intervention programs can provide comprehensive case management, speech, physical and occupational therapy, as well as social work and psychological services, to eligible children up to age three at no cost. The Committee on Pre-School Education provides similar services to children ages three to five, either at home or in a school setting.

Often, children may show some minor less-than-typical behavior, but still may not be eligible for state-funded services. While private therapy is one option, Cherney Zaltz suggested having the child reevaluated in a few months. Parents who refuse to accept the fact that their child isn’t developing typically can also be a cause for concern. “If there is a problem it needs to be addressed early so that your child is more likely to get ahead of the game,” noted Cherney Zaltz. “There has to be a balance of cautious optimism and doing the best you can for your child.” The early identification of developmental delays is extremely important for children, according to the American Academy of Pediatrics, particularly because later developmental skills often build on earlier ones, leaving a child who

hasn’t mastered the fundamentals lagging behind their peers. Research has shown that children who are referred for therapeutic services typically realize significant improvements, giving them the ability to get back on track with their peers. “The biggest thing is to be smart and know whether or not you should be concerned,” said Cherney Zaltz. “Understand the milestones and that there is a typical range of normal development and know that typical development is sequential. If your child isn’t walking but has those precursor skills then just be patient, but if your child is 15 months old and isn’t crawling or pulling themselves up then, yes, there is a cause for concern.” 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.

Act early by talking to your child’s doctor if your child DOES

NOT:

■ Respond to loud sounds ■ Watch things as they move 2 Months ■ Smile at people ■ Bring hands to mouth ■ Hold head up when pushing up when on tummy ■ Watch things as they move ■ Smile at people; hold head steady 4 Months ■ Coo or make sounds ■ Push down with legs when feet are on a hard surface ■ Bring things to mouth ■ Move one or both eyes in all directions ■ Reach for nearby objects ■ Show affection for caregivers ■ Respond to sounds ■ Make vowel sounds 6 Months ■ Roll over ■ Laugh or squeal ■ If he has difficulty getting things to mouth, is very stiff, or seems very floppy ■ Bear weight on legs with support ■ Sit with help ■ Babble (“mama”, “baba”, “dada”) ■ Play any games involving back-and-forth play 9 Months ■ Respond to own name ■ Recognize familiar people ■ Look where you point ■ Transfer toys from one hand to the other ■ Crawl ■ Stand when supported ■ Search for things she sees you hide ■ Say single words like “mama” or “dada” 1 Year ■ Point to things ■ If he loses skills he once had ■ Learn gestures like waving or shaking head ■ Point to show things to others ■ Walk ■ Know what familiar things are for ■ Copy others 18 Months ■ Gain new words ■ Have at least 6 words ■ If he loses skills he once had ■ Notice or mind when a caregiver leaves or returns 2 YearS 14 |

■ Use two-word phrases (“drink milk”) ■ Know what to do with common objects ■ Copy actions and words ■ Follow simple instructions ■ Walk steadily ■ If he loses skills he once had | November 2016

Source: CDC.gov


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Medicine Today

Avigayil Perry

EpiPen Update on Generics and Prices As many as 8 million Americans (2.5% of the population) have food allergies, some of which cause anaphylaxis, a life-threatening allergic reaction that can happen extremely quickly upon exposure to the allergen. These individuals need an EpiPen or EpiPen Junior in the event of such an incident. However, this summer, drugmaker Mylan came under fire for pushing up the price of EpiPens by more than 450 percent since 2007, prompting calls from individuals, politicians and even the American Medical Association that the company lower its price. Mylan countered that it is working to keep the medication cheap for consumers by offering $100 coupons to offset high insurance copayments. The company said about 80 percent of patients with insurance get the EpiPen free. Insured individuals who need to pay out of pocket can obtain a savings card, saving them up to $300 off the over $600 cost. The effort to lower costs of epinephrine is on-

going. Consumer Reports recommended a generic alternative, Adrenaclick, which contains the same active ingredient, epinephrine, in the same dosage. A search for EpiPen alternatives yields many articles about many products, including details pro and con.

Make the Most of Your Medicare Wellness Visit

Upon receiving Medicare, within the first 12 months, individuals are eligible for the “Welcome to Medicare” preventive visit, encompassing a review of their medical and social history, height, weight, blood pressure, BMI, vision, potential risk for depression, and a written plan for follow up. After 12 months, they need to schedule a yearly wellness visit as a follow up. There may be a deductible for these appointments and/or a coinsurance for additional tests and services.

What to bring to your “Welcome to Medicare” preventive visit

■ Medical records, including immunization records. Even if your current doctor does the visit, gather as much medical information as you can to make sure nothing is overlooked. ■ Family health history. Try to learn as much as you can about your family’s health history before your appointment. The information will help you and your doctor better understand what screenings you need to get and what to watch for in the future. ■ Prescription drugs. Bring a list of any prescription drugs, over-thecounter drugs, vitamins, and supplements that you currently take, how often you take them, and why. Avigayil Perry lives in Norfolk, Virginia and writes for various Jewish publications.

16 |

| November 2016


What Is the Danger of “Superbugs”? Antibiotics and similar drugs have been used for the last 70 years to treat patients who have infectious diseases, and have greatly reduced illness and death from these diseases. However, these drugs have been used so widely and for so long that infectious organisms have adapted to them. Who’s to blame? Judy Stone in Forbes Magazine writes, “We commonly blame physicians for overprescribing antibiotics, patients for demanding them and, increasingly, agribusiness for squandering antibiotics as growth promoters. All of those are major problems. One less-often mentioned factor is a side effect of the manufacturing process itself, where pharmaceutical companies dump huge quantities of antibiotics into wastewater—which then goes into rivers, or is used in irrigation.” This is a big problem in India, and has also been noted in Germany, Denmark, Pakistan, China, Croatia and the United States. According to the CDC, each year in the United States, at least 2 million people become infected with bacteria that are resistant to antibiotics and at least 23,000 people die as a direct result of these infections. Researchers from Meinig School of Biomedical Engineering and Weill Cornell Medicine have received a $500,000 grant from the CDC to closely study antibiotic resistance in individuals with low levels of white blood cells (leukemia). This national initiative aims to scrutinize how to combat drug resistant organisms, or “superbugs.”

Thinking About a Fad Diet? While a diet may be effective for the goal it seeks to achieve, not every diet is for everyone. Before trying a popular remedy, speak to your doctor who knows your specific medical history and can help you determine if a particular diet is suitable for you.  Here are wellknown food plans: Atkin’s Created by cardiologist Dr. Robert Atkins, this diet reduces sugar and carbohydrate calories. When done right, individuals experience energy throughout the day, as well as less hunger and cravings. While over 80 clinical studies have shown Atkin’s to be effective, its side effects can include headache, dizziness, weakness, fatigue, kidney stones and kidney disease, as well as constipation and bad breath. Gluten-free Gluten free diets mainly target those with celiac disease and non-celiac gluten sensitivity. Only these individuals need to be gluten free. Many other individuals report feeling physically better after cutting out gluten. People who choose this food system should schedule regular appointments with a dietitian to ensure that the body is receiving sufficient amounts of nutrients such as iron, calcium, fiber, thiamin, riboflavin, niacin, and folate.   No-nightshade People with painful conditions such as arthritis report that avoiding the nightshades – white potatoes, eggplant, tomatoes, peppers, chili, and sweet bell peppers – noticeably reduces their level of pain.

November 2016 |

| 17


Ita Yankovich

Unma

sking

T

here is a link between hypertension and sleep apnea; 60 percent of patients with cardiovascular disease also suffer from obstructive sleep apnea. This is important because up until recently, studies have shown that some patients who use a Continued Positive Airway Pressure (CPAP) device are less likely to suffer a cardiovascular complication. Sleep apnea occurs in about 18 million Americans, or about one in 15 people. Those suffering from sleep apnea rely heavily on their CPAP device not only to help them sleep comfortably, but also to make sure that they don’t experience any medical difficulties while sleeping such as a cessation in breathing, stroke or even heart attack. Recently, a study revealed that in terms of cardiovascular emergencies, patients using CPAP showed no difference from the usual care-only patients after more than three years, on average. What is alarming about these findings is that 17 percent of patients in the CPAP group have actually experienced some kind of serious heart event. This is especially jarring, considering an earlier study which claimed that three times as many fatal heart attacks and strokes were occurring over a 10-year period for those who did not use the device compared to those who did.

18 |

CPAP’s

Benef

After the new study got into the headlines, many are asking: Should I just unplug? The Study A team of researchers and clinicians from across the globe designed the Sleep Apnea Cardiovascular Endpoints trial (SAVE) to better understand the problem and see whether rates of heart disease or stroke decreased with treatment. Beginning in 2008 and concluding in December 2015, 2,717 patients, ages 45–75, were enrolled in the study, which was monitored by teams of cardiologists, sleep medicine physicians, and clinical trialists from 89 medical centers in Australia, South America, Europe, Asia, and the United States (North America). Half the study patients received CPAP and half were untreated. Patients were studied for an average of almost 4 years each, during which time the investigators compared the rates of heart disease “events” (such as strokes and heart attacks) in treated and untreated groups. The study recruited patients who already had a history of having a high risk of subsequent heart attacks or strokes. They also recruited patients who had at least moderate sleep apnea and patients who showed they were able to tolerate wearing a CPAP mask. Results Surprisingly, the rate of heart

| November 2016

its

disease events did not significantly differ for those who received CPAP or those who were untreated. However, patients treated with CPAP did experience significant improvements in sleepiness, anxiety and depressive symptoms, and in quality of life. Moreover, a sub-analysis restricted to patients who wore CPAP at least 4 hours a night for the first two years of treatment showed that CPAP reduced the risk of stroke by about 40 percent. It’s not clear why CPAP treatment did not improve cardiovascular outcomes. “We interpret the data as indicating the need to find ways help to patients get their sleep apnea diagnosed and treated earlier in life and before the onset of heart disease, help patients better adhere to their CPAP, and to continue to research new ways to treat sleep apnea that are well tolerated and effective. We also recognize that new studies will be needed to study the effects of more effective levels of CPAP and other treatments on important health outcomes, like heart disease, in patients both with and without known heart disease,” says Susan R. of apnea.org. Should I Unplug? Some CPAP users may be eager to leave off using the machine, since the nose mask can be uncomfortable and noisy, and the

device can be cumbersome – although more streamlined, less invasive models have been introduced in recent years. In addition, some patients may develop complications from the device, such as nasal congestion or a runny nose. While it may be tempting to disconnect the CPAP, professionals caution against this for the many benefits it does provide — such as better sleep, less snoring, better cognition, memory, mood and overall quality of life. Dr. Doug McEvoy, the SAVE study’s principal investigator, explained in a news release that patients using CPAP “are much less sleepy and depressed, and their productivity and quality of life is enhanced.” In one study researchers compared CPAP with fake CPAP, which did not provide enough pressure to be effective, and found improvements in intellectual abilities after just two months of (actual) CPAP use for about four hours a night. Therefore, even though the study results do not support the expectation that CPAP will reduce the risk of heart attack or stroke in patients with sleep apnea, Dr. McEvoy is among those who still consider CPAP to be “worthwhile.” Ita Yankovich is a freelance writer. She also teaches English and Literature courses at Kingsborough Community College and at Touro College.


Sandy Eller

When End of Life Isn’t Really the End M

ost often, the phrase “climate change” is associated with weather and the environment, but recently there has been a noticeable shift in an environment of another kind: the world of medicine. While not that long ago the art of healing was the highest priority in medical facilities, lately it seems as if the importance of human life has taken a backseat both to economic constraints and to value judgments made by physicians and others in the healthcare arena. While suicide has been making headlines, it became a highly controversial topic in the 1990s when Dr. Jack Kevorkian helped more than forty people end their own lives in Michigan. Since that time the movement to allow the terminally ill to end their lives has grown and it is currently legal in several countries. In the United States, aid in dying is authorized for terminally ill, mentally competent adults in California, Montana, Oregon, Vermont and Washington, with several other states, including New York, New Jersey and Maryland considering assisted suicide legislation. Advocates for physician-aided dying describe their mission valiantly as “dying with dignity” and “compassionate choice,” but opponents cite numerous cases of misdiagnosed patients, patients who have defied the odds, the possibility of abuse of seriously ill or disabled patients, and concern that, if

legalized, the policy would devalue human life and would prematurely end the lives of many. This cavalier attitude towards human life is particularly disturbing to the Jewish community, which places a high premium on the value of life and believes strongly in pursuing available medical options for patients in end of life situations, instead of having doctors decide whether a particular patient’s quality of life makes theirs an existence worth living. Such was the situation that Flatbush resident Rivie Schwebel encountered when his father was diagnosed with stomach cancer. Schwebel was shocked to discover that no doctor was willing to treat his father because of the advanced stage of his cancer. “The line that I received throughout every doctor’s office was ‘Why treat him? Take him home, make him feel comfortable. He’s 84 years old.’ In other words, let him die at home,” said Schwebel. Over the years, several groups within the Jewish community have responded to the alarming trend, creating vehicles to defend the rights of Jewish patients. Yeshiva University launched a nine-part online course in June titled “Confronting End of Life Issues” to give rabbis a better understanding of the many issues involved in end of life cases as well as their own role during that crucial

time. The course, developed in conjunction with the Rabbi Isaac Elchanan Theological Seminary and the school’s Center for Jewish Life, attracted more than six dozen participants from all over the world. “Rabbis often find themselves involved in halachic, emotional, medical, legal and familial decisions that have become increasingly complex to navigate,” said Rabbi Yaakov Glasser of the CJF. “This course provides the training to inform and guide rabbanim through the critical issues at a moment of significant crisis for their members.” While not everyone is acquainted with a rabbi familiar with the complexities of medicine and Jewish law, Chayim Aruchim, a project of Agudath Israel of America, has a staff of medically trained rabbis available around the clock to answer questions from those dealing with end of life situations. Frequently calls come into Chayim Aruchim from family members who are confused and afraid because they have no idea how to proceed in end of life situations. Many are grateful just to have someone qualified to turn to for advice. “In one case we had a man from a traditional but non-observant Sefardic family who reached out to us asking for help,” said Rabbi Berish Fried of Chayim Aruchim. “He explained the situation to us and we were able to tell him that he was handling the situation cor-

rectly. He called us back again before Yom Kippur, telling us that he couldn’t go to shul on Yom Kippur without thanking us for having walked him through a difficult medical situation.” Founded to ensure that patients’ religious rights are being upheld, Chayim Aruchim has spent years cultivating close relationships with major medical institutions and elected officials in order to more effectively champion the rights of Jewish patients. With a medical advisory board that includes prestigious members of the medical community, several well-respected rabbinic authorities, and legal experts all working hand in hand, Chayim Aruchim has the ability to deal with the complicated situations that can arise in end of life scenarios. While every case may be unique, ultimately the goal at Chayim Aruchim is the same in every situation: preserving the sanctity of human life whenever possible. “When life is of infinite value, every day is of infinite value,” explained Dr. Howard Lebowitz, chief medical office of the Acute Care Health System in New Jersey and a member of Chayim Aruchim’s medical advisory board. “We are willing to do whatever we can to give patients the longest, best life possible.” 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.

November 2016 |

| 19


& continues after the MIND, BODY SOUL section…

W

Is That red, Swollen Leg Cellulitis? What You Need to Know

hen Ed, a 71-year-old Florida man, noticed swelling in his leg, at first he thought nothing of it. After a few days, however, the swelling had not only not gone down, but had actually increased. Ed began to feel what he described as “unbearable pain.” He went to his doctor, who diagnosed the condition as cellulitis. Cellulitis is “an acute, spreading, bacterial infection of the skin,” according to the American Heritage Dictionary of Medicine. Most often this occurs as a result of bacteria entering through a cut in the skin. Once cellulitis begins, if it is not fought off by one’s immune system, it can spread to other parts of the body. Cellulitis can even be fatal, although such occurrences are rare. Aside from a cut in the skin, another way cellulitis occurs is from an untreated case of strep or from a staph infection. (Cellulitis itself is non-contagious, however.)

Aside from the pain and swelling in the area affected by the cellulitis, other symptoms may include nausea, fatigue, sweating, chills, or fever. Dangerous if untreated, cellulitis is especially dangerous in young children or older adults, because their immune systems tend to be weaker. Although cellulitis can occur in most parts of the body, it is most common on the lower leg or on the foot. One of the challenges medical professionals face in treating cellulitis is diagnosing it correctly. When a patient has redness on the leg, it is possible that another condition — such as eczema or psoriasis — is the cause. While swab tests, blood tests and biopsies can usually help in obtaining a correct diagnosis, what happens is that patients are often incorrectly diagnosed. “Three-fourths of cellulitis diagnoses proved to be other skin disorders mimicking cellulitis, a

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Barry Katz

| November 2016

retrospective review at four large medical centers showed,” according to a 2013 article on the website Medpage Today.

In the scenario of misdiagnosis, patients may be receiving ineffective treatment and also paying a hefty sum for it. Additionally, if a patient is given antibiotics when he or she does not need them, the body can develop immunity to the drugs. And if the patient were to get cellulitis later on, a regular course of antibiotics treatment might not be sufficient to fight the bacteria. For those who have been diagnosed with cellulitis, the main form of treatment is antibiotics taken orally. In such instances, it is important for patients to complete their medication even if they see that the cellulitis has healed. At times, however, oral antibiotics are insufficient. In those cases other options exist. A patient may be hospitalized to allow stronger antibiotics to be administered through an IV. Another treatment option is called compression therapy, which consists of wearing special socks or stockings designed to increase blood circulation in the leg. These stockings also help minimize the swelling; however, cellulitis is painful, and a patient may not be able to tolerate the pain caused by additional pressure. Patients are advised to elevate the affected area to reduce the swelling and also to take pain medication if needed. In some cases, it may be necessary to perform surgery to drain the infected area. In older adults, treating cellulitis with antibiotics could be

complicated. This is because older adults are likely to have other medical conditions, there is a strong likelihood that they are already taking medications, and those medications might interfere with the medication given to treat cellulitis. This is true for not only prescriptive medication but even for over-the-counter drugs, vitamins, and herbal supplements. Therefore, it is important for patients to tell their doctor about each medication they are taking. Given the potential dangers of cellulitis, health care professionals offer a number of preventive measures. One is to avoid situations in which one’s skin can be punctured, even slightly. For instance, this could mean wearing gloves while gardening, or always wearing something on one’s feet. In the event that one’s skin was cut, one should wash the area immediately and put a bandage on it. If one notices redness, he or she should contact a doctor right away, because cellulitis is easier to treat in its early stages. It is also important to treat dry skin on any part of the body, because dry skin is more susceptible to cracking and breaking, which in turn can allow bacteria to enter the body. It is also critical to pay attention to one’s personal hygiene. As mentioned, one cause of cellulitis can be a staph infection. Staph bacteria are found near the nose and the mouth. By touching these areas, one can spread the bacteria to other parts of the body that can allow them to enter and spread. Of course, a very significant preventive measure is living a healthy lifestyle. This means eating vitamin-rich foods, avoiding highly processed foods, and getting plenty of exercise. Healthy living provides a strong immune system, which makes it less likely that the harmful bacteria can spread and become cellulitis. Barry Katz is a college administrator and adjunct professor who lives in Brooklyn, NY. He can be contacted at iambarrykatz@gmail.com.


Dr. Jeffrey E. Weber

Chiropractic and Chronic Pain P

ain is a useful crisis messaging system for the body. It says that something is wrong, at a volume that cannot be easily ignored. Pain exists to protect the body, encouraging protective action to prevent further injury. The network that carries these messages is the nervous system, from the peripheral nerves to the spine, and then to the brain. While pain is a useful tool to keep us healthy and to minimize injuries, it can get out of control and continue long after its purpose has been served. Chiropractic treatment is useful in reducing or eliminating many kinds of pain, and may be most effective with chronic pain. Before we examine how Chiropractors treat pain, it is necessary to delve deeper into the subject of pain itself. Chronic vs. Acute Pain Acute pain occurs suddenly, in response to an injury or unhealthy change in physical function. Chronic pain is pain that may have started suddenly, but persists. Many accidents and disease processes result in pain that lingers long after the event that triggered it. Chronic pain is a complex entity; the longer we feel a particular pain the more our bodies and brains change to accommodate it. It’s as if chronic pain creates grooves in brain function that complicate attempts to reduce or stop it. Chronic pain, in some cases, can become a habit, one that’s very difficult to break.

Sources of Chronic Pain Chronic pain can arise from many sources: injuries that do not completely heal, long-term disease processes and injuries to the nervous system. There are many potential sources of chronic pain, but they all have in common a state of injury or disease that has failed to completely resolve. There are also categories of psychogenic chronic pain, such as phantom leg syndrome, that work through a different mechanism and are troublesome for many people. Theories of Pain Perception Pain is a somewhat mysterious experience, not well-understood by science. Pain can be intense and overwhelming, and yet it can also be modified by opiates, hypnosis and placebos. It can also be modified by physical modalities such as massage, acupuncture and Chiropractic. Though unpleasant, pain can be quite useful. There are documented cases of people dying of organ failure, a burst appendix and massive internal infection because they did not feel pain and thus did not seek treatment in time. Several competing theories describe how the brain perceives pain, but most agree on fundamentals. There are three basic components to pain perception: the sensory effect, which involves the electro-chemical perception of pain by the brain; the emotional effect, which is our immediate response to pain; and the sensory-emotional effects of chronic

pain. Each of these components relates to a different part of the brain, which gives some clues as to the mechanism of various pain mediation techniques. Manual techniques such as Myofascial procedures, Applied Kinesiology and Chiropractic work on the sensory component, interrupting or mediating pain signals before they reach the brain. While organ dysfunction or physical injury may be the original cause of pain, nothing in the body happens without involvement of the spine. Any impact to the body sufficient to cause more than a minor injury will involve the skeletal structure in general and the spine in particular. Likewise, organic disease or failure causes muscular reactions. These muscles, anchored in the bones of the skeleton affect the spine as well. Nerve impulses blocked or impeded at the spinal roots will lead to chronic pain and dysfunction along the nerve pathways. The Role of Chiropractic in Chronic Pain Management Chiropractic is particularly effective in the treatment of chronic pain that results from nervous system irritation, injury or damage due to its action on the nerve roots. Chiropractic is effective in re-establishing normal function of muscles, joints and the lymphatic and vascular systems, helping to eliminate the root causes of chronic pain. Doctors of Chiropractic are also trained in a number of other thera-

pies that are useful in the treatment of chronic pain. These include trigger-point therapy, massage and Myofascial techniques. Chiropractors may have specialties in Clinical Nutrition and in the use of nutritional supplementation to strengthen overall treatment. Trigger-point therapy, in particular, is often quite helpful in mediating pain. A “trigger point” is a hyper-irritable point in muscles associated with tight bands of muscle fibers. Manipulation of the point will, at first, replicate the patient’s pattern of pain, but on continued manipulation the pain will be reduced and even resolved. Many Chiropractors use trigger-point therapy in their practices. Taken together, Chiropractic and related therapies are among the most effective treatments for pain. Chiropractic offers the additional advantage of a low-risk profile, with no drug side effects. Sufferers of chronic pain, no matter the source, may find Chiropractic to be an effective therapy for longterm pain management, and perhaps even the elimination of pain. Dr. Jeffrey E. Weber MA, DC, DCBCN,

FACCN personalizes patient-centered care and incorporates state-of-the-art procedures for pain relief with integrating functional medicine. His goal is to resolve health issues with the most conservative multi-disciplinary approaches, which include Chiropractic, Applied Kinesiology, clinical nutrition, physical therapy, energy psychology and pain management. His office is at 2037 Ocean Avenue. Contact at: 718.376.2300 or www.oceanchiro.net.

November 2016 |

| 21


ITA YANKOVICH

Diagnosis

Gout

at a

Glance

I

t’s been called the “rich man’s disease” because it is said to be triggered by decadent foods such as red meat and wine, but Glenn Y. of Midwood, age 33, felt as low and poor as can be when he saw the sad look on his children’s faces as he limped to the couch, canceling the family outing to the park. Glenn was experiencing a gout flare-up and knew he would be out of commission for days. An estimated 8.3 million people in the United States—nearly 4 percent of Americans — suffer from gout. “I am no wimp and have experienced my share of injuries, but nothing compares to the excruciating pain of gout. I felt like needles were stabbing my red, swollen knee, which already felt like it was on fire!” recalls Glenn. What Is Gout? Normally, uric acid dissolves in the blood, which passes through the kidneys, and it leaves the body in urine, but when too much builds up, it can lead to the formation of sharp, uric acid crystal deposits called tophi and lumps under the skin in joints, especially the big toe, ankle or knee. Gout can even occur in the pinna of the ear, according to Dr. Bruce Pinker, a foot and ankle surgeon practicing in Progressive Foot Care in Pomona, New York. Gout can be triggered by overuse of alcohol, drugs and by too much stress. Uric acid forms from the breakdown purines, substances found in all the body’s tissues, which the body converts to uric acid. Purines are found in many foods, such as liver, dried beans, herring and red meats. “Gout is often associated with other medical conditions such as obesity, hypertension, and elevated blood lipids,” says Dr. Nathan Wei, a board-certified rheumatologist with more than 30 years of practice and clinical research experience in Maryland. Gout attacks typically last three to ten days and may begin at night, suddenly, when one is asleep. Some gout sufferers experience flare ups every couple of weeks, others can go for months or years.

22 |

How is Gout Diagnosed? Many people initially ignore the symptoms of gout, believing it is arthritis, a pulled muscle or part of aging. Left untreated, gout can lead

skim milk, cherries or cherry-juice concentrate capsules as well as beets and blueberries to reduce gout attacks. While diet and lifestyle are im-

of gout, but the level of uric acid in your urine is increased. Side effects may include a rash, stomach pain and kidney stones. A majority of physicians surveyed

to severe crippling arthritis and even kidney failure, warns Dr. Wei. Some physicians take x-rays of the inflamed joint or do a musculoskeletal ultrasound to detect the crystals. There are blood tests to check for high levels of uric acid, but because these results can be misleading, a doctor will draw a sample of fluid from an inflamed joint to look for crystals associated with gout as confirmation. Just a warning–this can be very painful. Treatment “After my fourth or fifth flareup in a matter of months, I knew I had to change my diet and lifestyle,” acknowledges Glenn, who was overweight, “or else I would be on medications forever, and I didn’t want that.” So he started going to the gym, cutting back on red meats and alcohol as well as seafood, and, thankfully has not have a recurrence in months. “Water became my best friend. I would take it everywhere I went and drink two liters a day to flush out my system,” he says. Dr. Bruce Pinker recommends that gout sufferers consume

portant in managing gout, they are often not enough to get patients’ levels to target, since gout is hereditary. To help deal with acute pain, the doctor may prescribe the pain reliever colchicine. Colchicine doesn’t eliminate the pain immediately; it takes a few doses to see any effects. Many doctors prescribe a low, daily dose of colchicine so patients can prevent future attacks. If colchicine disagrees with you, your doctor may recommend corticosteroids such as prednisone pills or given as an injection in the joint to control inflammation and pain. Corticosteroids’ side effects may include mood changes, increased blood sugar levels and elevated blood pressure. To block or limit the amount of uric acid your body produces, your doctor may put you on xanthine oxidase inhibitors, including allopurinol (Aloprim, Lopurin, Zyloprim) and febuxostat (Uloric), which help curb gout, or even probenecid, which improves the kidneys’ ability to remove uric acid from the body. This may lower your uric acid levels and reduce your risk

express a desire for additional treatment options for their patients. “... We as physicians agree gout is not only a painful, often debilitating disease, but can have longterm consequences like permanent joint damage.  Moreover, studies are showing ... association between gout and comorbid conditions such as cardiovascular disease and kidney disease. Yet clinicians who treat patients with gout are only getting about half of those patients to their target uric acid levels,” said Paul Doghramji, M.D., Family Physician, Collegeville Family Practice, Collegeville, PA. Glenn credits his gout diagnoses with revamping his life. He has joined a gym, lost 40 pounds, cut out soda and only eats red meat on special occasions. “I am not a rich man, but my gout diagnoses really enriched my life. It was the wakeup call that my body desperately needed.”

| November 2016

Ita Yankovich is a freelance writer who also teaches English and Literature courses at Kingsborough Community College and Touro College.


Ariel R. Shapiro

I

n recent years, much attention has been focused on the BRCA1 and BRCA2 gene mutations and their potential impact on women’s health. These mutations, which run in families, affect the production of tumorsuppressor proteins involved in DNA repair that are believed to help prevent cancer. Such mutations significantly raise a woman’s risk of breast and ovarian cancers. The chance of developing breast cancer before age 70 among BRCA1 and BRCA2 carriers is 55–65 percent and 45 percent, respectively. By comparison, women in the general population have about an eight percent chance. BRCA1 carriers have up to a 55 percent risk of developing ovarian cancer before age 70, compared to women in the general population who have less than a two percent chance of developing ovarian cancer. Although BRCA2 carriers are still at elevated risk for ovarian cancer, they face somewhat less risk than BRCA1 carriers. “Having a BRCA1 or BRCA2 genetic mutation does not mean that a woman has or will necessarily develop breast or ovarian cancer,” says Karen David, M.D., chief of the division of genetics at New York Methodist Hospital. “But it does mean that she is at greater risk for it. Knowing the family history,

Screening for the Breast and Ovarian Cancer Gene and having genetic testing done as recommended, enables women to make more informed decisions about screening and prevention.” Women who have a personal or family history of breast cancer — especially cancers that developed before age 50 — should consider being tested to determine whether they carry one of the BRCA genetic mutations. Women who have a personal or family history of ovarian cancer at any age should also consider testing. Men can also carry the mutations, and if so, are at increased risk for developing male breast cancer and prostate cancer. People of Ashkenazi Jewish heritage are more likely to carry the BRCA1 or BRCA2 mutations and may benefit from genetic testing. It is estimated that one in 40 people of Ashkenazi Jewish descent carries a BRCA mutation, regardless of personal or family history of cancer. That is at least 10 times the rate of the general population, and the likelihood of passing it on to children is high. Every child born to a parent with the mutation has a 50 percent chance of inheriting it. The first step in the testing process is to meet with a medical geneticist or genetic counselor, who will determine whether the test

could be beneficial. If so, a sample of blood or saliva will be taken and sent to a laboratory for evaluation. It may then take several weeks to receive results. For women who fall into high-risk categories, the testing is usually covered by insurance. If results come back positive, a medical oncologist or genetic clinician can develop a course of screening and prevention. Enhanced screening for early detection of breast cancer includes annual breast MRIs starting at age 25, with annual mammograms starting at age 30 and physical examinations every six to 12 months. Breast cancer risk can also be reduced through the use of chemoprevention drugs such as tamoxifen and raloxifene. However, these drugs do come with side effects that should be discussed with a physician. There are also screening methods for ovarian cancer, including annual pelvic exams starting at age 25, annual transvaginal ultrasound examinations starting at age 30 and CA125 blood testing, which can detect a protein in the blood that may be suggestive of cancer. However, unlike breast cancer, ovarian cancer is notoriously difficult to detect in its early stage, and screening is not considered to be comprehensive. National guidelines recommend that women who carry the BRCA

Karen David, M.D.

mutations have their ovaries and fallopian tubes removed, as this significantly reduces the risk of developing ovarian and breast cancer. If women choose to have the procedure, they should have it done by age 35–40 or once desired childbearing is completed. BRCA mutation carriers may also choose to get the breasts removed, as this procedure substantially reduces the risk of developing breast cancer. A negative BRCA test result can be a relief, but it is not a guarantee that a woman will never develop breast or ovarian cancer, as these cancers are not always related to BRCA mutations. It is important to consult a physician to develop an appropriate screening routine. To consult with a medical geneticist at

New York Methodist, call the Hospital’s Genetic Service at 718.780.5256 or go to www.nym.org and search “genetic testing.”

November 2016 |

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Tanya Rosen, M.S CAI CPT Trim & & &Fit

I

Is Throwing Out Food a Waste?

know this is a controversial topic, but that’s exactly why we’re going to address it. Why does the thought of throwing out food upset people? You’ve heard all of these, I am sure.

Children in Africa are starving (and some children in Brooklyn don’t have enough to eat either). Throwing out food is throwing out money. You must finish everything on your plate, according to the old European mentality. If you don’t, you didn’t eat enough, and you’ve even insulted whoever made the food.

I’ll tell you my personal stance on this. I personally will throw out food. I will tell my clients to do the same if: It can’t be given to someone else immediately. It can’t be frozen immediately.

You can’t leave the situation immediately.

Holocaust survivors (or their offspring) have heightened sensitivity to throwing out food.

Your diet is more important than the food and you’ll do anything not to sabotage yourself.

Judaism teaches the concept of “bal tashchis” — waste is bad.

Note that I used the word immediately — this is a time-sensitive matter.

Do you think I’m being dramatic or I’m exaggerating? Try sitting in my chair for the last 12 years and hearing the struggles that I hear. Here are some examples: “There was leftover cake on the counter, staring at me. I gave in, and now I feel so upset.” “My kids didn’t finish their pizza. I wish I had just thrown it out, but instead I ate it!” “When my guests left, I was too tired to put away the food and when I came back into the kitchen I had a major binge, eating everything I wouldn’t touch in front of them.” These are just a few examples... There are many more. It all boils down to choice: self control or the trash.  Sounds simple, right? Wrong!  Self-control is a very desired trait that dieters would pay big money for if it came neatly packaged or in some sort of pill.  In an ideal world, we would all have lots of self-control, and nicely wrap up the food and place it in the freezer, or give it to homeless people. However, in the real world we are: busy, tired, overwhelmed, hungry, stressed.... While throwing out food is a waste, I’d like to point out that waste takes many forms: Wasting money on a nutritionist because you’re going against her advice and you’ll need to spend extra weeks there. Wasting money on your gym membership or trainer because you just ate back all the calories

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you burned. Wasting your health. While everyone should ask their own she’eilos, I did ask a well-known posek three years ago when I got a lot of complaints after doing something controversial. I was at my shul’s Purim party, it was 5 p.m. (which felt, mentally and physically, like 11 p.m.). After running around with my kids plus trying to multi-task and do some work in the car, I was zonked.  Mishloach manos kept coming, and although I have “forced self control” (meaning everyone is always watching my plate, plus I have to stay in shape or I may lose my job), even I was reaching a point where I wasn’t thinking clearly anymore. There was no healthy food around, or coffee to help me out, and I kept eyeing a kokosh cake — my most tempting dessert. I had run out of people to talk to, my kids were busy, my husband was dancing and I couldn’t use my phone.  It was then that I decided that I was either going to end up eating the cake and NOT be happy about it or I needed to get rid of it. There were no immediate freezers or homeless people, and I could not immediately leave. So, I went to the sink, poured water and soap over the cake, and then threw it out. Oh, and I had someone video it so I could share this on social media, hopefully to inspire clients and friends to take matters into their own hands when necessary.

| November 2016

I got enormously angry reactions from people who saw the video for all five of the reasons I named above. Add to that the complaint that as a nutritionist my job is to teach self-control.  Sorry, but you can’t just “teach self control.” Rest assured that there were many people who, both privately and publicly, thanked me for inspiring them to do this, and also for being honest, showing that even a nutritionist struggles sometimes.  Back to my point about asking a rabbi.  I was at the time working with a Rosh Yeshivah and I asked him if, based on halachah, my action was right.  He told me that not only was it permitted to throw out food in such a situation, it is even a positive thing, as it is helping you to take care of your body. He went so far as to compare it to an alcoholic who, tempted by a bottle of wine, should spill out the bottle, even though there are plenty of people who could have used it for kiddush, for example. So is throwing out food a waste? You can ask your rabbi — but I hope I showed you why I personally feel that, for myself and for my clients, sometimes it is a good option. Tanya Rosen is the owner of Nutrition by Tanya, with locations in Flatbush, Boro Park, Williamsburg, Monsey, and Lakewood. You can learn more at www. nutritionbytanya.com or by calling 844.TANYA.DIET.


Leah ? Wolofsky

Top

Facts

About Nuts

A

mericans are nuts about nuts. Every year, the average American will eat roughly 8 pounds of nuts. Despite nuts being a high-allergen food, nuts are found in almost every form of food. Whether eaten roasted, baked into something else or right out of the shell, here are 10 in-a-nutshell facts you probably didn’t know about your favorite tough nut to crack.

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A nut is, by definition, a fruit comprised of a hard shell and a seed. Though most of us buy nuts at the supermarket with their shells already removed, the easiest way to classify a nut is by its shell. True nuts have shells that remain closed and hard until they are harvested. They do not open and can only be tapped into with a nutcracker. Examples of true nuts are acorns, hazelnuts, and chestnuts. True nuts also only have one piece per shell, unlike their legume cousins which might have two to three pieces per shell.

Many foods we consider nuts today are actually drupes, which is the inner part of a fleshy fruit. For example, you can actually crack open the pit that’s left over on the inside of a peach or a plum to discover a little drupe on the inside. Almonds, pecans, and walnuts are examples of drupes that are thought of as nuts.

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The peanut, or groundnut, is not a nut but a legume. It is a species of the pea family, hence the name peanut. Peanuts used to be America’s favorite nut, even though they aren’t true nuts. Peanuts are extremely popular both as a standalone snack and as peanut butter, which can be found in everything from sandwiches, to cereal, to ice cream. Peanut butter is most popular as creamy peanut butter, followed by chunky, natural, reduced fat and honey roasted.

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Did you ever wonder why you can’t find cashews in their shells in the same way you can find almonds in their shells? Cashew shells are full of the same itchy component found in poison ivy. Though cashew shells are harmful, cashews are an extremely healthy, risk-free nut to eat. 

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Almonds have surpassed peanuts in popularity since 2014, in part due to their health benefits. Almonds are lower in fat and higher in dietary fiber than any other nut, and they are also a good source of calcium. Almonds, like flowers, need bumblebees to pollinate them.  Almonds  have an incredibly long storage life, and can stay good in the refrigerator for up to two years.

Pistachio nuts, which are referred to as “smiling” nuts in Iran or “happy” nuts in China, open naturally when they are ripe. If you ever get a closed pistachio nut, it is unripe. Their shells turn from green to yellow or tan as they ripen, and there is actually an audible popping sound when they open. Coconuts aren’t real nuts but are drupes, like almonds. Coconuts naturally contain coconut water, not coconut milk. Coconut milk is made by grating the flesh of a coconut into coconut water and straining it the mixture to turn it white. Fresh coconut water is completely sterile, full of vitamins and minerals and has the same sodium balance as the human blood. You could survive on a desert island eating and drinking only coconut water!

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All nuts make great snacks! They are an excellent source of mono and poly unsaturated fats (the “good” fats) and are superrich in fiber. Nuts are naturally gluten-free and are full of protein and vitamins. Though they are very high in calories, nuts are nutrientdense and give you a lot of nutrition for your calorie buck. If you watch your serving sizes, and choose nuts that are dry-roasted, they are a great way to add a boost of energy to your day.

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Stuck with leftover nuts? Nuts can be used to make granola, ground up to add texture in baked goods like breads and muffins and can even be used in place of breadcrumbs atop chicken or fish. Chopped nuts can be used to top of oatmeal, yogurt, or salads. They can also be turned into nut butter by putting them through the food processer.

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You can make delicious, homemade honeyroasted nuts by mixing together 2 tbsp. butter, 3 tbsp. honey and a dash of salt on a very low flame in a saucepan or using the microwave. Pour the mixture on top of your favorite nuts, such as peanuts or cashews, and mix. Spread the coated peanuts onto a baking sheet and bake at 350°F for 5-10 minutes, until the nuts look caramelized. 

Leah Wolofsky, MS, CDN, is a New York State Dietician-Nutritionist with a private practice in Boro Park. She can be contacted at 347.746.0453.

November 2016 |

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Rochelle Rothman

Keeping Your Fridge Stocked With Healthy Food

W

hew! Baruch Hashem, we got through the cooking and eating Yom Tov marathon! Did you have to pick and choose what you could eat when invited out for a meal or two over Yom Tov?

It’s important to note that eating a variety of healthy foods is the key to a good diet — one that will improve your overall health, help fend off disease, and increase longevity. And while no one single food is a cure-all, researchers have

found that some foods in particular have superior disease-fighting properties that can make you healthier. Regularly incorporate some of these healthy foods into your diet and the health benefits they deliver may stick with you for

Recipe for a Well-Stocked Refrigerator

a lifetime. Most of the foods I’m listing are well-known to you. When cooking meals, make foods that can become planovers. In my house, we always say, “Tonight’s supper is tomorrow’s lunch!”

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Cucumbers are a cool, crisp, low-carb choice for everyone, especially diabetics. A generous one-cup portion Who nee n Fact Greeks a ds aspirin? Ancie has fewer than 5 grams of carbohydrates. Translation: You can get your fill without worrying about raising your nd R nt asparagu omans believed blood sugar too much. Cucumbers are an excellent source of vitamin K, and they also contain some potassium s possess that ed prope and vitamin C. Cucumbers are not only for salads —add thin slices to sandwiches or wraps, or serve up cucumber for healin r ti es g too spears for a crunchy afternoon snack. They’re great for lunch anytime! and bee s thaches tings. Peppers harvested in early fall are both sweet and spicy. They’re great for stir-frys or added to any salad and cut in strips for dips for school lunches. Winter Squash of all sorts comes into season in early fall and usually last well into winter, as does zucchini. Squash can be cut up and stored in any TUPPERWARE Fridgesmart for a quick salad to go. I love making Squash Latkes as well as delicious Butternut Squash Soup. They are both easy to prepare and freeze well. Email me for the recipes. Honey Crisp Apples and Pears are great this time of year to add to most salads. For optimum freshness, refrigerate them. Sprinkle a bit of fresh lemon juice on slices when adding them to a fresh salad to keep them from turning brown. Make sure to top off your salad with all colored peppers, baby spinach, chopped walnuts or almonds and a light dressing. This past Yom Tov, most of us enjoyed eating pomegranates. Why not sprinkle some pomegranate seeds on top of your salads? They are in season starting in October and are usually available fresh through December. Parsnips look like white carrots and have a great nutty flavor. Look for thinner parsnips, since fatter ones tend to have a thick, woody core (which you need to cut out). In lieu of mashed potatoes try Pureed Parsnips. The recipe is on joyofkosher.com. Recently, I discovered another vegetable to try as a dip. It is a recipe from Robin Jenkins. I have been preparing roasted asparagus for one of my sons with great success! For something new, try the “champagne” of vegetables, fresh white asparagus. When asparagus is in season, it’s hard to resist eating it all fresh. But if you want to have the bright, grassy flavor of fresh asparagus all year, whirl up this emerald green purée that’s perfect for freezing. I checked how to prepare asparagus properly according to the Halachah, regarding bugs, etc. You can (and should) check with your own Rav. I was told that This is an emerald-green purée of asparagus to top vegetables or pureeing can be acceptable. pasta. By the way, during Pesach, it’s an added choice for a dip for veggies or matzah. 1 1/2 pound fresh asparagus 1/2 cup water 2 teaspoon lemon juice 1/2 teaspoon coarse salt  Rinse asparagus and snap off tough ends if needed. Place in a large stockpot and cover with water.  Bring water to a boil over high heat. Cover and cook 10 to 15 minutes, until asparagus is tender when pierced with a fork. Drain The amino acid asparagine gets its name from asparagus, which is rich in well. this compound.  Place asparagus in the bowl of a food processor fitted with Asparagus is cropping up all over at farmers’ markets and in grocery stores. a metal blade, or TUPPERWARE Power Chef. Add water, lemon Its season is February to June, peaking in April. Look for tight tips (unfurling juice and salt. Process, adding more water if necessary, until purée is a sign of age), and skip any bunches with dry or split ends. is thick and smooth. (You may need to process the asparagus in 2 Green asparagus is the most common and most affordable, with delicate, batches.) Pour purée into dated TUPPERWARE freezer containers. grassy flavor. Check for color from end to end. When cool, cover and freeze. The purée will keep in the freezer up Purple asparagus gets its color from potent antioxidants called anthocyato 1 year. Yield: 3 cups nins. It’s also the sweetest variety. It is best eaten raw. Nutritional Info (per serving): Calories 10; Fat 0g; Saturated Fat White asparagus This mild, exotic variety is great in simple salads. It’s 0g; Polyunsaturated Fat 0g; Monounsaturated Fat 0g; Cholesterol white because it is grown underground. Choose stalks with no browning, and 0mg; Sodium 80mg; Potassium 115mg; Carbohydrates 2g; Fiber 1g; peel before cooking. Sugars 1g; Protein 1g

Asparagus Sauce

Asparagus 101

Over 550 recipes and tips are featured in Rochelle’s humorous and entertaining cookbook, NOT JUST A COOKBOOK. It also features many multi-ethnic recipes that were adapted

for the kosher cook. Rochelle’s book examines food around the year by month. Call 718.258.0415 for a Tupperware Full catalog. Rochelle is available for cooking demo events for fundraisers, hotels, stores, as well as private Tupperware demonstrations. Call to find out about the current-Month sales!

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| November 2016


,QVWDOODWLRQ.LWV Showcase The Drip Dry Rack

Leah Postelnik

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EW YORK, NY – The Drip Dry Rack kit The Drip Dry Rack allows homeowners to enjoy clear, beautiful is easy to install, takcountertops uncluttered by dish racks, and to ing about a half hour save time, thanks to multi-purpose storage. The and requiring just innovative cabinet dish rack drain system, available four screws. Perfect for standard and custom cabinets, is made of for a kosher kitchen sturdy, corrosion-resistant materials designed to with limited space, the Drip Dry Rack last a lifetime. Thanks to this innovative drainage system, water flows comes with easyinto the sink from the cabinet, a system well-known to to-use instructions, anyone who has spent time in an Israeli kitchen. along with readily As Orthodox communities grow, developers available You Tube want to make home construction particularly eco- videos on installation. To get control nomical and still meet the specialized needs of the kosher kitchen. Developers love to include these over clutter in your easy-to-install items in kosher kitchens especial- kitchen, visit www. ly, where separate sets of dishes, utensils, pots and thedripdry.com or www.cabinentdishrack.com to order yours today! pans for meat and dairy can easily create a major &DELQHWGLVKUDFNGUDLQLQJV\VWHP storage challenge. To solve the problem of cluttered, crowded kitchens, Eli Kleinman, a carpenter in Crown Heights, Brooklyn, says it makes sense to install a • Easy to install cabinet dish rack above the sink. He is particularly • Elegant functional wet impressed withand the Drip Dry Rackhidden kit, because it storage space provides all the pieces to mount drying racks into • Stain and water resistant standard or custom cabinets.

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Rust proof and dishwasher safe Built to last a lifetime Beautiful design keeps counter tops clear and organized Saves time and energy Drain system for standard and custom cabinetry

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Assurance Locking Systems Alzheimer’s Lock – Designed With Safety of Your Loved One in Mind

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o more wandering worries! Designed specifically to provide security and peace of mind for caregivers of patients with Alzheimer’s Disease or dementia, Assurance Locking System’s Alzheimer’s Lock stops the Alzheimer’s or dementia patient while he or she is still safely inside the door. It is perfect for caregivers who are concerned about a loved one being able to leave the house unsupervised, without the caregiver’s knowledge. Assurance Locking System’s Alzheimer’s Lock is

simple to use. It attaches in seconds, will not damage the door, and includes an added flight blocker for additional security. Founded in 1985 and headquartered in Beech Grove, Indiana, Assurance Locking Systems products are manufactured here in the United States and are designed to fit your individual needs. The mission of Assurance Locking Systems is to create products that will help make  people’s lives easier and will help people feel safer at all times — all for an inexpensive, affordable price.

November 2016 |

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Community Provider Bulletin Maimonides Ranks #1 in New York State for Angioplasty and Heart Stents

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New Report also Shows Low Readmission Rates for All Cardiac Patients

rooklyn, NY – The NYS Department of Health just published its annual reports on patient outcomes for Percutaneous Coronary Interventions (PCI) and Adult Cardiac Surgery. The process of reporting, sorting and risk-adjusting this information takes several years, so the newest report reflects cases performed in 2013. And, in order to give consumers a better idea of the true level of expertise of any one hospital, the state presents the data for both a single year and a three-year period (2011-2013). The three year report helps eliminate “blips” in the data when a statistical cluster of cases—good or bad—causes unusual rates for any one year. PCIs are better known to the public as angioplasties and other cardiac procedures performed in a minimally-invasive way: a slim catheter is placed within a large blood vessel in the groin or wrist and threaded to the heart. Once there, cardiologists look for blockages or other problems and make

repairs, as needed. This might include removing plaque build-up on the walls of arteries, delivering medication to those areas, and/or inserting stents into the arteries to keep blood flowing freely. According to NYS, Maimonides ranks #1 for patient outcomes across all cases in PCI (angioplasty and heart stents) for the three-year period reported.   The Adult Cardiac Surgery Report includes information about patient outcomes for heart bypass surgeries (also known as open-heart surgeries) and/or heart valve surgeries. Maimonides surgeons performed well in all categories. Only four heart surgeons in the state were noted for significantly low mortality rates; our own Dr. Israel Jacobowitz was among them.   In addition, the state recently began measuring and reporting readmission rates. This refers to whether or not a patient has complications within 30 days of the original procedure and must return to the hospital for further

care. Both our cardiac surgeons and our interventional cardiologists were noted for having among the lowest readmission rates in the state for 2013. According to Dr. Jacob Shani, Chair of Cardiology, “We delighted, of course, with the report from the state. But the real winners here are the people in our care. It’s a privilege to make a positive difference every day in the lives of our patients.” “We continuously innovate,” explains Dr. Greg Ribakove, Chief of Cardiothoracic Surgery. “All of our cardiac experts work together daily to provide the very best options and care for each and every patient.” The Maimonides Heart & Vascular Center has the collective expertise to offer patients the latest strategies for diagnosing and treating the full spectrum of cardiovascular disorders. Among the many elite programs and procedures are: ■ TAVR Procedure – Transcatheter Aortic Valve Replace-

ment allows cardiac experts to repair or replace a faulty heart valve without major surgery. ■ LVAD Destination Therapy – The “bridge to transplant” is now a permanent option for Heart Failure patients who don’t qualify for transplant surgery. ■ Aortic Aneurysm Repair – Virtual Reality Simulation allows vascular surgeons to rehearse each repair in advance, dramatically lowering surgical risks. ■ A-Fib Convergent Therapy – Atrial Fibrillation, a dangerous heart rhythm disorder that increases the risk of strokes, is eliminated by radio-ablation inside and outside the heart. Long known for excellence in cardiovascular care, Maimonides Medical Center is among the most distinguished hospitals in the nation for outstanding patient outcomes. To learn more about the Maimonides Heart & Vascular Center, call 718-283-6401, or visit www.maimonidesmed.org/ heart.

Community CALENDAR DECEMBER

December

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Library Lab: Simple Machines Time: 3:00 p.m. – 4:00 p.m. Location: Flatlands Library 2065 Flatbush Ave. at Ave. P, Brooklyn, NY 11234 Contact: 718.253.4409

Library Lab is Brooklyn Public Library’s dynamic learning enrichment program for children ages 6 to 10 and their families.  Explore science, technology and math concepts with fun, free hands-on activities to spark curiosity. Get tips on how to use library resources and how to continue projects at home. December

2

Positive Aging: Blood Pressure Screening. Time: 11:00 a.m. – 11:45 a.m. Location: Kings Bay Library 3650 Nostrand Ave. (near Ave. W), Brooklyn, NY 11229 Contact: 718.368.1709

An experienced nurse, provided by the Sheepshead Bay/Nostrand NORC, will check your blood pressure free of charge. December

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Affordable Care Act (ACA) In-Person Assistance/Navigator Program Time: 10:00 a.m. – 6:00 p.m. Location: Kings Highway Library 2115 Ocean Ave. (nr. Kings Highway), Brooklyn, NY 11229

| November 2016

Contact: 718.375.3037

Public can obtain information about qualified health insurance plans from a trained and certified navigator. December

5

Chai Lifeline Annual Gala Dinner: Soaring Beyond Time: Reception 6:00 p.m., Dinner 7:15 p.m. Location: Marriot Marquis Hotel, 1535 Broadway, New York, NY 10036 Contact: Chai Lifeline: 212.699.6658

Master of Ceremonies Ethan Zohn, Cancer Survivor and Winner of the Reality TV series Survivor: Africa. Journal Ads are also available. December

5

Homework Help Time: 3:30 pm – 5:30 pm Location: Borough Park Library 1265 43rd St. at 13th Ave., Brooklyn, NY 11219 Contact: 718.437.4085

If you are in grades 1-8. We can help you with your homework for Free! December

5

Pulmonary Hypertension Support Group Time: 5:00 p.m.-7:00 p.m. Location: Wesley House 7A, 501 Sixth Street Contact: To register (required): 718.780.5614

Learn more about the disease and meet others dealing with Pulmonary Hypertension.


Community Provider Bulletin N

Dr. Stephen Peterson Named Assistant Dean of New York Methodist Hospital at Weill Cornell Medicine

EW YORK — Dr. Stephen Peterson, chairman of the Department of Internal Medicine at New York Methodist Hospital, has been appointed assistant dean of New York Methodist Hospital at Weill Cornell Medicine, effective Sept. 1. Dr. Peterson will serve as the primary liaison between New York Methodist and Weill Cornell Medicine, ensuring that clinical, biomedical research and educational activities are aligned at the two institutions. Dr. Peterson will collaborate with colleagues to help extend clinical trials and clinical research opportunities offered on the Upper East Side campus to New York Methodist, and will oversee Weill Cornell Medicine’s medical education and student clinical rotations at

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the hospital and facilitate faculty appointments. “It is an honor to be named assistant dean of New York Methodist Hospital at Weill Cornell Medicine,” Dr. Peterson said. “I am committed to working with Weill Cornell Medicine to continue to elevate the best hospital in Brooklyn into an even stronger academic medical center. This is a major opportunity for us to enhance our clinical care, biomedical research and academic programs, and take New York Methodist to the next level of excellence.” “We are delighted with this appointment. Dr. Peterson is most deserving of the recognition,” said Mark J. Mundy, president and CEO of NYM. “He will be an excellent representative and the Hospital will greatly benefit from

his appointment.” A board-certified internist, Dr. Peterson has been a leader in his field throughout his career. He has served as president of the New York Chapter of the American College of Physicians, been honored with more than 100 accolades for his professional accomplishments, and has published nearly 100 peer-reviewed studies. Under Dr. Peterson’s leadership, the Department of Internal Medicine at New York Methodist joined the National Resident Matching Program in 2015, matching talented new physicians to the Hospital’s internal medicine residency program. His expertise in curriculum design has helped resident physicians to complete their residencies well prepared for successful careers in medicine.

Stephen Peterson, MD

“When I was a resident physician, the chairman of my department told me that the best medical educators make the careers of their students and interns just as important as their own,” Dr. Peterson said. “A new physician will remember the words and guidance of his or her mentor for decades to come.”

Pediatric Unit Brings Top Emergency Care to Brooklyn

YU Lutheran has revamped its emergency medicine services to better serve young patients in Brooklyn. The newly implemented emergency department care model at  NYU Lutheran Medical Center  has introduced a new model of care to improve efficiency and provide a better patient experience. Highly trained emergency medicine clinicians now work in teams—known as “pods”—to provide this an

enhanced level of care delivery for young patients and their families. The emergency department also serves as an important gateway for families to the entire spectrum of care at NYU Lutheran,” says Robert J. Femia, MD, chair of the Ronald O. Perelman Department of Emergency Medicine at NYU Langone Medical Center, and who also oversees emergency medicine at NYU Lutheran. “We are seeing more and more pediatric patients in the NYU Lu-

theran Emergency Department,” says  Elizabeth J. Haines, DO, director of pediatric emergency medicine at NYU Lutheran. “We want to ensure that when families bring their children, adolescents, and young adults here, they will get the most attentive care. This requires our caregivers to know how to meet their particular needs and to work collaboratively to address them.” The reallocation of space within the emergency department

has created a separate area for children and their families, featuring five private rooms, all also equipped for critical care including asthma and other respiratory disorders. The aesthetics of the unit also have been designed to have a more calming, stress-reducing effect. To accommodate the cultural diversity of Brooklyn, comprehensive language services are available in Spanish, Chinese, Arabic, Russian, and more.

Community CALENDAR CONTINUED... December

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Positive Aging: Low-Impact Exercise Time: 1:00 p.m. – 2:00 p.m. Location: Kings Bay Library 3650 Nostrand Ave. (near Ave. W), Brooklyn, NY 11229 Contact: 718. 368.1709

Join low impact exercise for seniors. The service is provided by the Sheepshead Bay/Nostrand NORC. December

7

Never Too Late to Learn: Computer Basics Time: 11:00 a.m. – 12:00 p.m. Location: Flatlands Library 2065 Flatbush Ave. at Ave. P, Brooklyn, NY 11234 Contact: 718.253.4409

Learn the fundamentals of using a computer. No prior experience with computers is necessary.

December

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Introduction to American Sign Language Time: 11:00 a.m. – 12:00 p.m. Location: Kensington Library 4207 18th Avenue, Brooklyn, NY 11218 Contact: 718.436.0545

Find out more about American Sign Language.  Ideal for first-time learners and those who want to strengthen conversational skills. Facilitated by  Elizabeth Reyes, Sign Language Specialist at United Cerebral Palsy of New York City.

November 2016 |

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Misaskim Issues Safety Guidelines for Chanukah

Chanukah – the Yom Tov of light is here! Everyone is preparing for this special Yom Tov! Families are busy buying oil, wicks, and candles for their menorahs, dusting off recipes for latkes and sufganiot, and many are planning their Chanukah parties. The Fire Department is busy, too, getting out these safety tips to make sure everyone stays safe this Chanukah: DID YOU  Place menorahs at least 4 feet from curtains, shades or cabinets. KNOW? Children’s  Never leave children alone in a room with a lighted menorah. skin is th inner and burn Never leave the kitchen while frying latkes or doughnuts. s at a low e r p temeratures th  Turn frying pan handles toward the back of the stove. is why ch an adults’. That  Make sure smoke and fire detectors are working. ildren usually m ’s burns are Check the batteries before Chanukah. ore seriou s.  Always place menorahs on strong, sturdy furniture.  Never use a menorah made of plastic, wood or other material that can catch fire.  When frying latkes, never place towels, papers, or anything that could burn next to the stove.

Community CALENDAR CONTINUED... December

9

Adult Mental Health First Aid Training Tiime: 8:30 a.m. to 5:00 p.m. Location: NYC Department of Health and Mental Hygiene  42-09 28th Street, Long Island City, Queens 11101 Contact: nycmhfa@health.nyc.gov

A groundbreaking public education program which introduces participants to risk factors and warning signs of mental health problems, builds understanding of their impact, and overviews common treatments. This 8-hour course uses role-playing and simulations to demonstrate how to assess a mental health crisis; select interventions, provide initial help; and connect persons to professional, peer, social, and self-help care. Also covers the risk factors and warning signs of anxiety, depression, schizophrenia, bipolar disorder, eating disorders, and addictions. December

12

E-mail Basics Time: 11:00 a.m. – 12:00 p.m. Location: Kensington Library, 4207 18th Avenue, Brooklyn, NY 11218 Contact: 718.436.0545 E-mail Basics will teach new users the basics of email, as well as understanding its uses, services and properties.

December

13

Microsoft Power Point 2010 Time: 6:00 p.m. – 7:30 p.m. Location: Kensington Library, 4207 18th Avenue, Brooklyn, NY 11218 Contact: 718.436.0545

Microsoft PowerPoint 2010 gives you more ways to create and share dynamic presentations. December

13

Mind/Body Methods for Managing MS Stress Time: 7:00 p.m.-8:30 p.m. Location: Buckley Conference Room 820, 506 Sixth Street Contact: Preregistration required. Call 1.800.344.4867 to sign up.

December

18 19

December

20

December

14

Apecifically for those interested in understanding what the internet is and how it is used. Covers browsers, search engines, and navigating websites. December

14

Senior Health Seminars Time: 2:30 p.m.-3:30 p.m. Location: Brooklyn College Student Center East 27th Street and Campus Road Contact: 718.501.6092 to register (required)

Join NYM’s physicians as they lecture about senior health topics. December

14

Caregivers Support Group Time: 3:00 p.m. – 4:30 p.m. Location: Wesley 6A/6B, 501 Sixth Street Contact: 718.780.5367

Led by a licensed social worker, this support group is intended to provide support for family members and friends caring for an older adult.

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| November 2016

Internet Safety Time: 6:00 p.m. – 7:30 p.m. Location: Kensington Library 4207 18th Avenue, Brooklyn, NY 11218 Contact: 718.436.0545

Keeping your personal information, private data and finances safe can be difficult, but by following a few tips, you can avoid the majority of scams, spyware and privacy breaches. December

22

Surgical Weight Reduction Seminar/Support Group Time: 6:00 p.m. – 8:00 p.m. Location: NY Methodist Hospital, Executive Dining Room 506 Sixth Street, Brooklyn, NY Contact: 718.780.3288

A surgeon will conduct a 30-minute information session for individuals considering the procedure, followed by a 90-minute support group meeting open to pre- and post-operative patients. December

27

Parkinson’s Caregivers Support Group Time: 2:00 p.m.-3:30 p.m. Location: Wesley 6B, 501 Sixth Street, NY Methodist Hospital Contact: 646.704.1792 for more information and to register (required).

The group is led by NYM’s PD care coordinator and is open to individuals caring for loved ones with Parkinson’s.

Group is free and open to any individual living with an MS diagnosis.

Introduction to the Internet Time: 11:00 a.m. – 12:30 p.m. Location: Kensington Library, 4207 18th Avenue, Brooklyn, NY 11218 Contact: 718.436.0545

20th Annual NEFESH International Conference Location: Hyatt Regency Long Island Island and Wind Watch Golf Club, 1717 Motor Parkway, Hauppauge, Ny 11778 Register Online: www.nefesh.org

December

27

Microsoft Excel Basics Time: 6:00 p.m. – 7:30 p.m. Location: Kensington Library, 4207 18th Avenue, Brooklyn, NY 11218 Contact: 718.436.0545

Introduces new and returning spreadsheet users to the basics of storing, managing and analyzing data in a spreadsheet, and covers core features of Microsoft Excel 2010.

JANUARY

January

9

Care 4 Caretakers (Alzheimer’s Disease) Time: 5:00 p.m.-7:00 p.m. Location: NY Methodist Hospital, Wesley House 6A, 501 Sixth Street Contact: 718.246.8590 to register (required).

Join NYM’s cognitive care coordinator in this group for caretakers of patients experiencing cognitive deficits/memory loss. January

10

Mind/Body Methods for Managing MS Stress Time: 7:00 p.m. – 8:30 p.m. Location: NY Methodist Hospital, Buckley Conference Room 820 506 Sixth Street, Brooklyn, NY Contact: Preregistration required. Call 1.800.344.4867 to sign up. Group is free and open to any individual living with an MS diagnosis.


5 Questions for Dr. Melinda C. Keller

With more than 32 years experience and a degree from New York Chiropractic College, Dr. Melinda C. Keller is the leader of the Brooklyn Spine Center team. She is committed to providing patients with the many benefits of alternative natural health care solutions. Contact Dr. Keller and the Brooklyn Spine Center at 718.475.9438.

1

The Brooklyn Spine Center advertises that patients can lose between 20-40 pounds in 40 days. What does chiropractic care have to do with weight loss? We are committed to educating the community to all the far-reaching effects of Chiropractic care. Chiropractors are concerned with the misalignment of the spinal bones and improper nervous system function that results. Misalignment of even one vertebra will interfere with the normal flow from brain to body and result in reduced health and function. Weight loss is often viewed for aesthetic rewards; there are other rewards as well. Many of our patients no longer take costly medications. They consider successful long-term weight loss a wonderful health investment. In 35 years of practice, we have probably coached over 2000 patients towards a healthier weight and better functioning body.

2

Is there counseling or follow-up for patients who lose so much weight in so short a time? Our patients average 29 pounds of fat loss in just 42 days. We typically stay with the patient for a minimum of 90 days, communicating on a daily basis. By this time the body has normalized and most patients maintain their weight loss. It is not uncommon for us to stay in communication with patients for 9 to12 months.

3

What kinds of insurance are accepted by the Brooklyn Spine Center for treatments in general and for weight loss in particular? Over 900 insurance companies cover chiropractic care. We are happy to do an insurance check to let patients know what is covered and what might not be covered. Typically a year of care in our office is much less than one day of observation at our local hospital. For the most part, insurance companies do not cover weight loss services.

4

What is “cold laser therapy” and what kinds of conditions does it treat? Advanced Pain Relief LiteCure deep-tissue laser therapy is a non-surgical option that may eliminate or significantly reduce your pain. It works by flooding the tissues with photons, energizing damaged cells and increasing circulation to the painful area. The treatment is FDA approved, natural, painless, and comfortable.

5

The website mentions “state of the art” chiropractic techniques. What are some examples of breakthroughs in chiropractic care? Non-Surgical Spinal Decompression is a revolutionary new technology used primarily to treat disc injuries (bulging, herniated disks, pinched nerves, sciatica, radiating arm pain and more) in the neck and lower back. The technique has been shown to gently separate vertebrae from each other. Proper patient screening is imperative; only the best candidates are accepted for care. The trend toward instrument-based adjusting continues to grow within the Chiropractic profession, and we do utilize this state-of-the-art nonforce adjusting method, among others.

Community CALENDAR CONTINUED... January

11

Stroke Support Group Time: 2:00 p.m. – 3:00 p.m. Location: NY Methodist Hospital Buckley 8 Conference Room 506 Sixth Street, Brooklyn, NY Contact: Call 718.780.3777 for additional information and to register.

Share your experience, meet other survivors, and hear from different stroke specialists at NYM. January

11

Caregivers Support Group Time: 3:00 p.m. – 4:30 p.m. Location: NY Methodist Hospital, Wesley 6A/6B 501 Sixth Street, Brooklyn, NY Contact: For more information, contact 718.780.5367

January

19

A surgeon will conduct a 30-minute information session for individuals considering the procedure, followed by a 90-minute support group meeting open to pre- and post-operative patients. January

24

18

Parkinson’s Disease Support Group Time: 2:00 p.m. – 3:30 p.m. Location: Please call for location and to register (required): 646.704.1792.

Join NYM’s PD care coordinator in monthly meetings for those with Parkinson’s Disease.

January

19

Look Good…Feel Better® Time: 2:00 p.m. – 4:00 p.m. Location: Wesley House 6A, 501 Sixth Street, Brooklyn, NY Contact: register (required): 718.780.3593 Helping women with cancer feel beautiful inside and out.

Parkinson’s Caregivers Support Group Time: 2:00 p.m.-3:30 p.m. Location: Wesley 6B, 501 Sixth Street Contact: 646.704.1792.for more information and to register (required). The group is led by NYM’s PD care coordinator and is open to individuals caring for loved ones with Parkinson’s.

Led by a licensed social worker, this support group is intended to provide support for family members and friends caring for an older adult. January

Surgical Weight Reduction Seminar/Support Group Time: 6:00 p.m.-8:00 p.m.; Location: NY Methodist Hospital Executive Dining Room 506 Sixth Street, Brooklyn, NY Contact: 718.780.3288

January

24

Meet the Doulas BIMC Time: 7:00 p.m. – 8:30 p.m. Location: Beth Israel Baird Hall, 350 E 17th Street, 7th floor, NYC  Contact: birthfocus@gmail.com

At BirthFocus we understand the process involved in choosing the right doula to join women and their families on a most intimate experience, the birth of a baby.  Our  “Meet the Doulas” open houses give women who are expecting and their partners a chance to learn more about our doula practice and to connect  with several doulas through short one-on-one interviews. Each expecting couple will have a chance to meet with 4-5 doulas.

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Here’s How to Remove Those Campaign Bumper Stickers (The Seattle Times/TNS) - At some point, you had the bright idea of putting a bumper sticker on your vehicle that proudly proclaimed whatever you believed in at the time. But things have changed. You can probably remove the bumper sticker yourself. However, there are ways to do it wrong. “Do not use razor blades,” said Anthony Gabarino of AnthonyG’s Auto Detailing, which serves Kitsap County in Washington state and beyond. “It will scratch your car.” The best way to remove a bumper sticker is to use a heat gun. Aim it at the bumper sticker, and let the heat do most of the work. Then, carefully work a

fingernail under one corner and peel slowly. Gabarino says you can also try a blow dryer. Experts recommend keeping the heat source moving in a circular fashion a few inches from the bumper sticker to avoid damaging the paint in one area. If there’s a little gluey residue left, that can be removed with rubbing alcohol and a cloth. His most important tip, however, is for next time. “Don’t put bumper stickers on your car,” he said. “It’s been a pet peeve of mine my whole life and when I see one on a painted bumper I just cringe.” Put them on your glass windows, instead, where they’re a cinch to remove with a razor and Windex, he said.

Community CALENDAR CONTINUED... January

25

Senior Health Seminars Time: 2:30 p.m. – 3:30 p.m. Location: Brooklyn College Student Center, East 27th St. and Campus Rd. Contact: 718.501.6092 to register (required) Join NYM’s physicians as they lecture about senior health topics.

January

26

Diabetes Support Group: Time: 5:00 p.m. – 6:00 p.m. Location: NY Methodist Hospital, Buckley 8 Conference Room 506 Sixth Street, Brooklyn, NY Contact: 718.246.8603 for additional information and to register.

Care 4 Caretakers (Alzheimer’s Disease) Time: 5:00 p.m. – 7:00 p.m. Location: Wesley House 6A, 501 Sixth Street, Brooklyn, NY Contact: 718.246.8590 to register (required). Join NYM’s cognitive care coordinator in this group for caretakers of patients experiencing cognitive deficits/memory loss.

February

13

February

14

Led by a certified diabetes educator, this group is for people with diabetes and prediabetes.

FEBRUARY

February

3

Give Kids a Smile Day! Time: 9:00 a.m. – 3:00 p.m. Location: NY Methodist Hospital, Kirkwood Pavilion 506 Sixth Street, Brooklyn, NY Contact: 718.780.5410

Free Dental Exams for children including sealant placement, child prophys, x-rays and more. Children ages 1-16 welcome! February

3

Go Red for Women Day Time: 10:30 a.m. – 1:30 p.m. Location: NY Methodist Hospital, Carrington Pavilion Atrium 506 Sixth Street, Brooklyn, NY Contact: 718.780.5367

NYM will wear red and host a health fair, featuring free heart healthy screenings, educational information and giveaways. February

6

Pulmonary Hypertension Support Group Time: 5:00 p.m. – 7:00 p.m. Location: Wesley House 7A, 501 Sixth Street, Brooklyn, NY Contact: To register (required) 718.780.5614

Learn more about the disease and meet others dealing with Pulmonary Hypertension. February

8

Stroke Support Group Time: 2:00 p.m. – 3:00 p.m. Location: Buckley 8 Conference Room, 506 Sixth Street, Brooklyn, NY Contact: 718.780.3777 for additional information and to register.

Share your experience, meet other survivors, and hear from different stroke specialists at NYM. February

8

Caregivers Support Group Time: 3:00 p.m. – 4:30 p.m. Location: Wesley House 6A/6B, 501 Sixth Street, Brooklyn, NY Contact: 718.780.5367.

Led by a licensed social worker, this support group is intended to provide support for family members and friends caring for an older adult.

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| November 2016

Mind/Body Methods for Managing MS Stress Time: 7:00 p.m. – 8:30 p.m. Location: Buckley Conference Room 820, 506 Sixth Street, Brooklyn, NY Contact: Preregistration required. 800.344.4867 Group is free and open to any individual living with an MS diagnosis.

February

15

Senior Health Seminars Time: 2:30 p.m. – 3:30 p.m. Location: Brooklyn College Student Center, East 27th St. & Campus Road Contact: 718.501.6092 to register (required). Join NYM’s physicians as they lecture about senior health topics.

February

15

February

16

Parkinson’s Disease Support Group Time: 2:00 p.m. – 3:30 p.m. Location: Please call for location and to register (required): 646.704.1792. Join NYM’s PD care coordinator in monthly meetings for those with Parkinson’s Disease.

Surgical Weight Reduction Seminar/Support Group Time: 6:00 p.m. – 8:00 p.m. Location: NY Methodist Hospital, Executive Dining Room, 506 Sixth Street, Brooklyn, NY Contact: 718.780.3288

A surgeon will conduct a 30-minute information session for individuals considering the procedure, followed by a 90-minute support group meeting open to pre- and post-operative patients. February

Parkinson’s Caregivers Support Group Time: 2:00 p.m. – 3:30 p.m. Location: Wesley House 6B, 501 Sixth Street, Brooklyn, NY Contact: 646.704.1792.for more information and to register (required).

21

The group is led by NYM’s PD care coordinator and is open to individuals caring for loved ones with Parkinson’s

February

22

Alzheimer’s Disease Wellness Program Time:12:30 p.m. – 2:30 p.m. Location: Wesley House 6A, 501 Sixth Street Contact: 718.246.8590 to register (required).

Join NYM’s cognitive care coordinator in this group for patients with cognitive deficits/memory loss and their caregivers. February

23

Diabetes Support Group: Time: 5:00 p.m. – 6:00 p.m. Location: Buckley 8 Conference Room, 506 Sixth Street, Brooklyn, NY Contact: 718.246.8603 for additional information and to register

Led by a certified diabetes educator, this group is for people with diabetes and prediabetes.


Your Smartphone May Be Hurting Your Sleep

(With reporting from CNN) - Use of a smartphone near bedtime is associated with worse quality sleep, according to a new study. Dr. Gregory Marcus, author of the study and an associate professor at the University of California, San Francisco, and his colleagues conducted the study. On average, study participants used their smartphones for 38.4 hours over a 30-day period. About 35% of those who used smartphones for less time than average had sleep difficulties, compared with 42% of those with average or greater than average use. Participants who used their smartphones near bedtime were more likely to have poor-quality sleep. “We can’t exclude the possibility that some people can’t sleep for some completely unrelated reason, and because they can’t sleep, they’re using their smartphone, just to pass the time,” Marcus said. Other research has shown that the blue light emitted by smartphones and other digital devices might suppress the body’s production of melatonin, which plays a role in sleep cycles. Based on his results, Marcus suggested that troubled sleepers avoid screentime for 30 minutes or so before going to bed to see whether that helps their sleep quality. “There’s almost certainly no harm in giving that a good try,” he said.

Federal Funding for Alzheimer’s Research 2011 2016 2017 Goal (Year???)

$496 Million $991 Million $1.4 Billion $2 Billion Source: Mayo Clinic News Network

National Plan to Address Alzheimer’s Disease

Alzheimer’s disease is the sixth leading cause of death in the U.S. Nearly 5 1/2 million Americans have it. In 2011, after unanimous approval by Congress, the National Alzheimer’s Project Act was signed into law. The director of the Alzheimer’s Disease Research Center at Mayo Clinic, Dr. Ronald Petersen, has served as chair of the advisory council that helps set priorities for a national strategic plan of action. “We’re moving toward earlier and earlier identification of the disease process, with the thought of intervening earlier, rather than later,” says Dr. Petersen. The Alzheimer’s Disease Research Center at Mayo Clinic lists 22 clinical trials currently underway: quests for reliable biomarkers and brain imaging for diagnosing it, new therapies for treating it, and vaccines for preventing it. While preventing suffering for individuals and families is a key concern, Dr. Petersen says the staggering costs cannot be ignored. In 2015, Alzheimer’s care topped $226 billion. “That number is projected to go to $1.1 trillion by 2050.” (Mayo Clinic News Network)

Keeping Your Pet (and Yourself) Safe on Chanukah  Confine pets away from the room where a menorah is lit.  If you’re playing dreidel, keep in mind that pets risk serious gastrointestinal obstruction from eating a dreidel.  Chocolate coins – Chocolate contains theobromine and caffeine (both stimulants), which can be toxic or even fatal for dogs. The foil wrapper, sugar, and fat can cause vomiting, diarrhea, and pancreatitis.  Potato latkes – Mix potato, egg and onion, fry it in oil, and slather with sour cream or applesauce. Then keep the delicious results away from your pet. Fresh grated onion causes Heinz body anemia in both dogs and cats. Besides, latkes are high in fat and carbohydrates, which are likely to upset your pet’s digestive tract.  Doughnuts are heavy on fat and sugar. If your pet eats a doughnut on Chanukah, it may cause vomiting, diarrhea, and loss of appetite.

6 Ways to Boost Your EI (Emotional Intelligence) Emotional intelligence differs from a person’s cognitive intelligence. EI involves social skills, knowing what one is feeling, and responding appropriately to the emotional state of others. These five tips will help you hone your EI.  Limit the negative When you feel adversely about someone’s behavior, avoid jumping to a negative conclusion right away. Come up with multiple ways of viewing (reframing) the situation before reacting. It will provide insight into the situation and lower your stress.  Keep your cool - The best way to combat life’s stressors is to energize yourself. That means exercise. Exercise boosts your confidence to deal with stressors in a more productive way.  Learn to say “no” without guilt - The key is learning to be assertive and express difficult emotions when necessary.  Be slow to judge - Avoid using sentences that begin with “you,” followed by accusation or judgment. That just puts the listener on the defensive, and makes him less likely to be open to what you have to say.  Think before you talk - When you feel angry with someone, before you say something you might regret, take a deep breath and count slowly to ten. Or, put yourself in the other person’s shoes to help gain perspective on what he or she is thinking.  Practice resilience - With every challenging situation, ask questions such as “What is the lesson here?” “How can I learn from this experience?” “What is most important now?” Constructive questions will give you the proper perspective.

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Health AND Living Service Marketplace ASSISTED LIVING Ateret Avot

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

Lakewood Courtyard

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

The New Nautilus

2001 Ocean Boulevard, Atlantic Beach, NY 11509 516.239.1400 • www.newnautilushotel.com An upscale oceanfront Senior Residential Hotel that provides a socially active retirement lifestyle in a secure and friendly environment.

CHIROPRACTIC CARE Dr. Jeffery E. Weber

2037 Ocean Avenue (Between O & P) Brooklyn, NY 718.376.2300 • www.oceanchiro.net

CLOTHING Lucky & Me

www.LuckyAndme.com Super Soft Comfy Underwear

COMMUNITY SERVICES Beineinu- Connecting Parents of Children with Special Needs

48 West Maple Avenue, Monsey, New York 10952 347.743.4900 • www.Beineinu.org

Counterforce

Jump Start Early Intervention 2294 Nostrand Avenue · Brooklyn, NY 718.853.9700 Announcing the opening of our New Center-Based ABA Program

COMMUNITY SUPPORT

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.

Hand in Hand Family 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

OHEL Family Caregiver Support Group

Genesights: The Jewish Genetics

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.

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.

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

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

Online Educational Series

MASK Mothers & Fathers Aligned Saving Kids 1431 E.12th Street , Brooklyn, NY 11230 718.758.0400 • www.maskparents.org Helpline, Referrals and Support Groups

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 |

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

| November 2016

Yad HaChazakah

Yad v’Ezer

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.

Zicharon Memory Loss

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


Health AND Living Service Marketplace DENTISTRY Doueck Dental

563 Kings Highway, Brooklyn • 718.339.7982 Dr. Jacques Doueck Diplomate, Academy Clinical Sleep Disorder Disciplines Covered by Medicaid, Medicare and most Medical Insurance

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.

ELDER LAW

Yitzchak Weissman

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

ELDER LAW ATTORNEYS Law Office of Amy Posner

20 Vessey Street, New York, NY 10007 212.385.1951

Solomon Blum Heymann LLP

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

FAMILY HEALTH

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.

Expos USA, Inc.

Health Events for seniors and families 305.290.3332 • info@exposusa.com • exposusa.com

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

Shape Fitness

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

HEALTHY EATING

Baum’s Gluten Free Delights

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

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

Assurance Locking Systems, LLC When You Need Security NOW!

Fiber Gourmet

Assist Caregivers for Alzheimer’s and Dementia Patients with Door Security. Keep them safe inside the house.

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

Gourmet Kosher Cooking

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

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

NO wandering worries as your Alzheimer’s Lock goes WITH you and the Patient. Designed Specifically for Caregivers. Easy to use. Enjoy more peace of mind for loved one’s Safety. ONLY: $24.95 Plus S&H Order See Video on Alzheimer’s Lock! NOW www.assurancelockingsystems.com

Organic Circle

1415 Avenue M 718.878.3103 Organic Supermarket

HOME HEALTHCARE Americare CSS

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

Attending Home Care

1125 Fulton Street · Brooklyn, NY 11238 Rivky: 718.508.4400 • rivky@attendingLLC.com www.AttendingLLC.com Choosing a caregiver for your family member on Medicaid just got easier than ever…Because now, Family members, Neighbors and Friends can qualify and get paid for it.

David York Agency

1416 Avenue M, Suite 301, Brooklyn, NY 11230 718.376.7755 • www.davidyorkagency.com Servicing the 5 Boroughs & Nassau County Certified Home Health Aides

November 2016 |

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Health AND Living Service Marketplace 855.HAMASPIK Home health aide, personal care aide, nursing, PT/OT, speech therapy, social work, nutrition.

Shabbos Stairlift

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

REFERAL SERVICES

Heart to Heart 718-305-5959 • CDPAP@h2hhc.com

Mental Health Services

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.

HamaspikCare

Center 4 Play Therapy

Get Paid Now to care for a loved one, neighbor, or friend.

David Schatzkamer, LMHC, RPT Registered Play Therapist 718.715.9384

Homebound Services

718.238.2100 • www.doctorsoncallnyc.com Medical house calls for the homebound and elderly. Servicing New York’s 5 Boroughs, Lower Westchester and Long Island. 7 days a week- most Insurances accepted

HYPNOSIS

Drucker Hypnosis Center

347.470.8262 www.MDHypno.com Specializing In Anxiety, Post Traumatic Stress, Panic Attacks, Social Issues, Stress, Low Self-Esteem, Fears and Phobias

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

Evolve

980 East 12th St., Brooklyn, NY 11230 646.606.3916 • www.evolvejcp.com A solution-Focused, Cutting- edge treatment program for Jewish teens (13-18), young adults, and adults struggling with mental health, addiction, and behavioral Issues

NEFESH International

INSURANCE

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

Adam Pearlman & Associates

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

MEDICAL PRACTICE

Sovri Helpline

888.613.1613 Emotional support for Orthodox victims of sexual abuse.

NUTRITIONAL SUPPLEMENTS

Cancer Institute of Long Island Hal Gerstein, MD

225 Community Drive, Suite 160, Great Neck, NY 11021 516.482.4790 • www.cancer-li.com

Dr. Harry G. Baldinger, D.P.M Medicine & Surgery of The Foot 845.425.8686 • drbaldinger.com Locations in Monsey & Williamsburg

Patrick Barry, M.D.

Orthopedic Surgeon & Knee Specialist (Knees Only) Non-surgical Knee Pain relief 800.359.5633 • www.newyorkkneedoctor.net

Bluebonnet Nutrition

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

Kosher Vitamins

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

Zahler

877.ASK. ZAHLER Advanced nutrition by Zahler Carries A wide variety of pure supplements designed to solve problems and enhance lives.

Dr. Masha (Friedman) Lewin

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

PHARMACIES New Age Pharmacy

Midwood Foot Care Dr. Zeev Hertz Podiatrist

2918 Avenue J, Brooklyn, NY 11210 718.253.1700

1911 Avenue L, Brooklyn, NY 11230 718.951.1620

MEDICAL SUPPLIES

Caregivers of Alzheimer’s Patients.

Our Alzheimer’s PortAble Door Lock will stop them At the door from leaving room. See Video at: www.assurancelockingsystems.com

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PRODUCTS Drip Dry Rack

7445 Harding Avenue #212, Miami Beach, FL 33141 646.894.1000 • www.thedripdry.com The Drip Dry is the first multi-use draining system kit for kitchen cabinets that instantly improves lifestyle and a kitchen’s appearance. Easy to install, it is used as a dish rack, colander, soap and sponge storage.

| November 2016

Medstar

REHABILITATION CENTERS 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.

SENIOR SERVICES

Senior Relocation Services

800.507.7431 • 561.923.5985 www.FloridatotheNortheast.com Transporting your loved ones with safety, security and Peace of mind.

SUPPORT GROUP Alzheimer’s Caregivers

The Alzheimer’s Portable Door Lock will keep your Patient safe inside the house. Lock will travel with You and Patient. No wonder worries. Easy to attach and remove from door. See Video at: assurancelockingsystems.com

SUPPORT PRODUCTS Olive Gold 03 Skin Care Lotion

561.882.4153 • www.olivegold03.com Helps Relieve: Fine Lines & Wrinkles, Sunspots, acne, Sunburn, Sinus , Dental Issues, Migraines and wounds.

Twiddle

www.4twiddles.com · 1.844.TWIDDLE Meeting sensory needs with comfort, warmth & activity. Serving the population of people with Dementia, Autism and other sensory conditions.

SWIMWEAR Aqua Modesta

Original Kosher Swimwear 718.810.2422 • www.aquamodesta.com

URGENT CARE MedRite

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


Community Profile SANDY ELLER

Sparks of Life Providing Crucial Support to Jewish Parkinson’s Patients resident Rabbi Moshe L2009akewood Gruskin was in Detroit on a fundraising trip the first time

someone suggested he might have Parkinson’s disease. The concerns were raised by a doctor friend who was worried by the way the then-58-year-old Rabbi Gruskin was walking, but a neurological examination was inconclusive. Rabbi Gruskin was told start taking medications given to Parkinson’s patients, and if the regimen provided relief it would prove that he had Parkinson’s. Rabbi Gruskin took the neurologist’s advice with a healthy dose of skepticism and chose to avoid medication. But four years later, Rabbi Gruskin’s children intervened and insisted that he pay a visit to Dr. Stanley Fahn, a world-class neurologist and an expert in movement disorders. “He took one look at me and said right away, ‘Yup, you got it, no question,’” recalled Rabbi Gruskin. An incurable, neurodegenerative brain disorder that typically progresses slowly, Parkinson’s affects more than 10 million people worldwide, according to the Parkinson’s Disease Foundation. Those who suffer from Parkinson’s can experience tremors, stiffness, balance issues and slowness of movement as well as mood swings and sleep disorders. More than 60,000 Americans are diagnosed with Parkinson’s annually, and because of its disproportionately high occurrence in Eastern European Jews, the Michael J. Fox Foundation for Parkinson’s Research recently launched a study to investigate the high prevalence of Parkinson’s in that demographic. As luck would have it, Dr. Fahn was the organizer of the World Parkinson Congress, an international conference held every

three years that brings together scientists, physicians, healthcare professionals, caregivers and Parkinson’s patients to discuss cures and best treatment practices for the disease. Rabbi Gruskin noticed a flyer for the upcoming 2013 conference in Montreal while at Dr. Fahn’s office, and the first spark for his future organization was kindled. “I used to fundraise in Montreal, so I decided I could hit two birds with one stone,” said Rabbi Gruskin. “My son and I could go to the congress and the rest of the time I could do fundraising.” The conference provided Rabbi Gruskin with a wealth of information on Parkinson’s. He came home with a plan to incorporate a 50-minute exercise program into his routine, which has been found to be beneficial to Parkinson’s patients. Rabbi Gruskin enlisted his children’s help to make sure that he didn’t slack off when his enthusiasm waned. “The exercise brings up my mood and I have a feeling of accomplishment,” reported Rabbi Gruskin. “When I finish, I am ready to take on the day.” Hoping to make the most of the post-conference momentum, Rabbi Gruskin decided to contact support groups for Jewish Parkinson’s patients and was stunned to discover that none existed. Undaunted, he elected to start his own. “Everyone seems to know a

friend or a relative who has Parkinson’s, and there is no question that it is more prevalent than ever,” said Rabbi Gruskin. “It was crazy that no one was doing anything.” Sparks of Life, a non-profit organization to help Jewish community members with Parkinson’s, officially launched this past March with a watchful eye towards the September 2016 World Parkinson Congress in Portland, Oregon. “The congress only happens every three years and is an opportunity to see that there are things that you can do, that is research being done,” explained Rabbi Gruskin. “You leave there with a new burst of energy, and I really wanted to get something going.” While Rabbi Gruskin’s main objective was making arrangements for Jewish conference participants, he also organized Sparks of Life’s first event in June, an evening of support in Lakewood for Parkinson’s patients. “My board thought it was a pipe dream and expected maybe two, three or even five people,” recalled Rabbi Gruskin. “But 100 people showed up.” Buoyed by the event’s success, Rabbi Gruskin turned his attention to the upcoming September conference. It took five weeks, but Rabbi Gruskin was able to offer daily minyanim and kosher food for conference attendees. “At the 2013 congress there were

three frum people,” reported Rabbi Gruskin. “This time, out of 3,700 people, we had 28 people coming from Portland, Long Island, New York, Lakewood, Chicago, Israel and Australia.” Being able to make the conference accessible to the Jewish community was extremely gratifying to Rabbi Gruskin. “What makes this conference unique is that so many people who have Parkinson’s are there with their caregivers, and they can talk to doctors and researchers who are the best in their field, and ask questions,” noted Rabbi Gruskin. “Everyone gets a better understanding of what Parkinson’s is, because they are getting information straight from the source.” Currently, Rabbi Gruskin is busy planning more events in Lakewood and Brooklyn. Ultimately he hopes to create a gym with therapists, Parkinson’s libraries, a 24-hour hotline, respite programs for caregivers and more. “We want to make a Chai Lifeline for the person who has Parkinson’s and their caregiver,” said Rabbi Gruskin. Rabbi Gruskin has also been in communication with interested parties in Monsey and in Israel and hopes that, as its name suggests, his organization will continue sending out even more life-giving sparks. “I would love down the road to have branches in Los Angeles and Chicago, but Rome wasn’t built in a day,” said Rabbi Gruskin. “I can only hope that the Ribbono shel Olam gives me the kochos and the health to be able to do it.” 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.

November 2016 |

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yaakov kornreich

From the Doctors Desk

The New Approach to Fighting Cancer

I

An Interview with Dr. David Fishman

n his State of the Union address this past January, President Obama asked Vice President Joe Biden to head a task force to coordinate the efforts of the best and brightest in medical science working to end cancer as we know it. The White House Cancer Moonshot Task Force is dedicated to breaking down the barriers which have impeded collaboration between the various teams of researchers responsible for the recent advances in prevention, diagnosis and treatment. The task force also aims to form new alliances to encourage innovation and double the current pace of progress toward a cure. This effort has yielded a new approach to understanding what cancer is and how to best attack it. Traditionally, each form of cancer was categorized primarily according to the organ in which it originated. Research traditionally approached cancers of the lungs, breast, colon and other organs as separate diseases, but thanks to the Moonshot Task Force, that is now changing. Dr. David A. Fishman is director of the American College of Surgeons accredited Cancer Program at NewYork-Presbyterian/Queens and vice chair of obstetrics and gynecology and director of gynecologic oncology at NYP/Queens. At the NYP/Queens Cancer Program each cancer patient and their tumor is viewed as unique, regardless of the cancer’s location in their body. The multi-disciplinary team analyzes the cancer at a molecular and protein level in order to uncover its biological pathways and develop a personalized treatment for each patient. “More effective cures for cancer are coming,” Dr. Fishman said. “Today there are hundreds of ongoing clinical trials of new drugs which have been developed as the result of

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recent discoveries about the biological processes which are common to all forms of cancer, including cell growth and metastasis, as well as the role of specific genetic mutations in unleashing those processes.” According to Dr. Fishman, most cancer-related genes serve as blueprints for the production of proteins which are essential to re-

pairing damaged DNA in the cells, and to the process of cell division. The human body is constantly producing new cells and repairing damaged DNA. When a gene has a mutation, which is not an uncommon occurrence, it fails to produce the right amount or the right kind of protein, and can lead to the creation of a cancerous cell. Usually, the immune system identifies such a cell as a threat and immediately destroys it. That is why a single genetic mutation is usually insufficient to start a life-threatening cancer. It takes multiple risk factors working in conjunction to enable a cancer cell to avoid attack by the immune system and grow into a tumor. About 25% of genetic mutations are passed down from parent to

| November 2016

child. The rest occur spontaneously. Research has associated more than 60 separate genes with cancer, and today we can test for 53 genes related to inherited cancers. The risk factors between these genes and their cancers are so complex, and the pace of genetic research is so rapid, that it takes an expert to keep up with the field. Any cancer patient should ask their doctor for a referral to a board-certified genetic counselor to design their screening process and to evaluate the results, including any hereditary risk to their families. Proper screening can be lifesaving. The identification of BRCA1, BRCA2 and other genetic risk factors, coupled with more effective screening, means that today, 90% of breast cancers are being discovered early enough (stage 1) to be treated effectively, leading to a 90% survival rate. BRCA and other genetic mutations which run in Jewish families are also risk factors for breast, prostate, skin, bladder, pancreatic, ovarian and other cancers. While much less common than breast cancer, ovarian cancer is more deadly. With about 24,000 new cases each year in the US, ovarian cancer causes more deaths than any other cancer of the female reproductive system. Because it has no telltale symptoms, it is often diagnosed too late to be treated effectively. The CA125 blood test, the only one now available, is only 47% effective at detecting early-stage ovarian cancer. If not discovered until it reaches stage 4, the 5-year survival rate for ovar-

ian cancer is poor, approximating only 13%. But genetic screening will not help the approximately 50% of Jewish women who will develop ovarian cancer without any family history of the disease. As a result, Dr. Fishman urges any woman who suffers an undiagnosed abdominal problem for more than 7 days to ask for an ultrasound test to determine if it might be caused by ovarian cancer. Once cancer is diagnosed, Dr. Fishman recommends “a comprehensive, multi-disciplinary team approach to improving patient care using all of the cutting-edge technology and expertise available. The goal, in addition to treating the cancer, is to help the patient and their family to optimize all aspects of their journey with chronic disease by providing, from the outset, palliative care, physical therapy, and psychological, nutritional and spiritual counseling.” Dr. Fishman believes that, thanks to the “Moonshot” initiative, we can look forward to much more rapid progress in cancer detection, treatment and more. “The future of oncology is prevention,” he says. “Today it is possible to identify and optimize care for patients who are at increased risk for developing cancer, and to intervene before the disease occurs.” Dr. David A. Fishman is the director of the American College of Surgeons accredited Cancer Program at NewYorkPresbyterian/Queens (NYP/Queens) and vice chair of obstetrics and gynecology and director of gynecologic oncology at NYP/ Queens, a teaching hospital serving all metro New York residents. Dr. Fishman is also a member of the Weill Cornell Medicine faculty. He recently established the Cancer Center Risk Assessment and Cancer Prevention Program at NYP/ Queens. For more information on the program or to schedule an appointment, call 718.670.1731. Yaakov Kornreich is the Senior Editor of Health & Living, and has been writing for Anglo-Jewish publications for almost 50 years.


Join Us for Our December 2016 Issue

A SPECIAL NEEDS MAGAZINE September 2016

Special Needs Impact on Marriage Page 18

Autism & Technology Page 24

Non-Profit Crisis Page 22

Expan ded Produc t Section

Disability or Special Needs? Page 32

A Supplement of the

Finding a Place for the Child Who Doesn’t Fit

For More Information Contact Moshe Klass at sales@jewishpress.com or 718.330.1100x352 Page 12

September 2016

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