Jewish News Health Care May 15, 2017 by United Jewish Federation of Tidewater

Health Care in the Jewish community Supplement to Jewish News May 15, 2017 jewishnewsva.org | May 15, 2017 | Health Care | Jewish News | 15

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16 | Jewish News | Health Care | May 15, 2017 | jewishnewsva.org

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Health Care

PFLAG of Norfolk and South Hampton Roads Claudia Isler

ounded in 1972, PFLAG is the nation’s largest family and ally organization. Locally, it provides support and resources to the LGBTQ community of Hampton Roads and its family, friends, and allies. The group meets monthly to discuss personal, local, and national issues, or to look more deeply into a particular topic. Presentations for African American History month and Women’s History month, as well as a special screening of National Geographic’s film, Gender Revolution have taken place. All meetings are friendly, informal gatherings, with opportunities to share or just listen, meet new friends, or get information. Once a year, the Norfolk

chapter of PFLAG offers a workshop to help students, teachers, and advocates in the creation and maintenance of a GayStraight Alliance (GSA) in their schools. Research shows that the existence of such organizations improves the lives and academic performances of many students in a given school, whether they’re gay, straight, or transgender. PFLAG meets at 6:30 pm at the LGBT Center of Hampton Roads on the third Tuesday of each month. The LGBT Center is at 247 West 25th Street in Norfolk. The phone number is 757-640-0929. A meeting on the second Tuesday of each month is for parents and guardians to be able to ask questions and talk about their concerns, or just meet new people.

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he most revealing account of A Common Struggle is indeed the Rabbi Zoberman uncommon struggle with mental health issues of a member of America’s perhaps most famous family, the Kennedys. Author Patrick J. Kennedy is the erstwhile Congressman from Rhode Island and son of the late Senator Edward “Ted” Kennedy. His very public car crash at the U.S. Capitol in May 2006 made headlines and was followed by rehab at the Mayo Clinic with exclusive coverage

on the pages of the New York Times. Senator Ted Kennedy was reportedly very upset over his son’s decision to go public with his bipolar disorder and addiction. Five months prior to the car crash, Patrick was treated at the Mayo Clinic, but failed to take it seriously, relying instead on hazardous self-medication. Early in his life he suffered from asthma and depression accompanied by heavy drinking and cocaine use. In 1984, Patrick sustained a serious head injury in a car accident near his home in Hyannis Port.

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Health Care The young Kennedy left the House of Representatives in 2010 following 16 years of service, and has been sober since February 22, 2011, which would have been Ted Kennedy’s 79th birthday. Patrick attributes his recovery, the longest since he was 13 years old, and which is after all, one day at a time with the threat of relapse, to meeting and marrying his wife Amy, his first marriage at age 44. Patrick highlights love and faith as essential to the complex healing process. He also focuses on the genetic factor. His mom, Virginia, suffered from serious alcoholism inherited from her own mother and Ted lived through the assassination of his two distinguished brothers, President Jack and Senator Robert, along with the tragic death of Marry Jo Kopechne in Chappaquiddick Island. In 1964, Ted suffered a back injury from a small plane crash. Ted Kennedy experienced all of this trauma without reaching out for proper help, even as he was there for others in need, which Patrick concludes prevented his father from becoming President of the United States. Aunt Rosemary, who was born with developmental disabilities and psychiatric issues, underwent a lobotomy in 1941 at the direction of her father, Joseph P. Kennedy that only worsened her condition. On October 31, 1963, three weeks before his assassination, Rosemary’s brother and Patrick’s uncle, President John F. Kennedy, signed the landmark Bill for the Construction of Mental Retardation Facilities and Community Mental Health Centers, now known as the Community Mental Health Act. So close to his own family’s pain and concerns, President Kennedy’s inspiring message remains most relevant, “It was said, in an earlier age, that the mind of a man is a far country which can neither be approached nor explored. But, today, under present conditions of scientific achievement, will be possible for a nation

as rich in human and material resources as ours to make the remote reaches of the mind accessible. The mentally ill and the mentally retarded need no longer be alien to our affections or beyond the help of our communities.” Patrick is rightfully proud of the Mental Health Parity and Addiction Equity Act that he and his father were instrumental in passing in 2008, describing it as “the equivalent of a medical civil rights act.” He contends that together with the Obama Patient Protection and Affordable Care Act, a most vulnerable population has more opportunities to receive mental care, though legal, governmental, and psychological hurdles persist. Not the least challenge is convincing all Americans that we face a “common struggle,” with 25% suffering from mental illness and addiction, involving one-third of hospital stays, and more than 50% of those diagnosed do not receive treatment. The book’s Appendix 1 (“What You Can Do”) and Appendix 11 (“Your Own Brain Health Scoreboard”) are both practical and enlightening. Patrick is the founder of the Kennedy Forum offering national leadership and initiations on mental health, and is co-founder of One Mind with its supportive international dimension. The book’s co-author, award-winning Stephen Fried, has written two books on related themes. Patrick Kennedy has courageously chosen to turn private pain into public promise, becoming the leading crusader in a complex field with much destructive stigma still attached to it. “My hope is that by writing about and exposing the worlds I get to visit—as a politician, advocate, patient, and family member—I might be able to make your journey less isolated.” —Rabbi Dr. Israel Zoberman is the founding rabbi of Congregation Beth Chaverim, and the only rabbi to receive a doctorate in Pastoral Care and Counseling from the Presbyterian affiliated McCormick Theological Seminary in Chicago.

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jewishnewsva.org | May 15, 2017 | Health Care | Jewish News | 19

Health Care

Dan Grimsley cites JFit as a major player in changing his life transformation and his ability to lose more than 300 lbs. “My wife had heard good things about very day, Dan Grimsley, a 52-year-old, JFit and we decided to tour it. My wife 195-pound, 6-foot-2-inch-tall man, and I are both very religious. The minute can be found using the strength training we walked through those equipment at JFit at the doors, I knew I was Simon Family JCC. At the where I was supposed to same time, his wife, Leigh, be,” says Grimsley. “I felt participates in the JCC’s it and my wife felt it and array of fitness classes. after talking to everyone, It’s hard to believe how many pounds we knew that we would that just over two years lost by be members for life! ago, Grimsley weighed Dan Grimsley “I began to go to the 502 lbs., subsisted on 12 JCC daily. Now, my life different heart medicahas drastically changed. tions, and was told by his It was hard work on my cardiologist not to expect part, but without the to live another year. center, it would have At 50, coping with been so much more difficult. I have never congestive heart failure, he was in and met a more supportive group of people. I out of the hospital on a monthly basis, was a big boy, it is easy to be intimidated on oxygen almost 24 hours a day, and to go to a gym, but I have never ever felt struggled to walk around his own home. that way at JFit. I’ve developed relationGrimsley found himself on the sidelines ships with the other members and care of his former life and was forced to retire about them. It is like a supportive family on disability. and you will not get that at any other gym. “I think we all have a time when we JFit was a major player in my success.” realize, this is when I need to make a Grimsley wants to share his experichange,” says Grimsley. “They say you ences to assist others. His journey helped always hit bottom first…that day with my him learn how to avoid the pit falls of doctor was my bottom. I was furious with emotional eating and to establish healthy him, but he just spoke the truth. He told life habits. He says, “I have learned to me ‘You have a 10-year-old son and you look at the bigger picture. I know the are not going to see him be 11 years old!’ donut looks good, but it will not help me I am not a very emotional individual, but in the larger picture of my life. I still can I started crying that day. I called my wife eat pizza, but I don’t have to eat the whole and I said I have to change, for you, for my pizza.” son, and for my own quality of life.” Today, Grimsley is studying to be a The next day, with a medical team, certified personal trainer. He believes it is and nutritionist on call, Grimsley started his life calling. “My heart is pulling me to working out at home. He says he began work with other people,” he says. with baby steps, “I started off just using “Sometimes, I could kick myself for a hand bike, because I could barely walk. not making all my health changes sooner, You put it on a table and move it with but now I can set an example. I see people your arms—little by little—I started to and know they are struggling. All it takes increase my activity. Five minutes on a is a little encouragement to get over the treadmill at a time and I was done! But hump. At one point, I was on 12 cardiac steadily, I continued to drive myself and drugs, now I am on only one. I went back noticed that I was feeling a bit better every to the cardiologist and they were amazed, other day.” my heart has improved to almost normal. Grimsley credits the support system The JCC was a godsend.” at JFit as a major key to his health Sherri Wisoff

300

20 | Jewish News | Health Care | May 15, 2017 | jewishnewsva.org

Health Care

Jewish groups weigh in on health care bill J

ewish groups criticized the passage of a health care bill by the House of Representatives to repeal and replace major parts of the Affordable Care Act. The bill, backed by Republicans and President Donald Trump, passed Thursday, May 4 in a 217–213 vote almost entirely along party lines. The measure, which is now headed for the Senate, would nix tax penalties for those without health insurance and decrease state programs to insure low-income Americans expanded by President Barack Obama. Among those that criticized the passage were the Reform movement, the Jewish Federations of North America, B’nai B’rith International, the National Jewish Democratic Council and Jewish Women International. However, the Republican Jewish Coalition praised the bill as “an important legislative victory for President Trump and Speaker Paul Ryan.” The Reform movement said it was “deeply disheartened” by the bill’s passage. “This reverses the tremendous progress that has been made in recent years to increase the number of Americans with health insurance,” Rabbi Jonah Presner, director of the movement’s policy arm, the Religious Action Center, said in a statement. “We urgently call on the Senate to reject this profoundly harmful legislation.” Jewish Federations said it was “distressed” by the approval. “We are distressed by the House passage of this legislation that would literally gut Medicaid, which provides an essential safety net for millions of Americans,” William Daroff, director of the umbrella group’s Washington office and its senior vice president for public policy, said in a statement. “Jewish Federations’ network of health and social service agencies depends on Medicaid to care for the vulnerable who rely upon it.” B’nai B’rith said the act would harm senior citizens. “We strongly urge the Senate to reject

the House plan, which would have a negative consequence for many communities, including low-income seniors,” the group said in a statement. The National Jewish Democratic Council called the bill a “catastrophe.” “We are not surprised, but still extremely disappointed, that President Trump and the Republican leadership decided to go for a short-term win instead of thinking about the millions of lives that they have negatively affected by jamming this bill down our collective throats,” the NJDC said in a statement. “Mark our words—We will ensure that history will not look kindly on the congressmen who voted in favor of the catastrophe known as Trumpcare.” The Republican Jewish Coalition in its praise said Trump and Ryan, R-Wis., “worked tirelessly for this victory.” “As the legislation moves to the Senate, we hope for swift passage so President Trump can sign it and fulfill his commitment to the American people for affordable health care,” RJC’s executive director, Matthew Brooks, said in a statement. Jewish Women International said the the bill “will harm women, families, the elderly and the poor” and called it “a careless, undisciplined effort by the president to make everyone think he is fulfilling a campaign pledge and it will wreak havoc on our nation, including the very people who supported him.” Sen. Charles Schumer, D-N.Y., called on Senate Republicans to reject the bill. “This bill is going nowhere fast in the United States Senate,” Schumer, the Jewish Senate minority leader, said in a statement. “Rather than trying to pass a different version of the same Trumpcare bill that would mean higher costs and less care, Senate Republicans should refuse to follow their House colleagues over a cliff, reject repeal, and work with Democrats to improve our health care system in a bipartisan way.” (JTA)

jewishnewsva.org | May 15, 2017 | Health Care | Jewish News | 21

Health Care

Hadassah’s Coalition for Women’s Health Equity convenes Women’s Health Empowerment Summit for National Women’s Health Week Wednesday, May 17, 10 am–2 pm The Newseum, Washington DC

he inaugural Women’s Health Empowerment Summit, hosted by the Coalition for Women’s Health Equity, takes

place during National Women’s Health Week (May 14–20) of which Hadassah, the Women’s Zionist Organization of

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22 | Jewish News | Health Care | May 15, 2017 | jewishnewsva.org

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America, Inc., is a national supporter. The half-day event will bring together women’s health policymakers, advocates and thought leaders to identify legislative opportunities and align mobilization efforts to advance women’s health equity. Rear Admiral Susan J. Blumenthal, MD, who served as the country’s first Deputy Assistant Secretary for Women’s Health and U.S. Assistant Surgeon General, will serve as keynote speaker. Blumenthal’s pioneering work helped expose inequities in women’s health. She developed a broad range of initiatives and public/private sector partnerships to address critical women’s health issues and the study of sex differences across the life cycle. The Women’s Health Empowerment Summit’s bipartisan Honorary Host Committee includes: Sen. Susan Collins (ME); Sen. Dianne Feinstein (CA); Sen. Kirsten Gillibrand (NY); Sen. Patty Murray (WA); Sen. Elizabeth Warren (MA); Rep. Joyce Beatty (OH-03); Rep. Brenda Lawrence (MI-14); Rep. Michelle Lujan Grisham (NM-01); Rep. Carolyn Maloney (NY-12); Rep. Linda Sanchez (CA-38); Rep. Jan Schakowsky (IL-09); Rep. Debbie Wasserman Schultz (FL-23); Rep. Maxine Waters (CA-43). The 2017 Women’s Health Empowerment Summit will feature policy briefings on women’s health issues, testimonials from patients and medical professionals and opportunities to network and align mobilization efforts. With a rapidly changing legislative landscape, the 2017 Summit will focus on action strategies to further women’s health equity—from prevention and diagnosis, to treatment and cure. The Summit will also highlight how key advances in women’s health equity have been achieved and identify the next frontiers—including the emerging scientific, economic, and advocacy solutions to improve women’s health. Blumenthal says, “In the past, lack of attention to the health of 51% of the U.S. population—women—has resulted

in striking gaps in scientific studies and inequities in their health care. While significant progress had been made over the past two decades, women’s health issues are being threatened in the current political environment and much more work needs to be done. A new national prescription is needed that increases investments in women’s health, ensures that sex differences in research are evaluated and reported, expands access to quality health care, educates the public and providers about gender differences, and makes the prevention of disease a top priority. The results should be a healthier future for women—and men—in America.” Ellen Hershkin, national president of Hadassah, who will open the 2017 Summit, says, “Women’s health impacts all aspects of our lives and society— from the classroom and workplace, to our communities, family life, and more. Eliminating disparities and discrimination in women’s health is the top priority for the Coalition for Women’s Health Equity. The inaugural Women’s Health Empowerment Summit will mobilize the resources of Hadassah, our Coalition partners and other key stakeholders in the fight for positive policy change.” The 23-member Coalition for Women’s Health Equity, which has nearly doubled in size since its 2016 launch, was convened by Hadassah to address inequities in quality of care, funding, support, and gaps in women’s health awareness. The Summit helps further the Coalition’s mission to publicly promote policies in support of gender equity in medical prevention, research, access, and treatment, and will raise awareness about how that lack of equity adversely affects women and families throughout the United States. The Newseum is located at 555 Pennsylvania Avenue NW, Washington DC. For more information, visit: www.hadassah.org/ womenshealthequity

Health Care

Mother’s family history could pose risk for preterm birth, according to Ben-Gurion University of the Negev study mothers and daughters over 22 years BEER-SHEVA, Israel—If a pregnant (1991 to 2013), and found that the risk of mother has a family history of premature preterm delivery was significantly higher birth, she is at risk for a preterm birth among the 34 percent of women whose of her baby, according to a new study by mothers had given birth early for any of researchers from Ben-Gurion University her pregnancies. The risk remained sigof the Negev (BGU) and Soroka University nificant even after adjusting for the race Medical Center. and age of the woman giving birth. Preterm birth occurs when a baby is Additionally, the researchers also born before 37 weeks of pregnancy and is found that even if a mother’s aunt or sister the leading cause of infant hospitalization, had premature births, her risk of deliveraccording the Center for Disease Control ing prematurely was and Prevention. In also 30 percent higher 2015, preterm birth than normal. affected one of every “Women who are 10 infants born in the at risk can benefit United States. from close monitoring The study, pubinfants born in the U.S. and early detection of lished in the American are preterm genetic markers,” says Journal of Perinatology, Prof. Eyal Sheiner, followed 2,300

1 of 10

M.D., Ph.D., vice dean of the BGU Faculty of Health Sciences (FOHS), member of the Department of Obstetrics and Gynecology, and a physician at Soroka, and one of the researchers.

Exposure to events, situations and/ or substances in one generation can affect the growth and development of the next generation, according to the researchers.

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jewishnewsva.org | May 15, 2017 | Health Care | Jewish News | 23

Health Care

The three cancers Jews need to worry about most— and how to reduce the risks Niv Elis

NEW YORK—As if Jews don’t have enough to worry about. Geopolitical threats to the Jewish people may wax and wane, but there’s another lethal danger particular to the Jewish people that shows no signs of disappearing anytime soon: cancer. Specifically, Jews are at elevated risk for three types of the disease: melanoma, breast cancer and ovarian cancer. The perils are particularly acute for Jewish women. The higher prevalence of these illnesses isn’t spread evenly among all Jews. The genetic mutations that result in higher incidence of cancer are concentrated among Ashkenazim—Jews of European descent. “Ashkenazim are a more homogenous population from a genetic point of view, whereas the Sephardim are much more diverse,” says Dr. Ephrat Levy-Lahad, director of the Medical Genetics Institute at Shaare Zedek Medical Center in Jerusalem. But there is some hope. Susceptible populations can take certain precautions to reduce their risks. Recent medical advances have made early detection easier, significantly lowering the fatality rates from some cancers. Cheaper genetic testing is making it much easier for researchers to discover the risk factors associated with certain cancers. And scientists are working on new approaches to fight these pernicious diseases—especially in Israel, where Ashkenazi Jews make up a larger proportion of the population than in any other country. Understanding risk factors and learning about preventative measures are key to improving cancer survival rates. Here’s what you need to know.

Melanoma Melanoma is the deadliest type of skin cancer, representing some 80 percent of skin cancer deaths, and U.S. melanoma

rates are on the rise. It’s also one of the most common forms of cancer in younger people, especially among women. Just a decade ago, Israel had the second-highest rate of skin cancer in the world, behind Australia. One reason is that Israel has a lot of sun. Some credit better education about the dangers of sun exposure for helping reduce Israel’s per capita skin cancer rate, now 18th in the world. But the sun isn’t the whole story. Jews in Israel have a higher incidence of melanoma than the country's Arab, non-Jewish citizens. What makes Jews more likely to get skin cancer than others? It’s a combination of genetics and behavior, according to Dr. Harriet Kluger, a cancer researcher at Yale University. On the genetics side, Ashkenazi Jews—who comprise about half of Israel’s Jewish population—are significantly more likely to have the BRCA-2 genetic mutation that some studies have linked to higher rates of melanoma. The other factor, Israel’s abundant sunshine, exacerbates the problems for sun-sensitive Jews of European origin. That’s why Arabs and Israeli Orthodox Jews, whose more conservative dress leaves less skin exposed than does typical secular attire, have a lower incidence of the cancer. “There are epidemiological studies from Israel showing that secular Jews have more melanoma than Orthodox Jews,” Kluger says. So what’s to be done? “Other than staying out of the sun, people should get their skin screened once a year,” Kluger says. “In Australia, getting your skin screened is part of the culture, like getting your teeth cleaned in America.” You can spot worrisome moles on your own using an alphabetic mnemonic device for letters A-F: See a doctor if you spot moles that exhibit Asymmetry, Border irregularities, dark or multiple Colors,

24 | Jewish News | Health Care | May 15, 2017 | jewishnewsva.org

have a large Diameter, are Evolving (e.g. changing), or are just plain Funny looking. Light-skinned people and redheads should be most vigilant, as well as those who live in sunny locales like California, Florida or the Rocky Mountain states. If you insist on being in the sun, sunscreen can help mitigate the risk, but only up to a point. “It decreases the chances of getting melanoma, but it doesn’t eliminate the chances,” Kluger warns. As with other cancers, early detection can dramatically increase survival rates. In the meantime, scientists in Israel—a world leader in melanoma research—hold high hopes for immunotherapy, which corrals the body’s immune mechanisms to attack or disable cancer. At Bar-Ilan University, Dr. Cyrille Cohen is using a research grant from the Israel Cancer Research Fund to implant human melanoma cells in mice to study whether human white blood cells can be genetically modified to act as a “switch” that turns on the human immune system’s cancer-fighting properties.

Breast cancer Breast cancer is already more common in developed, Western countries than elsewhere—likely because women who delay childbirth until later in life and have

fewer children do not enjoy as much of the positive, cancer risk-reducing effects of the hormonal changes associated with childbirth. Ashkenazi Jews in particular have a significantly higher risk for breast cancer: They are about three times as likely as non-Ashkenazim to carry mutations in the BRCA-1 and BRCA-2 genes that lead to a very high chance of developing cancer. One of the BRCA-1 mutations is associated with a 65 percent chance of developing breast cancer. Based on family history, including on the father’s side, the chances could be even higher. “Every Ashkenazi Jewish woman should be tested for these mutations,” says Levy-Lahad, who has done significant research work on the genetics of both breast and ovarian cancer. Iraqi Jews also have increased prevalence of one of the BRCA mutations, she says. Levy-Lahad is collaborating on a long-term project with the University of Washington’s Dr. Mary-Claire King—the breast cancer research pioneer who discovered the BCRA-1 gene mutation that causes cancer—on a genome sequencing study of Israeli women with inherited breast and ovarian cancer genes. The two women are using a grant from the Israel Cancer Research Fund to apply genomic technology to study BRCA-1 and BRCA-2 mutations and their implications for breast cancer risk in non-Ashkenazi women in Israel, who are similar to populations in Europe and the United States. In a project that is testing thousands of women for deadly cancer mutations, they are also studying how mutations in genes other than BRCA-1 and BRCA-2 impact inherited breast cancer in non-Ashkenazi Jews. The earlier breast cancer mutations are discovered, the sooner women can decide on a course of action. Some choose to have bilateral mastectomies, which reduce the chances of breast cancer by 90-95 percent. Actress Angelina Jolie famously put a Hollywood spotlight on the issue

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when she wrote a 2013 op-ed in the New York Times about her decision to have the procedure. But mastectomies are not the only option. Some women instead choose a very rigorous screening regimen, including more frequent mammograms and breast MRIs. Early detection is the cornerstone of improving breast cancer survival rates. “Breast cancer is not nearly as deadly as it once was," Levy-Lahad says.

Ovarian cancer Of the three “Jewish” cancers, ovarian cancer is the deadliest. Linked to the two BRCA mutations common among Jews, ovarian cancer is both stubbornly difficult to detect early and has a very high late-stage mortality rate. Women should be screened for the mutations by age 30, so they know their risks. In its early stages, ovarian cancer usually has no obvious symptoms, or appears as bloating, abdominal pain or frequent urination that can be explained away by less serious causes. By the time it’s discovered, ovarian cancer is usually much more advanced than most other cancers and may have spread to surrounding organs. If that has occurred, the five-year survival rate drops considerably. Women with the BRCA mutations have about a 50 percent chance of getting ovarian cancer. The best option is usually to remove the ovaries. “We put a lot of pressure on women to have their ovaries removed because it’s a life-saving procedure,” Levy-Lahad says. That doesn’t mean these women can’t have children. The recommendation is that women wait to have the procedure until after they complete child-bearing, usually around the age of 35-40. Much work still needs to be done on prevention, early detection and treatment of ovarian cancer, but new research shows some promise. “The exciting thing is that we live in a genomic age, and we have unprecedented abilities to understand the causes of cancer,” Levy-Lahad says. “There’s a whole field that, if you become affected, can look at the genetic makeup of the

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therapy is part of the standard of care for many cancer types, is FDA-approved and covered by jewishnewsva.org | May 15, 2017 | Health Care | Jewish News | 25 Medicare, Medicaid and most insurance providers.

26 | Jewish News | Health Care | May 15, 2017 | jewishnewsva.org