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PAGE 12A HERITAGE FLORIDA JEWISH NEWS, OCTOBER 25, 2013 i German breast cancer detection tool employing blind women Dr. Frank Hoffmann, Discovering Hands The Medical Tactile Examiners (MTEs) use self-adhesive stripes with tactile orientation points to identify abnormalities in the breast. By Alina Dain Sharon JNS.org As of 2005, German gy- necologist Dr. Frank Hoff- mann was no longer allowed to send women under the age of 50 to get mammo- graCns without first finding a breast abnormality during his routine examination. Since some breast lumps can be very small, Hoffmann wasn't certain he could discover something during the few minutes he had to spend with each patient. That's when he decided to launch an innova- tive program, Discovering Hands, hoping to give blind women an opportunity for a life-changing creer by turn- ing their more acute sense of touch into a skilled breast tumor detection tool. With 17 Medical Tactile Examiners (MTEs) already trained and working across Germany, Hoffmann's initia- tive has connected with the Ruderman Family Founda- tion, a organization based in Israel and Boston that priori- tizes the iriclusion of people with disabilities in the Jewish community. This partner- ship may enable Discovering Hands to branch out to Israel and the U.S. "I don't know many ex- amples of a Jewish and Israeli funder foundation investing in Germany. It's not easy with our history," Jay Ruderman, president of the Ruderman Family Foundation, told JNS.org. Ruderman first met Hoff- mann at a philanthropy conference in Switzerland. He then toured Germany with Hoffmann, examining the program in action at hospitals and clinics. With the support of variou Ger- man governmental bodies and Hoffmann's 2010 election as fellow by ASHOKA, an organi- zation that invests with social entrepreneurs, Hoffmann was able to develop an entire curriculum training blind and visually impaired women to become MTEs. The Ruderman foundation granted Discover, ing Hands an initial $72,000 donation in 2013 to help it grow across Germany, and it will offer logistical support to bring the program to Israel, where initial discussions have taken placewith the Hadassah University Hospital-Mt. Sco- pus in Jerusalem. For women under the age of 40, mammograms are not always'very good at detecting tumors because the breast density is pretty high at that. point and a lot of things are hidden," said Dr. Virginia Kaklamani, an oncologist at Chicago's Northwestern Memorial Hospital and associ- ate professor of hematology- oncology at Northwestern University Feinberg School of Medicine, when asked about the potential of Discovering Hands. But studies have shown that "if nurses are taught how to do self breast exams and they do them on themselves," then their exams are much more useful, Kaklamani told JNS. org. Therefore "the idea of having somebody trained to do breast exams, especially if because that individual.., is visually impaired, [he or she] has a better sense of touch, I would think that would work." In the MTE breast exami- nation method, self-adhesive oi'ientation stripes with tactile orientation points are at- tached to the patient's breaSt in various positions, and the breast is divided into zones that allow the examiners to By Annette Powers First person NEW YORK (JTA)--For months leading up to my wedding, I was a bundle of nerves. Sure, I was worried about whether or not my dress would fit and if the swing band would be able to pull off the hora, but that wasn't it. I was petrified that my fiance would die. I pictured him being killed by a bus while crossing the street or being blown up on the train by a dirty bomb. I envisioned him in a hospital bed, slowly succumbing to a gruesome terminal illness, or being struck in the head by a fastbail at Yankee Stadium. Every morning when he kissed me goodbye, a wave of panic would wash over me as I imagined it would be our last kiss. I saw myself at the cemetery and then sitting shiva, my friends and family dropping by with kugels, offering their condolences and support. It was ironic. Here I was plan- ning our wedding, but in my head I was planning his funeral. define the precise square cen- timeterwhere an abnormality is found. Unlike an exam by a doctor, an MTE breast exami- nation takes between 30 to 60 minutes. Discovering Hands con- ducted astudy in conjunction with the University of Essen, looking at 451 patients that were examined by MTEs. Among these patients, there were 32 abnormal findings that were discovered by the MTEs but not by the doctors. "Women with those findings would have been sent home by the doctors," Hoffmann told JNS.org. A new peer review study will begin in November. "The restflts [of the Discov- ering Hands study] are very encouraging," Kaklamani said, cautioning that more studies are needed to test the program's full effectiveness. "This technique can be seen to be complementary to mammograms, replacing the mammograms, or not at all beneficial if a woman has yearly mammograms. S0 all these are things that need to be taken into consideration," she said. Hoffmann believes that that his program has potential beyond breast cancer detec- tion. "A well-trained sense of touch is useful in other diagnostic situations... MTEs one day (could examine) the eye bulb, the prostate, the testicals" or lymph nodes, he said. According to Kaklamani, breast cancer is notably preva- lent in the Ashkenazi Jewish community because individu- als of that ancestey can carry BRCAgene mutations. "In the general population one in 500 individuals are positive and in the Ashkenazi Jewish popula- tion it's one in 40 .... BRCA mutations predispose signifi- cantly for breast cancer. So from that standpoint there's an increased incidence," she said. Given its focus on the inclu- sion of people with disabilities, what sparked the Ruderman Family Foundation's interest in Discovering Hands is less the science behind breast cancer detection and more the program's potential to employ visually impaired women, "I think [Discovering Hands] has a huge medical benefit for the community, but it also has a huge benefit for providing employment and inclusion for blind women," Jay Ruderman said. Currently in Germany, training to become an MTE lasts nine months and takes place through vocational cen- ters for'the blind and visually impaired across Germany. Of the eight such centers in Ger- many, four are now qualified to train MTEs. "Losing your sight means that youretract yourself from public life, lose contact with your friends, lose your job. Many of them are reduced to the four wails of their own home," Hoffmann said. "Tak- ing part in aspects of other lives...connects them them intensively with patients. On the other hand, doing their job, they are real life savers." In addition to learning anatomy and breast exami- nation technique, women through Discovering Hands also-learn communication and Braille technology skills so that "they can do their documentation on their own [and] don't need another help- ing person with them when they are doing their job," Hoff- mann said. After six months of Study and a final examination, the women undertake a three- month internship at a clinic. According to Kim Chad- son, director of the Perkins Braille & Talking Book Library at the Perkins School for the Blind in Watertown, Mass., one challenge blind people discover when searching for employment is "the attitude of people who are sighted about the abilities of people who are blind." She said some-people think, "How could I do this job if I were blind? I couldn't; therefore, the person must not be able todo that job." "The women in this pro- gram are absolutely going to have that extra skillset because they know how to interpret what'they detecting with their fingers, whether it's Braille or if they're looking for a tumor," Charlson, who is blind herself, told JNS.org. "It's a great opportunity to work in that kind of health- care field where blind people can make a significant contri- bution in some way, and have a job, and pay taxes, and do all those things like everybody else does." Charlson, who is also a breast cancer survivor, is acutely aware of the challeng- es surrounding its diagnosis and treatment. "I've gone through treat- ment, and early detection was critical for me," she said. "We should use all the tools that are out there." For the Ruderman Family Foundation, the next step is to try to bring Discovering Hands to Israel by 2014, Jay Ruderman said. If the founda- tion can bring tire program to a hospital and make it a success, the project may get " some public attention and induce demand, and then the Israeli government might re- spond with funding and other assistance, he said. The foundation is also open to helping bring the program to the U.S., where "most centers of Jewish gathering are not inclusive" to people with disabilities, Ruderman said. Of the entire U.S. population, about 17-18 percent have disabilities. In the U.S., the implementation of Discovering Hands could begin in Boston, according to Ruderman. "I do think that this tech- nology could be influential all around the world. You have to think of all the countries in the worldwhere [mammo- grams are] either not available or extremely expensive. This is a very Iow-tech, brilliant idea that could be replicated all over he world," Ruder- man said. How about shiva for the divorced? My anxieties eased a bit the day after the wedding. We had made it through the big eventwithoutamajor tragedy. I really started to relax the next Week as we wandered along isolated stretches of the Portuguese beach and drank sangria in Seville. Over the next few years, we drifted from the honeymoon stage to the new-parent stage, and the fears I once had about my partner were now replaced with typical maternal anxieties about sleep training and teething. The waltz of woiry about my husband slowed until it was merely a quiet background murmur. At some point, I'm not even sure when, I stopped kissing him goodbye as if it were the last time. A few weeks after we cel- ebrated our third wedding anniversary, it happened. The thing I had feared most came true when the man I knew and loved disappeared. It just didn't happen in a why I thouhtwas possible. In one moment my husband was my best friend, my confidante, my emergency contact. Then, like something out of "Invasion of the Body Snatchers," he became a stranger. Sitting there on the cappuc- cino-colored ottoman in our living room, he told me he was having an affair and wanted a divorce. This guy looked like my husband and sounded like my husband, but what he was saying could-not be coming out of my husband's mouth. I had imagined losing him so many times, but never by choice. Though my husband wasn't killed by a bus or a bomb, he was gone. That night he went to her house and never returned to our marital bed. Thankfully, I had a cadre of family and friends who took care of me during this critical time. My morn flew orat to New York and stayed with me for a week. She accompanied me to the lawyer's office to iron out the details of our separation and helped me sort through bills to figure out what my new monthly budget should be. Thesewere tasks that required a presence of mind I did not have at the time. One of my best childhood friends, Missy, who lived in Mexico, was attending a weddirig in Colorado when I emailed her with the .news. Within hours she had rerouted her flight home to stop in New York. "I couldn't let you go through this alone," Missy said. She stayed with me for two weeks, nurturing me with delicious andhealthy cooking, trips to the gym and constant pep talks. Peri and Sara came over every day to help me care for my 16-month-old, entertain- ing him, changing diapers and giving him baths, and plying me with nourishing meals. On a weeklong trip to my parents in Michigan, my friend Amy drove an extra three hours to take my son and me to join her in Chicago for a weekend. Friends living all over the world ga*e me a sympathetic ear at any time of day. At midnight, I could call Jenny in California.At 4 a.m., I could call Hadass in Tel Aviv. When I look back, I realize just how much my friends and family sustained me then and keep me going even now, three years later. Not everyone has that kind of built-in support. For a people who tend to apply ritual to almost every aspect of life, I wonder why we Jews haven't yet prescribed a set of shiva-like rituals for divorce. When a separation happens, the community should spring into action just like they would after a death. Neighbors should drop over with babkas, and there should be tea and sympathy always at the ready. For the newly separated, it's critical to stay busy, healthy and surrounded by supportive friends and family. Due to stress and depression, many newly separated are at risk for developing unhealthy habits and getting sick. Like mine did for me, friends can help keep the new- ly separated person healthy by cooking for them, going on walks together, inviting them to the gym or taking them to a yoga class. They can arrange fun out- ings for Saturday nights, when everyone else seems to be on "date night" and the newly single feel especially lonely. They could extend invita- tions for the holidays, and understand if the invitation is declined because sometimes celebrating with someone else's family is harder than not celebrating at all. Most importantly, friends and family can listen to the painful, angry, sad and often very repetitive monologues of those who going through a separation. As with a death, the griev- ing doesn't end with shiva; it can take years I still have my moments. Recently, as I sat on the subway, I felt the hot sting of tears when I realized it was the 10th anniversary of the day I met my ex. It still hurts to think of those happier times and the loss I feel. But that morning on the train, I heard my father's voice reciting one of his favorite Solomonic prov- erbs: "This, too, shall pass." In that moment, I sensed his loving embrace from afar and felt a little better. Annette Powers is a mar- keting and communications professional. In her free time, she writes about a variety of topics from co-parenting to Yore Kippur to compulsive texting.