Health

I’m a tinker, a tailor, a soldier, a sailor, a rich man, a poor man, a beggar and a thief!

GAW – I don’t understand your point or is it you don’t understand the R’ Akiva Eiger. He says in order for it not to be Chashad the women have to live in a town with All women or All sterile males.

As far as I know, such a town doesn’t exist in the world in our day and age. If the story of Amazon women is fact not fiction, they would be able to live in an area like that!

hello 99 -“Stating that the Halacha follows the vast majority of the Poskim is not “deceitful”. It is not Geneivas Da’as to omit mentioning a da’as yachid among the Poskim.”

So is that what you posted -“the Halacha follows the vast majority of the Poskim” or is this what you posted -“Certainly is only permitted when risk to mother’s life, and even then not always.”?

Being that there are all types of people here -from just the original post -they will think that the Halacha is exactly from the Gemorrah and they will have no clue that there can be any dissention acc. to Halacha. For example – If s/o says you can’t eat pig no matter what unless it’s a matter of life and death. Period. Now let’s say there was s/o who held in certain times pig would be Mutter, but you made a blanket statement it is never Mutter. This is being deceitful and that is exactly what you did!

This is a public forum. You would be right if s/o came to you and asked you a Shaila privately -you wouldn’t be required to say this is my Psak or the Psak of so and so. They are asking You what you hold. Over here no one asked you -your opinion.

Recently I quoted a Halacha in a different post, but I made sure to include the dissenting Daas Yochid! Why? Because I didn’t want anyone going out with the opinion that there is no one who disagrees!

I posted a reason why they learn so slow under the Food Stamps topic!

GAW – I was waiting for you to ask that question. Why don’t you ask all those guys sitting in those “Elite” Yeshivos for the last twenty years in Kollel -perhaps they can help you? I only got 3 months of Kollel behind me. Maybe you can find a clue to where it is in the topic I started called “Who wants to be a Tzaddeikes like Rus?”!

hello 99 -“Certainly is only permitted when risk to mother’s life, and even then not always.”

You certainly aren’t a Poisek because Poiskem Matter abortions in cases where it isn’t life threating – eg.- genetic problems with the fetus! Stop Paskening from Gemorrohs!

Adorable -“what if she is the type that knows she hates rain”

Ok, most people don’t like rain. An adult keeps to their duties even when it’s uncomfortable. Why is this a duty? Because you scheduled a time to be somewhere with s/o. His time is also important.

Do you know anybody who doesn’t go into work (if not given off) because of inclement weather? Do you know anybody who says I’m not going to the hospital today because it’s rainning or snowing and having my kid in the house?

If a person is dating to get married, not just to have a good time, then dating is on the level of the things I just mentioned -that noone in their right mind would take off because of a little rain!

OOmis -“I invariably got an itch on my nose.”

I would scratch that itch -even if they would have to do that part over. If the doc offers you a choice between MRI or CT -if the CT is going to be a long test -take the MRI because you aren’t exposed to any radiation.

Seahorse -“I’m confused, do women have an obligation to get married?” YES, they do!

“I thought we don’t because only men have to have kids.”

While they aren’t included in the Mitzva of “Pru OOrevu”, the S’A states another reason why they have to get married!

Ames -(I think this is my first post to you, even though I’ve been here a few years.) The Gemorrah says when rain is pure Berochoh it rains on Fri. nite when noone is out.

gavra_at_work -“You have no Mitzva to get married, so no need to push.”

From the topic in the CR titled:

“Who wants to be a Tzadaikes like Rus?” –

“also, a woman, from my understanding, does NOT have a chiyuv to get married.”

“This is totally not true, even though I brought above one Shitta who holds this way.”

(That Shitta is a Das Yochid, so you can’t Pasken like him.)

ARWSF – “I was once an aspiring Midwife. But fortunately I woke up.”

“There are 2 types of midwives, certified nurse midwives and professional midwives (Shifra/Puah); their training is different.”

Your getting the two mixed up. CNM’s are medical professionals -a lot work in hospitals. They don’t necessarily push the natural birth agenda!

Did you watch the Market today? The Fed Reserve with their interest tricks couldn’t keep it afloat more than a day.

twisted – “And she knows I mean that absolutely sincerely.”

There must be some sort of twist!

taking a break -“but she heard that hospitals wont let midwifes in and malpractice is too high to make any money.”

“There are 2 types of midwives, certified nurse midwives and professional midwives (Shifra/Puah); their training is different.”

The second type is usually excluded from hospitals, except as a doula. You won’t have to pay malpractice if you work for a hospital. Coney Island Hosp. has a lot of CNM’s working in OB/Gyn.

ARWSF – “but I am too old, and too heimishe, and have too many kids and lots of brachas which I can’t trade”

Too old you’re not. No such thing as too Heimishe, in the NYC area.

The kids would be a problem, if there isn’t anybody to watch them. Maybe your husband and parents and in-laws can help out, if you can’t afford babysitting?

Also becoming an OB ain’t what you think it is, there is a lot of surgery involved. You could become a Certified Midwife. They basically don’t do any surgery, they just do check ups and regular deliveries. Also, the schooling is much less than a Doc.

Is there a problem with your method?

Shlishi/Ben levi/ Joseph -whomever you are -“As far as Rav Elyashev’s teshuvas, he has several on the issue on abuse and molestation, and his other teshuvos too demand that a rov be asked before any action is taken.”

If you have such a Teshuva, copy and post it here. It has to be on molestation, not just abuse. If you don’t have one, then Aries is 100% correct and you are the one who is being Mevazeh Gedolim by twisting their words.

What do you think NA means?

Have you noticed that most of his lib defenders aren’t saying anything much this time, esp. here on YWN? Because the market is crashing and this would never have happened under a Republican Pres.

ItcheSrulik – The only ones I eat in have a Hechsher. This includes Teaneck, Highland Park and Balto. And no it’s not R. Mehlman.

Edited for “You saying what” – These all have different Hashkochos. No reason to name the Rabbi in Balto.

Shlishi – So why should anyone follow what the Agudah says? It sounds to me that nothing has really changed because they just found a way to circumvent the Psak. Because guess what some of these Rabbonim will tell you -whatever they have been telling you all along. And I don’t have to elaborate.

“Rather, he should present the facts of the case to a rabbi who is expert in halacha and who also has experience in the area of abuse and molestation”

If such a Rov exists, please name him! I do know that they made a Bais Din in Lakewood to deal with these molesters. But what happened? They started investigating a “chasuva, well connected” guy and they caved in to the pressure of “others” and closed down. The people who continue to protect molesters, esp. the do-gooders are not going to have an easy time Achar Meah Vesrim!

To all: This seems like Deja Vu from 9 months ago. Shlishi are you Joseph? Because we had this out before with him. If there is Reglyim L’dovor you go to the police. Anybody who says Bshem R’ Elyashiv differently is being Megaleh Ponim BTorah Shelo K’halacha! And I don’t know what the Agudah says, but this is the P’sak from the Godol Hador:

Courtesy of Aries from CR -“Molesters Why do some in our community etc…”

“To my dear friend…HaGaon Rav Shraga Feivel Cohen…?..

But according to what was said [above], in a case that entails tikkun hao/am, governmental authorization is not necessary. However, all of this, to permit notifying the government, is only where it is clear that he participated in the crime. It is in this case that there is an issue of tikkun haolam. But where there is not even circumstantial evidence (rag/ayim /adavar), but only some impression [that he is guilty], then not only is there no issue of tikkun hao/am, but [to the contrary] there is heres haolam (ruination of the world) here. And it is possible that because of a certain bitterness that a student feels toward the teacher and makes a false accusation against him or because of [someone’s] delusion, a person [i.e. the accused] will be put into a situation in which his death will be preferable to his life. And it will be through no fault of his own, and [in that case],4 I see no permit in the matter.

And with this I remain your friend seeking the welfare of your distinguished person of Torah,

Yasef Shalom Elyashlv.”

ZK – “Did you hear if it’s contagious to family members / siblings / chavrusos?”

If you would have read my Megilla (megillas health), you’d know the answer.

From above:

“The virus is not spread from person to person or from infected birds to humans without a mosquito bite.”

Here is info from emedicinehealth:

“West Nile Virus Overview

West Nile virus is transmitted to humans by a mosquito bite. The virus can cause encephalitis (inflammation of the brain) or meningitis (inflammation of the lining of the brain and spinal cord).

West Nile virus was discovered in 1937 in the West Nile district of Uganda. New interest was created when West Nile emerged in the United States for the first time in the New York City area in August 1999. There were 62 confirmed human cases and 7 deaths during this outbreak, creating widespread concern.

* Since the initial 1999 New York City outbreak, the cases of West Nile encephalitis have been relatively limited. In 2002, there were a total of 480 reported cases in humans and 24 deaths (as of August 28, 2002).

* The distribution of the virus is spreading across the United States, as determined from surveillance of infected birds by the Centers for Disease Control and Prevention. In a little more than a year, West Nile spread to 11 states along the East Coast. In 2002, the virus spread to Florida, Arkansas, Louisiana, and Texas. Cases are also being seen in the Dakotas, Colorado, Nebraska, and Wyoming.

* Whether West Nile encephalitis will present a serious health risk to the United States in the future is unknown. Using precautions directed at limiting contact by mosquitoes is the best preventive measure at this time.

West Nile Virus Causes

West Nile virus is transmitted to humans by the bite of an infected mosquito. Mosquitoes become infected by biting birds that harbor the virus. The virus is not spread from person to person or from infected birds to humans without a mosquito bite. The virus has now been found in 111 bird species and about a dozen mammals.

* How West Nile virus entered New York is not entirely clear. The most likely explanation is that the virus was introduced by an imported infected bird or by an infected human returning from a country where West Nile virus is common. Before the 1999 New York outbreak, West Nile encephalitis had been identified only in Africa, Asia, the Middle East, and only rarely in Europe.

* Most cases of West Nile occur during the warm weather months. Nonetheless, the mild climate in southern states is expected to sustain the mosquitoes beyond those months.

West Nile Virus Symptoms

Signs and symptoms of the West Nile virus infection range from no symptoms at all to a rapidly fatal brain infection. In areas where the virus is common, people are more likely to show no symptoms of the infection or have only a mild, flulike illness rather than a severe brain infection. Even in an area of outbreak, the likelihood of a person developing illness after infection with West Nile virus is about 1 in every 140-300 people.

* West Nile virus infection typically begins with the abrupt onset of fever, chills, muscle aches, headache, and overall feeling of illness. Headache is particularly common and may be severe. The person may have sensitivity to light with pain behind the eyes.

* Most people fully recover. In others, particularly the elderly, the disease can progress to cause encephalitis or meningitis.

* In the 59 people hospitalized during the initial New York outbreak, signs and symptoms included fever (90%), muscle weakness (54%), headache (46%), altered mental status (44%), rash (22%), stiff neck (19%), joint aches (17%), sensitivity to light (15%), and body aches (14%).

When to Seek Medical Care

West Nile virus is transmitted only by mosquitoes during summer months and generally only appears between the months of May to October.

* People who experience signs or symptoms of serious illness, and have been bitten by a mosquito in the geographic area where West Nile virus is known to appear, should see their doctor immediately.

* Most people with mild symptoms of low-grade fever and muscle aches do not have West Nile virus and will not require specific diagnostic testing.

Anyone who has symptoms of severe illness such as mental status changes, high fever, neck stiffness, sensitivity to light, or confusion should go to the hospital’s emergency department immediately. The West Nile encephalitis that occurred during the initial New York outbreak was especially notable for its severe muscle weakness. This is another important warning symptom.

Exams and Tests

Diagnosing West Nile virus infections is generally done through a combination of observing signs and symptoms along with specialized molecular biologic testing for the virus itself.

* Only people with severe symptoms will require further testing. There is no cure for West Nile and therefore little to gain by widespread testing of people with mild symptoms. In addition, there is only limited laboratory capacity for testing at this time.

* Confirmatory diagnosis of West Nile virus infection is generally done by a DNA test called polymerase chain reaction (PCR) or viral culture of fluid around the spinal cord. A doctor sends both blood samples and spinal fluid samples, obtained by lumbar puncture (also called a spinal tap), to a specialized outside laboratory for these tests.

West Nile Virus Treatment

Self-Care at Home

Home care for people who suspect they may have become infected with West Nile virus is fairly limited. There is no specific treatment.

Mild illness does not require therapy other than medications to reduce fever and pain. Avoid aspirin because it presents a risk for a fatal condition known as Reye syndrome, especially in children.

Medical Treatment

There is no known effective antiviral treatment or vaccine to prevent West Nile virus.

* Milder illnesses do not require treatment.

* In severe cases of West Nile virus, intensive supportive therapy is indicated. This includes hospitalization, IV fluids and nutrition, airway management (some people may need a tube to keep the airway open), ventilatory support (some people may need a machine to help them breathe), prevention of secondary infections, as well as good nursing care.

Next Steps

Follow-up

Anyone who has developed West Nile encephalitis should follow up with a doctor regularly to assure that recovery is taking place in an appropriate manner. The most severely affected people may take as long as 6 months to a year to recover. Some may have permanent nervous system problems.

Prevention

The only way to reduce your risk of contracting West Nile virus is by avoiding contact with mosquitoes during the months of April to October. Mosquitoes are active in the early morning, from dawn until 10 am, and in the later afternoon and early evening. Limit your outdoor activities or protect yourself during those times. Take these precautions:

* If outside during dawn and evening hours, when mosquitoes are most active, wear protective clothing such as long-sleeved shirts, long pants, and socks.

* Consider using an insect repellent containing 10-30% DEET solution. Children should not use a DEET repellent stronger than 10% strength. Other precautions when using DEET include avoiding use on infants or pregnant women, avoiding prolonged or excessive use, storing DEET out of the reach of children, and preventing children from applying it themselves. The manufacturer recommends applying DEET first to your own hands and then spreading it lightly on your children.

* You can spray your clothing with repellents containing permethrin or DEET because mosquitoes may bite through thin clothing. Do not apply repellents containing permethrin directly to exposed skin. If you spray your clothing, there is no need to spray repellent containing DEET on the skin under your clothing. For more details on pesticides and their application, check the National Pesticide Information Center.

* Citronella, which is frequently used in outdoor candles, is a good deterrent against mosquitoes; however, it does not provide long-term protection.

* Limiting mosquito habitats and breeding grounds may also help limit human exposure. Mosquitoes lay their eggs in standing water, so dispose of all tin cans, plastic containers, rubber tires, or any other possible water-holding containers from your property. Drain water from pool covers. Make sure roof gutters drain properly. Clean your gutters regularly.

* Make sure your doors and windows have tightly fitted screens without holes.

* Birds who have died from West Nile virus pose no health risk. The disease is only transmitted by a mosquito bite. Mosquitoes become infected by biting birds that harbor the virus. Report dead birds (especially crows and blue jays) to local health officials so they can be tested and the virus tracked. Use gloves if you touch dead birds.

* Development of a vaccine: Since the virus first appeared in New York, researchers began looking for a vaccine. According to the Proceedings of the National Academy of Sciences, US government scientists have now developed a vaccine that protects mice from the West Nile virus infection. Researchers were expected to begin testing the vaccine in monkeys in March 2002, with testing in humans likely to take place in late 2002.

o The vaccine consists of a combination of genes from a virus called dengue and the West Nile Virus. Both the West Nile virus and dengue viruses are flaviviruses, a group of tick- and mosquito-borne organisms that cause diseases such as yellow fever and St. Louis encephalitis. Researchers from the National Institute of Allergy and Infectious Diseases (NIAID) and Walter Reed Army Institute of Research have shown that although the individual flaviviruses differ from one another, their parts can be intermixed with those of dengue virus to form a hybrid that can be used in a vaccine.

o Because this new vaccine consists of a combination of 2 viruses, it offers 2 benefits. First, the vaccine consists mostly of the dengue virus, which does not target the central nervous system. This means that the vaccine will not infect the brain. Second, because the vaccine has West Nile parts, it will stimulate the body to produce strong antibodies to the virus, offering protection against future exposures.

Outlook

The prognosis of West Nile virus is directly related to the severity of the illness and the age of the person with the infection.

* Those with mild infection recover fully with no permanent disability.

* Death occurs in 12% of people with West Nile encephalitis. The elderly are most at risk for death. Younger people recover much more quickly and are much less likely to show signs and symptoms of severe illness. In the New York outbreak, most cases occurred in people 50 years and older.

Multimedia

Media file 1: The Culex mosquito, common to the Eastern United States, is the primary vector responsible for infecting humans with West Nile virus. Prevention of West Nile virus is primarily directed at reducing the mosquito population from May to October and by taking precautions to limit human exposure during these months of high mosquito activity.

Synonyms and Keywords

West Nile virus, arbovirus, flavivirus, West Nile encephalitis, encephalitis, meningoencephalitis, meningitis, WNV, dengue virus, mosquito-borne virus

Authors and Editors

Author: David A Donson, MD, Staff Physician, Department of Emergency Medicine, New York Methodist Hospital.

Coauthor(s): Mai Kim Lai, MD, Staff Physician, Department of Emergency Medicine, Sparrow Hospital, Michigan State University College of Human Medicine; Steven H Silber, DO, FACEP, Clinical Assistant Professor, Department of Emergency Medicine, Weill Medical College of Cornell University; Vice Chair, Department of Emergency Medicine, New York Methodist Hospital.”