Questions on Health

I wrote about health back in May. Such questions should definitely be asked, no matter how uncomfortable they might make you.
Ask about family health in general, and the person you are looking into specifically, both physical health, and mental health.
Be reasonable, certain conditions are not life threattening and do not greatly influence the couple's life. Others are of concern but can be dealt with and still others have to be discussed with a doctor. Consider your own family history as well. No one is perfect but if both families carry the same tendencies, they might get aggravated in the children.
Don't hesitate to ask your doctor if you are not sure, (and even if you think you know) whether a condition is acceptable or not.

Cont'd Dr. Mittman on Health Research

Dr. Mittman continues writing:

" Genetic Assessment
The organization Dor Yeshorim has increased awareness of genetics in the Orthodox community. The testing it provides is one way to alert people considering marriage as to whether, together, they are likely to have children with a specific genetic condition, such as cystic fibrosis, Tay Sachs, Canavan disease, or Bloom syndrome.
In regard to other illnesses and conditions, however, my research has unraveled many erroneous beliefs. Do they constitute a genetic condition or not? As an Orthodox physician articulated to me, “People often call me with genetic questions. There are lots of different disorders, and many people don’t have any idea whether they are genetic, or even important.”

Getting an accurate genetic risk assessment in a quick phone inquiry is rather tricky. First of all, genetics is a complex science, and demands a close familiarity with the rapidly evolving nature of the field and emerging findings of human genome research. Moreover, only a careful examination of the health history of both sides of the family would be reliable enough to be used as a basis for such an important question as “chasana or no chasana?” So, where do we go from here?

The Benefit-Burden Concept
While Dor Yeshorim offers a reliable way to do premarital testing for recessive conditions, it does not guarantee perfect health for a myriad of other conditions that are not recessive. Simply put, there is no such thing as a “free lunch.” Everything we do in life demands some compromise, some work, and yes, risk-taking.

When one gets into a car one takes a major risk for injury and even fatal accidents, G-d forbid, but one takes this risk daily because one needs to get places to carry out our routines. In other words, for the benefit of driving we have to put up with the risks that driving entails: getting lost on the way to our destination, having a flat tire, or, G-d forbid, worse possibilities. In the same way, finding our bashert means taking a chance. We hope that we and our children and loved ones will live to me’ah ve’esrim (120) in wonderful health, but we cannot predict our future, and there are no guarantees. We do not know whether the child will develop asthma, have an attention deficit disorder, or grow up to have hypertension.

The Beauty of Diversity
We have to remember, also, the special value of uniqueness, our diversity is what makes the world such a wonderful place. Having said that, if there are serious health issues in the family beyond those of the general population, it is possible to ascertain genetic risk. Just remember, it is a matter for experts. Call your doctor, and if the doctor is not sure, ask to speak to a genetic specialist. To find a genetic counselor in your area, you can log into the web site of the National Society of Genetic Counseling: www.nsgc.org.

Dr. Mittman is a certified genetic counselor and a public health expert at the Office of Minority Health and Health Disparities in the Maryland Department of Health and Hygiene.

What I want to bring to your attention with this article is that one should be discriminating when doing research on matters of health. Do not reject a shidduch out of hand because of a health problem. Consult with a doctor who can advise you.

Health in research

An important aspect of research is health.

Not just the boy’s/girl’s health, but the family’s physical and mental health.
This is not an easy thing to research, and you might not feel comfortable asking questions about this, but it is nevertheless a very important subject.
Be aware that certain conditions are not genetic, and therefore have no bearing on the future children the couple will have.
If you are not sure about a particular condition, consult with the family doctor.

Unfortunately, scrutiny on health issues tends to be more rigorous for young ladies. One shadchan’s opinion of the problem is that boys are much more marketable than the girls because of the PERCEPTION that there are more eligible girls than boys in the chareidi community, (Would the Eibishter make such a mistake as to have considerably more boys than girls?). What this means is that a boy can have a serious condition, and he will still get a shidduch. And the girl? She can have a pimple, and she won’t!
It’s the law of supply and demand. How sad that we reduce creating a new branch of Klal Yisroel to a marketplace transaction!

Dr. Ilana Mittman wrote an article on genetics and shidduchim. Here are some excerpts from her article: ' "Some may think that a woman bears the child and is therefore solely responsible for the health of the progeny. Nothing could be further from the truth! The term “it takes two to tango” certainly works in the genetic world. Both parents pass on their genetic endowment equally to the next generation. Each one of us carries about 50,000 genes (units of heredity) on 23 pairs of chromosomes. A child inherits half of his or her genetic material from the mother and half from the father." "It is essential, too, to remember that, while genes are certainly important to what we become, they work along with the environment. Unlike Tay-Sachs disease and certain other conditions that are passed directly from parents to children in a simple fashion, most conditions pertaining to health are governed by a host of genes that interact with one another – and most importantly, interact with and respond to the environment in which we live." To give a few examples, having a sibling with a seizure disorder or mental retardation does not mean that a person will have a child with either of these conditions." "Some conditions are acquired because of a difficult birth or subsequent accident or illness, for instance, and not in any way genetic. Others follow a complex pattern of inheritance, involving combinations of many different genes. In addition, and most significantly, Hakadosh Baruch Hu has given us advanced medical technology that provides effective treatment for some afflictions, like diabetes and hypertension, and cures for others." "The bottom line is that none of us is ‘genetically flawless’. It is a fact that all of us, regardless of our ‘stellar’ family medical history, carry a few deleterious genes, whether we know it or not, which may never be expressed. Virtually all of us have a family history for at least one of the following: heart disease, diabetes, hypertension, Alzheimer’s disease, and certain cancers. It is also a fact that two to three out of every 100 newborn babies will have some kind of a birth defect – most commonly, a heart defect. The vast majority of these cannot be predicted by family history, and many of them are not genetic.” "It is also a fact that two to three out of every 100 newborn babies will have some kind of a birth defect – most commonly, a heart defect. The vast majority of these cannot be predicted by family history, and many of them are not genetic. It is important to define the difference between a “birth defect” and a “genetic condition.” A birth defect is an abnormality either in structure, function, or body chemistry that is present from birth and has physical and/or mental consequences. However, a birth defect is not necessarily genetic, meaning it does not “run” in the family line. One common example is Down Syndrome (DS). The vast majority of persons with DS have this condition as a result of an accidental abnormality of chromosomal rearrangement. So, having a family history of DS does not mean that the person is any more likely than anyone else to have children with this condition.