The English expression “long time, no see” took on a quite literal meaning with Israeli medical science restoring sight to the blind

By David E. Kaplan

It was like a miracle out of the Bible when an Israeli resident from Haifa “saw the light”!  However, it was all about science, not divine intervention.

And yet there was something majestically “biblical” about the scene played out at the Rabin Medical Center when a 78 year-old BLIND man from Haifa on the 3^{rd of} January was able to see his youngest grandchild – only three months old!

An Arab from Haifa, Jamal Furani had gradually lost most of his vision over the past decade due to corneal disease.

If someone resembling a friend or neighbour stood in front of him, “I would not be able to tell the difference,” he said. His cause had seemed lost following four donor transplants to try to restore his vision. All had failed!

That was until the 3^rd of January 2021 when he became the first patient to receive the KPro artificial cornea from CorNeat Vision in Ra’anana.

Prof. Irit Bahar, Chief of Ophthalmology at Beilinson Hospital of Rabin Medical Center in Petah Tikva who performed the implant surgery, explained that “each successive surgery has less chance of success,” however, “the synthetic cornea changed all that. The surgical procedure was straight forward and the result exceeded all of our expectations.”

The day after the operation, Prof. Bahar said that even she was “amazed”, “surprised” and “thrilled” at how well Furaniwas “able to read a vision chart and to recognize family members.” And of course Furani’s family had changed over the years but the absolute thrill was seeing for the first time the new members who he had spoken with and touched but now could see!

It has been emotionally tough for medical practitioners all over the world over the last year with COVID-19, so this was a thrill. “The moment we took off the bandages was an emotional and significant moment. Moments like these are the fulfillment of our calling as doctors,” said Prof. Bahar.

To which an exuberant Furani replied, “As much as you are happy, I am even happier. It’s my treasure to be able to see.”

So what is this artificial cornea that can now restore sight to the blind?

CorNeat co-founder and the inventor of the KPro, Dr. Gilad Litvin, told Channel 13 news that “The innovation here stems from the ability to take something totally synthetic that has no cells or tissue and implant it in the wall of the eye so that it essentially becomes part of the body.”  Litvin who sat in on the operation, revealed to the Times of Israel the sensation of “Unveiling this first implanted eye” and “being in that room was surreal. Witnessing a fellow human being regain his sight the following day was electrifying and emotionally moving. There were a lot of tears in the room.”

You bet!

It was only last July, the first in-human trials of the CorNeat synthetic cornea were approved at Beilinson. This is only the start of a procedure which will undoubtedly impact the lives of millions.

First Step

CorNeat Vision’s Co-Founder, Chief Executive Officer and VP R&D, Almog Aley-Raz, noted that theCorNeat KPro’s first-in-human implantation is just the first step in a multi-national clinical trial, geared toward attaining CE Mark, FDA Clearance and China NMPA approval. “A total of 10 patients are approved for the trial at Rabin Medical Center in Israel with two additional sites planned to open this January in Canada and six others at different stages in the approval process in France, the US, and the Netherlands. Our first trial includes blind patients who are not suitable candidates for- or have failed one or more corneal transplantations. Given the exceptional visual performance of our device, the expected healing time and retention, and the fact that it cannot carry disease, we plan to initiate a second study later this year with broader indications to approve our artificial cornea as a first line treatment, displacing the use of donor tissue used in full thickness corneal transplantations.”

Now, when Haifa grandpa Jamal Furani says to someone “I’ll be seeing you” he sure means it!

While the mission of Lay of the Land (LotL) is to provide a wide and diverse perspective of affairs in Israel, the Middle East and the Jewish world, the opinions, beliefs and viewpoints expressed by its various writers are not necessarily ones of the owners and management of LOTL but of the writers themselves.  LotL endeavours to the best of its ability to credit the use of all known photographs to the photographer and/or owner of such photographs (0&EO)

The severe conditions of COVID-19 that we are living through have made one fact painfully clear – Preventive Care in the ‘best of times’ can reduce health risks in the ‘worst of times’

By Lionel H. Phillips D.O.

Now is the time to be proactive and embrace the power of preventive care. In the same vein of prevention, it is also important to stay as active as possible.

American pharmacologist and 1998 Nobel Laureate in Physiology, Prof. Louis J. Ignarro, describes one of the body’s many natural defenses against pathogens:

“Inhale through your nose and exhale through your mouth. It’s not just something you do in yoga class – breathing this way actually provides a powerful medical benefit that can help the body fight viral infections.”

I have requested that health Ministries make a point of questioning each and every COVID-19 virus sufferer, as to whether they are nose or mouth breathers.

I am convinced that a larger percent are mouth breathers.

Nose breathing – as opposed to mouth breathing, increases circulation, blood oxygen and carbon dioxide levels, slows the breathing rate and improves overall lung volumes. Diaphragmatic Breathing – When you inhale, your diaphragm contracts (tightens) and moves downward, extending the area. This creates more space in your chest cavity allowing the lungs to expand. The diaphragm muscle not only separates the upper from the lower organs, it also acts as a massager tool to both areas. Your nose cleans the air you breathe – The nose helps clean the air. On the surface of the nasal tissues, particularly the turbinates, are cells with small hair-like appendages called cilia that trap much of the bad stuff. Writes Prof. Louis J. Ignarro, Distinguished Professor Emeritus of Molecular & Medical Pharmacology, UCLA School of Medicine, in an article dated 19th June 2020:

“Inhale through your nose and exhale through your mouth. It’s not just something you do in yoga class – breathing this way actually provides a powerful medical benefit that can help the body fight viral infections. The reason is that your nasal cavities produce the molecule nitric oxide, which chemists abbreviate NO, that increases blood flow through the lungs and boosts oxygen levels in the blood. Breathing in through the nose delivers NO (nitric oxide) directly into the lungs, where it helps fight coronavirus infection by blocking the replication of the coronavirus in the lungs”.

It would be surely advantageous for the Health Ministries to take note of the experience and views of Prof. Ignarro.

Air temperature – In the same way as our throat and lungs do not like dirty air, they do not like air that is too cold or too hot. The passing of the air through the nose allows the air to become more like our body temperature, which is better tolerated by the tissues.

Your Respiratory System

We all know that breathing is a vital necessity, that we do without giving it a thought. In addition, we have been given two options – to breathe through the nose or mouth. We breathe to supply our body with oxygen as we breathe in – inhale, whilst we get rid of Carbon Dioxide plus other elements when we exhale. The Oxygen that we inhale either through the nose or the mouth, will enter your lungs. The diagram illustrates the route. The oxygen inhaled will enter your Pharynx, pass through the Trachea and then enter your Lungs. Research shows that Nose breathing is the correct and most optimal way to breathe. Not only are our bodies designed for nose breathing based on the specific apparatus and the mechanisms by which we inhale and exhale through nose breathing, but there are numerous important health benefits to be had from correct consistent nose breathing. The converse is also true, because mouth breathing bypasses important filtering stages in the breathing process and this method of breathing may lead to many health problems, not the least of which may include snoring and sleep apnea. Our lungs are full of tunnels that end in tiny air sacks called alveoli. This is where the exchange of oxygen and carbon dioxide takes place. The oxygen then passes into your blood, which supplies the oxygenated blood to every part of your body.

Diaphragmatic Breathing – The In’s and Out’s

The diaphragm is a dome-shaped muscle at the base of the lungs that separates the thoracic (chest) from the abdominal cavities. It is the principal muscle of respiration, though you may not be aware of it. When you inhale, through the nose your diaphragm contracts (tightens) and moves downward extending the abdominal area. This creates more space in your chest cavity allowing the lungs to expand. When you exhale, the opposite happens — your diaphragm relaxes and moves upward in the chest cavity, providing a great massage for both upper and lower organs. All of us are born with the ingrained knowledge of how to fully engage the diaphragm to take deep, refreshing breaths. As we get older however, we get out of the habit. Everything from the stresses of everyday life to common poor postural habits, results in shallower, less satisfying “chest breathing.”

Nasal breathing – as opposed to mouth breathing – increases circulation, blood oxygen and carbon dioxide levels, slows the breathing rate and improves overall lung volumes. The internal nose not only provides around 90% of the respiratory system air-conditioning requirement, but also recovers around 33% of exhaled heat and moisture. Your nose cleans the air you breathe. The air we breathe has all kinds of stuff in it – from oxygen and nitrogen to dust, pollution, allergens, smoke, bacteria, viruses, small bugs and countless other things. The nose helps clean that air. On the surface of the nasal tissues, particularly the turbinates, are cells with small hair-like appendages called cilia that trap much of the bad stuff. Once captured, the bad stuff sits in the mucous and is gradually pushed into the throat, where it is swallowed. Our stomachs tolerate bad stuff much better than our lungs. This is lessened by blowing your nose when it feels blocked, rather than waiting until it is swallowed. In your Lungs there are sacs called Alveoli. Blood vessels cover the alveolus that connect to a system of veins and arteries that move blood through your body. The oxygen then spreads into the blood vessels so that the heart can pump it to different parts of your body. The sense of smell is not only for pleasure; it is necessary for safety. We need our smell to detect smoke, spoiled food and toxic gases. People who have lost their sense of smell need to have alarms for these gases and they must be careful with what they eat. Our nose regulates the temperature. Just like our throat and lungs do not like dirty air, they do not like air that is too cold or too hot. The passing of the air through the nose allows the air to become more like the body temperature, which is better tolerated by the tissues. Warming cool air is more common than cooling warm air. That is because we spend more time in environments below body temperature than above it. A clear manifestation of the warming and humidifying effect is the runny nose we get in cold weather, which is related to condensation of the moisture in the nose. Smell plays a key role in taste. We have four primary tastes – bitter, sour, sweet and salty. All of the refinements in taste are in fact related to smell. That is why people feel that food is tasteless when their ability to smell is decreased.

Diaphragmatic breathing technique – How to get started

Lie on your back on a flat surface or in bed, with your knees and head supported with pillows as shown in the diagram. Place one hand on your upper chest and the other just below your rib cage. This will allow you to feel the movement of your diaphragm as you breathe in and out. Breathe in slowly through your nose so that your abdominal section moves out against your hand. The hand on your chest should remain as still as possible. Tighten your abdominal muscles, letting them fall inward as you exhale through pursed lips. The hand on your upper chest must remain as still as possible. When you first learn the diaphragmatic breathing technique, it may be easier for you to follow the instructions lying down, as shown above. As you gain more practice, you can try the diaphragmatic breathing technique while sitting in a chair. To perform this exercise while sitting in a chair: Sit comfortably, with your knees bent and your shoulders, head and neck relaxed. The rest of the breathing process is identical as when lying down. Note: You may notice an increased effort will be needed to use the diaphragm correctly. At first, you will probably get tired while doing this exercise. But keep at it, because with continued practice, diaphragmatic breathing will become easy and automatic. Correct Nose Breathing has a positive effect on every system in the body. Mouth breathing will have a negative effect.

How often should I practice this exercise?

At first, practice this exercise for a few minutes about 2 – 3 times per day. Gradually increase the amount of time you spend doing this exercise, and perhaps even increase the effort of the exercise by placing a book on your abdomen if lying down.

A change from an ingrained habit of mouth breathing to nose breathing is extremely difficult for many. Please do not give up too easily. In addition, it is understandable that the elderly often find mouth breathing easier for them. Even in their situation, I would encourage them to have patience. You may find children and grandchildren easier to convince before the mouth breathing becomes ingrained.

As for the COVID-19 Virus, allow me to share a thought on the assumption that you have read through the above information on the Respiratory system. During this time, nose breathing becomes even more important and relevant. Nose breathing can reduce dust, pollution, allergens, smoke, bacteria and viruses from entering the lungs. As usual, I welcome your views and comments on the above. Shoot straight from the hip. May you and yours keep safe and healthy.

About the Author:

Lionel Phillips is a Doctor of Osteopathy (1975), an International Fitness & Health Instructor, Consultant and Lecturer. He has researched and designed ‘The Needs & Functions of the Human Body’ as an educational subject for inclusion in all School Curriculums World-Wide.

A past Federation Member and Israel Liaison Representative of IHRSA (International, Health & Racquet Sportsclub Association) and member of their worldwide “Panel of Experts”, Phillips is a recipient of the “Prime Ministers Award of Merit” (PM Menachem Begin).

Our mailing address is: global@globalhealth-education.com

While the mission of Lay of the Land (LotL) is to provide a wide and diverse perspective of affairs in Israel, the Middle East and the Jewish world, the opinions, beliefs and viewpoints expressed by its various writers are not necessarily ones of the owners and management of LOTL but of the writers themselves.  LotL endeavours to the best of its ability to credit the use of all known photographs to the photographer and/or owner of such photographs

Without leaving airport terminals to avoid quarantine, Israeli volunteer organ courier travels the world saving lives

By David E. Kaplan

In every moment of darkness, it seems, there are countless moments of light. Time and again, individuals, communities and organizations have demonstrated that the direst situations tend to bring out the best in people. Literally illuminating this in the ‘Age of Corona’ is Omri Nahmias’ article in The Jerusalem Post (April 13) “The Israeli Who Never Leaves Ben-Gurion Airport”.  Well, not quite –  he does leave but mostly to other airports.

Of all the endless articles on Corona, Omri’s one resonated the most – I read it and then again three times!

While people the world over are rightly preoccupied with the health and wellbeing of themselves, a 47-year-old Israeli family man remains committed to the lives of people he does not even know. Mishel Zrian is a volunteer organ courier for awaiting recipients; whose lives are dependent on such organs arriving “on time”.

He has been volunteering for 20 years mostly transporting bone marrow to patients across the globe.

Corona now complicates the process and procedure.

When Mishel’s employer told him last month that he was about to be furloughed until the end of April because of countries’ policies of lockdown and isolation, Mishel thought about the lives at stake and decided to take his volunteering work to the next level and “do it full time.”

But with “full time” came immense complications, inconveniences and personal sacrifices like not seeing his wife and children.

Since that fateful decision, he has landed in Israel five times but never left his country’s airport in order to avoid the mandatory 14-day quarantine!

Explaining to local media, Mishel says he has an agreement with the Israel Airports Authority that he is permitted to stay at the airport lounge “until I need to get back to carry the next bone marrow delivery. Sometimes, I can land in Israel from New York at 5.00 p.m., and by 10.00pm be on a flight in the opposite direction.”

This type of selfless travel during a global life-threatening pandemic is proving to be hugely challenging but does not deter the intrepid volunteer.

Something to chew on

One of the many challenges is finding the time to eat – something most folks take for granted.

For this organ courier during Corona, “It’s hard to find an open restaurant when you are traveling,” he explains. “If I’m at the airport and I see an open place, I will eat chicken at ten in the morning. Why?  Because I don’t know when the next time will be to eat.”

In the hotels, “the situation is odd as well,” he continues. “Rooms are not always clean because of different guidelines regarding staff work, and if you need a towel or shampoo, you need to go down to the reception and ask for it. I have been in hotels with no breakfast or even coffee.” It is not uncommon for Mishel, he says:

“for me to travel 24 hours without eating!”

But the main challenge, he said, is getting insurance cover.

“I couldn’t find anyone who would allow me to take out an insurance policy for the US,” he said. “I am worried about the possibility that I will get sick; so I do my best to practice social distancing while traveling.”

Bracha Zisser, founder and director of Ezer Mizion Bone Marrow Donor Registry and Collection Center, told the Post that before the coronavirus outbreak, hospitals around the world used to send a courier to pick up the bone marrow.

“But things got complicated in the past few weeks. It is hard to deliver the bone marrow and to allow couriers to enter the country. So we are now working with Royale – a courier company with whom Mishel is volunteering and with El Al – that are helping us with no cost, in full volunteering,” she said. “They understand that it is about saving lives.”

Zisser revealed that in March 2020, Ezer Mizion was able to deliver 26 bone marrow donations:

– 14 to EU countries

– 10 to the US

–   1 to Argentina

–   1 to Panama.

Mishel says that despite all the challenges, he is determined to keep traveling because he knows that his work saves lives.

“The hardest part is to land in Israel without seeing my family. I have a wife and two children. Fortunately, they are supporting me.”

Mishel Zrian hails from the Israeli city of Petah Tikva, which aptly translates from the Hebrew: “Opening of Hope”.

Mishel does his city proud by living up to its name.

In the vanguard of cutting-edge fiber technologies, Argaman is protecting lives

By Gina Raphael

Outside of my family and business, my entire life’s focus has been working on behalf of the State of Israel. Each year, I look forward to a summer adventure focusing on philanthropic projects and visiting friends, bringing this mission to life. Memories of my summer adventures live on through pictures on Facebook but also through lives changed and bridges built.

 As Chair of the Women’s International Zionist Organization (WIZO) in Los Angeles, I am so honored to lead an amazing movement of Chaverot working on behalf of women and families in Israel. We are proud of our Women’s Shelters, Day Care Centers, Youth Villages, after school programs focused on Ethiopian Youth and so much more. It has also been a gift to work with and build connections between elected officials in California and our City of Beverly Hills with the State of Israel.

While my love for Israel has been expressed through philanthropic and leadership opportunities, we have continually pursued ways to carry products at Mickey Fine – our small chain of pharmacies – that are made in Israel. The goal has been to bring Israel to life in our stores in Beverly Hills not just through our love of the country but by bringing unique Israeli products into our stores.  Yes, there has been the occasional skin care, gift item and food product; and of course, the Israeli pharma company Teva, through our distributor McKesson Pharmaceuticals has been critical in our ongoing inventory.

What brought us this long-sought business connection to Israel from a commercial perspective has ironically been the Covid-19 pandemic. While Teva Pharmaceuticals has been an essential part of fighting the virus with its hydroxychloroquine product, our strongest connection ever has come from a leader in the scientific break-throughs, Argaman Technologies, their amazing founder, Jeff Gabbay and their BioBlocX Reusable Face Mask. Seeking a way to better protect our family, team and community, we literally sought out Argaman to bring a fresh perspective to the traditional face mask in this most challenging of times.

Originally pursuing unique materials to cure hospital infections and better deliver cancer therapies, Argaman utilized revolutionary new applications that have been modified in face masks to battle the current pandemic.  The textiles have been tested on RNA viruses like bird flu and swine flu and have been applied to the current Corona virus. The cotton fiber of the mask is infused with compounds that are bad for bacteria but benign for humans. They use ultrasonic waves that are used to attach to the fibers.

According to Jeff Gabbay, President & Chief Technology Officer of Argaman, “the virus will wane but we have to make sure while the virus slows down that we are proactive and do what we can now to protect ourselves in  the event there will be a second wave; only we don’t know when. It means acting now to avoid the disorganization and anxiety we all suffered with this wave.”

With mandatory usage of face masks in Los Angeles and in other cities as well, finding a reusable mask that provides a super level of protection became critical. In just a few short weeks, we have placed several orders and brought face masks for local and customers across the country. With the uncertainty of the virus, the belief in mighty Israel and brilliant Argaman to protect us is comforting at every level. Building distribution of this product line has been a top priority for us at Mickey Fine with the double mitzvah of protecting people while highlighting the innovation that Israel brings to the world.

While I am optimistic that my annual summer Israel adventure to Jerusalem will take place this August to work on behalf of philanthropic projects in Israel and finally meet my new friend Jeff Gabbay, I know that the world in which we live will remain forever changed. Most likely face masks will become a standard part of what we put in our purse and take on the plane. But we are also more confident that Israel is providing us that extra protection every day in our stores and for the community.

Gina Raphael and her husband Jeff Gross own Mickey Fine Pharmacy & Grill (www.mickefine.com), the leading independent pharmacy chain in Beverly Hills. gina@mickeyfine.com