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Diabetic retinopathy can lead to blurred vision and blindness

By David Dunaief, M.D.

Dr. David Dunaief

With diabetes, we tend to concentrate on stabilization of the disease as a whole. This is a good thing. However, there is not enough attention spent on microvascular (small vessel disease) complications of diabetes, specifically diabetic retinopathy, which is an umbrella term.

This disease, a complication of diabetes that is related to sugar control, can lead to blurred vision and blindness. There are at least three different disorders that make up diabetic retinopathy. These are dot and blot hemorrhages, proliferative diabetic retinopathy and diabetic macular edema. The latter two are the most likely disorders to cause vision loss. Our focus for this article will be on diabetic retinopathy as a whole and on diabetic macular edema, more specifically.

Diabetic retinopathy is the number one cause of vision loss in those who are 25 to 74 years old (1). Risk factors include duration of diabetes, glucose (sugar) that is not well controlled, smoking, high blood pressure, kidney disease, pregnancy and high cholesterol (2).

What is diabetic macula edema, also referred to as DME? This disorder is swelling, due to extracellular fluid accumulating in the macula (3). The macula is a yellowish oval spot in the central portion of the retina — in the inner segment of the back of the eye — and it is sensitive to light. The macula is the region with greatest visual acuity. When fluid builds up from blood vessels leaking, there is potential loss of vision.

The highest risk factor for DME is for those with the longest duration of diabetes (4). DME is traditionally treated with lasers. But intravitreal (intraocular — within the eye) injections of a medication known as ranibizumab (Lucentis) may be as effective as laser. Unfortunately, many patients are diagnosed with DME after it has already caused vision loss. If not treated after having DME for a year or more, patients can experience permanent loss of vision (5).

In a cross-sectional study (a type of observational study) using NHANES data from 2005-2008, among patients with DME, only 45 percent were told by a physician that diabetes had affected their eyes (6). Approximately 46 percent of patients reported that they had not been to a diabetic nurse educator, nutritionist or dietitian in more than a year — or never.

The problem is that the symptoms of vision loss don’t necessarily occur until the latter stages of the disorder. According to the authors, there needs to be an awareness campaign about the importance of getting your eyes examined on an annual basis if you have diabetes. Many patients are unaware of the association between vision loss and diabetes.

Treatment options: lasers and injections

There seems to be a potential paradigm shift in DME treatment. Traditionally, patients had been treated with lasers. The results from a randomized controlled trial, the gold standard of studies, showed that intravitreal (delivery directly into the eye) injections with ranibizumab, whether given prompt laser treatments or treatments delayed for at least 24 weeks, were equally effective in treating DME (7).

Increased risk with diabetes drugs

Diabetic retinopathy is the number one cause of vision loss in ages 25 to 74. Stock photo

You would think that drugs to treat type 2 diabetes would prevent DME from occurring as well. However, in the THIN trial, a retrospective (backward-looking) study, a class of diabetes drugs, thiazolidinediones, which includes Avandia and Actos, actually increased the occurrence of DME compared to those who did not use these oral medications (8). Those receiving these drugs had a 1.3 percent incidence of DME at year one, whereas those who did not had a 0.2 percent incidence. This incidence was persistent through the 10 years of follow-up.

To make matters worse, those who received both thiazolidinediones and insulin had an even greater incidence of DME. There were 103,000 diabetes patients reviewed in this trial. It was unclear whether the drugs, because they were second-line treatments, or the severity of the diabetes itself may have caused these findings.

This is in contrast to a previous ACCORD eye substudy, a cross-sectional analysis, which did not show an association between thiazolidinediones and DME (9). This study involved review of 3,473 participants who had photographs taken of the fundus (the back of the eye).

What does this ultimately mean? Both of these studies were not without weaknesses. It was not clear how long the patients had been using the thiazolidinediones in either study or whether their sugars were controlled and to what degree. The researchers were also unable to control for all other possible confounding factors (10). Thus, there needs to be a prospective (forward-looking) trial done to sort out these results.

Diet

The risk of progression of diabetic retinopathy was significantly lower with intensive blood sugar controls using medications, one of the few positive highlights of the ACCORD trial (11). Medication-induced intensive blood sugar control also resulted in increased mortality and no significant change in cardiovascular events. But an inference can be made: A nutrient-dense, plant-based diet that intensively controls blood sugar is likely to decrease the risk of diabetic retinopathy complications (12, 13).

The best way to avoid diabetic retinopathy is obviously to prevent diabetes. Barring that, it’s to have sugars well controlled. If you or someone you know has diabetes, it is imperative that they get a yearly eye exam from an ophthalmologist so that diabetic retinopathy is detected as early as possible, before permanent vision loss occurs. It is especially important for those diabetes patients who are taking the oral diabetes class thiazolidinediones, which include rosiglitazone (Avandia) and pioglitazone (Actos).

References:

(1) Diabetes Care. 2014;37 (Supplement 1):S14-S80. (2) JAMA. 2010;304:649-656. (3) www.uptodate.com. (4) JAMA Ophthalmol online. 2014 Aug. 14. (5) www.aao.org/ppp. (6) JAMA Ophthalmol. 2014;132:168-173. (7) ASRS. Presented 2014 Aug. 11. (8) Arch Intern Med. 2012;172:1005-1011. (9) Arch Ophthalmol. 2010 March;128:312-318. (10) Arch Intern Med. 2012;172:1011-1013. (11) www.nei.nih.gov. (12) OJPM. 2012;2:364-371. (13) Am J Clin Nutr. 2009;89:1588S-1596S.

Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician. 

٭We invite you to check out our weekly Medical Compass MD Health Videos on Times Beacon Record News Media’s website, www.tbrnewsmedia.com.٭

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From left, graduate students Prakhar Avasthi, Alisa Yurovsky, Charuta Pethe and Haochen Chen with director Steven Skiena, center. Photo by Gary Ghayrat/Stony Brook University

By Daniel Dunaief

Steven Skiena practices what he teaches. Named the director of the Institute for AI-Driven Discovery and Innovation in the College of Engineering and Applied Sciences at Stony Brook University, Skiena is using artificial intelligence to search for three staff members he hopes to hire in this new initiative.

He is looking for two tenured professors who will work in the Department of Computer Science and one who will be a part of the Department of Biomedical Informatics.

“We hope to use an artificial intelligence screen,” which Skiena calls a Poach-o-matic to “identify candidates we might not have thought of before. Ideally, the program will kick up a name and afterward, we’d bump our hand on our head and say, ‘Of course, this person might be great.’”

Steven Skiena. Photo from SBU

Artificial intelligence and machine learning have become popular areas in research institutions like Stony Brook, as well as in corporations with a wide range of potential applications, including in search engine companies like Google.

Skiena, who is a distinguished teaching professor, said he has “several candidates and we’re now actively interviewing,” adding that many departments on campus have faculty who are interested in applying machine learning in their work.

“There’s been an explosion of people from all disciplines who are interested in this,” Skiena said. He recently met with a materials scientist who uses machine learning techniques to improve experimental data. He’s also talked with people from the business school and from neuroscience.

SBU students have also shown considerable interest in these areas. Last semester, Skiena taught 250 graduate students in his introduction to data science class.

“This is a staggering demand from students that are very excited about this,” he said. Machine learning has become a “part of the standard tool kit for doing mathematical modeling and forecasting in many disciplines and that’s only going to increase.”

In an recent email, Andrew Schwartz, a core faculty at the institute and an assistant professor in the Department of Computer Science at Stony Brook, said he believes bringing in new faculty “should attract additional graduate students that may become future leaders in the field.”

Increasing coverage of AI beyond the current expertise in vision, visualization, natural language processing and biomedical engineering can “go a long way. There are a large amount of breakthroughs in AI that seemingly come from taking an idea from one subfield and applying it to another.” Schwartz appreciates the impact Skiena, who is his faculty mentor, has had on the field.

Skiena has “managed to contribute to a wide range of topics,” Schwartz explained. His book, “The Algorithm Design Manual,” is used by people worldwide preparing for technical interviews. Knowing this book thoroughly is often a “suggested step” for people preparing to interview at Google or other tech companies, Schwartz added.

The students in Schwartz and Skiena’s labs share space and have regular weekly coffee hours. Schwartz appreciates how Skiena often “presents a puzzling question or an out-of-the-box take on a question.”

The core technical expertise at the institute is in machine learning, data science, computer vision and natural language processing.

The creation of the institute shows that Stony Brook is “serious about being one of the top universities and research centers for expertise in AI,” explained Schwartz.

A few years ago, researchers realized that the artificial intelligence models developed biases based on the kind of training data used to create them. “If you’re trying to build a system to judge resumes to decide who will be a good person to hire for a certain type of job” the system has a danger of searching for male candidates if most or all of the people hired had been male in the past, Skiena explained.

Unintentional biases can creep in if the data sets are skewed toward one group, even if the programmer who created the artificial intelligence system was using available information and patterns.

In his own research, Skiena, who has been at Stony Brook since 1988, works on natural language processing. Specifically, he has explored the meaning of words and what a text is trying to communicate.

He has worked on sentiment analysis, trying to understand questions such as whether a particular political figure who receives considerable media coverage is having a good or bad week.

Another project explores the quality of news sources. “Can you algorithmically analyze large corpuses of news articles and determine which are reliable and which are less so?” he asked. 

One measure of the reliability of a news source is to determine how much other articles cite from it. “It is important to teach skepticism of a source” of news or of data, Skiena said. 

“When I teach data science, a lot of what I teach includes questions of why you believe a model will do a good thing and why is a data source relevant,” he added.

A resident of Setauket, Skiena lives with his wife Renee. Their daughter Bonnie is a first-year student at the University of Delaware, where she is studying computer science. Their tenth-grade daughter Abby attends Ward Melville High School and joins her father for bike rides on Long Island.

Skiena, who grew up in East Brunswick, New Jersey, said he appreciates the university community. By working in the AI field, Skiena, who has seven doctoral students in his lab, said he often observes glitches in online models like article classification on Google News or advertisements selected for him on a website to try to figure out why the model erred. He has also developed a sense of how probability and random events work, which he said helps him not overinterpret unusual events in day-to-day life.

As for his work at the institute, Skiena hopes Stony Brook will be recognized as a major player in the field of machine learning and areas of artificial intelligence. “We have good faculty in this area already and we’re hiring more. The hope is that you reach critical mass.”

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Penguins are among the few animals that live in the South Pole. Stock photo

By Elof Axel Carlson

Elof Axel Carlson

Life abounds from pole to pole and from the bottom of oceans to the peaks of Asian mountain tops. It does this by using the air, water and land to sustain life.

For most of the time on Earth life was confined to single-celled organisms, mostly bacteria. They take in water across a cell membrane. Most do not use oxygen from the air. Those that do came later, when some bacteria developed tools to use sunlight to combine carbon dioxide in the air with water to produce food (carbohydrates) and more abundant energy for the cell. They released oxygen and the atmosphere began to accumulate oxygen. 

Most forms of multicellular life use oxygen from the air to provide the energy to sustain their cellular life. Multicellularity permitted specialization of cells to form tissues, and the tissues then permitted organs to specialize in exchanging carbon dioxide (a waste product for animals) for oxygen.

The branching of limbs on trees is efficient to increase surfaced area for gaseous exchanges. So too are the branching of filaments in the gills of fish or the trachea of insects or the branching of the bronchi in our lungs.

When I see a tree, I see those organ systems reaching skyward with terminal leaves and an equally branched underground of roots, which are bringing in water and minerals from the land into which they are penetrated. The artist sees the beauty of the landscape. The mystic feels the awe of the complexity that seems beyond human comprehension. The scientist explores the structures and assigns functions as they emerge through the tools of science and experimentation.

It is as thrilling to me to see the cellular network of living tissues or organs under a microscope as it is to watch the changing scenery of life when driving from Indiana to New York, or taking walks in Amsterdam, Capetown, Samara, the Seychelles, the nature preserves in Kenya or the beaches of Baja Mexico.

I think of life through time as a fractal drawing with many repetitions creating new patterns. All of life requires a few basic activities. Life requires molecules to form membranes. It requires carbon-based compounds to produce the organelles that compose a cell.  All life (except viruses) is cellular. Life requires molecules that can store information to provide the molecules of life — proteins, nucleic acids, carbohydrates and lipids.

I think of the tools of the artist — a palette, brushes, tubes of oil paint, a canvas stretched on a frame, an easel to hold it. The artist can meticulously render a face, a still life or a landscape with the skills of many hundreds of hours of practice. 

Life also uses cellular tools to construct more complex membranes, organelles, chromosomes and vesicles to a symphony of functioning parts. Science enriches our understanding, opens new worlds of the very small and the very large that we do not normally see.  At most, a galaxy other than our own Milky Way is a mere dot in the sky, but close up it has 100 billion stars in it, most of them like our own sun. Our universe has billions of galaxies. 

As I type a page for an article or book, I am aware that I am coordinating the 37 trillion cells composing me. Human life mimics the universe in its immensity as our Earth now contains some 7 billion people. But this is humbled by the immensity of the astronomer’s universe or the biologist’s inventory of our own cells.    

Elof Axel Carlson is a distinguished teaching professor emeritus in the Department of Biochemistry and Cell Biology at Stony Brook University.

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Traditional Lasagna

By Barbara Beltrami

Lasagna is the answer to a cook’s and diner’s prayer — a favorite one-dish balanced meal that’s always a palate pleaser. And with the availability of no-boil lasagna, which I think produces a lighter, more delicate pasta than the old-fashioned kind that is so difficult to handle, it’s really just a matter of precooking some of the fillings and assembling them in alternate layers with the pasta. Here are two versions.

Traditional Lasagna

Traditional Lasagna

YIELD: Makes 6 to 8 servings

INGREDIENTS:

¼ cup olive oil

1 large onion, diced

½ pound crumbled Italian hot or sweet sausage meat

½ pound lean ground beef

½ cup dry white wine

2 garlic cloves, minced

One 28-ounce can tomato puree

One 14-ounce can crushed tomatoes

2 tablespoons chopped fresh basil or 2 teaspoons dried

1 tablespoon chopped fresh oregano or 1 teaspoon dried

Large pinch sugar

Pinch baking soda

Salt and freshly ground black pepper to taste

1 pound ricotta cheese

1¼ cups freshly grated Parmesan cheese

2 cups shredded mozzarella cheese

1 large egg

½ cup chopped fresh Italian flat-leaf parsley

Salt and freshly ground black pepper to taste

Nonstick cooking spray

1 pound no-boil lasagna sheets

DIRECTIONS:

Preheat oven to 375 F. In a large saucepan, heat olive oil over medium heat. Add the onion, sausage meat and ground beef and cook, stirring frequently, until onion is golden and meat is brown. Add the wine; stir; then add the garlic, tomato puree, crushed tomatoes, basil, oregano, sugar, baking soda, salt and pepper. Cook over medium-low heat 5 minutes.  

Meanwhile, in a large bowl, combine ricotta, Parmesan and mozzarella cheeses, egg, parsley, salt and pepper. Coat a 9×13-inch baking dish with nonstick cooking spray. Spread a thin layer of sauce on bottom. Next, place lasagna sheets over the sauce. Place six dollops of ricotta mixture on top of sheets and, with a large spoon or rubber spatula, spread evenly; top with sauce.  

Repeat procedure until lasagna sheets, ricotta mixture and sauce are used up, ending with lasagna sheets, then sauce on top. Cover with aluminum foil and bake 30 minutes, until sauce is bubbling at sides. Remove the foil and bake another 10 to 15 minutes. Let rest 10 minutes. Serve hot or warm with a tossed salad and a light red wine.

Roasted Veggie Lasagna

Roasted Veggie Lasagna

YIELD: Makes 8 servings

INGREDIENTS:

1 medium eggplant, cut into half-inch slices

2 medium green or yellow zucchini, cut into half-inch slices

8 ounces sliced mushrooms

1/3 cup extra virgin olive oil

Salt and freshly ground black pepper, to taste

Nonstick cooking spray

One and a half 14-ounce cans diced tomatoes

1 garlic clove, minced

2 tablespoons fresh basil or 2 teaspoons dried

1 tablespoons fresh oregano or 1 teaspoon dried

3 tablespoons extra virgin olive oil

Salt and freshly ground black pepper, to taste

6 ounces goat cheese 

1 cup freshly grated Parmesan cheese

1 pound no-boil lasagna sheets

DIRECTIONS:

Preheat oven to 425 F. Brush vegetables with olive oil and season with salt and pepper. Coat two to three baking sheets with nonstick cooking spray and place veggie slices on them; roast 15 to 20 minutes, until tender. Remove from oven and reduce heat to 400 F. 

Meanwhile in large skillet or saucepan combine tomatoes, garlic, herbs and the three tablespoons olive oil. Cook over medium heat for five minutes. Combine goat and Parmesan cheeses. 

Spread a little sauce in a 13×9-inch nonreactive baking dish; add lasagna to cover, the eggplants slices, overlapping if necessary, then 1/3 of the cheese mixture and finally enough tomato sauce to lightly cover. Repeat procedure using zucchini for second layer and mushrooms for third layer, ending with lasagna topped with tomato sauce. 

Cover with aluminum foil, bake 30 minutes, uncover and bake another 10 minutes. Remove from oven and let rest 10 minutes. Serve hot or warm with a spinach salad and dry white wine.

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Pay inequities based on gender and color are finally being addressed in Suffolk County. Stock photo

By Lisa Scott

Somewhat quietly in late 2018, the Suffolk County Legislature and County Executive Steve Bellone (D) added an important tool to the fight for pay equity: The Restricting Information on Salaries and Earnings (RISE) Act. 

The League of Women Voters of Suffolk County commends the entire Legislature and the county executive for taking this action. It is fair; it’s sound economics; it can reduce the need to pay for additional social support for working families; and it’s good for Suffolk County’s citizens. It shows that our county’s legislators and executive can work to reclaim their place as innovative, socially responsible elected officials while operating with foresight in a fiscally prudent manner. 

Why should pay equity be a concern for us all? Race and gender are significant factors in what women earn for doing the exact same jobs as men. In April 2018, the New York State Department of Labor reported that Suffolk County women in general earn just 78.1 cents for every dollar a man earns. Comparably, black women are paid about 64 cents for every white male dollar, and the pay gap of Latina women is about 55 cents to a white man’s salary dollar. 

Equal Pay Day in April reflects how long AFTER the end of the year a woman has to work before she takes home the same amount of earnings as a man in the prior year — thus, over 15 months of work for a woman to earn what a comparable man earned in 12 months!

Pay inequality isn’t just a women’s issue; it is a family issue. Recent research has found that 42 percent of mothers with children under the age of 18 are their families’ primary or sole breadwinners. Wage discrimination can impair their ability to buy homes and pay for a college education and limits their total lifetime earnings, thereby reducing their retirement savings and benefits.

Gender pay inequity and low wages put the burden of meeting the expenses of employees squarely on the backs of local taxpayers, who make up the difference in the costs of living with social safety net programs.

The pay gap not only hurts women and their families, but it also hurts the communities they support. That means local businesses are hurt through lost sales, as are local schools and governments that depend on sales tax and property tax dollars to fund the programs and the infrastructure those communities need to exist. In New York State, social service costs are paid directly by county governments that then must wait for state and federal reimbursement. 

If pay equity makes good economic sense for our communities, how does the RISE act work toward this goal? The bill, which takes effect on June 30, 2019 was initially created to restrict employers from using salary and benefits history when establishing salary and benefits for new employees. The Legislature explained that utilizing this information in decision making perpetuates wage discrimination and the wage gap experienced by women, racial and ethnic minorities and employees returning to the workforce after an extended period away.

Gov. Andrew Cuomo (D) recently signed an “equal pay for work of equal value bill” that directs the president of the civil service commission to study and publish a report evaluating public employers’ wage disparities related to the job titles segregated by the gender, race and/or national origin of the employees in the title. Once completed, the study will be delivered to the governor and the leaders of the Legislature, and the data from the study will be used to address pay inequities in the state’s workforce. 

“New York State has to be a leader on this issue — a model of reform,” the bill’s sponsor, Assembly member Barbara Lifton (D-Ithaca) said. “By getting our own house in order and ensuring that our public employees are being paid fairly for the work that they are doing, we are sending the wider message that wage disparities cannot be tolerated in a society that prides itself on treating everyone fairly.”   

The NYS Legislature is only in session until June. We must advocate now to strengthen our equal pay laws so that women have the tools they need to fight back against pay discrimination. 

The league’s work on pay equity stemmed from member concern over the feminization of poverty in the 1980s. Additional sources for pay equity information and advocacy include AAUW, PowHerNY, National Women’s Law Center and the Center for American Progress.

Lisa Scott is president of the League of Women Voters of Suffolk County, a nonprofit, nonpartisan organization that encourages the informed and active participation of citizens in government and influences public policy through education and advocacy. For more information, visit www.lwv-suffolkcounty.org or call 631-862-6860.

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MEET PRISSY!

Prissy

Patiently waiting at Kent Animal Shelter for a new home, this 2-year-old sweetheart has one blue eye and one brown eye. Prissy has had a rough start to life but is ready to put all that behind her and put her best paw forward. Rescued from a high kill shelter down south, she’s very sweet and is just looking for someone to love. Could that be you? 

Prissy comes spayed, microchipped, and up to date on vaccines. Kent Animal Shelter is located at 2259 River Road in Calverton. The adoption center is open from 10 a.m. to 4 p.m. every day. For more information on Prissy and other adoptable pets at Kent, call 631-727-5731 or visit www.kentanimalshelter.com.

Update: Prissy has been adopted!

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PHONECEPTION!

Daria Martorana snapped this artistic photo at Cedar Beach in her hometown of Mount Sinai in December. She writes, “It’s ‘phoneception!’ I took a photo of my iPhone X’s camera screen with my Sony A6000. Sunsets are among my favorite photos to capture because they produce stunning shots with little need for much effort or planning. Although I do enjoy manipulating photos in Lightroom, there’s something to say about a winter sunset with the bright pink and orange tones that only requires a bit of exposure and detailing.”

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One of the best parts of our job is providing an outlet for readers to express their beliefs and passions on the Letters to the Editor page. Knowing what is on the minds of community members is always valuable to us and to the rest of our readers. This is a platform for releasing passions.

That’s why we’re hoping a few readers who called us last week will take pen to paper — or fingers to keyboard — and write us a letter. After the Jan. 10 editorial criticizing the extended government shutdown over a proposed wall on the U.S. and Mexican border, we received a few calls from readers who were unhappy with our opinion. Some went as far as to say they would no longer read our papers. Even though they want to end their relationships with us, we appreciate their calls. We wish they would have taken the time to write a Letter to the Editor, because that’s one of the purposes of the page — for a reader to let the newspaper staff and readers know that they don’t agree with an editorial or even an article.

We encourage and appreciate letters from all our readers no matter where they stand, even when it comes to politics. Also, we would love to see more letters from those who voted for and support President Donald Trump (R) as well as those who don’t. We want readers to tell us what they like and don’t like about the president — we appreciate hearing from all sides. We think our readers do too.

Speaking of Trump and national issues, many have asked why they don’t see more letters about local topics. When we receive them, we gladly publish them. We would love to hear more about what our readership thinks of political decisions on the town and village levels as well as our local elected officials. 

These letters to the editor can create much-needed conversations, but a few readers have commented there’s too much back and forth between some individuals in some of our papers. We always do our best to give people an equal opportunity to respond to each other, but some of that back and forth would stop if we received more letters about a wider variety of topics.

So, if you’re reading this editorial right now, don’t be shy. We accept letters with opinions about local, state, national and international issues. Whatever is on your mind, we want to hear from you. Take action. Keep in mind that letters are edited for length, libel, style and good taste — the letters page is not a place for foul language or personal battles. Letters should be no longer than 400 words, and we don’t publish anonymous letters. All submissions must include an address and phone number for confirmation.

On a side note, here at TBR News Media we go by “The Associated Press Stylebook” to edit our articles, letters and editorials. One reader pointed out in last week’s edition we didn’t refer to Trump as president. But we did. In the first reference we wrote “President Donald Trump (R),” but following AP style, on subsequent references used only his last name. 

We hope this editorial gets you to write or email, leading to more diverse and productive conversations in the future —  waiting to hear from you at [email protected] (Village Times Herald/Times of Middle Country), [email protected] (Port Times Record/Village Beacon Record), [email protected] (Times of Huntington and Northport, Times of Smithtown). 

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Stock photo

By Daniel Dunaief

Daniel Dunaief

From birth, hair has been a signal. I had hair when I was born, which probably doesn’t come as too much of a surprise to people who have known me for years.

When I was young, my haircutter used to imagine becoming wealthy by figuring out what made my hair grow so rapidly.

For those without hair, this isn’t a boast; it’s a part of a genetic heritage that cuts both ways. My hair, as it turns out, is also thick and fast growing on my eyebrows or, as people have preferred to say, eyebrow. The space between my eyebrows is just as eager to grow hair as the area just above my eyes.

In college, I tried to grow my hair longer to see how I’d look with shoulder-length hair. That was a failed experiment as my hair grew out instead of down, turning it into a heavy tangle of thick hair.

When I met my wife, I convinced her that I couldn’t disconnect the hair between my eyebrows, or I would be like Sampson and loose my strength. Amused as she was by the story, she let it slide. The afternoon of our wedding, she was stunned to see me with two eyebrows. She wanted to know what had happened and, more importantly, how I was still standing?

I told her that I went for a professional shave so that my usual facial shadow wouldn’t appear during the wedding. While I had my eyes closed, the barber removed the hair above my nose with a quick wrist flick.

Fortunately, my wife didn’t ask for ongoing removal of that hair when it returned.

As I’ve gotten older, hair has emerged from unwelcome places, making appearances from my ears and nose. Who needs hair there — and how could Charles Darwin possibly explain the presence of such unwelcome hair? Does the ear hair announce my advancing age and lower social value?

That brings us to today. As I was maneuvering through the usual deep thoughts, resolutions and promises for the start of the new year, an errant and unwanted fellow emerged from my nose. He was clearly long enough to attract attention, but what was especially surprising about “Jedediah” wasn’t just that he was long or that he seemed to rappel out of my nose. It was his color that offered such an unwelcome but realistic signal — Jedediah was gray.

Ugh! Who wants or needs a gray nose hair, not only offering the world a clue that my hair growth was out of control, but that I’m also so much older that even my nose hairs have started to show signs of aging? Do people dye their nose hairs?

Should I pluck him, trim him or wear him with pride, hoping that he distracts people from the progressively bushier pile of hair pouring out of my ears?

Wouldn’t a rugged individualist defy convention and wear the years and the hair growth with pride, despite the lack of magazine covers with contemporary studs like Hugh Jackman with hair coming out of their noses? If Hugh made gray nose hair fashionable, would I feel less self-conscious about Jedediah?

Poor Jedediah, who worked so hard to emerge from the nose cave, suffered the same fate as the errant hairs that grew out of my ears. He reluctantly left the warm comfort of my nose and was discarded into the trash.

While hair may tell a story about each person, Jedidiah will no longer be sharing mine, except for readers of this column.

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By Leah Dunaief

Leah Dunaief

A friend called the other day to wish us a happy new year and to tell us that she and her husband had sold their house. The buyers were going to tear it down and build a new one on the property. Before I could react, she assured me that they had lots of pictures from over the years, and their many memories of raising the children there would always stay with them. Clearly she had mixed feelings about what was happening.

It got me to thinking about what a house is. For starters, it’s four walls and a roof, maybe even a basement, but maybe not, in which we shelter ourselves, our families and our stuff. It is also a place where we invite friends and neighbors to drop in for a drink, a chat or even an elegant dinner party. Some of those guests may even stay over from time to time, so a house is a hospitality center in which we connect with those we enjoy and perhaps love.

A house is a physical location where we can be found. When people ask our names, they may immediately follow up with a second question: “Where do you live?” So to some extent, where we live helps define us. But a house is more, so much more. It is a home where those closest to us reside, perhaps where our children grow up, where we planned, and from which we traveled to and from work to become the people we are today. 

Home is where we want to go immediately when we are not feeling well. It’s where we can get a soothing cup of tea or our regular sustenance at mealtimes. Home is a place where we rest, watch television, read the newspaper, use the computer, play video games, call our friends, wash our clothes, floss our teeth and sleep one-third of our lives. Home is our center, where our car knows to go automatically. Home is safe.

The longer we live there, the harder it is to leave.

When my elder brother died, leaving the co-op empty that my parents had bought and lived in for many years, I started slowly to have alterations made inside the apartment. The bathroom and kitchen needed to be brought up to date, appliances modernized, floors improved. 

My cousin watched with some amusement. “You are making a temple to your parents’ memory,” she offered. Not really, I thought to myself. I was investing for a far more pragmatic reason. I had hopes of one day renting it out for some supplemental income. 

But when I thought about her wry comment, I had to admit there was an element of truth in it. Our family had lived there happily for such a long time. I was even born there. It wasn’t just an apartment. It was the physical container for some of my happiest times. And it was comforting, somehow, that it was still there, even if we no longer were.

I remember when I was still in elementary school, just down the block, that one of my young classmates came to school one day to wish us goodbye. With tears in her eyes, she explained that her family was moving to someplace called Ohio for her father’s job, and she would be leaving us. 

“Don’t worry,” soothed the teacher, “you’ll go to a nice school there and make new friends. You’ll grow from the experience. And you can always come back to visit.” She nodded her head obediently, but I remember thinking then how sad it must be to leave one’s home and all associated with it to start over. 

Leaving a home means interrupting the momentum of one’s life. I wondered if my father would ever move us all elsewhere and comforted myself with the thought that he seemed pretty anchored where he was, which meant I would continue to live near my school.

A house is just an inanimate thing, bought and sold. But when it is a home, it can be the soul of the people who once lived there. 

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