Wellspring Issue #38 by The Wellspring

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MARCH 2019 // ADAR II 5779 // ISSUE 38

Is Sugar Addictive?

Grin &Bear it

This Purim, you could prevent sugar overdose

Registered dietitian Laura Shammah shows you how

Pediatric illness is no fun.

How do children juggle their double identity of innocent childhood and their dark reality?

4 courageous adults share how they did it.

Are You Kidding?

I will never let you drink again 4 tips for safe alcohol consumption

3 New Columns!

Dr. Jacques Doueck, DDS

Do I Really Need to Have My Wisdom Teeth Removed?

6 ridiculous health fads the masses are actually falling for

When Rabbi Yisrael Pinchas Tirnauer was desperate for urgent halachic guidance in medicine, he learned that the community had no such address. Meet the visionary behind the Refuah KaHalacha hotline.

Heart to Heart

“I have everything going for me but I don’t feel happy.”

Not a Laughing Matter

One mother’s quest to find a cure for PANDAS

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2/10/19 4:08 PM

From the Editor shiffy@wellspringmagazine.com

You hold in your hand a miracle. Every month, when the printing presses get to work on bringing The Wellspring to life, we take a moment to sit back and marvel that it happened again.

Producing valuable content that is both of interest to the community as well as well-researched and encouraging is our constant goal, and the entire team devotes itself toward achieving it, but bringing this vision to life month after month can only happen through a miracle. On the publishing end, there’s always that last minute hitch—the interview that falls through, the eyesore typo, the missing title. And in our personal lives, things can get pretty unpredictable too—the teething baby, a virus, a family commitment. In the end, when we actually flip through the pages of a hard copy of our sweat and toil, our gratitude knows no bounds. But that’s no wonder. Of course we’re grateful for having reached this point. Except deadlines, we have so much to appreciate. Feeling thankful when the miracle is in disguise, now that’s a different story. And incredibly, every single one of our interviewees in this issue’s cover feature, “Grin and Bear It,” did exactly that. Each of these impressive young women experienced chronic or life-threatening illness in their youth, from juvenile diabetes to Crohn’s disease to cancer and multiple sclerosis. And all of them, without exception, found what to be grateful for in the challenge. Even Tehilla, the young girl who was stricken with cancer just weeks before her wedding, which ended up being cancelled, found the silver lining in her darkest moments. Racked with pain and her heart heavy with the agony of dashed dreams, she chose to see the gifts Hashem was sending her: her supportive family and friends; the fun times; her newly acquired, deeper perspective on life.

Not surprisingly, the correlation between how the interviewees each viewed their illness and their parents’ perspective on the circumstances is pronounced. When children detect that their condition is an ominous cloud in their parents’ lives, especially in terms of its social ramifications, it becomes something they feel ashamed of. As psychotherapist Chaya Henchy Friedman writes in her sidebar to the article, “When we tell our children to keep a large part of their lives a secret, the subliminal message that we are imparting is ‘you are damaged,’ or ‘there is something very wrong with you.’ This message is internalized over time and becomes a vicious thought cycle that causes unwarranted experiences of isolation and grief.” On the other hand, the interviewees whose mothers were their rock were much more positive about their prognosis. Even those with chronic illness who live with their condition to this day speak of their situation without a trace of self-pity or shame, all thanks to their parents’ perspective that was impressed upon their hearts. Since their parents accepted their diagnosis in stride, they did too. While their condition may have had a physical impact on their life, their emotional and social development was unaffected. Among our other fine qualities, we’re a nation of Yehudim, of people whose essence is gratitude. When we find what to be grateful for even in circumstances that don’t appear ideal to our human eyes, even the bleakest diagnosis doesn’t bring us down. Our upcoming Yom Tov of miracles, Purim, is one great proof of this reality. Queen Esther, who, undeterred by the decree, garbed herself in clothes of royalty even when the situation seemed bleak, was the perfect Heavenly messenger for our nation’s collective miracle. Find the light, was her message, and we will rejoice one day soon. A simchas Purim and a simchas tamid to you all!

Sincerely, Shiffy Friedman

Well-Put! “When I treat a patient, I don’t only look at the particular organ they came in to talk about. I see a network of wondrous parts of one whole, all of which must work seamlessly together to enable optimal functioning.” Dr. Chayala Englard, pg.72

Adar II 5779 | Wellspring 13

Contents

MARCH 2019 ADAR II 5779 ISSUE #38

WELL INFORMED 22 26 28 30 36 38

TORAH WELLSPRING By Rabbi Ezra Friedman DENTAL HEALTH By Dr. Jacques Doueck, DDS

SECRETS OF A KOSHER DIETITIAN By Beth Warren, RDN HEALTH UPDATES IN THE NEWS By Rikki Samson FIGURES By Miriam Katz HEALTH ED Sugar Addiction By Laurah Shammah, MS, RDN DEDICATED TO HEALTH 10 Questions for Rabbi Yisrael Pinchas Tirnauer By Sarah Weinberger

THE PESACH ISSUE OF THE WELLSPRING WILL APPEAR IY”H ON APRIL 17TH. 14 Wellspring | March 2019

NEW COLUMN

LIVING WELL 46 IN GOOD SHAPE The Plank By Syma Kranz, PFC 48 ASK THE NUTRITIONIST Weight Loss with PCOS By Shani Taub, CDC 50 MEDICAL MYSTERY Not a Laughing Matter By Tzirel Davidowitz

NEW COLUMN

54 HEALTH PROFILE Client: Yocheved By Rachel Esses 56 COVER FEATURE Grin and Bear it By Shiffy Friedman 70 AT THE DIETITIAN Digestive Issues By Tamar Feldman, RDN, CDE 72 CUP OF TEA With Dr. Chayala Englard By Shiffy Friedman 76

MEMOS FROM A KINESIOLOGIST Thieves Oil By Miriam Schweid

78 DIY Natural Cleaning Detergents By Miriam Schweid

50 WELLBEING 81

HEART TO HEART By Shiffy Friedman, LMSW

NEW COLUMN

84 CHILD DEVELOPMENT By Friedy Singer & Roizy Guttman, OTR/L 88 SERIAL DIARY By Zahava List 90 CLEAN SLATE By Shiffy Friedman, LMSW

ISN'T IT AMAZING HOW OUR CHILDREN ARE MINI MIRRORS OF US?

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Springboard

Letters

Mental Illness, Tongue Tie, Bedwetting, & The Neck Check The Danger of Comparing Mental Illness to Cancer Issue #37: From the Editor

As usual, you outdid yourself with this edition of The Wellspring. I really enjoy reading all the different sections. I loved the nutritionists’ breakfast ideas!

invites readers to submit letters and comments via regular mail or email to info@ wellspringmagazine. com. We reserve the right to edit all submissions and will withhold your name upon request. We will honor requests for anonymity, but we cannot consider letters that arrive without contact information.

18 Wellspring | March 2019

I would like to address a point Shiffy Friedman made in her letter, which is something that has become the right thing to say, apparently: the idea that mental illness is an illness just like cancer and therefore there should be no stigma attached to it and no fear of writing about it publicly. I disagree. Allow me to explain.

Although I have not interacted with Zahava List personally, I have heard many wonderful things about her, which are corroborated by her insightful series. I think it is a shame that some people still need to hide their mental and emotional challenges for fear of stigma, and I commend Zahava for her willingness to get out there for the good of the klal. Kol hakavod! On this aspect, I agree completely.

However, I believe there is a lot of danger in comparing mental illness to physical illness. While it is true that there are many biological components to mental illness, it cannot be argued that there are many other factors as well, far more than with physical illnesses. Almost without exception, recovery from mental illness requires active participation on a patient’s part — whether behavior modification, stress-reduction exercises, etc. In cancer treatment, while studies do show the benefits of a positive mindset, the treatment is basically outside of the power of the patient.

This, to me, is a very important distinction. While it is crucial not to blame the sufferer for the illness, it is equally important for them to know how much of the healing is possible — and in their hands. Psycho-pharmaceutical intervention can be helpful in minimizing the symptoms, but the patient still has to be involved and work hard. Another danger in calling mental illness simply “another kind of diabetes” is the risk of condoning unsafe environments. Nearly all (or all, depending who you ask) mental-illness symptoms are the

result of trauma. Not all traumas can be prevented, but some can. Failing to recognize this impact, and slapping a diagnosis on someone who is acting in a way that is actually a normal human reaction to abnormal circumstances, can potentially distract attention from where it should be directed.

This brings me to my final point. People who have diagnoses of mental illness are experiencing normal human reactions on a more extreme level. They are not fundamentally different than people without such a diagnosis. Circumstances, both external and internal, have caused them to act in ways that may seem different, and this is the basis of their diagnosis. Of course, it is important to validate people’s difficulties and gain support from those who understand. But let’s not minimize the power within the patients’ hands, the impact of the environment on their mental health, and the fact that they are just like you and me in every way. Thank you, Tzipora Schiffer, BSW, Certif ied Peer

Quick Question

Thanks for a very informative magazine. I find it fascinating to read about new health issues every month. Is there anything to be done to cure herpes/cold sores? Conventional medicine has nothing to offer but temporary fixes. I’m looking for a total cure to this virus, which lives in the body and shows up at the most inconvenient times (probably due to stress or hormones). Aside from it being painful and itchy, it is downright ugly. I did read online about natural remedies including resveratrol, circumin, and quercetin given in a specific order and amount, but it is very unclear. Would you know anything about this issue? I would really appreciate any advice or guidance.

Thank you so much, Rochel Pollak I agree with you that cold sores come at the most inconvenient times, when your immune system is low due to stress, lack of sleep, and overworking. In addition to dealing directly with these three issues, such as getting more sleep and cutting down on the workload, try boosting your immune system with multi-vitamins, Maxibiotic, and vitamins C and D. For a real “quick fix,” there is an essential-oil combination called Cold Sore Relief that is made of myrrh and tea-tree oils. The combination heals and dries the herpes and sores in a matter of hours. It can be used inside the mouth as well on the outside.

This Bedwetting Solution Worked for Us Issue #36: Quick Question

We love your magazine! It’s informative, compelling, and a pleasure to read.

I read the quick question about bedwetting and would like to contribute my experience to the conversation. Bedwetting is more common than we think, especially because people don’t usually talk about it. We are actually in the middle of a treatment with one of our children. It's called TheraPee by Drs. Jacob and Tal Sagie (from Israel) and we are definitely seeing improvement. The program is said to have a 90 percent success rate.

Two of my friends have also tried this with their children, and both had success with it, baruch Hashem.

It’s a process that takes time (months) and patience, but, with Hashem’s help, it works. The program includes an alarm system, exercises, and a progress chart. Dr. Sagie can be reached at (855) 3772443. Y. H.

Take care, Miriam Schweid, health consultant and kinesiologist

Craniosacral Therapy for Tongue-Tie

Issue #35: Cover Feature

I missed the magazine where you discussed tongue-tie, but I read the follow-up letters. My baby was not gaining weight and was diagnosed with tongue-tie by two lactation consultants. When I learned that my neighbor practices craniosacral therapy, I asked her if she had experience curing tongue-tie using this therapy. Upon confirmation, I asked her to work on my baby. My neighbor came over pretty soon afterward, and while my baby was sleeping, she did her

work. When my baby woke up, I noticed her tongue moving freely. I had not even noticed until then that I had never seen her tongue outside of her mouth! Baruch Hashem, my baby is doing beautifully now, though we’re on the lookout for volunteers for the midnight feed... Baila Vorhand

I Feel Normal Issue #36: Torah Wellspring

I can’t tell you how spot-on I felt the article titled “Am I Normal?” was. The feeling of relief, and the validation that there really is no “normal,” was a gift. To quote the

author, “The truth is that while chasing the elusive normal, every individual simultaneously yearns to be able to express their uniqueness, to give to the world in a way only they can.”

It felt good to have someone put into words the real struggle that I face daily, of having to both thank G-d for my challenges and for who I am, and walk with my head held high for my uniqueness, trusting that I really am precious to Hashem and am good enough. May we all have that gift, especially during this month of Adar. Thank you. Respectfully, Cindy Abrams, Los Angeles, CA

Adar II 5779 | Wellspring 19

Springboard

Letters

Herbs for Ligament Healing Issue #37: Cup of Tea

I enjoyed the article about Chayala Englard’s work. I would like to point out that there is a great herb called Solomon’s Seal with an affinity to the ligaments. It stretches them if they’re too tight, and tightens them if they’re too loose. I hope you can make this known. There is always hope and methods of treatment for every condition. No one should feel like they’re stuck because they had babies.

There are also great homeopathic remedies to treat prolapsed organs. And, according to Chinese medicine, prolapse of any organ is based on the spleen’s weakness, as one of its jobs is keeping the organs in place. Thus, herbs that nourish the spleen would be a great way to start. I think people should know there’s always hope for whatever they’re experiencing. M.S., a longtime student of herbs and natural medicine

What’s the Neck Check? Issue #37: HealthEd

I was fascinated by Laura Sham-

20 Wellspring | March 2019

mah’s well-researched article on hypothyroidism. There, she mentions the importance of doing a “neck check” self-exam. I would love to know what that entails. Looking forward to your response, Tzivia D. Lakewood, New Jersey

Laura Shammah, MS, RDN, responds: Thank you for your positive feedback on my article. The lack of awareness about the existence of our thyroid gland is alarming, since an estimated 15 million Americans currently have undiagnosed thyroid problems. It’s important to understand that early detection is key to treating your thyroid condition Here is how to perform a five-step thyroid “neck check” self-exam. All you will need is a mirror and a glass of water. 1. While standing close to the mirror, focus on the lower front area of your neck, above the collarbone, and below the voice box (larynx). Your thyroid gland is located in this area of your neck. 2. While focusing on this area in the mirror, tip your head back. 3. Take a drink of water and swallow. 4. As you swallow, look at your neck. Check for any bulges or protrusions in

this area when you swallow. Reminder: Don’t confuse the Adam’s apple with the thyroid gland. The thyroid gland is located further down on your neck, closer to the collarbone. You may want to repeat this process several times. 5. If you do see any bulges or protrusions in this area, see your physician. You may have an enlarged thyroid gland or a thyroid nodule that should be checked to determine whether further evaluation is needed.” An at-home self-exam known as the “neck check” can help you find thyroid lumps or enlargements on your own thyroid gland. These growths may point to any number of thyroid conditions from nodules and goiters to thyroid cancer, G-d forbid. Lumps in the neck can be caused by thyroid disease, and they can also be caused by a variety of other conditions, such as lymph-node enlargement, lymphoma, an infectious abscess, or a traumatic injury. In general, a neck check is not considered the most accurate or reliable way to identify thyroid disease; you can still have serious thyroid disease even if you have a completely normal neck check, and a major growth can be a sign of an important but easily treatable thyroid problem, like an iodine deficiency. A self-check is not a substitute for a medical evaluation of your thyroid gland’s structure and function.

CMY

Well Informed

Torah Wellspring: Spiritual Health By Rabbi Ezra Friedman

The Power of Will If all it takes is ratzon, and I really want it, why have I still not reached my goal?

We’re accustomed to hearing declarations regarding willpower

that encourage us on the one hand, but may also bring a feeling of despair. The phrases “ein davar ha’omed lifnei haratzon,” loosely translated as “if there’s a will, there’s a way,” and the Yiddish expression, “ratzon brecht eizen,” offer a sense of chizuk. They imply that if you want to reach a certain goal, all you need to do is want it. In other words, there is no real impediment that could get in the way. For example, an individual might say to himself, “I wish I would earn more money.” But then he looks at himself, his weaknesses, his bank account, his debts and he says, “But how? How is it even possible?” There are technical matters that are holding him back from getting there. Then, if he hears that all he needs to do is want it enough, he could draw chizuk from these phrases. He understands from them that the only component to success that’s really missing here is ratzon, and if he works on that, he’ll get there.

The same is true for all of our goals and wishes, such as wanting better shalom bayis, good children, more yiras Shamayim, friends, simchah—anything. With all of these things, the individual might be under the impression

22 Wellspring | March 2019

If it all depends on my ratzon, something doesn’t add up. Of course I want a fulfilling marriage. Who doesn’t want to be ehrlich? Who doesn’t want to have good children?

that certain technical difficulties are impeding him from attaining his objective, but when he learns that all that is required is ratzon, he feels empowered and encouraged. He concludes that apparently, at this current moment, he doesn’t want it enough, but when he will want it enough, it’ll happen.

On the other hand, after we hear such statements, we’re confused. There are so many things that we feel we really want and we still haven’t attained them. If it all depends on my ratzon, something doesn’t add up. Of course I want a fulfilling marriage. Who doesn’t want to be ehrlich? Who doesn’t want to have good children? While such phrases give us chizuk, we simultaneously doubt their veracity. Let us understand how these conflicting messages about ratzon essentially go hand in hand. Ratzon is a very broad subject whose scope cannot be covered in just one article, but we will touch upon one particular aspect this month.

Before we delve into the depth of willpower, we must make an important distinction. Much of what we think of as ratzon is not in essence ratzon. As ambiguous as this sounds, many of the things we say we want, and we may really think we want, don’t actually emanate from a place of wanting. How can that be? With everything we think we want, we must ask our-

As ambiguous as this sounds, many of the things we say we want, and we may really think we want, don’t actually emanate from a place of wanting.

selves, “Do I want this or do I simply not want its opposite?”

Let’s return to our gashmiyus example of money to understand this better. Many people say they want to be rich, they want money. Two such people could be thinking that they want money, but when we delve a little deeper we notice a profound distinction between them. The question is: do you want the pleasure of having money or do you have a problem with being poor?

Weight loss is another simple example. Are you losing weight because you want to look and feel good or do you not want to be heavy, not want to be the way you are now?

Moving on to ruchniyus, when you say you want to be a talmid chacham, do you want to have a deep connection to Hashem and His Torah or do you not want to be an am ha’aretz, a loser? When you say you want to have good children, do you want to connect your children to the legacy of our Avos, to perpetuate the Torah’s transmission from your generation to the next, bring more Shechinah into the world, or do you not want that your children should make you feel like a failure? With regards to shalom bayis, do you want the Shechinah to rest in your home, to live with ahavah and achvah with your spouse, or do you not want a tense home?

As these examples portray, there’s a world of a difference between having a ratzon for something and not wanting its opposite. Very often, we make the mistake of calling the latter our “ratzon,” which it is not. Let’s understand the profound difference between them.

Rashi (Bereishis 23:8) explains this in one powerful statement. In his commentary on the verse, “im yesh es nafshechem,” he explains nafshechem to mean “retzonchem.” In other words, he’s telling us that one’s nefesh and one’s ratzon are one and the same. The person is his will. The ratzon is not just another thing that he wants. It’s him. It’s his essence. Thus, if a person wants something, he is what he wants. And because it’s him, he will reach it because the koach of a person knows no bounds. He’ll persevere until the end to make it happen.

Not wanting something, on the other hand, is completely deficient of power. It has no koach. This is called pachad, fear. I have a fear of being a loser. I have a fear to not look good. I have a fear of tension, of fights. I have a fear to be an am ha’aretz. These are all fears, not retzonos. It’s easy to confuse the two but they’re complete opposites. Because these are not retzonos, we’re not connected to them. If you’re driving a car that has a powerful engine, you’ll get to wherever you need to go. Your ratzon is that engine. The more powerful

If you’re driving a car that has a powerful engine, you’ll get to wherever you need to go.

it is, the farther you could reach. It’s a drive. Fear, on the other hand, is not a motivator. It’s an inhibitor, like a barricade. It doesn’t have the power to carry you anywhere. Practically speaking, the individual who has a ratzon to learn Torah and be connected to Hashem, will have a drive to do so. He’ll get out of bed early in the morning and find as much time as possible throughout the day to devote to his avodas Hashem. If, however, he wakes up in the morning with the fear of being an am ha’aretz, it’s as if a barricade was plunked down before him. He is forced to wake up, forced to drag himself to shul. The barricade may keep him back from doing things that would make him look like an am ha’aretz, but he has no engine; his fear is not driving him anywhere. There are times when a barricade is stronger than an engine. It has the capacity to keep us back from doing things we may never have imagined that we’d be able to say no to. It has energy, but it has no power. Every time we think we want something, we must look deeper to see if this is actually our ratzon or we’re simply afraid of its opposite. It’s not easy to differentiate between the two, especially when we’re new at this. It’s not easy for a person to admit, let’s say, “I don’t feel that I want to be close to Hashem. I only have a great fear of being a loser,” es-

Adar II 5779 | Wellspring 23

Well Informed

Torah Wellspring: Spiritual Health

When you say you want to have good children, do you want to bring more Shechinah into the world or do you not want that your children should make you feel like a failure?

pecially if he’s working his whole life toward this goal. But, if we want to live with our ratzon, we must first know what is driving us.

People often say, “I wanted to stop smoking so many times and it didn’t work out,” or “I really don’t want to look the way I do, but my diets keep failing.” They say it about various addictions and bad habits. But if we listen carefully to their words, we get a clue as to why they haven’t been successful up until now. They don’t say, “I so badly wanted to be healthy, to take care of myself, to look and feel good, to be a loving spouse, to be a caring parent.” Rather, their focus is on what they didn’t want, on not doing what they’re doing now. To help you gauge whether or not it’s your ratzon driving you, see how successful you’ve been at attaining your goal. If you’re aiming for something for a long time and you see you’re not getting it, look deeper to see if you’ve been driven by your ratzon at all.

Another good way to ascertain if we’re operating from ratzon or fear is to take the time to think, “What do I envision when I’m working toward the goal? Do I see a healthy person, a person who is close to Hashem, or do I see a barricade, the current state that I’m unhappy with?” When we connect to what we do want, we can be successful in our endeavors, with the

24 Wellspring | March 2019

help of Hashem, as the opening phrases in this article attest.

There is no dearth of stories that convey that when an individual is driven by his ratzon, he manages to achieve great things. I recently came across one such story in the sefer Ohr Dovid, which touched me deeply. The story took place in Williamsburg, Brooklyn, about 70 years ago. A destitute lonely widow who lived there had an only child whom she could not afford to send to the talmud Torah at the other end of the city. Thus, the boy spent his days in the nearby public school environment, and later in the afternoon, when he returned home, his mother would teach him the basics—how to daven, how to read in lashon hakodesh, etc. At twelve years old, with a very elementary foundation in Yiddishkeit, this young boy found out for the first time that about an hours’ walk away from their apartment Jewish children were sitting and learning Torah all day long. His Yiddishe spark was kindled within. This was what he wanted, what he yearned for. And so, he made up his mind that no matter what, he would join them too.

When the boy approached his mother and told him of his plan, she said to him, “What should I tell you? I also want this for you, but first of all, it’s very expensive. The transportation itself costs a lot. And it’s in the middle of the winter now. You don’t even have a decent coat!”

But the child’s burning ratzon wasn’t extinguished by his mother’s words. He begged and pleaded long enough until she said, “Look, my child. I can’t help you, but I won’t stop you either.”

The next morning, the young boy left his apartment, a flimsy sweater on his back. With no money for transportation, he braved the frigid cold by foot, pushing himself against the blustering winds. With every gust of wind, his ratzon only intensified. The colder and wetter he got, the louder he said to himself, “I want to learn. I want to go to cheder.” And finally, one hour later, with chattering teeth and frostbitten ears, he arrived at the building. With a radiant face, he ran up the stairs to find the menahel. He knocked fiercely on the door and said to the principal, “I just walked for one hour to come learn Torah.”

The menahel took one look at the child, cold and wet, without a coat, and he didn’t know what to make of him. When he inquired about the boy’s learning and which grade he was in, the boy was confused. “I don’t know much. Maybe a bit of siddur you could test me on.” The menahel turned to the boy and said, “My dear child, we learn how to read the siddur in kindergarten. You’re almost bar mitzvah,” hoping the boy would get the message that this place was not for him. But the boy was undeterred, arguing that it would be a merit for him

with

happens to all of us. You’re trying to grocery shop with your children in tow, and just as you head down Aisle 7, the crying begins. Overwhelmed by the colors and ﬂavors, your toddler points to a sugary yogurt and wants one now.

On Purim, the Yidden reaccepted the Torah, and the Gemara states that this time it was from love. The difference between accepting something from love and from pachad is precisely what we discussed in this article. An individual doesn’t choose what he doesn’t love, only what he does love. Thus, there’s a world of a difference between choosing to accept the Torah versus being forced to accept it. When we choose Torah, we have an engine driving us, fueling our connection and making fulfillment of its commandments an invigorating pleasure. May Hashem help us attain the proper connection to Torah, which will take us to where we need to go. Simchas Purim!

lorie

Of course, the menahel was moved by the words of this twelveyear-old child with a burning ratzon. The child entered kindergarten and gradually learned. He didn’t have the strongest head, but his ratzon drove him to become the ehrliche Yid he was dreaming to be. Years later, Rav Zvi Meir Zilberberg shlit”a, the one who told this story, attested that this boy turned out to be a great talmid chacham and marbitz Torah who despite his background and limited intelligence reached great heights. It was his ratzon that empowered him to fight against all the impediments along the way.

M e h a d r i n Fit N’ Free yogurts are w s eetne delicious, low in calories, fat free, and sugar free. With a high-protein, reduced-sugar Greek option as well, these yogurts are a great option for kids and adults alike—and the variety of ﬂavors means there’s a yogurt for every taste. Packed with healthy protein and low-calorie sweetness, Mehadrin Fit N’ Free is just right for a sweet choice that can keep you full for hours. ca

Moved by the boy’s words but also confused, the menahel wanted to understand why the boy needed such a note. “I’m an orphan,” the boy explained. “And when I meet my father in the World to Come, I know he will want to know why I didn’t do everything in my power to learn Torah. If I’ll tell him that I killed myself for this, that I was ready to embarrass myself for this, will he believe me? That there was a menahel who didn’t let? Because in the Olam Ha’emes they know the truth, he will tell me that if I had a ratzon I would have gotten there. He won’t believe me. And so, I beg you to write this down for me, that I did my utmost but you were the one who stopped me.”

Luckily for you in this scenario, just as you’re about to grab that sugar-loaded treat, you notice an item on the shelf that says M e h a d r i n Fit N’ Free. Fit? Free? That yogurt has your full attention, and with good reason. -

This time, the menahel had a new excuse. “Come let me show you how packed the kindergarten class is. There’s simply no room for you there.” He led him by the hand to the classroom, where the boy saw the reality with his own eyes. “I see,” he said in defeat, “that you’re right. I wish I could sit in this classroom and learn, but I’ll have to go back home now. I ask of you one thing, though,” he said, turning to the menahel. “Please write the following note for me. Write that I came, that I walked for one hour in the cold, that I begged to join the kindergarten class, that I did everything in the world to actualize my dream, but there is simply no room for me.”

Low

to go to kindergarten and work his way upward.

Since you’re a responsible, self-respecting mom, no one would blame you if you want to avoid the commotion and give him what he wants (the yogurt) while giving yourself what YOU want (the quiet).

Pair it with slivered almonds or granola and a fruit for a wholesome breakfast, or enjoy it on its own, in a smoothie, or as frozen yogurt for a good-for-you snack you're sure to love.

Raspberry

. Plain . Strawberry . Vanilla . Coffee . Peach . Mixed Berry . Blueberry

Well Informed

Dental Health By Dr. Jacques Doueck, DDS

FAQ

WISDOM TEETH

Q. Do wisdom teeth cause crowding of the front teeth? A. No. A 20-year study showed that crowding occurs with or without the wisdom teeth, so this is not a reason to remove them. Q. Should wisdom teeth be removed if there are no problems? A. No. Removal of wisdom teeth is a surgery, and we don’t want to put our patients through surgery unless there is a high risk of damage by keeping them. X-rays and visual exam allow us to help patients with this important information. Q. What is the best age to have wisdom teeth removed? A. Usually between 16 and 18 years old. Without a doubt, younger patients (adolescents) heal faster, in a more predictable fashion, and with fewer complications than older patients.

New Column!

DO I REALLY NEED TO HAVE MY WISDOM TEETH REMOVED? I was prompted to write this article because of two adult patients who suffered severe damage, infection, and swelling because they delayed taking out wisdom teeth. One of them actually broke his jaw because of a wisdom tooth that should have been removed long ago. The patient, 48 years old, lost both teeth, and the fractured jaw forced him to eat baby food for six months. The other patient was 65 years old and had to have the wisdom tooth and the adjacent molar removed. Keeping your wisdom teeth past your twenties may not be so wise after all, according to the results of a seven-year research study by the American Association of Oral and Maxillofacial Surgeons (AAOMS). Keeping poorly-positioned wisdom teeth puts you at higher risk of developing infections of the gums and jawbone.

Of course, it would be foolish for a dentist to recommend that everyone should have their wisdom teeth removed. We consider many factors, such as their proximity to the cheek, whether the tooth is impacted, and the condition of the bone, gums, and teeth. Once a well-thought-out decision is made, postponing wisdom-teeth removal may be more complicated, require a longer recovery period, and involve damage to adjacent teeth, sinus, and jawbone that may not be easy to repair.

Q. What if I don’t have my wisdom teeth removed despite the dentist’s recommendation?

If you have insufficient room in your mouth for your wisdom teeth, they can cause a multitude of problems:

A. The problem with taking a “wait and see” approach is that if it becomes necessary to remove a wisdom tooth in your thirties or beyond, it is much more difficult for the patient, and the potential complications are much greater.

Infection

26 Wellspring | March 2019

Without enough room for the wisdom tooth to come in, the gum tissue around the wisdom tooth can become irritated and infected, resulting in recurrent pain, swelling, and problems

with chewing and swallowing.

Damage to Adjacent Teeth If it is difficult to clean around the wisdom tooth, the tooth directly in front of the wisdom tooth, the second molar, can be affected, resulting in gum disease (bone loss), cavities, and root canal. Cysts Cysts are fluid-filled bubbles inside the jawbone associated with impacted wisdom teeth that slowly expand, destroying adjacent jawbone and occasionally adjacent teeth. Although rare, certain tumors can be associated with impacted teeth. Both of these conditions can be very difficult to treat. If a wisdom tooth is completely horizontal, the chances of bone disease are so high that we can predict that in 10 or 20 years that person will almost definitely have gum and bone problems that will pose a risk to other teeth.

-c

alorie

The longer you wait, the higher the risk of complications. There is risk of infection, and some risk of jaw fracture, cavities and root canal on the adjacent teeth, gum disease, and more. Delaying wisdom tooth removal may result in many serious complications, such as numbness of your lip for a couple of years, or even for life, due to nerve damage when the tooth is pulled.

A wisdom tooth that comes only partially through the skin leaves a person open to high risk of decay and infection. As is, a wisdom tooth is very difficult to clean, even when it looks like it is in a good position, because it is far back against the upward curve of the jawbone. Sometimes it’s not even possible to get a toothbrush back there.

etn

So before you refuse your dentist’s advice to remove your wisdom teeth because “they don’t hurt,” consider all the risks and potential long-term consequences.

Dr. Jacques Doueck has been practicing family dentistry in Brooklyn, New York since 1977, and is a Diplomate of the Academy of Clinical Sleep Disorders Disciplines. He speaks nationally and trains other dentists in oral appliance therapy and state-of-the-art dentistry. Dr. Doueck is a member of the American Dental Association and serves on the District Claims Committee for the state society.

Raspberry Plain Strawberry Vanilla Coffee Peach Mixed Berry Blueberry

Well Informed

Research Based Recommendations By Beth Warren, MS, RDN, CDN

||| SECRETS OF A KOSHER DIETITIAN |||

SECRET

#12

If you’re using artificial sweeteners, it’s likely you’re consuming too much.

28 Wellspring | March 2019

ARE YOU USING TOO MANY ARTIFICIAL SWEETENERS?

sweeteners to examine their efficacy in weight management. The studies followed more than 400,000 people for approximately 10 years. Seven of the studies were randomized controlled trials, considered to be the gold standard in scientific research. Artificial sweeteners did not appear to help people lose weight. Instead, obser vational studies that looked at consumption over time suggested that people who regularly consumed them—by drinking one or more artificially-sweetened beverages a day—had a higher risk for health issues, such as weight gain, obesity, diabetes, and heart disease. Research presented in an annual Experimental Biology meeting in San Diego identified a number of pathways linking artificial sweeteners with metabolic changes at the genetic level that could lead to diabetes and obesity. Specifically, the researchers found that three weeks of exposure to aspartame and acesulfame potassium, two artificial sweeteners frequently combined in products such as Equal, altered the expression of certain genes responsiIn a report published in the Canadian ble for lipid metabolism in the cells of Medical Association Journal, researchboth rats and humans. ers analyzed 37 studies on artificial

Many people are under the belief that it’s better to use artificial sweeteners than natural sweeteners. It may seem logical. After all, they’re non-caloric and aren’t actually sugar. You think you can consume these sweeteners without anything to worry about. But when something is too good to be true, it is. Over 40% of adult Americans consume no-calorie sweeteners on a daily basis, and studies that measure sweeteners in blood and urine show that many people who report not using artificial sweeteners are unknowingly consuming them. There are only five approved by the Food and Drug Administration for use in the United States: acesulfame potassium—sold as Sunett and Sweet One; aspartame— sold as Equal, Nutrasweet and Sugar Twin; neotame—sold as Newtame; saccharin—sold as Sweet’n Low, Sweet Twin and Necta Sweet; and sucralose—sold as Splenda. There is a multitude of consistent research proving that over time, artificial sweeteners do not aid in weight loss. In fact, they contribute to weight gain long term.

To schedule a nutrition appointment with Beth in the Brooklyn, NYC, NJ locations or virtually, or book an appearance, email beth@bethwarrennutrition.com or call 347-292-1725. Most insurances accepted. You can also follow her Instagram for healthy eating motivation and recipes @beth_warren

metabolic changes did not What was perhaps most surprising was that these se and fructose. This sugoccur in the presence of natural sugars, such as gluco olic disorders, such as metab gests that artificial sweeteners could contribute to than natural sugars. anism mech ent diabetes and obesity, by an entirely differ

A few reasons why this might occur:

1 Some researchers speculate that sweeteners interfere with a person’s microbiome, a collection of gut bacteria crucial for the absorption of nutrients.

2 Regularly eating or drinking sugar substitutes may also cause people to crave sweeter foods more often.

People may believe that because they haven’t consumed calories, they have license to splurge elsewhere.

4 Some researchers believe that sweeteners may interfere with the body’s mechanisms for metabolizing sugar.

There’s always more to a food and its effect on your health and weight than just calories. The bottom line is that if you’re using artificial sweeteners, it’s likely you’re consuming too much. You’ll add two packets to your coffee, find out there are one or two inside your yogurt, crackers, cereal, flavored water, and other foods you weren’t even aware contained them.

Keep in mind that cutting back on any and all sweeteners is probably a good idea, even the more natural ones, and independent of whether they contain calories or not. However if you’re using a small amount, it’s probably not a big deal. Consuming sweeteners appropriately might not significantly affect your overall weight and health. Be a savvy consumer and read food labels to ensure you’re keeping your intake to an appropriate minimum. Better yet, try not adding sweeteners at all. You may surprise yourself by discovering you don’t need them and get used to the flavor of the food or drink the way Hashem intended it to taste.

Adar II 5779 | Wellspring 29

Well Informed

Health Updates in the News By Rikki Samson

I WILL NEVER LET YOU DRINK AGAIN 4 Tips for Safe Alcohol Consumption While the health benefits of moderate wine consumption are supported by some studies and refuted by others, Purim is one day a year when most of our menfolk imbibe—health benefits or not. But just because you’re drinking to fulfill a mitzvah, there are steps you can take to play it safe. Here are four tips to prevent health problems, accidents, and trauma for everyone involved.

1. Know Yourself A standard drink contains about 10 grams of ethanol (alcohol), which is the amount the body can process in 1 hour. How much alcohol you can handle depends on age, weight, gender, and how you feel at the time. Know your limits.

3. Hydrate Sipping water between alcoholic beverages is not only a great way to slow down the count, but also to prevent dehydration. To get the best out of mixing food and alcohol: • drink plenty of water • don’t mix alcohol with sugary or energy drinks • avoid salty snacks—they will make you thirsty and you’re likely to drink more

2. Eat First Alcohol enters the bloodstream through the stomach and small intestine. If your stomach is empty when you start drinking, the alcohol will enter the bloodstream more quickly. So, it’s a good idea to eat before you down your first drink, and while you’re drinking.

4. No Car Keys In most states, including New York and New Jersey, driving with a blood alcohol content (BAC) of .08 perfect or more is illegal (even lower BAC levels may be held against you). For some individuals, all it takes it two to three drinks to reach that level. If the driver in your family is planning to drink, make an advance plan of how the family will be transported, if necessary.

30 Wellspring | March 2019

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Well Informed

Health Updates in the News

HOW HIGH IS YOUR TEEN’S BLOOD PRESSURE? Here is why you should treat it today

Hypertension is not only an adult disease. In adolescents, in fact, treatment is vital to promote renal health in adulthood. As a new study published in JAMA Internal Medicine indicates, high blood pressure in adolescence is associated with kidney failure in adulthood. Led by Dr. Edud Grossman of the Chaim Sheba Medical Center in Ramat Gan, Israel, researchers studied health records of more than 2.6 million healthy 16- to 19-year-old subjects from 1967 to 2013. Almost 8,000 had a diagnosis of hypertension. Over an average follow-up of 20 years, 2,189 developed renal disease requiring dialysis or kidney transplant.

About half of the young people with hypertension were overweight or obese, which has been shown to be a risk factor for future renal disease. But even after controlling for body mass index and for gender, age, and socioeconomic status, they found that hypertension in adolescence doubled the risk for end-stage renal disease in adulthood. The risk was similar even when those with severe hypertension—160/100 or higher—were eliminated from the analysis. “Don’t ignore hypertension in young people,” says Dr. Grossman. “If you don’t treat it, you increase the risk not only for kidney disease but for stroke and cardiovascular disease as well.”

SLEEPLESS NIGHTS WITH BABY Is Catching up on Sleep Even Possible?

New parents know all too well how rare a good night’s sleep becomes after a baby arrives. Middle-of-the-night feedings and predawn wakeups take their toll. In a recent study published by Oxford University Press on behalf of the Sleep Research Society, researchers have calculated just how great a toll it really is. The study found sleep satisfaction and duration sharply declined with childbirth, reaching the lowest point during the first three months after birth. And even six years later, parents’ sleep still hadn’t fully

32 Wellspring | March 2019

recovered. (Apparently there’s no mention of siblings there.)

Not surprisingly, both sleep satisfaction and duration were much lower for new mothers than for fathers. Women saw an average sleep reduction of 62 minutes a night, compared to men, who got about 13 minutes less sleep, according to the study. Breastfeeding was associated with a slightly greater decrease in moms’ sleep satisfaction. Six years after birth, mothers still slept 20 minutes less and fathers slept 15 minutes less than before the baby arrived.

So before you welcome that little bundle of joy, brace yourself: you may still be somewhat sleep deprived when they’re in first grade—and always. But as my Bubby says, I’ll choose to sleep somewhere else.

Book your appointment with the best doctors around! 1312 38th Street Brooklyn, NY 11218 1278 60th Street Brooklyn, NY 11219 (718) 686-7600 EzraMedical.org

Adar II 5779 | Wellspring 33

Well Informed

Health Updates in the News

I FORGOT AGAIN This scientifically proven trick will help you remember almost everything. The next time you need to remember something important—like your husband’s birthday or to schedule your child’s dentist appointment—grab a pen and paper and draw something to remind you. In a study to be published in Consciousness and Cognition, researchers found that drawing was the best method to retain new information. It was more effective than writing and rewriting notes, visualization exercise, and passively looking at images. And fortunately, this was true even if the person was a subpar drawer—no need to be a modern-day Rembrandt to really remember. The findings are especially valuable for aging adults and those who suffer from dementia, says Melissa Meade, a doctoral candidate in

34 Wellspring | March 2019

cognitive neuroscience at the University of Waterloo in Canada, where the study was conducted.

“Drawing pictures is such a simple task, and it can easily be implemented in everyday life to improve memory,” she says. “For example, drawing a picture of some groceries you need to pick up later or the meal you are planning to make will result in that information being remembered much better later on than if it were written.” To conduct the study, Meade and her team recruited 48 adults ranging in age from college undergraduates to those in their 80s. To start, the researchers asked the people to write down 15 words and doodle 15 other words—for example, a simple drawing of a boat for the word “yacht.”

To create a clean slate to test memory, the subjects were then asked to perform a filler task—classifying 60 audio tones as low, medium, or high. Once the filler task was complete, the subjects were given two minutes to recall as many words as possible from the first part of the experiment. In the end, young and old showed better retention when they used drawing rather than writing to encode the new information. This effect was particularly notable in older adults. According to Meade, drawing leads to better memory compared with other study techniques because it incorporates multiple ways of representing the information—visual, spatial, verbal, semantic, and motor. And hey, it’s fun too.

These statements have not been evaluated by the FDA. These products are not intended to diagnose, treat, prevent or cure any disease.

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maxihealth.com 800.544.MAXI info@maxihealth.com Adar II 5779 | Wellspring 35

Well Informed

Figures By Miriam Katz

Pediatric Health Stats

asthma 1 12

84%

is the leading chronic childhood disease

out of every

of children aged 5-11 are in excellent or very good health

school-aged children has asthma

Juvenile Diabetes: approximately

people under age 20 have type 1 diabetes

million

1.25

American children and adults have type 1 diabetes

only

About

Crohn's Disease:

780,000

36 Wellspring | March 2019

200,000

people in the U.S. have Crohn's disease

of diabetics have type 1 diabetes

Approximately

20-30%

of all patients with Crohn's disease present when they are younger than 20 years.

although multiple sclerosis (MS) is more likely to be diagnosed in adults between the ages of

20-40

children can also develop the autoimmune disease

8,000 10,000 and

(Sources: AAFA, CDC, American Cancer Society)

Multiple Sclerosis:

Between

children under the age of 18 are diagnosed with MS each year, and many more could be living with the condition but have yet to be diagnosed

Childhood Cancer:

10,590

children in the U.S. under the age of 15 were diagnosed with cancer in 2018

childhood cancers make up less than

of all cancers diagnosed each year

leukemia, the most common childhood cancer, accounts for about

30%

of all cancers in children Adar II 5779 | Wellspring 37

Well Informed

Health Ed By Laura Shammah, MS, RDN

Are You Addicted to Sugar? Sugar is the generic name we use to describe sweet-tasting soluble carbohydrates that are present in many foods. But what is it exactly and what impact does its consumption have on our health? Take this quiz to find out how much you know about one of the most popular Purim-related villains.

True or False: If I’m craving sugar, it means my body isn’t getting enough of it. Answer: False.

One of the ways your body tries to tell you that you may be having too much sugar is when you’re constantly craving sugary things. In other words, the more sugar you eat, the more you’ll crave it.

Here are some other symptoms your body might be giving you to convey this message: • You feel sluggish throughout the day. After sugar causes an initial spike of insulin and that “high” feeling, it causes an inevitable crash.

• Your skin won’t stop breaking out. The spike in insulin from sugar intake can set off a hormonal cascade that can lead to a breakout, like acne or rosacea. • You’re way moodier than usual. When your blood sugar drops after it spikes, it may cause you to be cranky.

• You’ve been putting on weight. Because it doesn’t contain protein or fiber, sugar does not fill you up. This sets you up to eat more. Sugar also triggers the release of insulin, a hormone that plays a big role in weight gain. • You keep getting cavities in your teeth.

• Your brain tends to get foggy, especially after a meal. When you eat too much sugar, your blood sugar becomes like a roller coaster. When it’s crashing downward, your brain may feel foggy.

• Nothing tastes as sweet as it used to. Eating too much sugar basically kills your taste buds, causing you to crave more sweetness. Cutting back can make you crave less within weeks or even days. Eventually, a carrot or a sweet potato will taste sweet to you. We all know that candy and soda aren’t healthy, but did you ever stop to think how their sugar content is affecting your body?

38 Wellspring | March 2019

Which of these is an immediate reaction of sugar consumption? A. Mental fog

B. Insulin release

C. Weight gain

D. Acne outbreak

Answer: B.

While the others are eventual effects of sugar intake, insulin release is the body’s first reaction. The pancreas releases insulin in order to regulate blood sugar. Over time, if sugar is regularly consumed, this can lead to insulin resistance.

True or False: Overconsumption of sugar puts you at risk for diabetes. Answer: True.

Insulin resistance forces the pancreas to produce more insulin, since tissues lose their sensitivity to it. Eventually, the pancreas loses the capacity to generate this surplus production and stops secreting sufficient insulin. When this occurs, type 2 diabetes may develop. Other possible results of sugar overconsumption are obesity, high blood pressure, and inflammation. High-sugar diets are linked to an increased risk of depression and heart disease. They may also increase androgen secretion, oil production, and inflammation, all of which raise the risk of developing acne. Studies show that drinking a 20-ounce soda on a daily basis is equivalent to 4.6 years of cell aging, the same as smoking cigarettes, which has been linked to a shorter lifespan.

Which of these foods has the worst kind of sugar content? A. Candy B. Soda C. Cake D. Ice cream Answer: B.

Sugars in beverages are absorbed very quickly, which results in rapid increases in blood glucose and insulin.

True or False: You should stay away from fruit because it’s high in sugar Answer: False.

Do you fear fruit because it’s full of sugar? As people shy away from soda, sweet breakfast cereals and store-bought cookies, it’s tempting to celebrate sugar’s status as a nutrition super-villain. As a dietitian, I can’t help but feel this new awareness comes with some consequences, like an increase in a number of people who ask me, “Is it okay to eat fruit? It’s so high in sugar.”

If you compare an orange to a can of soda, per gram, they would have same calories and sugar. However, we all know that soda is empty calories and an orange is full of fiber, potassium, and vitamins A and C. So if you’re concerned only with the sugar content, you will be missing out on all the nutrients in fruit that are vital for the health and maintenance of your body. The potassium in fruit can reduce your risk of heart disease, stroke, diabetes, cancer, and more. Potassium may reduce the risk of developing kidney stones and help to decrease bone loss as you age. Folate (folic acid) helps the body form red blood cells. Naturally occurring sugars, as in fruit, don’t have the same negative effects because they’re paired with fiber, which helps slow absorption, as well as other important nutrients. Replacing high-caloric, less-nutritious foods with fruit and vegetables is a good strategy for weight loss. Eat a variety of fruit.

Understanding the hazards of sugar does not mean that you must adapt a no-sugar detox plan. As a dietitian, I believe in having everything in moderation. Having a sweet treat every once in a while is perfectly okay, but daily overconsumption has been shown to have significant negative health outcomes. Many clients come to me feeling “addicted to sugar” and feel lost how to reduce their sugar intake. I help them learn to focus on eating whole, unprocessed foods. This automatically decreases the amount of sugar in their diet and lifts their spirits. I teach them to enjoy their favorite foods in moderation instead of eliminating them. You can still indulge in an occasional treat after you learn how to reduce your sugar intake. The idea is to avoid wasting your daily sugar quota on non-dessert foods like cereals, ketchup, and marinara sauce. To avoid overdoing it, set specific limits about when you may enjoy dessert: with friends, on Shabbos, and/or at restaurants. The best alternative for a sweet treat is fruit or over-72-percent dark chocolate.

Adar II 5779 | Wellspring 39

Well Informed

Health Ed

Check Your Labels To see if a food contains added sugars, check the ingredients list carefully. It is important to note the order in which sugar appears on the list, since ingredients are listed in order of percentage. The closer to the beginning of the list, the greater percentage of sugar the product contains.

Food companies also use more than 50 other names for added sugar, which makes it more difficult to spot. Here are some of the most common: High-fructose corn syrup Cane sugar or juice Maltose

Dextrose

Invert sugar Rice syrup Molasses Caramel

Tips on reducing sugar intake: • Drink unsweetened teas, water, or flavored seltzer instead of sodas, energy drinks, juices, and iced teas.

• Drink your coffee black. Going cold turkey on sugar isn’t realistic for most people. I suggest cutting back slowly. If you normally put two packets of sugar in your coffee, for instance, try one for a week, then finally half or none. • Consume whole fruits instead of sugar-sweetened fruit smoothies. • Replace candy with fruit, nuts, or a serving of dark chocolate chips.

• Use olive oil and vinegar in place of sweet salad dressings like honey-mustard.

• Choose marinades, nut butters, ketchup, and marinara sauce with zero added sugars. • Look for cereals, granolas, and granola bars with under 5 grams of sugar per serving.

Avoiding the Sugar Crash on Purim While many mothers are concerned—and rightfully so— about their children’s sugar intake on Purim, withholding all sweet treats backfires. I believe in letting kids enjoy. We don’t want our children to look back and remember Purim as the day Mommy was busy grabbing away their candy. We want them to remember the fun, being with family, and enjoying the mitzvos of the day. Kids will only want the junk more if you take it away from them. Rather, show them from a young age what a reasonable portion of junk food looks like. This doesn’t need to happen on Purim itself. If you discuss this with them in advance, they will be prepared. I believe that if children’s indulgences are too restricted, the psychological damage of being different from everyone around them and the feeling of deprivation are worse than the damage of eating candy for one day. Of course, it’s certainly worthwhile to have your children (and you) start the day with a healthy, high-protein breakfast, and lunch, balanced with complex carbs and fat. Keeping them satisfied will help in reducing the junk intake. Set limits on when and how you’re going to enjoy your sweets. You could choose to have an ice cream once per week and/or include a dark chocolate square after dinner every night. Choose your favorite treat. If you have a hard time controlling your treats, set boundaries around what sweet treats are worth the indulgence, when is appropriate to enjoy them, and how much you can enjoy. This will keep you from reaching in the middle of the day for jelly beans out of habit.

40 Wellspring | March 2019

• Swap your morning cereal for a bowl of rolled oats topped with nut butter, or an omelet made with fresh greens. • Instead of jelly, slice fresh bananas onto your peanut butter sandwich. • Use natural nut butters in place of sweet spreads like Nutella.

• Avoid alcoholic beverages that are sweetened with soda, juice, honey, sugar, or agave.

• Lack of sleep causes people to favor high-calorie, sweet, and salty foods over healthy foods, like fruits and vegetables. Get a good night’s sleep to help you eat less sugar. At first, cutting down on sugar can feel like an impossible task. Eventually, though, your taste buds will adjust. It takes the tongue only 10 days to a couple of weeks to adjust to less sugar. Before you know it, your sugar habit will be a thing of the past.

Laura Shammah MS, RDN, has been operating a private practice in New York and New Jersey for over 20 years. Her clientele runs the gamut from people with eating disorders to those dealing with hypertension, high cholesterol, diabetes and cancer. She also helps clients who run in marathons or are looking to lose or gain weight in a healthy way. Her nutritional guidance is published in MaryAnne Cohen’s book Lasagna for Lunch: Declaring Peace With Emotional Eating. Laura can be reached at 718-376-0062 or Laurashammah@aol.com.

Never Go Fake When you’re reducing your sugar intake, you may be tempted to switch to artificial sweeteners for your sweet fix. Do your best not to reach for that diet soda, sugar-free chocolate, or add packets of fake sugar to your coffee. These can confuse your taste for sweet. When you eat something sweet, your body expects calories and nutrition, but artificial sugars don’t provide those things. That may be why fake sugars, such as saccharin, acesulfame, aspartame, neotame, and sucralose, are associated with weight gain—not loss.

How to Reduce Sugar Cravings Sticking to naturally sweet foods, including berries, apples, pears, carrots, sweet potatoes, and beets is a great way to satisfy your sweet tooth. Since these naturally sweet foods are packed with fiber, the sugar gets absorbed into your bloodstream slowly. That means you skip the sugar high (and resulting crash) that leaves you craving more sugar in a vicious cycle. When a craving hits, reach for a piece of fruit (or other naturally sweet produce) to satisfy your sweet tooth while still getting nutrients like vitamins, minerals, and fiber.

Many people ask me if they should cut out sugar completely from their diet. I tell them they don’t need to eliminate it completely, only to set boundaries on the sweet tooth. We all have a sweet tooth; it’s normal. An all-or-nothing mentality can set you up to binge on sugar. Set limits on when and how you’re going to enjoy your sweets. You could choose to have an ice cream once per week and/or include a dark chocolate square after dinner every night. Choose your favorite treat. If you have a hard time controlling your treats, set boundaries around what sweet treats are worth the indulgence, when is appropriate to enjoy them, and how much you can enjoy. This will keep you from reaching in the middle of the day for jelly beans out of habit.

Adar II 5779 | Wellspring 41

Well Informed

Dedicated to Health By Sarah Weinberger

What motivated you to launch this endeavor? Seven years ago, a close family member of mine was in a dire medical state that required emergency guidance in halachah. We had serious questions regarding what constituted pikuach nefesh and what didn’t, and at that time I realized that only very few rabbanim were able to answer me. Understandably, they were not always available. I remember at one point spending a few hours to get an answer for one of my questions. Once this ordeal was baruch Hashem over, I had the yishuv hada’as to do more research on this subject and I learned that there was no address for people to turn to with their medical halachah inquiries. While there is no lack of rabbanim who are wellversed in many areas of halachah, nowadays, this is one particular niche that even some very learned rabbanim don’t know enough about. And when such questions arise, they are often of an urgent nature. Spending time trying to track down a knowledgeable party becomes an arduous feat in those moments of stress. And so I took it upon myself to create that address for Klal Yisrael, to find the rabbanim who are particularly familiar with the halachos regarding medicine and medical treatment and initiate a system that would make at least one of them available to the klal at every moment of the day.

42 Wellspring | March 2019

How did you go about creating the hotline?

From my personal experiences, I knew that here in Eretz Yisrael, Rav Moshe Shaul Klien shlit”a of HaRav Wosner zt”l’s beis din and Rav Yitzchok Zilberstein shlit”a are two of the most learned dayanim in this arena. I reached out to both of them and we sat down together, along with some other rabbanim, to set up a system that would allow people to call in at all hours with their medical halachah questions. With their blessing, encouragement, and commitment to participate, I set up the 24-hour hotline.

10 Questions for:

Rabbi Yisrael Pinchas Tirnauer Founder and Director of Refuah KaHalachah Refuah KaHalachah in a nutshell: 24-hour hotline for medical halachah inquiries

Is the hotline catered toward callers in Eretz Yisrael? Originally, the hotline was geared toward Yidden in Eretz Yisrael. We had an Israeli phone number only, and the rabbanim, who spoke Yiddish, Hebrew, or English answered calls primarily throughout the Israeli daytime hours, although they were available for emergencies during night hours, as well.

Over time, when word about the hotline reached other Jewish communities, I received requests to expand our services internationally. In Europe, we operate under the direction of Rav Moshe Chaim Padwa shlit”a of London and Rav Aharon Schiff shlit”a of Antwerp. At this point, we’ve expanded to the States, as well.

Before we branched out to America, I went to consult with Rav Michel Steinmetz shlit”a of Boro Park, to gauge the need for this service, as well as to discuss halachic matters, and for his da’as Torah on the concept. While speaking to him and other rabbanim, I learned that in America, too, there was no address for Yidden to reach out to with any and all medical halachah inquiries. With their blessing, we set up an American phone system and recruited American rabbanim who are well versed in these subjects to devote several hours a day to answering calls. Now that our services are available worldwide, when a caller in America calls during his nighttime hours, the calls reach a rav in Eretz Yisrael, and vice versa. Baruch Hashem, every Yid around the globe now has a chance to have his questions answered at every hour of the day.

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Well Informed

Dedicated to Health

What types of questions come in to your line? The range is vast. From inquiries relating to serious illness and life-and-death matters, to how to apply an ointment on Shabbos, we get it all. We aren’t only here for serious medical issues, but also simple medical questions relating to halachah that come up in every home. Someone recently called to ask if doctors are allowed to use die on his skin to prepare for surgery or if that would be considered etching into the skin. We get lots of questions regarding the kashrus of medication, each of which gets its individual ruling based on the age of the patient, the severity of the condition, and other factors.

We also get questions regarding the health of the nefesh. People are not aware that many shittos in psychology are not al pi Torah and halachah. These questions are fielded by Rav Moshe Pinchas Sander shlit”a. People with medical conditions who are in shidduchim call to find out what they need to say, what they don’t have to say, and so on. We have a fertility department as well for intricate halachah sheilos that come up in that area, as well as rabbanim who answer questions regarding alternative medicine. We often get questions from callers who have an elderly parent in an unresponsive state. The doctors are telling them, “Your parent is suffering. Why don’t we just disconnect the machines now?” Our rabbanim have the halachic and medical background to guide them with what to do and how to do it.

They know which machines to keep connected, which ones are muttar to disconnect, and what’s assur. Recently, our rabbanim guided the family of an illustrious Rebbe during his final days in this world. For one whole day, machines were keeping him alive. The psak our rav gave them was that once the oxygen medication finishes, there was no need to refill it. In areas like these, many sheilos arise. While most questions that come in to the line involve less complex circumstances, our rabbanim take every caller seriously and provide the guidance needed with care and thought.

On average, how many calls come in on a daily basis? The numbers fluctuate every single day, so it’s hard to tell. But our mission is to be there for every Yid, at every hour of the day, at the moment that he needs us. With this in mind, the numbers don’t matter that much. Every Yid who gets the guidance they’re looking for, even if it’s relatively not urgent in nature, is worthy enough for us to keep the line running.

44 Wellspring | March 2019

What is it about medical questions that necessitates the response of a rav or dayan who is particularly well versed in this field? The average rav or dayan may know a lot of halachah, but the combination of knowing halachah, as well as how it fuses with medical and health-related issues, requires particular expertise. The halachos of pikuach nefesh on Shabbos, for example, are complex. A rav might be hesitant to tell his questioner to take a car to the hospital if he’s not clear with what constitutes pikuach nefesh. Even rabbanim who serve as chaplains in hospitals have admitted to me that many of the questions they’re asked are beyond their scope of knowledge. Medical halachos are particularly complex and intricate. Rav Yosef Hoffner shlit”a, the Rav of Mayanei Hayeshua for the past 20 years, is one of the rabbanim who reaches out to us with questions. He recently told me about a child who was brought in to the hospital on Motza’ei Shabbos by his parents with a serious infection in his brain. When the doctors asked the parents why they came so late when their child was clearly ill, they answered that their rav told them not to go to the hospital on Shabbos.

It’s important to note that this is an exception. Most rabbanim who aren’t sure about a halachah will say they don’t know, but in cases like these, when people are misguided, erroneous halachic conclusions can have serious ramifications.

What is your current role at Refuah KaHalachah?

While I am not the one to actually answer the calls, I single-handedly take care of all behind-the-scenes matters. This includes arranging the rotation system between the rabbanim to ensure that at least one rav is always on call. I’m on top of the phone system, as well as the advertisement of the line. And now that many people are using email and messaging as a means of communication, I make sure that every message gets answered by relaying the questions to the rabbanim on call.

Can you share a recent interesting question that was answered on your line? On a recent Erev Shabbos, which is probably our busiest time in the week, a man called to ask for guidance for his wife, who was in the hospital. She had to be connected to a certain machine, but when she needed to leave her bed, the machine had to be disconnected. Was she allowed to disconnect the machine? If yes, how?

The rav on call inquired about the details of this machine and, once establishing the parameters of the case, he ruled that it would be preferable for them to get a non-Jew to disconnect it, but if that wasn’t possible, she was allowed—even encouraged—to disconnect it on her own. Since such questions are extremely individual, they require very personalized direction.

What do you wish people would know about medicine and halachah? First, to know that in many cases, waiting until Motza’ei Shabbos to seek medical help is considered “shofeich damim,” bloodshed. If a person has a safeik of an issur, not only is there no inyan to be stringent, but it is forbidden. On the flip side, people should know that halachic decisions cannot be made without rabbinic guidance. If you’re not 100% sure that a certain procedure or medicine is halachically permitted, don’t take matters into your own hands. Especially when a patient or the family of a patient is pressured into making decisions by the medical team, they may feel compelled to go along with it, but halachah is not a matter to be taken lightly. Being in touch with rabbanim helps such families stand strong with their principles.

Refuah KaHalacha's U.S. Phone Number:

718 564 6484

As a case in point, we were in touch with a family whose two-year-old child who had drowned broke the record for being alive for almost a month after being declared clinically dead. While the doctors kept persuading the parents to disconnect the machines, from a halachic standpoint that would be killing the child. Because he was receiving constant guidance from rabbanim who are very learned in this area and who even took the time to speak to the doctors, the father had the strength to hold his stand.

What was the best compliment you’ve ever received? When I heard that Rebbes and gedolim are encouraging their chassidim and followers to turn to our hotline with their medical halachah inquiries.

The nicest brachah I got was from Rav Michel Steinmetz: May the only questions Yidden have for you be regarding the time of a bris, when the baby was born in the range of Rabbeinu Tam on a late Friday afternoon.

Note: All of the rulings mentioned in this article were applicable to that particular case only and should not be taken as a general ruling. Please consult with your rabbinic guidance or the Refuah KaHalachah hotline with your individual inquiries.

Adar II 5779 | Wellspring 45

Living Well

In Good Shape By Syma Kranz, PFC

My Secret Fitness Move for Flatter Abs:

THE PLANK

After years of doing 500 crunches at every workout, I learned that determination only gets you so far when the approach is wrong. As research and anecdotal evidence reveals, even an entire hour of crunches won’t match the total body benefits of a 10-minute plank workout. The plank is one of the best exercises for a flat, toned stomach because it works all the muscles in your core, including the rectus abdominis, transverse abdominis, internal and external obliques, hips, and back. These muscles also provide support for the entire body in everyday movements, reduce back pain, and improve posture. Plus, planks burn more calories than sit-ups or crunches because they recruit muscles in the legs, arms, and glutes too. They’re truly the ultimate total-body toner. Here are some of my favorite plank variations. Start with holding each exercise for 30 seconds (work up to 1-minute holds). Do each plank variation once and then repeat the entire series 2 more times (3 reps total). When you feel comfortable with the first four planks, advance to incorporate the next three (No. 5–7), holding each one for 30–60 seconds. For a killer core workout, combine all moves into one routine. Bonus: Most of these moves don’t require a single piece of equipment! Even if you’re too busy to hit the gym, you can do this workout from the comfort of your home.

FOREARM PLANK (LOW PLANK)

This is what most people consider the standard plank. Lie facedown with legs extended and elbows bent and directly under shoulders; clasp your hands. Feet should be hip-width apart, and elbows should be shoulder-width apart. Contract your abs, then tuck your toes to lift your body (forearms remain on the ground); you should be in a straight line from head to heels. Hold for 60 seconds or as long as you can.

46 Wellspring | March 2019

STRAIGHT-ARM PLANK (HIGH PLANK)

This plank is done at the top of the push-up position. Kneel on all fours with hands directly under shoulders. Come onto toes, contract abs, and straighten legs; keep body in line from head to heels.

From plank position, press your right hand into a mat and turn your body so your weight is on the outer edge of your right foot; stack your left foot on top. Imagine you have a big beach ball under your right side; press your torso up and away from the ball, extending your left arm with fingers pointed toward the sky. Tighten your lower-ab muscles and brace your entire core. Hold for 60 seconds, then return to plank position and repeat on the left side; thatâ&#x20AC;&#x2122;s 1 rep. Do 3 reps.

PLANK/PELVIS TUCK

This exercise works both the rectus abdominis and transverse abdominis. Lie facedown with legs extended, elbows bent, feet hip-width apart, elbows shoulder-width apart. Contract abs, then tuck toes to lift body, elbows directly under shoulders. Hold for 4 breaths. Bend knees (do not touch ground), tilt pelvis up; hold for 4 breaths. Keeping abs tight, straighten legs, hold for 4 breaths. Repeat 3 times.

PLANK JACKS

Adding a jumping jack to the standard plank engages your abs even more.

RESISTANCE PLANK

Add a resistance band to work your core, shoulders, and glutes. Place band around wrists and ankles; form a straight-arm plank. Move left hand and right foot out 6 inches. Return to start; repeat on opposite sides. Thatâ&#x20AC;&#x2122;s 1 rep. Do 10.

This move targets your upper back, chest, sides, core, and glutes. While in plank position, extend one arm and/or one leg.

SIDE PLANK

PLANK WITH ARM/LEG LIFT

ONE-LEGGED PLANK

Challenge your balance. From a straight-arm plank, lift right leg up and hold. Lower down. Repeat with left leg.

PLANK WITH OPPOSITE LIMB EXTENSION

This is a total-body exercise that places extra emphasis on your core. Keep your spine straight and your abs engaged throughout the movement.

ON-THE-BALL PLANK

Place your shins and tops of your feet on a stability ball with your hands on the ground in plank position. Engage your core, squeeze your glutes, and hold for 1 minute.

Syma Kranz, PFC, is a certified aerobics, Pilates, and Barre instructor, as well as the fitness director at Fusion Fitness in Lakewood, New Jersey. What started out as a small exercise class in her home catapulted into a popular gym that prides itself with tzanua, professional instructors and an appropriate atmosphere with lyric-free music and proper attire. Syma specializes in training women to integrate fitness into their busy lives, paying special attention to proper form and alignment and specializing in core and pelvic floor strengthening.

Adar II 5779 | Wellspring 47

Living Well

Ask the Nutritionist By Shani Taub, CDC

Navigating Weight Loss with PCOS

Does the condition have to be an impediment to my success?

Question: Due to my PCOS and insulin resistance, I’ve accumulated extra belly fat. I know that it’s unhealthy (forget about unsightly) and I would love to get rid of it. I’m wondering what would be the fastest, most efficient route to go about that. I’m eating carbs in moderation, to have less insulin released, and I do exercise most days of the week, sometimes just walking and sometimes Pilates or exercises that target the abdominal muscles. However, I haven’t seen much improvement. Is there anything else that I can do to help the process along or do I simply have to make peace with the fact that weight loss won’t be happening any time soon? Also, does consuming a small amount of carbs generate the same response as having more carbs? For example, will eating one square of chocolate generate the same response as eating five squares? Can you please help me navigate this issue? I’m sure more PCOS’ers out there will appreciate some education on the topic.

PCOS is a unique health condition that requires an equally unique approach to achieve effective and sustainable weight loss. 48 Wellspring | March 2019

Shani’s response: I commend you for taking the initiative in taking care of your health. As a general introduction to my response, I would like to point out that while PCOS (polycystic ovary syndrome), which affects about 30% of the women I see, is known to impede weight loss, it presents in many different forms. From my experience, some women with PCOS even lose weight faster than those without the condition. Not everyone who has PCOS is overweight or has a slow metabolism. Some say that full-fat dairy is better for them, while others find that having no fat whatsoever helps them lose weight. Others do very well on a low-fat, low-carb diet, but there are no rules. PCOS is a unique health condition that requires an equally unique approach to achieve effective and sustainable weight loss. It’s a very individual condition that requires case-by-case treatment. Very often, probably in 70% of cases, women with PCOS do succeed in losing weight when following a general weight loss program. In the same way that weight loss has its challenges for any individual, women with PCOS experience similar challenges. With the knowledge of their condition, however, some women believe that the difficulties emanate from that, which may or may not be true. Only after I observe that following a standard regimen does not work for a woman with PCOS do I then work to restrict the regiment according to her needs. Thus, I would like to suggest that you keep in mind that weight

loss is a challenge for every individual. Getting rid of belly fat is not the easiest thing to do, regardless of whether you have PCOS or not. Understanding this may be helpful in the way you view your situation, especially when you feel like giving up. For many women with PCOS, weight loss takes on an added urgency of facilitating fertility, which makes knowing this even more encouraging. Know that there is hope for you. Your weight loss journey may require more work, but it is definitely doable. Now that you know that, no, you don’t have to simply “make peace with the fact that weight loss won’t be happening any time soon,” is there anything you could do to speed up the process? As I mentioned earlier, this may require a more tailored plan, but in general, answering your next question will give you a clue as to what you can do. Be aware that every gram of food you take into your body has an effect on your system. This is true for every individual. Thus, of course if you have one piece of chocolate it will affect you one way while if you have more it will affect you in another. Every gram, especially of carbs, makes an impact. Thus, even if you’ve consumed a food that isn’t good for you, know that consuming more of it will only exacerbate your issue. It’s not, “I had one anyway so I may as well have five.” Rather, keep in mind that every gram of carb impacts you more strongly. I would suggest that you look for a licensed nutritionist who can guide you through the process. You might need a stricter diet than someone else, but where there’s a will, there’s a way, and with time, your body could return to its healthy size.

Please send your questions to the nutritionist to info@wellspringmagazine.com. Shani Taub, CDC, has been practicing as a certified nutritionist in Lakewood for almost a decade, meeting with clients in person and on the phone. She also owns the highly popular Shani Taub food line, which carries healthy, approved, pre-measured foods and delicacies sold at supermarkets and restaurants.

Adar II 5779 | Wellspring 49

Living Well

Medical Mystery

50 Wellspring | March 2019

New Column!

Not a

Laughing Matter We did not recognize our son, but the doctors couldn’t help us.

By Tzirel Davidowitz

One mother’s quest to find a cure for PANDAS When my then-nine-year-old Shloimy came home from school one day feeling ill, I wasn’t perturbed. Our second child, he was a relatively healthy kid who got the regular cold here and there. This time, he was vomiting. Nothing alarming there. We cleaned up the mess and were ready to move on. But this time, it didn’t end with the vomiting. Our usually calm child was uncharacteristically restless, from one moment to the next. And together with this restlessness came a host of fears, every day of something else. Until our Shloimy was stricken by his condition, I’d never met a nine-year-old boy who was so anxious. He would come to the table to eat his dinner, and then ask, “Okay, so what now? Can I go to sleep already?” He constantly wanted to move on to the next thing, but then when he’d go to bed, he had a hard time falling asleep. And when I asked him what was going on, he himself didn’t know what to tell me about his own feeling. To him, too, this was one confusing saga. He had no idea how or why he fell into this and how he would emerge. It was as if he was looking in the mirror and an unfamiliar face was staring back at him. Of course, our first address was the pediatrician. Soon after Shloimy started exhibiting the bizarre symptoms, we were in his office. When the doctor asked me a whole list of questions about my son, I said to him, “Look at my child. He’s right here. I don’t know

Adar II 5779 | Wellspring 51

Living Well

Medical Mystery

what’s wrong with him, but he’s not himself.” First, we ruled out emotional factors that may bring about restlessness in children, such as abuse. When the doctor ascertained that my son’s physical health was in top shape, his suggestion was for me to give him vitamins to help him calm down. To his credit, already at our first visit, the doctor gave us a clue that turned out to be the culprit. As we were on our way out, he said to me, “Your son might have PANDAS, but I’m not sure.” I stopped and asked, “What’s that?” I’d never heard of the term before. PANDAS, I soon learned, is the acronym for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, which is often misdiagnosed as Tourette’s syndrome or OCD. While not every strep infection turns into PANDAS, every PANDAS case is linked with a strep infection. Since it doesn’t always show up in blood work, however, it’s often hard to diagnose. After one week of sticking to the vitamin regimen with no improvement, we were back at the doctor’s office. This time, he ordered bloodwork to be done. To his surprise, the results confirmed his suspicions: the elevated levels of DNase and ASO, both antibodies that linger in the body after a strep, pointed toward PANDAS. Since my son did not test positive for strep and he was only exhibiting the neuropsychiatric symptoms that are characteristic of PANDAS, the doctor diagnosed him with this condition. “Your son is the second patient I’m diagnosing with PANDAS in my 30 years of practice,” he told me. And I consider myself lucky, not because the disease is fun—it really is not—but because over time, I’m learning how many children are walking around with the disease without having a clear diagnosis. With a diagnosis in hand, it was time to move on to the treatment phase. The pediatrician prescribed a 30-day antibiotic regimen. Soon after Shloimy started taking his medication, his old self reemerged. There was hope. There was light. But then, when the 30 days were over, his symptoms returned with a vengeance. Out came the restlessness, the frustration, the fears. We were starting to doubt who the real Shloimy was. Back to the doctor we went. He prescribed another 30-day antibiotic regimen, which Shloimy dutifully completed once again. Hope reappeared, but this time, it was tempered by the fear in the back of our minds. How long would this oasis of peace last before the storm would hit again? The answer? Thirty days. After Shloimy’s symptoms returned a second time, we decided to see another doctor in the same clinic. Perhaps she would have a solution that would prove to be the one. She too prescribed antibiotics, thought a different type, hoping that it would help. But much to our dismay, the same pattern repeated itself. 52 Wellspring | March 2019

With three failed attempts, it was time to declare the antibiotic route ineffective. What now? I was never one to take the alternative route. Where would I begin to find a cure for my son? The first solution I could think of was to walk into the local health food store and ask the salesperson for his help. He suggested a probiotic regimen, along with a garlic supplement, which I dutifully purchased. I left the health food store with a spring in my step and a prayer in my heart. This, I kept telling myself, was probably what we’d been waiting for all along. But very soon, we realized it wasn’t. Not this, and not the fermented foods we tried next. Though his symptoms were stable at the time that I made him consume the foods he made a fuss about, Shloimy was still unrecognizable. Of all my eight children, Shloimy had always been the most relaxed one in the bunch. He was the child who would never fight with anyone, the A+ student. I believe that things were easier because it was him, but things were not simple at all. Poor Shloimy. All this time, he was still succeeding in school, but it took arduous efforts on his part to achieve what had once been so simple for him. But even while he was still doing well, as his mother, I saw this wasn’t him. One day, in a phone conversation with my sister, I expressed my frustration regarding Shloimy’s mystery. I reviewed the many different avenues we’d tried and how none of them seemed to rid

Raindrop for All In the two years since Shloimy’s ordeal came to a close, I’ve spoken to many people who are plagued by conditions that seemingly have no cure. Whether it’s PANDAS, Lyme disease, or recurring strep or sinus infections, they’re desperate for a thread of hope. I’ve heard from many mothers who’ve spent thousands for psychiatric care, to no avail, thinking that their child’s PANDAS is a psychiatric issue. After meriting to find an effective, natural solution for Shloimy, I was filled with a burning desire to help others who are still seeking wellness for themselves or their children. Since Joann’s Raindrop Method has been so effective in restoring health and hope for us, I am happy to share her technique—which is effective for a variety of health issues—with the community. I hired a massage therapist who familiarized herself with this technique, as well. The therapist performs the technique for her clients and parents who feel comfortable doing the treatment for their children are more than welcome to come and watch her so they can do it on their own. From my experience and the experience of those who have tried this technique, it boosts the immune system and relaxes the nervous system. Instead of treating symptoms, it helps treat the core problem.

Shloimy of his uncharacteristic symptoms. In exasperation, I asked her what she thought we should do next. Having no prior background on this condition, my sister was kind enough not to leave me hanging. “How about a Google search?” She asked me. Right then and there, she entered “PANDAS help” into her search bar, to be greeted to an array of options. While Google is an amazon of ideas, many of which are not necessarily helpful, one website caught her attention. On PANDAS Hope for Healing, my sister found the story of my life, told by a woman named Joann Cook. This mother, too, experienced a harrowing few months while her child exhibited strange symptoms that no doctor or alternative healer could find a cure for. Finally, when she found a solution that worked for her child, she was eager to share it with parents around the world. Joann’s son’s salvation came in the form of essential oils, which she massaged in a very targeted approach. While I had never cared for essential oils, my desperation did not allow for cynicism. Besides, I had nothing to lose. Curious to learn more, I filled out an online form that would give me the opportunity to communicate with Joann and see how I could help my child. Two months later, she got back to me. As a free service, and without any affiliation to a particular essential oils brand, this messenger from Hashem guided me step by step in learning the targeted approach for natural PANDAS healing, which she calls the Raindrop Method. In preparation for my first conversation with Joann, she asked me to buy 12 different essential oils so I can do hands on exercises with her guidance. When we spoke, she explained her technique, which involves massaging essential oils into the spine and sole. As she explained, Hashem created the body as an amazing selfhealing organism if given the right resources. While essential

oils are not medication, they are an all-natural tool to help aid and support the body in the natural healing process. Once I had Joann’s clear instructions, I was excited to get to work. Twice a week, Shloimy was treated to an all-natural, relaxing treatment session. The invigorating aromas of the essential oils were a bonus for both of us. Before I took this route with Shloimy, I checked with his pediatrician to ensure that we wouldn’t be causing any harm. Thankfully, he gave me the go ahead, recommending that we come in for bloodwork to ascertain that the numbers were indeed going down. As Joann prepared me beforehand, during the first six weeks of the treatment, Shloimy experienced ups and downs. There were days when the old Shloimy reemerged, only to be rapidly replaced by the restless, fearful child who had taken his place. But when we went to take a blood test at the doctor, we were excited to learn that his numbers were finally moving. “I don’t know what you’re doing,” the doctor told me, “but keep doing whatever you’re doing because it’s working.” And then, after three months, when his symptoms were starting to disappear completely, we were forced to stop the treatment. It was time for him to go to summer camp. Although he was back to his old self when he boarded the bus to camp, I felt my apprehension in every muscle as I waved him off. Would his symptoms return or were they gone forever? The miracle was yet to come. Baruch Hashem, the camp season passed uneventfully. Every time he called and I heard his calm, happy voice, I allowed myself to relax just a bit more. Today, two years later, there is no sign of Shloimy’s PANDAS. He made a complete turnaround. He’s the calm, happy child we always knew him as. He’s Shloimy. Tzirel can be reached through The Wellspring.

To submit your story for this column, write to submissions@wellspringmagazine.com. Adar II 5779 | Wellspring 53

YOCHEVED

Living Well

Health Profile By Rachel Esses

Age: 30

Gender: Female

Weight: 180 lbs.

Location: Boro Park

Height: 5’4”

Marital Status: Married

Occupation: Motherhood

Favorite health food: Almonds That’s a great choice. Almonds contain lots of healthy fats, protein, fiber, magnesium, and vitamin E. Some of their health benefits include reducing blood pressure, cholesterol, and blood sugar levels. Favorite junk food: This isn’t food, but I absolutely love sugary syrups and creamers in my coffee! This tends to be a challenge for many people. However, you can still use skim milk and healthier sweetener alternatives such as Splenda, Truvia, or stevia. As for the creamer alternative, try Splenda’s coffee creamer. It’s amazing and 1-2 tablespoons count as a free addition to your daily meal plan. Favorite exercise: Elliptical Favorite nutritious dish: A piece of salmon with Brussels sprouts and slivered almonds. Salmon is always a good healthy protein option. Brussels sprouts are actually quite high in vitamins and minerals, fiber, and antioxidants. They also help decrease inflammation and improve blood sugar levels. My usual bedtime: Around 10:45 pm My usual wake-up time: 7:00 am My weight-loss challenge: Keeping up with my minimum of eight cups of water a day Water intake can be hard to keep up with whether it’s because you’re busy, you keep forgetting, or you just don’t feel like having to find a bathroom all day. Let me tell you this—it’s worth it! Water flushes out toxins, increases brain power, and provides energy, helps with weight loss, and prevents headaches. Drinking water makes a whole lot of a difference, not only with losing weight but, more importantly, with how you feel. Prepare the amount of water bottles you need for each day. That way you will know you be able to keep track of your water intake and will know you’re drinking enough. Here’s another challenge. I find it difficult to prepare a healthy amount of fruits and vegetables throughout the day, as well as being on top of my water intake, as I mentioned earlier. Prepare fruit and vegetable “snack bags” at the beginning of the week. Cut up some fruits and vegetables, such as peppers, cucumbers, tomatoes, and carrots and prepackage them into snack bags. As a result, you will be more prepared and therefore have a much easier time incorporating fruits and vegetables into your diet. My weight/lifestyle goals: To always feel my best How I would treat myself if I get to my maintenance plan: Oh, my… a cheese Danish Rachel Esses is a nutrition counselor at Nutrition by Tanya, a nutrition practice run by Tanya Rosen, which has locations in Boro Park, Flatbush, Lakewood, Monsey, Monroe, Williamsburg, Queens, Five Towns, and Israel. Tanya is the creator of the TAP (Tanya approved products) line available on her website, offices, and at select supermarkets, offering all-natural low-calorie delicious snacks and food. Tanya can be reached through The Wellspring.

54 Wellspring | March 2019

WHEN I TAKE CARE OF MYSELF, I TAKE BETTER CARE OF THE PEOPLE I LOVE.

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56 Wellspring | March 2019

Grin and Bear It Pediatric illness is no fun.

How do children and adolescents juggle living with a difficult diagnosis and making the most of their youth?

Four courageous adults share how they did it.

by shiffy friedman

Adar II 5779 | Wellspring 57

Living Well

Cover Feature

would be okay. If they were smiling, I could smile too.

Ariella, 23 Condition: Type I

diabetes Age at

diagnosis: 7

For the average seven-year-old, life is still an idyllic bubble. Her simple happiness and innocent youth may be occasionally marred by a run-in with a friend or a punishment that sends her to her room until the Shabbos party is over. My memories as a seven-year-old are vastly different. As a juvenile diabetic, straddling the world of jump rope and insulin injections was no easy feat. Although I don’t have crystal-clear memories of every step of the way, I certainly remember the confusion, the desperation, and the understanding that something that was beyond my cognitive grasp was going on. It all began with a one-week consecutive stretch of bedwetting nights. Since I had been toilet trained at the age of two, my linen was dry every single morning. Suddenly, it needed to be washed on a daily basis. On the first night it happened, my mother asked me if I had drank too much before going to bed. I hadn’t remembered doing so, but I made a mental note to be extra careful with my drinking the next night—which was especially hard for me because I was constantly thirsty. But when it happened again and again, and emotional triggers were ruled out, my parents realized that something more was going on beneath the surface. At the first doctor’s visit, I sat quietly while the nurse pricked my finger. As young as I was, I sensed the tension in the room. Would I land in the hospital like my friend, who became sick and then passed away? I had no idea what was going on. For one moment, I was afraid. The next, I was thinking about our upcoming Purim play. And all this time, I scanned my parents’ eyes for their reassurance that everything 58 Wellspring | March 2019

The next day, we were back at the doctor’s office to get the results. “Ariella has juvenile diabetes,” the doctor told my parents. Of course, I could not decipher his words. Thankfully, he handed me a fun-looking workbook and said, “Your parents will read this with you so you will understand.” Despite my youth, this was my health we were talking about, so I didn’t have a choice but to understand. I had to learn the carb count in foods, how to use a meter to measure my blood sugar levels, and how to give myself an insulin shot when necessary. I went from being the child who dreaded the nurse’s prick to becoming a pro at pricking myself at a moment’s notice. And I had to learn that having a bowl of ice cream meant running for my pump soon after. As I grew older, it helped that my friends started to understand what was going on with me. Thankfully, my parents never kept it a secret, and so I felt confident explaining the unique way in which my body functioned—that since it wasn’t producing enough of the sugar-digesting hormone insulin on its own, I had to inject myself with it sometimes. When I went to camp for the first time, I quickly became best friends with the. Whenever my blood sugar levels were low, they would have good food waiting for me, or I would grab a soda from the fridge. As an easygoing preteen, I took advantage of things like that. Only later, when I entered my teenage years, did I find my condition to be more challenging from a social and emotional perspective. Although I didn’t care that people knew about my diabetes, I didn’t want it to define me. I didn’t want to be “the kid with diabetes,” but a normal kid like everyone else, who just happened to have this condition. Because I was so adamant not to let my life be controlled by diabetes, and I desperately wanted to be a carefree teen like everyone else, there were times when I went above my limits. I would party along with the crowd and then ignore the signals that it was time for an injection— dizziness, lethargy, feeling weak. Staying in control—below 200 mg/ dL—was hard because it wasn’t at the forefront of my mind. Although I originally had to give myself insulin shots through a syringe, I eventually got an insulin pump to wear on my abdomen, which is what almost everyone with type 1 diabetes uses nowadays. It’s a small, computerized device that mimics the human pancreas, by delivering small doses of short-acting insulin continuously. For years, I’ve only had to give myself one shot every three days by pressing a few buttons. Nowadays, I rarely feel the presence of my condition, but I know how huge an issue it could feel to a young child. Because my parents never turned my diabetes into a “thing,” I didn’t view it that way. Today, when I speak to young girls who have been diagnosed with the condition, the stress most of them express has nothing to do with the condition itself and everything to do with how people perceive them. When parents are there for them as their rock, children can experience diabetes in the way I did.

The Silver Lining Having juvenile diabetes has taught me to be more understanding of others. Since I see that my condition doesn’t need to define me, I try to see the differences in others (specifically things that seem negative) in the same light.

My Shidduchim Story My condition was never a secret, but I was told by rabbanim not to talk about it until the third or fourth date. Not one boy said no because of it. When I told my future husband, he was not fazed at all. Several of his uncles and cousins are doctors, and when he consulted with them, they told him not be concerned about it.

How My Condition Affects Me Today

What I Wish People Would Know About Juvenile Diabetes People think diabetics can’t eat sugar, which isn’t true. As long as I give myself enough insulin, I can have sweet foods. Just like I brush my teeth on a consistent basis, I check my numbers. And as long as I’m in control, it doesn’t have to affect my life.

My Message Even with juvenile diabetes, life can still be normal. You’re no different than your friends. Learning how to control your numbers is just a skill, like learning to drive a car. In the beginning you stress out about every turn. Eventually you’re able to listen to music and take one hand off the steering wheel while you’re cruising along. With time, it won’t take over your life.

I don’t have a problem eating cake or ice cream, but I must remember to give myself more insulin when I do. If I forget, I feel disgusting. I experience an intense sugar rush, including a headache, nausea, and sometimes tiredness and lethargy. While in a healthy person this lasts 10-15 minutes, for me it could take 3 hours until I feel okay again. As a teenager, this happened a lot. Today, it happens too, but not often. I fast only on Yom Kippur and Tisha b’Av, and I usually make it only halfway through the fast day. From then on, I drink and eat in shiurim. As a teen, I went to the doctor once every four months. As an adult, these visits are less frequent. But during my pregnancies, I see the doctor every week to ensure that my numbers are very controlled. Baruch Hashem, I am the mother of three healthy little boys.

I’m Grateful That: I was diagnosed with the condition when I was so young. I believe that because I was diagnosed when my emotional world wasn’t yet developed, I didn’t experience such a difficult adjustment. I have always remembered myself as I am now, with diabetes; I don’t remember a life before controlling my numbers.

My Support My parents were very supportive and open about my condition. I attribute my easygoing approach to my condition to their perspective.

Adar II 5779 | Wellspring 59

Living Well

Cover Feature

Shaindy, 25 Condition:

Crohn’s disease Age at

diagnosis: 14

As a child, I had a relatively healthy digestive system. Except for the occasional stomach bug, I didn’t think much about my digestive organs. Sometime in the middle of sixth grade, however, I suddenly was in constant need of the restroom. In school, I found myself raising my hand every few minutes to leave the classroom. Since the teacher had a rule that every student could only leave three times per semester, I was forced to approach her and ask for special permission to leave more often. Although this new habit was odd to me and my parents, we attributed the changes to a sensitive stomach. Perhaps there was something I was eating that wasn’t good for me. And so, I tried this diet and that one, eliminating dairy, then gluten, but all to no avail. When summertime came around, I was looking forward to going to camp for the first time. While I had lots of fun between bathroom trips, I was shedding weight drastically. By the time I returned home, I had lost 20 pounds from my slim frame. Of course, my parents took me to the doctor, who couldn’t give a definitive diagnosis. A few months into the school year, after my bathroom trips had become the joke of the class, we went on a class getaway. While there, I fell ill with fever and spent much of my time in bed. While no one, including me, had any idea of what was going on, I was clearly living a life that my peers were not familiar with. Since our pediatrician couldn’t help me, and my parents were growing more concerned with every passing day, they took me to various other doctors. I remember going to one who kept us waiting for a long time. When we were finally told to enter the examination room, we found a bed so cluttered with paperwork that I couldn’t even get on it. After another wait, an intern whom the doctor was training came to speak with us. The conversation led us nowhere. 60 Wellspring | March 2019

We also explored energy testing. The woman who did the testing declared that I had an H. pylori bacterial infection, even attributing it to watermelon I had eaten in camp. The joke was that watermelon is one of the fruits I don’t like and thus never eat, but we were so desperate for a cure that I followed the vitamin regimen that she prescribed, only to watch my complexion turn green. Incidentally, when my mother later informed her that I had been diagnosed with Crohn’s disease, she refuted it. After eighth grade orientation, my mother got a phone call from the principal. She was concerned about my continuous weight loss and my sickly appearance and inquired if there was any medical condition she should be aware of. While my mother reassured her that she was aware of my unhealthy state, she couldn’t offer any definitive answers. The phone call jolted us into another round of ineffective doctor visits, which failed to turn up any solid solutions. By January, I was feeling so sick that I was admitted to the hospital. There, I finally received my diagnosis: Crohn’s disease, an inflammatory bowel disease that causes inflammation in the digestive tract, which can lead to abdominal pain, severe diarrhea, fatigue, weight loss, and malnutrition. My particular case required an ileostomy, a surgical operation in which part of the small intestine is diverted to an artificial opening in the abdominal wall. Practically, it meant that I would first be hospitalized for four weeks, and then live with a colostomy bag for a few months, until the part of the colon that was reverted would be inverted. By the time I got my diagnosis, my friends all suspected that I was struggling with anorexia. While I initially did not tell my friends about my diagnosis, as per the direction of our rav, their suspicions made my parents ask the rav again. This time, we were told to go public about my true condition. From then, there was no hiding anything, which made going through the experience so much less taxing for me. I was a young girl with enough going on in my life; to have to keep my condition secret would have exacerbated the heaviness of it all. For the first three weeks of my hospital stay, I couldn’t eat at all. Anytime a visitor would bring something that I liked for my mother, we would add it to my list of “Foods I Will Eat When This Is Over.” For the first two weeks, I was on medication to drain the inflammation, after which I transferred to a different hospital in preparation for the procedure. All this time, my mother was camping out with me, along with my baby sister, who was nursing at the time. To her credit, my mother was in great spirits throughout, which made me see the experience in a positive light. My friends would visit, and we spoke openly about everything that was going on in my life. After it was over, we put together a fun scrapbook that tells a happy, spirited tale. Life after my four-week hospital stay was almost back to normal, except that I was living with a colostomy bag. Just one week after I

returned home from the hospital, I was excited to return to school and to the teenage routine. But after pushing myself for a few days, I got sick again. I remember walking to school only to turn around midway and go back home. I had become dehydrated. Because my body was ridding itself faster of its fluids, I had to be on top of my hydration. I remember sitting in class one day, feeling that the bag was full to the brim. Fearing an embarrassing leakage, I picked myself up and ran out of the classroom. Because I was adamant not to miss out on school and my social life if I didn’t have to, we scheduled my reversal surgery for during the Pesach break. After that, I was finally just another eighth grader, getting ready for camp and looking forward to the summer break— while taking medication to keep my symptoms at bay. And, as young as I was, oh how I appreciated every day of normal life!

The Silver Lining Before this whole to-do, I had been rather shy and inhibited. My diagnosis and condition definitely spurred me to become more outgoing and expressive. But the grand prize I gained from my condition is my husband. Since he’s a diabetic, my parents wouldn’t have considered such a shidduch if not for my condition. Hashem has His ways.

The Hardest Part of My Condition When I was sick, I always had to know where the next bathroom was. Every time I arrived at an unfamiliar place, that would be the first thing I’d look for. Especially for a young child, that was a challenge and a pressure.

My Shidduchim Story My parents were apprehensive about my future, but I wasn’t. Since my condition was public, there was nothing to hide from the other side. Today, I’m a happily married mother of three.

How My Condition Affects Me Today I’m not currently on medication and I don’t follow a special diet, though I do have a hard time eating vegetables, so weight loss isn’t simple for me. My children know that if Mommy needs the bathroom, she’s first.

I’m Grateful That: I did not relapse after the original procedures.

My Support My parents were amazing. Now, as a mother myself, I see how frightening my saga must have been for them. I see how I fed off of their strength and positivity. One of my principals was very thoughtful. She sent me a book when I came home from the hospital. It meant a lot to me.

One Memorable Gift I received a simple card from a girl in my grade, who wrote that she had once been in the hospital over Purim with cellulitis and she remembered how hard it had been. Her sincere words of empathy and understanding meant so much to me.

My Advice If you or your child has been diagnosed with a chronic condition, work to see the bright side of it. It’s not easy, and some procedures are painful, but staying positive makes everything easier. Here’s another one: Listen to your body. Don’t push yourself. Getting a diagnosis is frightening, but if you suspect something’s not right, go to a doctor.

Adar II 5779 | Wellspring 61

Living Well

Cover Feature

Chani, 26 Condition: Multiple

sclerosis Age at

diagnosis: 12

When I was sitting in class one day as an eight-year-old, I noticed that I was seeing everything on the blackboard double. When I turned to look at my friends, I saw the same double view. While getting eyeglasses was the in-thing at the time, my parents sensed that my complaints were serious. However, a visit to the optometrist showed that from an optometric perspective, I had perfect vision. When vision-related tests all returned clean, and I was still complaining about double vision, the doctors suspected an internal issue. The results of a spinal tap revealed that there was something going on internally, but the diagnostic team attributed it to a virus. At that time, they didn’t fathom that someone this young could have multiple sclerosis (MS), which until recently was mainly diagnosed in adults. The explosion of research in recent years has led practitioners to learn of the existence of pediatric MS, but back then they didn’t have this awareness. “It’s just a virus,” was the answer we were left with, hoping it would leave my body soon. Sure enough, the symptoms did go away after a few weeks, which only helped to reassure my parents that a simple virus was indeed the culprit to the symptom that incited such fear. And then, when I was 12 years old, I suddenly started feeling another set of alarming symptoms: numbness in my legs and tingling in my back. This time, the diagnostic protocol included an MRI, which resulted in my diagnosis of MS (multiple sclerosis). I was all of twelve years old when the diagnostic team referred us to an MS specialist who works specifically with children, so he could 62 Wellspring | March 2019

break the news to us. The medical jargon he used, however, was all Greek to me. As I sat there, taking in the intensity of the moment, I felt completely numb. I had no idea what the condition was or how it would impact me. I had never heard of it before. I was a typical school girl, busy with my studies and friends. What did having a medical condition even mean? Once I knew more about MS, especially the more frightening aspects of the disease, I was nervous. I had no idea what the future would bring, or how I would look five years down the line. What I soon learned was that MS, a chronic, typically progressive disease involving damage to the sheaths of nerve cells in the brain and spinal cord, whose symptoms may include numbness, impairment of speech and muscular coordination, blurred vision, and severe fatigue, affects every individual differently. While the condition incapacitates some people, baruch Hashem, in my case, the symptoms don’t affect me permanently. Since I have what’s known as relapsing-remitting MS, my symptoms come and go. There are times when I feel numbness in my legs, for example, for about two weeks at a time, and then the symptoms disappear. From the start, I was concerned that other people shouldn’t know about my condition. In order for no one to suspect anything, I was back at school the morning after my diagnosis, as if nothing dramatic had happened just a few hours earlier. Whether that was good for me or not, I don’t know, because I don’t know what the flip side would have been. Until today, most people are not aware that I have MS. Since my symptoms are relatively mild, I’m able to function normally most of the time. If you meet me in the street, you wouldn’t suspect that I have this condition, especially not in the way most people think of it. In a sense, keeping up with everyone else was so much harder when I was still in school. My appointments were all scheduled on vacation days so I wouldn’t miss too much school. This meant I was always missing out on having a real “day off.” Taking my medication was a saga in itself. While I’m currently not on medication, I did take injections for years before switching to infusions. Until I graduated high school, this didn’t pose such a problem because I was home for enough hours every day to do it in private. But then I went to seminary in Eretz Yisrael, and for the entire year, I had to give myself an injection every morning, without having anyone suspect any unusual behavior. Tucked neatly into my cosmetics bag was the small syringe I took religiously into the bathroom every morning so I could take care of my health. For the entire year, the secret was mine. Since the medication could only be kept at room temperature for up to 30 days, my mother sent me a new supply from the States at the beginning of every month. And every time I got another package, my friends gushed about how lucky I was. Little did they know about its contents—that I was certainly lucky, but not in the way they thought.

The Silver Lining

Because I’ve learned on my own skin what it means to live with something that no one else knows about, I’ve learned not to judge anyone else. I can’t know what’s going on in someone else’s life, and it’s not my business.

My Comfort

Although the diagnosis was frightening, seeing with my own eyes that I was doing okay was and has been a great comfort for me.

The Hardest Part of My Condition

When I was first diagnosed, I did not know exactly what MS was. The doctors were using medical terms that didn’t mean anything to me, which left me feeling confused and afraid.

My Shidduchim Story

Since my condition has never been public, this was a tough period for me. In the end, my shadchan was someone who specializes in medical cases. My parents were more open about my condition than I was. They told whoever they needed to tell. But when regular shadchanim would call with suggestions, and they’d say we’ll get back to you, which either didn’t happen or they nixed the suggestion, I’m sure the shadchanim thought it was strange.

How My Condition Affects Me Today

While most doctors don’t believe that diet can affect MS, I have found that a gluten-free diet makes me feel better. However, there’s no definitive way of knowing whether a connection exists between my lack of symptoms and my diet. When I’m under stress, I feel my symptoms more. They include double vision, numbness in my legs, and tingling in my back.

I’m Grateful That:

I’m able to lead a normal life. I have, baruch Hashem, been able to get married and raise a family.

My Support

Years ago, I was part of a phone support group for frum females with MS, but the participants were mainly women much older than me. While I felt that they were in a different stage, it was encouraging to hear that people with MS actually get married and lead a normal life.

What I Wish People Would Know about MS

Many people who are not familiar with MS see it as a death sentence, that anyone who is diagnosed with the condition will be wheelchair- or bed-bound and paralyzed for the rest of their life. It’s hard for me to read articles that imply that. People with MS can lead a normal life.

My Advice

If you have been diagnosed with MS or any chronic condition, ask all the questions you have so you can be calm. Know that even if your condition is chronic, you can live with it.

My Message

Don’t compare yourself to others. Each person’s diagnosis is different, and each person’s life story is different. Even if it appears that your lives are similar, you can never make broad comparisons. Every person goes through their challenge differently.

Adar II 5779 | Wellspring 63

Living Well

Cover Feature

Tehilla, 22 Condition:

Hodgkin’s lymphoma Age at

diagnosis: 20

In the late summer of 2017, I celebrated one of the happiest milestones in my life—I was engaged to be married. After a whirlwind of dates and dreams of tulle and roses, it was official, and I was floating in the happy space reserved for young women who know of nothing but joy. My chosson was everything I’d dreamed of and we were looking forward to starting life together in Eretz Yisrael. When my kallah teacher suggested I schedule a routine checkup at the OB/GYN, I duly complied, adding “see the doctor” to my growing to-do list. After all, having been relatively healthy my whole life, I was twenty years old and had never been to a women’s doctor before. What I couldn’t know was that this visit would end up turning my whole life upside down—but saving it too. I will never forget the first words the doctor said to me when she walked into the examination room. I was sitting in the patient’s chair, waiting for her to come in and confirm my clean bill of health, but even before she managed to sit down, she looked at me in surprise and asked, “Did you realize that you have a huge bump on your neck?” That question spurred a week-and-a-half whirlwind of biopsy, CT scan, and intensive blood work, squeezed into an already hectic period of Yom Tov prep, stuffing wedding invitations, pre-wedding errands, signing on an apartment, going out with my chosson to pick his watch, taleisim, and tallis bags, college studies, and kallah classes, all of which came to a dizzying halt on Chol Hamoed Succos with the diagnosis: Hodgkin’s lymphoma (nodular sclerosis), stage 2B. Cancer. And my wedding date was only three weeks away. After the diagnosis, all the mysterious pieces of the puzzle fell into place. It explained why I had fallen asleep in shul on Yom Kippur; the 64 Wellspring | March 2019

night sweats I had experienced during the first days of Succos; the utter exhaustion I felt every day; and, of course, the two enlarged lymph nodes clearly protruding from my neck that we had simply missed during the hectic dating and engagement period. The tiredness and lethargy I’d felt had been attributed to the happy exhaustion that came along with this exciting period in my life, but now we knew there had been an additional reason for them. Later, when I looked through the photo album of my vort, I couldn’t help but notice the bump in my neck. It was clearly there all along, waiting patiently for just the right moment Hashem had deemed for my diagnosis—not a moment earlier or later. Interestingly, I had experienced one of the other symptoms, overreaction from drinking alcohol, at my L’chaim. I remember telling my friends that something didn’t feel right. I had been running on empty for so long that I was used to the symptoms of fatigue, loss of appetite, nausea, and itchy skin. But Hashem wanted me to get cancer and then get engaged, in that order. Like everything else in life, that was the precise moment when it was meant to be. In addition to the treatment plan that was immediately set into action that completely turned my life around, my diagnosis engendered yet another change of plans: the cancellation of my impending wedding. As per the guidance of da’as Torah, our engagement came to an abrupt end. Very soon, I was not only a patient, enveloped in the throes of painful, nauseating treatment, but I was racked with emotional pain as well, the death of my dreams searing at my heart. Very early in my saga, right after my engagement had been broken and the treatment process had just begun, I remember lying in bed and making the choice that would ultimately turn my life around, this time for the better. I was weak in body, but in my spirit, I felt an infusion of unbreakable strength. Lying there, with no strength to move my limbs, I made a conviction to turn the coming months into the happiest, most fun-filled time in my life. And they were. I involved my friends in the process, recruiting them as my cheerleading team, and made the most of every unpredictable moment. I have such happy memories from when I was in chemo. Whenever I felt up to it, I would go out with friends. I did things I never had time for before. Instead of focusing inward on my pain, I thought about how I could make the best of the experience. I had my friends come with me to chemo and see what it was like. As a side perk, it was a great learning opportunity for my friends who were going into the medical field. My six-month treatment plan turned into seven months of

Later, when I looked through the photo album of my vort, I couldn’t help but notice the bump in my neck.

outpatient chemo every other week. During that time, I ended up losing my hair. When it was actually happening, I didn’t really dwell on it because I was more focused on feeling horrible from the treatment. Now, after finishing the treatment, the hair loss really hit me. It’s hard to have short hair, especially at this stage in my life. I just want life to return to normal, but my hair is a constant reminder that I’m still not there yet. When I speak to girls who are going through a similar experience, I advise them to get a fall in addition or instead of a full sheitel. With a fall, once the hair starts growing back it blends in with the wig. It’s also much more comfortable. As a cancer patient, I began noticing the wondrous way in which our bodies work. With my antibody count down to almost nothing due to chemo treatment, I realized how much strength Hashem pumps into a healthy body. At one point, I was hospitalized for a week because I had a simple tooth infection. Because my white blood cell count was low, my whole face blew up. My body simply couldn’t fight the infection. Now that I’m free of cancer, baruch Hashem, and the repercussions of chemo are largely out of my system, I’ve learned to thank Hashem that I have cells that fight infection. When I was diagnosed, due to my age, I was given a choice to be treated in the pediatric or adult oncology ward. Many encouraged me to be treated in pediatrics, but the adult protocol (drugs) was the treatment route I wanted to take. I chose to be treated in adults because I didn't want to feel more "nebach" by being treated like a kid. I'm very happy I went through adults. I see that the way I dealt with the cancer was on an adult level. Cancer definitely helped me become an adult. I was always mature, but during chemo it was cool to see I was no longer a kid but a young adult. I loved being in the adult ward because the nurses and older people were happy to see a young face and were always so friendly and nice to

me. Had I been treated in pediatrics, I would have been the oldest and I could see how that would make a difference in the nurses' attitude toward me. Also, I personally would rather see adults who lived full lives on chemo rather than little kids suffering. I was treated in the John Theurer Cancer Center at Hackensack, which has a beautiful cancer center and amazing nurses. It's actually a cheerful place. I remember being shocked in the beginning to see how many patients were smiling! It was also interesting to observe how there were so many kinds of people yet everyone was so friendly and kind. That certainly impacted my healing in a positive way. While I tried my best to live it up during those trying moments, not every minute was bliss. One of the feelings I struggled with was that I was being a burden to my family. As a young girl in my parents’ home, everything fell on them. Thankfully, baruch Hashem, they were a great support to me throughout. Whenever I had a hard moment, I focused on the good that came about from my diagnosis. When my seminary principal called to give me chizuk, she told me something that helped me stay strong in tough moments. It was something I hadn’t heard from most other people, whose instructive reaction was, “Oy,” and then some sympathetic comment. She said, “Find Hashem’s hand and hold tight.” She also told me that sometimes, people need to know how loved they are, so Hashem sends them a reminder. She literally flipped the situation around for me. This perspective changed my life. Instead of feeling like a victim, that I was being handed a difficult ordeal, I saw the gift in it. I also drew a lot of chizuk when grandmothers would come over to me at a simchah and tell me they had had Hodgkin’s when they were my age. It was encouraging for me to see them with large, healthy families, leading full lives. There was hope for me, too. Adar II 5779 | Wellspring 65

Living Well

Cover Feature

The Silver Lining I got a second chance at life. I feel lucky and blessed for all the amazing friends I made along my journey. I got in touch with inner strength I never knew I had. Now, I don’t take good health for granted, or any day that I could accomplish something.

The Hardest Part of My Condition For me, harder than having cancer was losing the person I had planned to spend the rest of my life with. Most girls who break off their engagement can move on and focus on work, school, and dating again. For me, every other week meant another round of chemo and lying in bed feeling horrible, like my body was fighting something poisonous—it was. Chemo cures, but it does so using powerful chemicals. There were also many other side effects. I am very grateful to a friend from MyTEAM who coached me through stomach pain. I couldn’t have done it without you!

My Shidduchim Story My diagnosis marked its abrupt end. Hashem sent me Hodgkin’s. He will send me my bashert in the right time.

How My Condition Affects Me Today I’ve, baruch Hashem, been in remission from after the second round of chemo, which means that cancer hasn’t showed up on PET scans since, bli ayin hara. I needed to finish my protocol, so I had 6 rounds of chemo, which meant a total of another 12 chemo injections. Since this is my first year in remission, I go for scans every six months. For the next two years, scans only take place once a year. Every case is different. I can’t wait for my hair to grow back fully.

I’m Grateful That: I had such a large support network of friends and family members. Feeling that I’m not alone in the experience has made all the difference.

My Support My mother. She arranged for her friends to prepare 66 Wellspring | March 2019

yummy, nutritious lunches every day. That was huge for me. If she hadn’t done that, I probably wouldn’t have eaten. Two women in our neighborhood whose daughters also had lymphoma in years past, as well as the girls from MyTEAM and other survivors of Hodgkin’s, were a tremendous support to my family and me, especially when I was going through the side effects of chemotherapy.

What I Wish People Would Know About Hodgkin’s Lymphoma The disease can be very curable. Obviously, there are complex cases, but in general, people who are cured are done with it.

One Memorable Gift My friends threw a surprise Purim party for me. Everyone got dressed up, and we danced for a long time. I was so surprised and touched that they had arranged a whole party in my honor. I loved it when my friends from seminary who didn’t live nearby would send cute packages. It made me feel so cared for and loved.

My Advice To family, friends, and acquaintances of someone with cancer, my advice is to reach out in the way that is appropriate for your relationship with the person. If you’re a teacher, offer to learn with your student; if you’re a friend, offer to come over and spend time together. To parents of a child who has been diagnosed be a support to your child. You must be the strong one. To young people who are diagnosed, my advice is to party it up. Make your cancer the fun in-thing! If you want friends to come to treatments, make your treatments the place everyone wants to be. I was diagnosed as a kallah, when I was excited to begin my new life. When that wasn’t happening, I had to find new meaning. So I decided to learn from my experience and help others. More than anything, we need meaning in our lives. Find it in yours. And get the support you need. A Yid is never alone.

With my antibody count down to almost nothing due to chemo treatment, I realized how much strength Hashem pumps into a healthy body.

Note: A rav should be consulted regarding when and how it is permissible to conceal a serious illness from others. Adar II 5779 | Wellspring 67

Living Well

Cover Feature

I’m the Mother By Sarah Porgesz

A parent's perspective on her child’s ordeal Ever since my daughter’s birth nine years ago, she’s been suffering through monthly bouts of high fevers accompanied by sore throat, nausea, and a weak bladder. For the first three days of every bout, she practically sleeps through with burning fever, except for an occasional hour here or there when the Motrin is going strong. For the next three days she goes to school with that typical shiny-eyed look, feeling weak, and with a very laid-back attitude. As soon as the Motrin wears off, she’s back home under the covers. After a week she’s once again back to her happy self, baruch Hashem, until the ever-lurking dreaded illness rears its ugly head and attacks her full force once again. And the cycle repeats itself. Although her condition is thankfully not life-threatening, it’s extremely unnerving and at times makes her and us feel like we have no footing on planet Earth. After doing extensive testing and x-rays, with all the results coming back as normal, the only comfort our pediatrician could offer us was that our daughter will outgrow her cyclic fevers by age thirteen. His wise words: “If you run after a medical diagnosis, you will surely find one, but the only thing you will acquire is some ABC attached to her name. Let it be and this too will pass.” But, as her mother, I stubbornly refused to give up. I tried every single alternative I could get my hands on. We’ve been through kinesiology and acupuncture searching for that elusive cure. Low immunity, mono, and Epstein-Barr virus were some of the terms thrown around. I shelled out thousands of dollars and dutifully cajoled, bribed, and forced my daughter into taking tens of vitamins twice daily, all the while being convinced that the yeshuah was at arms’ length and just one more piece of hishtadlus would bring it forth. Now that my husband and I have spent all so much of our resources to no avail, all we can do is sit back and let Hashem take the wheel. This challenge has done something incredible to us. We have made a complete turnaround from being “take charge” parents to surrendering and leaving it 68 Wellspring | March 2019

all to Hashem, Who in His ultimate kindness has bestowed this nisayon upon us. And we thank Him for the good days in between. We are now serving Him wholeheartedly without expecting “an end to the means.” But the most difficult part of this journey is what to tell my daughter when she looks up at me with her feverish eyes and asks, “Why me?” My husband and I are going through this as adults — and we’re not the ones getting sick every month. We have an understanding far beyond her scope of reason, whereas she is a young child with limited experience of the gray areas of life. She is constantly losing out on simchos and trips since it arrives at any given moment. This year, her condition has begun affecting her social status and academic studies. Time and again, when she almost makes it socially and academically, she is once again thrown into a world of illness while her universe is on hold. Then she has to emerge and start fresh the next week. The older she gets, the more she starts coming to erroneous conclusions about herself, which severely affect her ego. (Signing her up for music lessons to boost her self esteem did help a lot.) I am thankful that hers is not a life-threatening disease, but I still wish there would be someone out there to help these kids understand and feel better emotionally while battling these illnesses. In the meantime, we sing Rabbi Efraim Wachsman's lyrics: “I believe in Hashem. I trust in Hashem. There has never been a moment when That I am alone, That I’m on my own; I believe and I trust in Hashem. And I understand that He is holding my hand, that every step is perfectly planned. He is holding me tight so I will be alright I believe and I trust in Hashem.”

Stop With the Secrets Emotional health is vital, too By Chaya Henchy Friedman, LCSW People with chronic illness—especially children and adolescents—don’t only face physical symptoms, but they also experience emotional and mental stressors that may deeply impact them even when the disease is well-controlled. It is unfortunate that the fear of stigma in our community often discourages people from sharing information about their illness with close family and friends, or from reaching out for vital support. As a therapist who deals with this population, I have watched individuals burdened with this secret that only grows more potent and toxic by the day. The weight of this often morphs into excruciating feelings of unjustified shame, guilt, and a poor sense of self, which only adds to the primary difficulty of their medical condition. Researchers who study the negative impact of keeping secrets have found that when people were deeply preoccupied with their secrets, they viewed potential challenges to be greater than they actually were. They judged hills to be steeper, distances to be longer, and physical tasks to be more taxing. It was as if they were carrying the proverbial weight of the world on their shoulders. Additional studies have shown that people who hide important aspects of their lives – whether they are mental or physical health challenges, or other difficult circumstances – have greater difficulty navigating social situations and maintaining close or intimate relationships. This is because the burden of secretkeeping causes individuals to hide their authentic selves. There is no way for someone to feel entirely trusting and comfortable with another human being when that person is so consumed with hiding critical aspects of his or her personal life. It’s no wonder that many people with hidden illnesses feel as if there’s something terribly wrong with them, and that if people were to find out how “damaged” they are, they would surely be rejected. It's important for us to realize that when we tell our children to keep a large part of their lives a secret, the subliminal message that we are imparting is “you are damaged,” or, “There is something very wrong with you.” This message is internalized

over time and becomes a vicious thought cycle that causes unwarranted experiences of isolation and grief. It’s heartbreaking to hear my clients — beautiful accomplished young women — tell me, “I feel like a fraud. I’m terrified for people to find out who I really am. Once they really know me, they’ll distance themselves from me.” I recently had a socially anxious client tell me, “I wasn’t always this way. I used to love school and camp. I had such a great time with my friends. After being diagnosed with my medical condition, which I was advised to keep hidden, I noticed this self-conscious feeling creeping up on me when I was with my friends. This vague, ugly feeling of shame just constantly enveloped me and drove an invisible wedge between me and everyone else. I’ve never been able to shake it off.” As she was talking, I kept thinking to myself, “My goodness, this is not an anxiety disorder, this is a shame disorder brought on from being ill advised about her condition!” Even more alarming, I have often observed that the fear of stigma can cause people to ignore critical symptoms, which could lead to serious or irreparable damage and the senseless need to undergo more debilitating treatments. The fact that the need for secrecy takes precedence over an individual’s need for physical and emotional care is truly unacceptable. The stories I’m bearing witness to are appalling and we need to understand that this is a real public-health issue. I recently worked with an individual who had what had started out as a minor metabolic condition. The need to keep this minor condition a secret went as far as denying that the condition existed in the first place. This person went for years without the proper medical treatment. Unfortunately, this individual currently has a full-blown condition that's extremely incapacitating and requires extensive medical intervention, as well as frequent hospitalizations. It’s painful to have to process such intense feelings of grief and loss—and to do so all alone—knowing that much of those feelings could have easily been avoided. It's sad for me to watch how some of my clients with chronic conditions like diabetes and Crohn’s disease cast themselves in such a negative light. Their shame is so pervasive, so real, you can almost touch it. It’s evident in their posture, their gait, and their silent plea of “Don’t look too close, lest you see the real, broken me.” In extreme cases, they sit in silence, shielding their faces, their eyes downcast while rebuffing all of my efforts to connect. It's hard to believe that a well-controlled medical condition can cause that level of traumatized presentation among individuals. Usually it's not the condition itself that causes it. Rather, it's the fear of judgment and unwarranted feelings of shame that create this reality. It's up to us as a community to educate ourselves about the damaging effects of keeping secrets from others, and to start healthy and respectful conversations that will facilitate acceptance, compassion, and a state of wellbeing for everyone. As the personal accounts in this feature portray, when children and adolescents are made to feel that their condition does not define them, that sharing their diagnosis is their prerogative, their emotional and social health is unaffected by their condition. They exude an air of confidence and an incredible sense of inner peace, no matter the circumstances of their condition.

Chaya Henchy Friedman, LCSW, is a psychotherapist in private practice who works with MyTEAM, an organization that provides confidential peer-connection, mentors, and teleconferences for high-school and post-seminary girls with non-life-threatening medical conditions, such as Crohn’s, colitis, juvenile arthritis, diabetes, chronic fatigue, and Lyme disease.

Adar II 5779 | Wellspring 69

Living Well

At the Dietitian By Tamar Feldman, RDN, CDE

ARE DIGESTIVE ISSUES CAUSING YOUR WEIGHT GAIN? GERD Numerous times weekly, I am contacted by individuals wanting to work with me for weight loss, but who suspect they first need to treat an underlying digestive issue. They are convinced, and I believe rightfully so, that their inability to lose weight despite tremendous effort is stemming from unresolved gut issues. They are encouraged when I agree that their hypothesis has validity, as clients with concurrent unresolved digestive issues often do not lose weight until we spend three to four months fixing up the gut. To quote Dr. Kenneth Brown, MD: “Gastrointestinal and digestive issues can definitely have a large effect on the way we eat and how our bodies absorb and digest foods, causing us to gain or lose weight. Most digestive problems tend to cause weight loss from poor absorption of food, but there are a few situations in which our intestinal health can contribute to weight gain.” Below are three common conditions that can contribute to difficulty losing weight:

70 Wellspring | March 2019

(GASTROESOPHAGEAL REFLUX DISEASE) ALSO KNOWN AS "HEARTBURN" GERD sufferers tend to experience relief when the stomach contains food, and often experience nausea on an empty stomach. Eating provides temporary relief because both the food being eaten and the saliva from chewing the food neutralize acid. The only problem? Once the food’s been digested, the bloating, burning, and nausea symptoms appear even more aggressively because of rebound acid production. Because people want immediate relief, it’s easy to get sucked into a dangerous cycle of overeating that leads to weight gain.

SIBO

CONSTIPATION

(SMALL INTESTINE BACTERIAL OVERGROWTH) This condition, particularly common in our community, manifests as severe bloating and distension post-meal, with often concurring IBS symptoms, such as pain, constipation, or diarrhea. It is caused by the movement of bacteria upwards from the large intestine into the normally sterile small intestine, where these bacteria then have a field day eating carbs coming in from the stomach, producing uncomfortable gassy by-products.

SIBO causes weight gain in two ways. First, the bacteria often produce methane gas, which slows down the overall function of the small intestine, allowing the intestinal villi to absorb more calories per bite. In other words, the exact opposite of what you want to happen if you’re trying to lose weight. Second, SIBO can slow down metabolism and cause insulin and leptin resistance, both of which help regulate hunger and satiety. As a result, you’re likely to crave carbs and probably won’t feel full after eating, even if it’s a fully satisfying meal. I find it helpful in SIBO cases to add to the regimen the probiotic strain Lactobacillus gasseri, which research has demonstrated to improve weight loss efforts.

When you’re stopped up, that weighed-down feeling you get may translate into extra pounds on the scale due to the weight of the extra fecal content being stored. But there’s good news: your body isn’t actually absorbing more calories, says Brown, so it’s not true fat storage gain. However, when individuals are constipated, they don’t exactly feel motivated to hit the gym or take a jog. That sluggish feeling accompanying long-term constipation can therefore indirectly lead to actual fat and weight gain due to decreased motivation to exercise.

The good news is that most individuals who resolve their digestive troubles can lose weight, although they need to be patient and work through the gut repair process for a few months first. Amazingly, we now know that the health of the gut and the billions of microbes that reside in it affect not just our long-term health, but our ability to lose and maintain a healthy weight as well.

Tamar Feldman, RDN CDE is a Registered Dietitian/Nutritionist and a Certified Diabetes Educator with over twelve years of experience. She maintains a busy nutrition practice with offices in Lakewood and Edison, and via phone/skype to numerous international clients, specializing in balanced and sustainable weight loss and nutrition therapy for autoimmune and gastrointestinal issues. She can be reached at 732-364-0064 or through her website: www.thegutdietitian.com Adar II 5779 | Wellspring 71

Living Well

Health Personality By Shiffy Friedman

r e h t o n A

Cup of Tea With:

n her colorful profession as a physical therapist who specializes in pelvic floor conditions, Dr. Chayala Englard treats patients that present with various symptoms, some rarer than others. Thanks to her open, understanding approach, there is rarely an issue that elicits her surprise. Still, with every patient she sees, she learns another lesson or two. “I learn more from my patients than I could ever have been taught in PT school, both in regards to the body and strength of character. One of my favorite aspects of my job is meeting new people and spending considerable time understanding their needs, a luxury that’s not feasible in the current medical system.” With this approach, Chayala has helped women recover from surgeries, cancer, and hysterectomies, providing physical and moral support along the way. And she has treated more than a handful of patients who experience bedwetting in late adolescence or adulthood.

“I’ve found that bedwetting is correlated with constipation and hormones. And as some occupational therapist colleagues taught me, it may also be a result of sensory defensiveness and unintegrated reflexes. I base my treatment of bedwetting on the

72 Wellspring | March 2019

Dr. Chayala Englard PART II OCCUPATION: Doctor of physical therapy SPECIALTY: Women’s health and pelvic floor rehab

LOCATION: Lakewood, New Jersey PASSION: Educating people through public speaking

WISHES PEOPLE WOULD KNOW THAT: the pelvic floor can only heal once constipation is resolved.

Adar II 5779 | Wellspring 73

Living Well

Health Personality

groundbreaking work of pediatric urologist Dr. Steve Hodges, creator of the M.O.P. protocol. His research found that enuresis (wetting) and encopresis (fecal accidents) are caused by a blockage of fecal matter in the colon and the rectum. A ‘stuffed up’ rectum will put pressure on the bladder, causing accidents. When the bowel is unclogged, it shrinks back to size and regains tone and sensation, thus resolving accidents.” When Hodges took x-rays of children who had enuresis, he found that over 90% had stool retention, whether in the rectum or large intestine. When the colon or bowel is so full, they get overstretched, which leads to a vicious cycle because they could now retain more stool.

“One time an adolescent patient with encopresis came to me, I felt a huge lump of stool in her colon. The way to get rid of it, according to Dr. Hodges, is to follow an enema-based protocol,” Chayala explains, “to consistently flush out the colon so it shrinks back to its regular size. The longer the stool was retained, the more overstretched the colon becomes, thus necessitating more extensive or aggressive treatment.”

What is a physical therapist’s role in the process? “In his last chapter of The M.O.P. Book, Dr. Hodges addresses this angle. Because the direction of stool evacuation defies gravity—it travels upward before it comes back down, stool moves across the colon through peristalsis, the involuntary constriction and relaxation of the muscles, creating wavelike movements that push the contents of the organ forward. However, if the colon’s walls are so overstretched, it exhibits ineffective or no peristalsis at all. Here is where learning the proper position for bowel movements comes into play—the squat. In addition, in order to ensure smooth evacuation, I teach most women how to perform the bowel massage, a specific technique that massages the colon to move the stool along smoothly. We’ve come to call it the I Love You massage because of the I L U shape in which it is done.” In addition to an overstretched colon, another factor that inhibits peristalsis is scar tissue. Abdominal surgery such as a C-section may generate scar tissue surrounding the colon, creating kinks around it.

While most individuals experience a bout of constipation at one point in their life or another, Chayala offers several reasons why pregnant women are especially susceptible to this condition. “During early pregnancy, it’s generally a hormonal issue. When progesterone is dominant, as it is during the first trimester, it slows down the GI (gastrointestinal) system. Thus, stool takes longer to go through the passageway. The longer it takes, the more of its water the body will absorb. To combat this, I advise women to drink lots and lots of water. However, many women are nauseous in the first trimester and have difficulty drinking water. Therefore, some women need to take a fiber supplement, chia seeds or Miralax temporarily to help with evacuation, which pulls water from the body back into the stool. This is a good thing, but

74 Wellspring | March 2019

if you’re doing so, you must make sure to give your body enough water to work with. If you’re nursing and not drinking enough water, your body will draw its hydration from your milk supply, drying it out. Or you may find that you’re parched. That’s because your body is drawing water from any possible source, including saliva.”

In the late stages of pregnancy, the main cause of constipation is usually the constricted position of the organs. “It simply takes longer for the stool to get through the passageway,” Chayala explains. “Also, mobility, not the strong point of most expectant women, helps with bowel movements. These are all contributing physical factors to the common condition.”

Because her specialty is the physical angle, Chayala notes, her treatment is primarily focused on physical causes, as well as physical treatment. She does emphasize, however, that sometimes physical symptoms are essentially manifestations of emotional issues, in which case she refers the patient onward for the help they need. “Anxiety, for example,” she clarifies, “can play a significant role in elimination. If I find that this is the case with a patient, I will work closely with the mental health counselor to achieve results. It’s always wonderful to have team effort in the healthcare profession.” When Chayala treats a patient, she sees more than the particular organ they come in to talk about. She sees a network of wondrous parts of one whole, all of which must work seamlessly together to enable optimal functioning. One of those integral parts, which often goes unaddressed, is the respiratory system. “When I teach in college,” Chayala expresses passionately, “I tell my students that if they walk away with one lesson from my classes, it’s this: You must understand the pressure system and its effects on the whole body. Breathing is the foundation of that system.” When we inhale, she explains, the diaphragm descends and pulls the lungs open. The abdomen opens, and the pelvic floor widens/lengthens. When we exhale, the pelvic floor comes up and in, the ab-

domen comes in, and the diaphragm bounces back up, causing an elastic recoil of the lungs. Breathing properly, the way babies do, enables optimal functioning of many different systems.

“Most women think they should be doing Kegel exercises, which consist of repeatedly contracting and relaxing the muscles that form part of the pelvic floor. However, sometimes Kegels are actually contra-indicated for that particular patient, especially if they have tightness. In addition, 95% of women are doing their Kegels wrong because they do them on a breath hold. When doing so, they’re fighting the body’s natural pressure system. Kegels should be done on exhalation, to follow the body’s natural pressure system.”

In the same vein, an individual with high anxiety whose upper body muscles are tense, as well as most pregnant women, don’t use the proper mechanics to breathe. One of the drawbacks is the effect this has on the diaphragm, whose additional function is to serve as the body’s “plunger.” When we don’t have that plunging effect, Chayala points out, we lose the advantage of moving the GI system along smoothly. “Not breathing properly could also lead to acid reflux, because of a backup of pressure.

If we train our body to breathe with the natural pressure system, it becomes second nature.

“If we train our body to breathe with the natural pressure system, it becomes second nature. When we cough, sneeze, laugh, or yell, we’re in exhalation. Based on how I explained what happens to the pelvic floor when we exhale, the pelvic floor should come ‘up and in’ and support the organs with the cough or sneeze. It’s called the ‘knack.’ If however, the pressure system is not trained, the pressure will build up in the pelvic floor, leading to leakage and/or gas release, plus an ineffective cough or sneeze. Air could exit either from the top of the body or below. When we exhale when exerting, the pressure exits through the mouth or nose and does not build up in the abdomen or the pelvic floor. A buildup of pressure in the abdomen or pelvic floor over time can lead to prolapse, hernias, or worsening diastasis. Thus, whenever an individual is exerting energy, such as carrying, pushing, or pulling, they should be in exhale mode.”

To drive the point home, Chayala recommends doing the following balloon exercise: “Before you blow, take a good inhale, stabilize/contract your pelvic floor, then blow. When you do so, you will find blowing up the balloon easier. You should feel your pelvic floor ascend, not descend, when blowing up the balloon. I’ve had women tell me, ‘I don’t know how to blow up a balloon.’ In one session, they learn to blow up a balloon. I love watching the surprise and joy on their face when they get it right! Learning how to breathe optimally is one way to maintain pelvic health. With the help of Hashem, drinking enough water and doing mobility exercises will go a long way in keeping this vital system—and your body—strong.”

Adar II 5779 | Wellspring 75

Living Well

Memos from a Kinesiologist By Miriam Schweid

When Infections Are as Thick as Thieves Thieves oil: an alternative to antibiotics For years, I felt like there was a latent bacterial colony living in my family’s throats, waiting to strike at any and every opportunity. We were all too frequent visitors at the pediatrician’s office, and if there would have been a “frequent shopper” program there, we would have been platinum members. I practically knew the children’s books in the waiting room by heart. My kids were bored of the toys and even lost interest in the fish tank.

Our main reason for the visits was their frequent strep-throat infections. After completing the standard round of antibiotics we were usually back at the office with the same symptoms within the month. We went from amoxicillin to Duricef to Augmentin and back again.

At one of the visits, which was ultimately the last one for strep, I met a friend in the waiting room. She was with her child who was having an allergic reaction of some sort, and she was glad to have a distraction. We began to talk, and I told her we were frequent visitors due to recurrent strep-throat infections. She handed me a tiny bottle, simply labeled “Thieves Oil” and told me that because her daughter was highly allergic to penicillin and many other antibiotics, she had needed to search for alternative remedies. A holistic doctor introduced her to thieves oil. Her daughter never suffered from strep throat again. I sat in utter disbelief, planning to do some research as soon as I left the office. First, I was curious to learn the origin of the oil’s bizarre name. As is well known, deadly plagues, especially the dreaded Black Death, killed millions in medieval times. In an outbreak in London in 1665, as many as one in five residents died.

According to legend, four cunning spice merchants used some of their imported spices and oils, rubbing the mixture over their bodies, and then entered and looted the homes of plague victims. They knew they wouldn’t get sick even if they came in contact with the contagious victims, as they had rubbed the oils over themselves. Their plan worked and the thieves set up a very lucrative business until they were caught by the local authorities.

When the town’s leaders heard their tale, they wanted to know the thieves’ secret. How did they protect themselves from contagious diseases without getting sick? They were given a choice to either share their secret formula for immunity or face punishment. The thieves decided to reveal their personal recipe. The secret formula was then posted all over town and the people were saved. So what was the secret? Cinnamon, cloves, eucalyptus, rosemary, and lemon, distilled into essential oil form, kill 99.96 percent of airborne bacteria and provide powerful immune support.

Legend or not, I was more than ready to try thieves oil with statistics like that. As instructed, I purchased a bottle and diluted some of it with water, placing it in a small spray bottle. I then sprayed the back of my child’s throat. There was a marked improvement overnight. I called my friend to thank her, and she shared some unbelievable stories about her own strep experiences. There were times when she couldn’t even open her mouth to talk from the intense pain. But just a few hours after the thieves oil treatment, there was a dramatic improvement. Her mother's lymph nodes were often swollen. The doctors had scared her with the frequent biopsies they ordered. She began using thieves oil and massaging those lumps. In a few days they had disappeared. My friend had been considering removing another child’s tonsils and adenoids, but after she tried thieves spray, the doctor never mentioned it again.

There was only one problem. The company that manufactured thieves oil charged $75 for just half an ounce. I was massaging the thieves oil into the neck, on the throat area, and diluting some to use as spray on a steady basis. That made this an expensive treatment plan. Taking matters into my own hands for the sake of my family and the many others who were learning about the efficacy of this wonderful oil, I contacted aromatherapist Chaya Sara Honig, who enthusiastically got involved. Together, we created affordable thieves oil and thieves spray. Those endless waits at the pediatrician’s office for yet another strep culture are a thing of the past.

Miriam Schweid is a Brooklyn-based kinesiologist. She can be reached through The Wellspring.

76 Wellspring | March 2019

FIVE-STAR DINING

Â®

DIY

Living Well

Home Lab By Miriam Schweid

recipes for natural living

Scrub Your House Down White vinegar and baking soda clean just about everything. Be kind to yourself, your skin, and the environment by using these homemade cleaning detergents for Pesach cleaning. Especially if you suffer from eczema, cleaning with commercial detergents can be a dreadful experience—the pain and itching intensify with use of harsh chemicals. Get your hands on some spray bottles and essential oils and you’re good to go.

Wood Polishing Oil • ¾ cup olive oil • ¼ cup vinegar • 30 drops lemon or orange oil

Natural Cleaning Detergent

Oven Cleaner

Use this refreshing detergent on all basic surfaces, such as for washing floors and counters. • ½ cup white vinegar • 2 Tbsp baking soda • 10 drops tea tree, lavender, or lemon essential oils • Water

Mix vinegar, oils, and a drop of water in a clean spray bottle. Adding baking soda and fill to the top with water— about 10-12 ounces. Gently shake to mix ingredients. Spray surfaces and wipe with cloth. Allow to dry.

Natural “Soft Scrub”

This makes for a perfect cleanser. • 1½ cups baking soda • ½ cup liquid washing detergent, such as All Clear or Arm & Hammer • 10 drops lemon or lavender oil

Mix well and store in sealed container.

What a welcome alternative to the suffocating commercial cleaners. And what a job it does! • ½ cup baking soda • 2-3 Tbsp water • ½ cup vinegar Spread paste on walls of oven and let mixture sit overnight. The next morning, pour some vinegar into a spray bottle and spray to create a foam. Wipe with damp cloth and rinse.

Glass and Mirror Cleaner

You don’t have to keep the baby away from this one when you’re busy bringing another window to a shine. • • • • •

Shake well to ¼ cup vinegar integrate the ¼ cup rubbing alcohol 1 Tbsp cornstarch (against streaking) corn starch. Shake before 2 cups water each use. 10 drops lemon oil

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Kid-Friendly Activity During a pre-Pesach snowstorm several years ago, cleaning served as the activity of the day to keep the little hands out of mischief’s way. Scrubbing and rubbing with gentle natural cleaning detergents served as the perfect safe outlet for their boundless energy.

Spring 2019 Courses March 25th School - Based Collaboration and Technology Brooklyn, NY Presenter: Kim Wiggins, OTR/L

May 20th From Sensory Processing to Executive Functioning Brooklyn, NY Presenter: Maude Leroux, OTR/L, SIPT, RCTC, DIR

June 5-6th Connecting the Dots on Reflex Integration: Treatment and Protocols Part 2 Brooklyn, NY Presenters: Amy and Evelyn Guttmann, OTR/L

www.handsonapproaches.com

May 7th Making Sense of Sensory Miami, FL Presenters: Amy and Evelyn Guttmann, OTR/L

May 21st Play the Floortime Way Brooklyn, NY Presenter: Maude Leroux, OTR/L, SIPT, RCTC, DIR

Visit our website to register, call 212-884-9101 or email us at: info@handsonapproaches.com

our secret ingredient is...

Fruit.

(and Fruit. and some more Fruit.) ÂŽ

Kosher Parve

No sugar added An individual pouch equals to 90% of a serving size of fruit

Wellbeing

In Session with Shiffy Friedman, LMSW

Heart to Heart

New Column!

So Many Gifts and Still Not Happy

For a long time, we’ve been contemplating an emotional health column in a question-and-answer format. Our main hesitation was our reluctance to give the questioner and our readers a generic response based on an unexplored question. Since we did not think it was possible to provide appropriate direction based on just a few lines submitted by the reader, we sought a style that would allow for more back-and-forth, allowing us to gain more clarity on the question. With gratitude to Hashem, we introduce you to the column that we hope and pray will do justice to the depth and infinite value of the nefesh. In this column, the respondent will not answer a question based on a few lines, but rather portray some of the back-and-forth that went on behind the scenes between him or her and the questioner. The summarized interactions in this column are either based on reader-submitted questions or are a portrayal of several sessions that helped guide the individual toward the first step of his or her emotional health journey. Since emotional work is always a journey, the goal of this column is to provide direction toward the first step, as well as important points of exploration that could b’ezras Hashem lead to the menuchas hanefesh the questioner, and every Yid, seeks. The Editors

I have everything going for me but I don’t feel happy.

My work.

Tell me about yourself.

Do you feel this way anywhere else?

I’m married, a mother of five young children, and I make a nice parnassah as an occupational therapist, both in private practice and at a local health center.

Do you have one happy place? Is there something you do or a certain interaction in your daily life where you do feel alive?

No. My husband and I have a good marriage. We don’t fight, and we rarely have arguments. I prepare my husband’s meals, take care of all his technical needs, I even clean up the kitchen the way he likes. But he always complains that I don’t spend enough time with him. The same goes for my kids. I love them very much, but I can’t say spending time with them is my favorite activity. And when you’re working, you do feel that spark?

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Wellbeing

In Session

Yes.

You say that your husband complains that you don’t spend enough time together. Do you feel that way too?

Here goes: 1. My work 2. My children 3. Myself 4. My husband 5. My social circle 6. My home Wow. This is painful. Which part is painful?

No. I think we’re doing everything right. I’m not sure what the fuss is about.

Here are the six basic priorities for a woman in your position (in no particular order): 1. Her home — housekeeping, meals, laundry, etc. 2. Herself 3. Her children 4. Her husband 5. Her work 6. Her social circle (family and friends) Can you place them in order of importance in your heart? This is not about how it’s “supposed” to look, but how you really feel about these categories. Which ones take up most of your brain space? Which ones are of greatest concern to you?

That my husband isn’t my top priority — that there are other things and other people that come first in my life.

When he’s asking for more time together, what do you think he’s really asking for?

He wants my heart to be in the marriage. It’s painful for me to admit that it’s not.

I’m tempted to list it the way it’s supposed to look. Let’s put it this way. If I would ask your husband what he thinks your priorities are, how do you think he would list them?

82 Wellspring | March 2019

It's painful for you to realize this about yourself. Before you jump to “this is not how it’s supposed to be,” or, "what can I do to fix this?" allow yourself to feel the pain that's coming up for you. Did you ever notice that your husband is not your first priority?

No. It hurts me to realize it now.

Searching for happiness without doing your utmost to facilitate a more fulfilling marriage may be a futile effort. As long your spouse isn’t your top priority, not only do other interactions and relationships excite you more, but there can be no real shalom bayis in your home. Shalom bayis is not only about no fights and doing for one another. It’s about a heart connection. As followers of the Torah, of which is said, “Deracheha darchei noam vechol nesivoseha shalom, her ways are pleasant ways and all of her paths are of peace,” this is our life’s goal. Thus, as you have found in your own life, attaining simchah in the absence of shalom bayis is an arduous, if ineffective, effort. Technically, you have a good marriage, but emotionally, you don’t feel connected. However, convincing yourself that your spouse is your priority won’t do the trick. Rather, allow yourself to feel the pain that he’s not. Acknowledge the reality. Only once you feel this pain can you turn to Hashem with a plea for His help. He is the only One who can turn on the switch in your heart. Obviously, the reason the reality is this way may result from various sources. You may have a fear of close relationships, you may be afraid to have someone look too deeply inside of you, or you may hold erroneous beliefs about relationships, in general, and about marriage, in particular. You may find it helpful to explore what’s keeping you back from opening your heart to another person, which may indicate that you too are disconnected from your inner world. Regardless of the reason, technical solutions are petty in comparison to the wonders Hashem can do when you turn to Him from your pain. As you stated above, it already appears like you’re doing everything right—and you should keep doing those things. Still, there is no heart connection. Thus, instead of rushing to find a technical solution for the problem, your first step toward healing would be to spend several minutes every day focusing solely on this new realization, on sitting with this pain and asking Hashem to open your heart for your husband. Acknowledging that you feel the way you do is key in the healing process. If you focus on this and bring it to your tefillah, with time, you’ll start doing what it takes to make the relationship more meaningful for you and your husband, such as setting aside time on a steady basis for conversation. Only when this happens as a gesture of the heart does it have an authentic impact. Know that tefillah for ruchniyus—for shalom bayis with a sincere desire to do your part—is never in vain. May you be zocheh to bring the Shechinah into your home very soon. When the Shechinah rests in the home, all of its inhabitants merit feeling simchah.

Vantage View Why Marriage? The questioner did not mention her marriage in her original question. The issue she presented was that she doesn’t feel happy. There are many areas that can be explored to help determine why she feels this way, such as what it is about her work that makes her happy and attempt to understand how she can carry over that feeling into other areas of her life. Another angle to explore regarding her lack of happiness is how she feels about herself as an individual. Why turn her relatively good marriage into the central point of focus here?

In her practice as an LMSW, Shiffy Friedman realized that her knowledge in psychology was not helpful in healing the infinitely profound nefesh. An intensive search led her to discover the Torah’s direction toward a more connected life. To sign up to receive Shiffy’s weekly message on this subject, write to emotionalwellnessthroughTorah@gmail.com. To submit a question for this column write to hearttoheart@wellspringmagazine.com. The respondent will then be in touch with you to further flesh out the issue.

Adar II 5779 | Wellspring 83

Wellbeing

Child Development By Friedy Singer & Roizy Guttman, OTR/L

Understanding Reflex Integration Part I

How Your Baby Crawls or Sits May Be an Indication of Future Development 84 Wellspring | March 2019

Friedy Singer and Roizy Guttmann are neurodevelopmental therapists and the directors of Hands on OT Rehab Services, Hands on Approaches, and the H.O.P.E. (Hands on Parent Empowerment) Foundation. They are focused on educating and empowering the community to help children with anxiety, processing and learning issues. They can be reached at info@handsonapproaches.com

hen Chaim, a delightful 8-year-old boy, came to us for an evaluation, his parents expressed concern that he was having academic as well as social-emotional issues in school. His teachers reported that Chaim presented with increased hyperactivity, difficulty with reading both Hebrew and English, and he required increased time to present his thoughts on paper, many times not completing his work. However, when tested orally, Chaim demonstrated that he knew most of the material. Of greater concern was that Chaim was having difficulty interacting with his peers. Of late, his teachers reported, he was becoming more withdrawn socially, preferring to sit on the side during recess. In an attempt to foster

Chaim’s engagement in age-appropriate activities with his peers, his father tried practicing sports with him to build his confidence. However, he reported that Chaim was having difficulty with his coordination, appeared clumsy, and expressed being tired, frequently giving up and not engaging. In reviewing Chaim’s developmental history as a baby, we discovered he had issues with feeding and regulating himself and that many of his developmental milestones were delayed.

One of our areas of expertise is reflex integration, a topic we’re passionate about, which has been gaining more awareness and prominence in treating neurodevelopmental delay in children. Reflex integration utilizes neurodevelopmental movements to facilitate the maturation of a child’s central nervous system so that they can successfully gain independent control of their body while challenging their cognitive abilities to learn, in addition to developing healthy social-emotional responses with their peers. How babies “graduate” from exercising certain reflexes and then developing postural control is indeed an indication of their current development — and a reflection of so much more. How the reflexes do or don’t diminish as a baby grows may reveal a lot about a child's future physical, social, emotional, and academic development.

utilize postural reflexes as well as to develop voluntary and appropriate movement responses, the baby doesn’t have a need for these primitive reflexes anymore. By that point, most of the reflexes will have been integrated. This is neurodevelopmental lingo for describing reflexes that vanish, so to speak, because they’re no longer needed. The continued presence of a cluster of these primitive reflexes beyond the first year of life may indicate that a child may present with developmental delays, which could affect his physical, academic, and social-emotional skills.

Since babies do not have any muscle tone nor the ability to do anything for themselves at birth, Hakadosh Baruch Hu endowed them with natural primitive reflexes. These reflexes are unconscious, automatic, stereotypical responses with no leeway for change, and most of them have a physical component. The purpose of these reflexes is for the child to get basic training in movement in order for him to be able to move and interact with the environment while the higher levels of his brain are developing. At around six months of age, once the higher levels of the brain begin exerting control and the baby begins to

This description is a sample of what we experience in our practice on a daily basis. Here’s the question this article will attempt to answer: What is the connection between Chaim’s development as a baby and his presenting symptoms?

Let’s look at some examples of primitive infantile reflexes that are vital at birth and then gradually become integrated once higher levels of the brain become more developed.

Grasp (Palmar) Reflex Reflex: When you touch the palm of a baby’s hand, he will automatically wrap all of his fingers around your finger. Purpose: This involuntary grasp pattern serves to calm the baby. In addition, this reflex is connected to feeding and helps improve the coordination of hand and mouth movements used in early development.

Integration: Should occur by two to three months of age. Around this time, the baby develops a voluntary grasp. He starts to differentiate between grasping with

Adar II 5779 | Wellspring 85

Wellbeing

Child Development

his whole hand to slowly beginning to use individual fingers to hold on. As his grasp develops, he will develop a pincer grasp (using the tips of his fingers) to hold onto a cheerio, isolate his finger to point, push a button, and continue to develop fine motor skills.

Developmental issues: A baby may not develop age-appropriate grasp patterns and fine motor skills. This can be seen from a baby not being able to hold objects properly, a child holding a pencil incorrectly, having difficulty manipulating utensils for feeding, and in general not having good dexterity of their fingers.

Asymmetrical Tonic Neck Reflex (ATNR) Reflex: Also known as the “fencing reflex,” when the baby turns his head to one side, the arms and legs on that side extend or straighten out, while those on the opposite side flex, or bend. For example, if a newborn turns his head to the left side, his left arm and leg will extend outward while his right arm and leg will bend inward. Purpose: This reflex helps the baby start moving

In a typically developing child, most primitive reflexes are integrated by six months of age, with the last one integrating when the child is three-and-a-half years old. one side of their body at a time, helping them become aware of their midline. It also aids in the development of the baby’s eye-hand coordination skills. For example, if the baby is holding a rattle and turns his head to the right, his hand will extend outward with his eyes looking towards the same direction as his outstretched arm. This is when a baby begins to transfer his gaze from looking at something that is right of front of him to something that is at arm’s length, increasing his ability to see things that are farther away from his body. Integration: Once the ATNR vanishes at around four to six months of age, the baby has independent eye, head, and arm movements. His eyes won’t have to 86 Wellspring | March 2019

look to the side when he turns his head.

Developmental issues: When the ATNR persists in a child or an adult, the eyes, head, and arms do not yet operate independently, which hinders functional activities. For example, when the child is writing, every time he moves his head to the side, he will have a physical pull on his arm that he will consciously try to control, perhaps by holding on tighter to the pencil or pressing harder while he writes, which makes the activity taxing. Writing and reading require exertion of energy. These are the children who may have a hard time reading and tracking nicely across a page. These may also be the children who are clumsy in sports. They may sometimes be considered troublemakers because their body shifts or veers toward a certain side, but they simply can’t control it. Teaching them to sit straight or hold the pencil right doesn’t help. While they’re constantly thinking about how to control their body’s movements, is it any wonder that they may not be able to freely access the information they know in their mind and put it down on paper?

Symmetrical Tonic Neck Reflex (STNR) Reflex: When a baby’s head is flexed forward, the forward head flexion will produce flexion (bending) of the upper extremities and extension (straightening) of the lower extremities. When the baby’s head is extended, it will produce extension of the upper extremities and flexion of the lower extremities. This reflex is used by the developing baby at six to nine months.

Purpose: STNR allows the baby to start separating the upper and lower parts of his body, which helps him pull up from sit to stand and helps get him into a crawling position.

Integration: Once the reflex has done its job, it integrates to allow the baby to crawl using a typical cross-pattern movement. If still present, since babies are smart, they will find a way to crawl, becoming bottom shufflers or using an inappropriate pattern. Despite the influence of this reflex, however, they may miss out on the benefits of crawling properly. Developmental issues: Children with a retained STNR may have a hard time sitting in a chair later in life. They’re the ones who sit with their legs stretched out in front of them, or love to do work on the floor, on their stomach. This may affect their posture. When the teacher tells them to sit straight, she thinks the child is listening and paying attention to the lesson, but what the child is not telling her, because the child herself is probably not aware of it, is that from now on

she’ll be busy figuring out how to be comfortable while listening to the teacher. Meanwhile, while she’s shifting around, she's lost five minutes of concentration, which may have repercussions on academic success.

In a typically developing child, most primitive reflexes are integrated by six months of age, with the last one integrating when the child is three-and-a-half years old. Just as lack of integration later than the desired age may pose a developmental issue, the presence of specific primitive reflexes in children who suffered trauma to their central nervous system, such as children diagnosed with CP, brain injury, or history of stroke, may pose an issue as well. The presence of the reflexes for these children actually indicates the child still needs them to protect himself, for survival. Thus, working toward getting rid of the reflex may not always be of benefit for the child. Treatment should be geared to facilitate integration to attain maximal functional developmental milestones to help each child reach their fullest potential.

Every single reflex that Hashem implanted in a newborn baby is vital for his survival. When an animal gives birth, it’s just a matter of minutes before the baby starts walking. Unlike humans, they do not require time to develop the connections between their sensory systems and the physical abilities of their body in relation to muscle tone and coordination, but rather get up and immediately start moving. But Hashem created our babies in a way that they’re first in survival mode.

For the first half-year of their life, human babies are simply trying to exist in a world in which they’re not ready to function independently. It’s important for us to keep in mind that every single one of a baby's reflexes is vital for his survival at that point. It begins with the Moro Reflex, where he startles and cries at everything that he needs to adjust to, whether it’s a positional change of his body, a bright light or a sudden loud noise. When we put the baby somewhere too cold or too hot, he cries, which helps him survive. When he is hungry, he cries for his mother, and when he is satiated, he feels safe and secure in his world. Just as it’s vital for a child to integrate these primitive reflexes, it’s important for him to exhibit and utilize them at the appropriate stage as well. In the weeks and early months to come, the baby will use these reflexes to help him survive and begin to navigate his environment. Through movement, he will develop an internal map of his body followed by the development of voluntary movements so he can walk where he wants to, climb onto every available surface with ease, to ultimately sit in a classroom, his body comfortable and at rest, allowing him the freedom to learn with an open mind.

Reflexes: A Brief History An awareness of reflexes, a fascinating

set of automatic movements that every

human being is designed with from the womb on, has been around since the early

1900s, when the first pediatricians desig-

nated what reflexes babies have. Dr. Ernest Moro was the first physician in Western

medicine to describe the infant reflex that

was later named after him (the Moro re-

flex). Normally present in newborns and

lasting up to three or four months of age, the Moro reflex is a response to a sudden loss of support, when the infant feels as if it is falling.

Since the 1970s, many programs have

been developed to help facilitate reflex integration in children when this doesn’t occur naturally. While there are many movements and exercises out there to work on

this area of development, parents should

do their due research to ensure that the

ones they choose for their child will not lead to an adverse reaction.

As mentioned above, while most of us have a reflex or two that was never fully integrated, the real problem arises when a cluster of reflexes hasn’t been integrated. When several reflexes don’t get integrated, they may affect the child physically, academically, and emotionally. In Part II of this series, we will discuss how development may be affected and what parents can do to help facilitate proper reflex integration in their children.

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Wellbeing

Serial Diary By Zahava List

Unveiled

Life with mental illness Although I experienced several manic episodes after the birth of my first child, my eye was constantly on the prize: on the day I would be healthy enough to have another baby, for my son to have a sibling. Finally, at around his fifth birthday, after having experienced a traumatic miscarriage in between, I gave birth to my second son. While I did experience lows during the pregnancy, my excitement to have another child was intense. I looked forward to the birth, preparing myself as much as possible mentally and emotionally for what was to come. The first few moments after the birth were magical. I had reached a milestone. When I was expecting my first child, I did not yet know what a gift I was being granted on a silver platter. This time around, I experienced such intense longing, a deep yearning to bring another child into this world. What a joy it was! After the birth, I was in a good mood, which is very different from mania. While in both of them the individual appears happy, the way to understand the difference is to think about the difference between being hyper and being drunk on Purim. In the latter case, the individual says things they don’t normally say and does things they don’t normally do. But then, seven days after my baby’s birth,

the euphoria-turned-mania took on a life of its own, resulting in another psychotic episode. Once again, my medication doses were increased dramatically until the psychosis subsided, after which I experienced an intense low, until I returned to the middle again. Even when life returned to relative normalcy, bipolar disorder was always in the backdrop. When life was calm, it was calm. But I never knew when the next shoe would drop. In Hindsight As I learned over time from my personal perspective, not as a professional, bipolar disorder is a more extreme reaction to the ups and downs in life. While every human being experiences highs and lows in their regular life, an individual with bipolar disorder experiences them with greater intensity. In general, this intensity is sparked by a trauma that is more severe than average. When the pain is so overwhelming, the individual must exercise more extreme mechanisms in order to escape it. With this awareness, when I look back at my life and the psychotic episodes I experienced, I notice that every time I got sick, a certain emotion came up for me. When the emotion threatened to overwhelm me, my body automatically resorted to mania as an escape mechanism. Although all of my relapses were similar in nature, each one exhibited a bit differently. The relapse I had when my oldest was six months old, for example, was not the same as when he was two and a half. Looking back, I see each one like an onion peel. With each layer that got peeled away, I got that bit closer to my essence. And once the episode was over, I wasn’t the same person anymore. Each one served as a stepping stone into the next level of recovery. To be continued...

Zahava List is the founder and director of Chazkeinu, a peer-led support organization for Jewish women who struggle with mental illness and their female family members.

88 Wellspring | March 2019

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Wellbeing

Clean Slate By Shiffy Friedman, LMSW

I’M A LOST CAUSE

BUT WHAT ABOUT MY DAUGHTERS?

Often, when adult women pay attention to how their self-esteem is dangerously dependent on their appearance,

part of Hashem’s plan in facilitating relationships that will perpetuate the world’s purpose. In fact, squelching this need raises a red flag. When a woman I’m working with—adolescent or adult—exhibits a disregard for her external appearance, I understand that this is an important element for us to explore. In Yiddishkeit, not paying attention to aesthetics is not a virtue. As Rabbi Yochanan states in the Gemara (Shabbos 114a), a talmid chacham who walks outside with a stain on his clothing is chayav misah. In another passage (Shabbos 113b), Rabbi Yochanan says that “a man’s clothes are his kavod.” Since our appearance is an indication our level of self-respect, looking presentable is important.

they are pained by the realization. It hurts them deeply that the way they and/or their family looks determines how they feel about themselves, and rightfully so. In their head, they may understand that they are valuable, inherently precious—even perfect—as they are, but in their heart, they’re anxious to be appreciated as all the above when seen in lessthan-perfect attire, if they’ve gained a few pounds, if they didn’t have time to apply their makeup this morning, or if their kids don’t look a certain way.

But what happens when this need takes a toll on our self-esteem? What happens when our need to look a certain way generates a slew of self-berating commentary in our head, to the extent that we can’t fully enjoy our blessings in life just because we don’t appear exactly as we wish? I’ve worked with women who obsessed over the twenty pounds they were gaining during pregnancy, and women who dreaded attending social events because they hadn’t yet reached their goal weight or found the perfect dress. For such women, the need to look good is no longer healthy. It has drifted into dangerous territory that profoundly affects their quality of life.

It’s important to note that the need to look good is healthy. It’s part of our humanness;

The path to healing for individuals whose self-esteem is dependent on externals is a dis-

90 Wellspring | March 2019

cussion for another time, but here’s a question many of these individuals ask, one that is worth opening in this space: “I’m a lost cause, but what about my daughters? I don’t want them to suffer like I do. I want them to feel good about themselves no matter what. What can I do to make that happen?” And the big question, which pertains to every area of parenting, is this: Is it ever possible for a parent to transmit a message that she doesn’t live by? If I don’t love to daven, can I teach my children to love davening? If I don’t especially love the mitzvah of tznius, will telling beautiful meshalim inculcate my daughters with a love for modesty? The answer, though obvious, isn’t one we like to hear. It implies that proper parenting always necessitates intensive inner work. It’s not only about knowing what’s right and wrong, and upholding it; it’s about loving the right and depreciating the wrong. A parent whose love for her child is dependent on the child’s appearance is suffering deeply inside; the deficiency in her love for her child is only a fraction of how deficient her love for herself is. This parent’s work toward loving herself unconditionally is vital in enabling her to give her children what they desperately need. But what happens while the parent is still engaging in the work? If she’s been suffering all her life from an uncomfortably fluctuating

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self-esteem, it doesn’t mean her daughters must, too. Here is some food for thought that could be put into action immediately, even while the parent is still working on her own self-image. If you’ve been a parent for long enough, you’ve certainly heard the advice: “Watch your words.” The things you tell your children go a long way in transmitting your priorities in their impressionable minds. Is the way you comment on your child’s externals giving her the message that she’s more lovable when she looks a certain way? When you visit your daughter in camp, is her appearance the first thing you comment on? Telling an adolescent daughter that a certain color or style suits her better is a normal part of the teaching process, but how is this message related? When a preteen or adolescent child complains that they look ugly because of the weight they put on or the pimple that appeared on their forehead, does your reaction imply your concurrence or does it reflect on your unconditional love toward them? However, only a small portion of our messages to our children are conveyed in the words we say to them. Whether we like it or not, they’re actually better on the subtle pickup. Tell them to clean up their room once, twice, even three times, and you may wonder whether your voice travels through space at all. Rave on the phone about how fantastically thin your friend looked at last night’s wedding, and they’ll hear you loud and clear. The takeaway of the awe with which a parent speaks of another’s appearance is that it takes up a giant space—that their perception of others, and by default their children’s, is largely dependent on this prominent factor. When you’re perusing family photos how do you react when you come across a photo of yourself ? A child who hears, “I can’t look at myself here,” or “I can’t believe I let myself be photographed like that,” absorbs the message good and well: value and appearance are inherently intertwined. When we insist on what our children should wear every day or on having the entire family in matching Purim costumes so that everyone “fits the theme,” we’re conveying a similar message: I need us to look a certain way so that I could feel a certain way. Does this mean parents should just let their kids run the show? As parenting coach Rebbetzin Sima Spetner often emphasizes, the choice is ours. As parents, we are the ones to decide when to put our foot down. If we’d like, we could choose to insist that every child, including the ones who don’t want to, must match the Purim theme. We could insist on choosing our kids’ clothes every morning, on deciding which hairstyle should be worn. We are the parents after all, and we have a right to have likes and dislikes, and to have our children obey our rules. But, she wisely notes, when we make these decisions, we must be cognizant of the underlying consequence: our children absorb our priorities based on what we insist on. Yes, we’re entitled to tell a child, “You can’t wear this today because I want you to wear something else.” We’re entitled to say, “Everyone is wearing this costume because I said so.” At the same time, we must know that our words carry weight. If these are the values we insist on, we’re conveying that, for us, appearance is intertwined with self-image. The more inner work a parent does to distinguish between her own inherent value and her externals, the more she will find that the values she insists on are those that really matter.

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SPOON INSIDE

F AT F R

ISSUE 38

MARCH â&#x20AC;&#x2DC;19 ADAR II 5779

ARRANGEMENTS YOUR FRIENDS AND FAMILY WILL ACTUALLY APPRECIATE

NUTRITION FACTS Even just half a grapefruit per day is beneficial for weight loss Boost Your Energy with this Power Shake

4 Fabulous

Mason Jar Salads

My Table

Your favorite nutritionist's Purim meal

Index Page

Authentic Gifting 3 INGREDIENT LUNCHES

Page

Page 120 111 128

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Have it

Purim Meal

Homemade

Boost

POWER SHAKE

TOMATO SAUCE

FRESH

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NUTRITION FACTS

THYME FOR DINNER

MASON JAR SALADS

6 RIDICULOUS "HEALTH FOODS"

THIS MONTH: GRAPEFRUIT

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Dietary restrictions are a thing of the past with Mehadrin's new Parve line!

Whether you're lactose intolerant or just ate chicken, you can now still savor the joys of Milchig foods.

Dear Cooks, I’d bet you don’t want to read another word about the surplus of junk that will be

making its way into your house over the next week or so, so I’ll leave it at that. But, I can’t resist offering you a creative alternative. In this issue’s Seasoned, we bring you a

variety of options for mishloach manos that your friends and family will actually enjoy.

From Rivki Rabinowitz’s fabulous Mason jar salads to Malky and Yossi Levine’s creative arrangements, if you haven’t yet planned out your ideas for this year, you have lots to choose from.

Even if your mishloach manos arrangements are all neatly stacked in your freezer or

basement, all of the featured recipes in this issue could come to good use for you. You

can’t go wrong with preparing carrot radish salad with maple mustard dressing for your Purim seudah, or one of the nut mixes as an on-the-go treat for your Purim guests. I can’t wait to try the authentic extracts in my own kitchen so I can use them for my baking needs as an alternative to the commercial flavors.

In this month’s installment of My Table, you’ll get a peek into a variety of dietitians’

and nutritionists’ Purim menu, to see how they manage to enjoy the day while staying in

balance. Here’s how I do the post-Purim partying. Every Purim, when the arrangements start coming in one after the next, I do a quick scan. Every bag, box, or container that comes through the door gets inspected for edibles. By edibles I mean “real food.” If I

spot a good salad, a nice dip, a healthy muffin, cut up fruit, or any other treat that fits

into this criteria, I add it to my post-Purim collection. The rest of the stuff, including bars of chocolate, fondant cookies, and themed cupcakes (sorry, friends!) are up for grabs—until the trade begins, where the kids get to cash in their junk for money.

Then, when things calm down but I’m still not in the mood of whipping up a meal

for myself, I get to enjoy the healthy treats I stashed away. This year, I think I’ll add an herbal tea mix to my post-Purim relaxation routine. How’s that for Pesach prep? Simchas Purim to you all,

Est her Adar II 5779 | Wellspring 97

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Recipes, styling, and photography by Yossi & Malky Levine

Authentic Gifting As the calendar inches toward Purim, the focus on mishloach manos becomes intense. Whether you enjoy getting creative and matching every last detail to your theme, or creating magnificent baked goods and pairing them with sweets or other goodies, or putting together a few ready-made foods, you probably have your style figured out by now. But here comes the million-dollar question: What happens with all the perfectly matched-and-themed mishloach manos and all the sweets and goodies when the day is over? Many of us end up discarding the containers and boxes along with lots of junk food we donâ&#x20AC;&#x2122;t want to find ourselves grazing on while we get to work on our Pesach prep. Hereâ&#x20AC;&#x2122;s our solution: How about taking a different route? This route has no cake or candy, but may still very well tie into your theme. Weâ&#x20AC;&#x2122;ve brainstormed and came up with several natural, homemade mishloach manos ideas that can be easily prepared, creatively presented, and will be appreciated and enjoyed either on Purim and/or well after that. Homemade gifts are a great way to maximize your thoughtful intentions. Most people would prefer a cheaper, homemade gift made especially for them over a last-minute store-grab expensive arrangement. With mishloach manos like these, you know your work will be well received.

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Homemade Authentic Extracts Homemade extracts are easy to make and great for gifting. You just need to add vodka to your vanilla, mint, etc. and let it sit for a few weeks until it’s ready to go. They are a lot healthier and more authentic than the store-bought version and so useful in your everyday recipes. Note: Since you will be making the extracts close to Purim, they will not be ready to be used when they’re gifted. Add a note to let them sit in a cool, dry place for 2 weeks or so (depending on when you put them together).

4–6 oz bottles with tight-fitting lids Labels 4-6 oz vodka per extract Extract ingredients—see below For each extract, vodka should reach the neck of the bottle. Seal tightly and store bottle in a cool, dry (preferably dark) place. Tilt bottle upside down every few days to gently mix the liquid inside.

Vanilla Extract 2 vanilla beans Cut vanilla beans in half, then split them open to expose the vanilla seeds on the inside of the pod. Place vodka and cut vanilla beans inside bottle. Allow to sit for at least 2 weeks. Note: When ready to use, vanilla beans can be removed from the bottle. If the vanilla beans are left in the bottle, the flavor will continue to evolve just like a fine wine. (However, be sure the beans are always submerged in alcohol).

Mint Extract 1 cup mint leaves Stuff mint leaves into bottle and cover with vodka. Use a skewer to lightly crush the leaves inside the bottle. Allow to sit for at least 2 weeks. Note: Advise your gift receiver to remove the mint leaves when the extract is ready and the leaves start to brown. 100 Wellspring | March 2019

Almond extract 12 whole raw almonds, skinless and split open Drop almonds into bottom of bottle and cover with vodka. Allow to sit for at 6-8 weeks for maximum flavor.

Lemon Extract 1 large lemon Peel thin strips of zest from your lemon, removing all of the white pith. Place peels into bottle and cover with vodka. Allow to sit for at least 2 weeks. Note: Advise your gift receiver to remove the peels from extract once they brown. For orange or lime extract, follow the process above with the fruit of your choice.

Well Informed

Wellness Platform By Rabbi Hirsch Meisels

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Personal Cocktails What an appropriate time for these adorable personal cocktails! They are simple to put together yet add a fun and unique twist to your typical mishloach manos gift. Pair your favorite vodka or rum with the ready juice mixture and watch your family and friends sip and enjoy.

Screwdriver ¾ cup orange juice ¾ cup cranberry juice ½ cup water ¼ cup lemon juice Mini vodka

Lemon-Mint Mojito ¼ cup freshly squeezed lemon juice ¼ cup mint leaves 1½ cups seltzer ½ cup honey Mini Glenfiddich

Pina Colada 1 cup pineapple juice ¼ cup coconut cream ⅓ cup fresh pineapple chunks Mini coconut rum

For each cocktail, add all ingredients, except alcohol, into a glass jar with a tight-fitting lid. Seal jar. Use twine or string to attach the mini alcohol (and straw) to jar.

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Flavored Salts Seasoning salt with citrus, herbs, or spices is one of the easiest ways to add a unique flavor to your daily meals, particularly when you’re cooking up healthy meals and reducing some of the traditional flavor makers. Adding a pinch of salt that’s been spiked can really elevate your recipes and family meals to a new level.

Lemon Pepper Salt ½ cup coarse sea salt 2 Tbsp lemon zest 1 tsp ground pepper Spread grated zest on parchment-lined baking sheet, then dry in the oven on 200˚F for 15–30 minutes. Once zest is dry, gently crumble with your fingers. Mix the salt, lemon zest, and pepper. Transfer homemade salt to a salt grinder.

Garlic Herb Salt ½ cup coarse sea salt 1 Tbsp finely chopped parsley 1 Tbsp finely chopped thyme 2 cloves garlic, minced Preheat oven to 200˚F. Combine sea salt, garlic, parsley, and thyme until mixed well. Transfer mixture to a baking sheet and bake for 15–20 minutes. If there are any lumps, pulse mixture with a hand blender. Let mixture cool for 5 minutes and transfer homemade salt to a salt grinder.

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Homemade Nut Mixes These tasty nut mixes make a great healthy mishloach manos treat that your friends will thank you for. They smell heavenly while you’re making them, and taste even better when they’re done. The maple glazed mix may look sugared, but it’s not. Its sweetness comes from pure maple syrup, which creates a lightly sweet glaze that coats the nuts beautifully, ensuring a delicious sweet-n-salty flavor in every bite. Note: Arrange them in single-sized portions for quick snacks on the go.

Maple Glazed Mix 1 cup raw pecans 1 cup raw almonds 1 cup raw hazelnuts ½ cup pure maple syrup ½ tsp cinnamon ¼ tsp salt Add nuts to a large nonstick skillet over medium to low heat. Toast nuts, tossing every 2 minutes until they are brown and toasted. Add maple syrup, cinnamon, and salt and mix well to coat. Transfer nuts to a parchment-lined baking sheet. Separate so they won’t stick together and allow to cool.

Spicy Mixed Nuts 1 cup peanuts 1 cup cashews 1 cup Brazilian nuts 1 cup banana chips 1 tsp salt ½ tsp cayenne pepper ¼ tsp cumin ¼ tsp freshly ground black pepper ⅓ cup xylitol 1 egg white Preheat oven to 300˚F. Line a baking sheet with parchment paper. In a medium bowl, whisk egg white until foamy. In another small bowl mix spices and xylitol. Fold nuts into egg whites. When sufficiently coated, fold in spice mixture. Spread nuts in a single layer on baking sheet. Bake for 45 minutes, flipping once. Remove from oven. They can be served warm, or stored at room temperature in an airtight container.

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Homemade Herbal Tea Blends Treat your friends with an herbal tea blend! That’s a special treat they don’t get every day. These recipes require a trip to your health food store, but they’re well worth it. These little bags of fragrant goodness don’t only make for a beautifully presented mishloach manos, they will actually be savored and enjoyed for days to come. Life gets hectic (by you too?) and we constantly need to remind ourselves to slow down. A nice cup of warm herbal tea in the evenings is the perfect way to unwind and de-stress. When I sat down to savor this fragrant, calming tea I could feel my entire body relax. Ahhh…. If no one’s sending this to you, you may want to try them to treat yourself.

Immunity 4 Tbsp rose hips 1 Tbsp cinnamon chips 1 tsp hibiscus flowers 1 tsp fennel seed ½ tsp lemon peel

Tranquility ¼ cup lavender buds ½ cup chamomile flowers ¼ cup dried orange peel 2 Tbsp rose petals

Combine ingredients for each blend and store in air-tight glass container. Spoon 1 heaping tablespoon of mixture into each tea bag. Note: Tea bags can be purchased on Amazon or you can use mini organza bags. Tie each bag with string and attach a personal tag. Optional: Add honey or other sweetener to your tea to suit your taste. 108 Wellspring | March 2019

Adar I 5779Adar | TheII Wellspring 109 109 5779 | Wellspring

e xplore Well-known for its majestic views and breathtaking scenery, the Pacific Northwest is also home to one of Americaâ&#x20AC;&#x2122;s premier wine growing regions. Benefiting from the warm stable weather of the West Coast, mixed with the cooler nights of northern latitudes, wines from Oregon and Washington feature lively ripe fruit of New World wines mixed with the refreshing acidity that Old World wine. Open a bottle of Pacifica wine and explore the tastes of the Pacific Northwest.

By Yossi and Malky Levine

Tomato Sauce Many store-bought tomato sauces contain heaps of added sugar to tame the natural acidity of tomatoes. Plus, they’re usually loaded with sodium. While making a homemade version sounds daunting, here’s our little secret: If you know how to turn on an oven, you can make a healthy sauce from scratch. And we won’t get started on the deep, authentic flavor, a la Italia. You could freeze the sauce for up to 3 months in a freezer-safe container, such as a resealable plastic bag or glass container with a lid, leaving an inch of room on top. When ready to use, thaw overnight in the fridge, then reheat in a saucepan over medium to low heat.

2 lbs. tomatoes, halved and stems removed 1 red pepper, roughly sliced 1 onion, diced 2–3 garlic cloves, minced Fresh basil, parsley, and/or oregano, chopped Olive oil Salt and pepper to taste Set oven to broil. Squeeze tomato halves over a bowl, so seeds and excess juice pop right out. Arrange tomatoes and pepper, cut sides facing downward, on a lined baking sheet. Lightly brush with olive oil and broil for 8–10 minutes. When slightly cooled, use tongs or your fingers to remove the peels. In a large saucepan, heat 1 Tbsp olive oil over medium heat. Add onion and garlic; sauté 5–7 minutes or until onion is tender, stirring occasionally. Add peeled tomatoes and pepper. Season with salt and black pepper. Bring to a boil, then reduce heat and simmer, uncovered, for 20–30 minutes. Let sauce cool slightly, then blend with an immersion blender until smooth. Stir in fresh herbs such as basil, parsley, or oregano.

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By Yossi and Malky Levine

What’s not to love about throwing some beef and veggies in a crock-pot and walking away to get on with your day, then coming back to a delicious slow-cooked meal? And of course, who doesn't love a good-old-fashioned classic beef stew? The simple ingredients in this recipe include meat, plenty of healthy vegetables, and potatoes. I like to add some chicken soup as I love the depth of flavor, as well as some homemade tomato sauce (see recipe in Have It Homemade). What I love most, though, is how simple it is to put this recipe together! You can also make this dish a night ahead and let it cook overnight.

VEGETABLE BEEF STEW

1 Tbsp olive oil 2 lbs. boneless beef chuck, cut to 1-inch chunks 2 cups chicken soup 2 cups water 1 cup homemade tomato sauce (refer to Have It Homemade for the recipe) 1 Tbsp salt ½ tsp black pepper 10 baby potatoes, halved 5 small (mini) sweet potatoes 5 small carrots 8 oz portobello mushrooms 8 shallots 1 cup chickpeas 2 Tbsp arrowroot powder (or flour) dissolved in cold water Preheat olive oil in a skillet on high heat. Season beef chunks with salt and pepper. Add to skillet and cook 4–6 minutes or until deeply browned on each side. In a large crock-pot, add the chicken soup, water, homemade tomato sauce, salt, and pepper, stirring until well combined. Add potatoes, sweet potatoes, carrots, mushrooms, shallots, chickpeas and let cook on low for 7 hours or overnight. In a small bowl mix ¼ cup cold water with 2 Tbsp arrowroot powder and add it to crock-pot. Stir and cook for an additional hour or until thickened.

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Bartenureâ&#x20AC;&#x2122;lE*

Freilichen Purim!

*Bartenura Moscato is now available in adorable 375 ml bottles, perfect for your Mishloach Manos!

Purim is associated with nonstop treats, sweets, and total bedlam…and for good reason! Piles of meticulously prepared mishloach manos build up as the day goes by, with increasing speed. We all know that friend who thinks ahead and drops off something energizing—maybe even green, maybe even perishable. (That’s never me. I’m the one who orders hers and maybe makes a personal label…) Here I’ve created a few Mason jar salad options for you. They stay fresh in the fridge for about four days, so whether it’s a meal prep idea you’ve forgotten about, or you’re industrious enough to take this on for a crowd, Purim can still be a balanced day.

Notes: 1. With the lid sealed tightly, these salads can last for several days in the fridge—up to five days or so. If you’re making salads with soft ingredients or perishable proteins, like avocados, tomatoes, hard-boiled eggs, or cooked chicken breast, wait to add those ingredients until the day you plan to eat the salad. These recipes are light on protein, so add your own personal preferences. 2. The general method when packing salads in jars is to start with the heaviest and most non-absorbent ingredients, with the dressing on the bottom of the jar, and work your way up through the lighter ingredients, until you end up with the salad greens themselves. As long as your jar doesn’t accidentally tip over in your bag, the delicate greens will be well-protected from the dressing until you’re ready to eat. Shake well before adding the salad to a bowl, and it should be good to go! If not, mix a little more with a fork.

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Triple C Salad How I feel knowing this salad is mine to eat? Excited, maybe even a little smug. So good!

½ cup sliced celery 1-2 cups red cabbage

ingredients

¼ cup cauliflower, steamed or raw ½ cup julienned raw zucchini arugula 2 hard-boiled eggs, optional 1-2 dates, chopped 1 Tbsp pumpkin seeds 1 Tbsp sunflower seeds Honey Lime Dressing ¼ cup lime juice 3 Tbsp coconut sugar/brown sugar 1 Tbsp honey 2 Tbsp apple cider vinegar ¼ tsp salt

instructions Layer 2-3 tablespoons of the dressing in the bottom of the jar. Continue layering first 4 ingredients. Fill rest of the jar with tightly packed arugula, or any lettuce of choice. Top with optional eggs, and dates and seeds.

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Sesame Cucumber Salad Feels like a night out at a restaurant, only in a jar, maybe at your desk, or even in the car.

½ cup assorted mushrooms, sliced and sautéed with a dash of salt ⅓ cup edamame

ingredients

2-3 cups julienned cucumber spinach ¼ cup tofu, recipe follows ½ Tbsp sesame seeds 1 Tbsp almonds, optional Tofu 1 package extra-firm tofu, diced ¼ cup water 2 Tbsp tamari sauce 1 Tbsp apple cider vinegar 1 Tbsp maple syrup

instructions Mix the marinade ingredients in a baking dish or a mixing bowl (water, tamari or soy sauce, vinegar, syrup) until well combined. Add the diced tofu and let it marinate, covered, in the fridge for at least 15 minutes. If you let it marinate longer, it will have a more intense flavor. Strain the tofu, but don’t discard the liquid. Sauté the tofu in a frying pan until golden brown.

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Classic Summer BBQ Salad Reminiscent of barbecue fair, with classic ingredients and minimal prep. ¼ cup pickled red onion, recipe follows ½-1 red pepper, finely diced 1 cup diced tomatoes ¼ cup corn

ingredients

⅓ cup quinoa romaine lettuce 1 Tbsp hemp hearts 2 tsp finely chopped parsley balsamic dressing, recipe follows Pickled Red Onions 1 red onion 1½ cups white vinegar 1 Tbsp stevia, or 2 Tbsp sugar 1 Tbsp salt Balsamic Dressing ¼ cup oil ¼ cup balsamic vinegar 2 Tbsp tamari sauce 2 Tbsp maple syrup ¼ tsp dried ginger

instructions Peel and slice red onion into thin slices. Place into a container with resealable lid. In a small saucepan stir together vinegar, stevia/sugar, and salt. Bring to a boil, then remove from heat. Pour mixture over onions in jar until full. Place the lid on and let cool to room temperature. Place the lid on to seal and refrigerate. Layer 2-3 tablespoons of the dressing in the bottom of the jar. Continue layering first 5 ingredients. Fill rest of the jar with tightly packed romaine, or any lettuce of choice. Top with hemp hearts, and optional parsley.

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Carrot Radish Salad with Maple Mustard Dressing Carrots, radishes, arugula—produce you can almost always find in my fridge. Their color makes eating vegetables exciting, and the flavor? It’s the bomb!

2 carrots, julienned with a julienne peeler, or ½ cup pre-shredded carrots ½ cup julienned raw zucchini

ingredients

1-2 watermelon radish, sliced thinly 6 grapes, quartered, optional arugula or frisée 1 Tbsp chickpeas, toasted or not 2 tsp chopped dill, optional 1 Tbsp golden raisins, optional maple mustard dressing, recipe follows Maple Mustard Dressing ¼ cup oil 2 Tbsp maple syrup 2 tsp lemon juice ½ tsp Dijon mustard ½ tsp salt

instructions Layer 2-3 tablespoons of the dressing in the bottom of the jar. Continue layering first 4 ingredients. Fill rest of the jar with tightly packed arugula or frisée, or any lettuce of choice. Top with chickpeas, and optional dill and raisins.

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Well Informed

Wellness Platform By Rabbi Hirsch Meisels

In the pages of The Wellspring, we get to read expert advice from the community’s most popular and competent dietitians and nutritionists. In this column, we get to see how they practice what they preach in their own kitchen. Pull up a chair at My Table and join the chat!

Purim Meal This Month:

Purim is one of those days for which your clients may need some advance prepping. How do you do it in your own kitchen? Do you prepare yourself a specific meal for Purim day? If yes, what does it consist of? If not, how do you choose your foods at someone else’s table?

Rabbi Eli Glaser, CNWC: I treat the Purim seudah like a Shabbos and Yom Tov seudah, enjoying special choices that fit within my food plan, to insure that my eating is a vehicle for kedushah. Otherwise, the seudah can become an excuse to indulge in excess and/or unhealthy eating or drinking, which in the end causes regret and a spiritual downturn. On Purim I’m even more mindful of that fact due to the very essence of the occasion. As the Gemara says, the Jewish people were subject to such a horrible decree by Haman specifically because they enjoyed themselves at the lavish and opulent seudah of Achashverosh, which was tragically a striking indication of the spiritual decline to which they had sunk. The teshuvah effected by Klal Yisrael, spearheaded by a historically unparalleled three-day fast, was in direct response to their gross indulgence in physical gratification that so greatly impeded their connection and relationship with Hashem. I feel pretty safe to say that the extravagant and excess mishloach manos that have become the norm in our “ultra-frum” society is not quite what Mordechai and Esther had in mind. In fact, it’s most likely quite the opposite.

Beth Warren, MS, RDN, CDN: I always load up on veggies first. That way, I can be sure I’m making mindful choices if I choose a treat. If I’m not sure the host will have veggies at the table, I’ll eat a salad before the seudah, especially since it’s often held later in the afternoon.

120 Wellspring | March 2019

Well Informed

Wellness Platform By Rabbi Hirsch Meisels

Health Coach Jacqui Kimmel, PT: I always have a light meal earlier in the day, like a salad with a protein, so I don’t walk into the seudah famished and overindulge. I try to balance my seudah plate with lots of veggies and a protein, and if there’s a heavier dish that I want, I’ll have a serving. When it comes time for dessert, I’m full and satisfied and can mindfully pick a treat or two to enjoy.

Dr. Rachael Schindler: I eat tuna salad with cucumbers while on the go, because it’s filling and tasty. If I go out for the seudah, I always bring a delicious, healthy main dish, like an avocado-turkey salad or a pesto salad topped with salmon, just in case there are no healthy options. The hostess is overjoyed to have some help, and I can fill up while enjoying what I eat and staying on track.

Tamar Feldman, RDN, CDN: I always prepare a meal for myself and my family, as full bellies will end up gorging on less junk. I try to make a simple brunch at around 10:00/11:00 a.m., consisting of toast, eggs, and smoothies. It does the trick big time for me, as the junk then calls to me a lot less. I advise all my clients to do the same, with whatever fast and filling foods appeal to them. I always advise including plenty of protein and fiber in the Purim brunch meal to make it filling until the next proper meal, which is likely to be the seudah.

Shani Taub, CDC: I always make sure to have a proper breakfast and lunch on Purim. This way, I’m not looking to pick from all the mishloach manos. For the actual seudah, I bring along matzah. I know I’ll always find a healthy protein.

Nutritionist Tanya Rosen, MS, CAI, CPT: Since I’m not home all day, I pack a big salad for myself in a container, containing lots of veggies; a protein, like tuna or turkey or beans; and a package of whole-wheat Melba toast. I munch on this salad throughout the day, and the temperatures are cold enough for me to leave it in the car while we do our rounds.

Laura Shammah, MS, RDN:CDN: I treat breakfast and lunch on Purim as I would any other day. I make sure to start off with a proteinrich meal. Not every year has gone my way—with a plan of eggs and Ezekiel bread turning into a quick grab of Greek yogurt and fruit. I advise my clients that it’s important not to skip lunch that day, just as on any other. Having protein with complex carbs and fat will make sure we don’t go to the seudah ravenous, which leads to overeating. Planning lunch or picking up from a restaurant can be very helpful. Keeping fruit and cut up vegetables in the car while delivering mishloach manos has helped many of my clients stay away from too much junk. We usually go to my sister-in-law for the seudah. She makes a great meal. I make sure not to go hungry so I can enjoy whatever she makes, in moderation. I always need to have room for my dessert.

Compiled by Shiffy Friedman

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Well Informed

Nutrition Tidbits in the News By Liba Solomon, CNWC

Are You Kidding?

“Health Foods” The Masses Are Actually Falling For You may have thought these foods were healthy,

but here’s why they may not be.

1. Granola/ Granola Bars Granola’s oats deliver impressive numbers in fiber and iron, while nuts and seeds add heart-healthy unsaturated fats and some protein. But along with these benefits, granola can be very high in calories, oils you don’t need, and contain scoops of sugar with healthy-sounding names. If you love the taste and texture, nutritionists advise making homemade granola for a healthier option.

2. Coconut Milk Coconut water has become the foodies’ Drink of the Year. Supermarkets are stocking it in multipacks, and you can often find it in your local corner shop. Despite the fact that it may not contain as much sugar as mainstream juices (made from concentrate), there are still almost 4 teaspoons of sugar per 250ml of drink. It all adds up.

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Well Informed

Nutrition Tidbits in the News By Liba Solomon, CNWC

3. Diet Soda When taken at face value, diet soda seems like a health-conscious choice. It saves you the 140-plus calories you’d find in a sugary soft drink, while still satisfying your urge for something sweet with artificial sweeteners like aspartame, saccharin, and sucralose. But there’s more to this chemical cocktail than meets the eye. Artificial sweeteners have a more intense flavor than real sugar, so over time products like diet soda dull our senses to naturally-sweet foods like fruit, says Brooke Alpert, RD, author of The Sugar Detox. Even more troubling, these sugar stand-ins have been shown to have the same effect on your body as sugar. “Artificial sweeteners trigger insulin, which sends your body into fat storage mode and leads to weight gain,” Alpert says. Diet soda is calorie-free, but it won’t necessarily help you lose weight. Researchers from the University of Texas found that over the course of about a decade, diet soda drinkers had a 70% greater increase in waist circumference compared with non-drinkers. And get this: participants who slurped down two or more sodas a day experienced a 500% greater increase. The way artificial sweeteners confuse the body may play a part, but another reason might be psychological, says Minnesota-based dietitian Cassie Bjork. When you know you’re not consuming any liquid calories, it might be easier to justify that extra slice of pizza.

Drinking one diet soda a day was associated with a 36% increased risk of metabolic syndrome and diabetes in a University of Minnesota study. Metabolic syndrome describes a cluster of conditions (including high blood pressure, elevated glucose levels, raised cholesterol, and large waist circumference) that put people at high risk for heart disease, stroke, and diabetes. When you drink diet soda, you’re not taking in any calories—but you’re also not swallowing anything that benefits your body, either. The best no-calorie beverage? Plain old water. Water is essential for many of our body processes, so replacing it with diet soda is not a good idea. If it’s the fizziness you crave, try seltzer.

4. Popcorn Air-popped and eaten plain, popcorn is a healthy whole-grain food that is low in calories (about 30 calories per cup) and high in fiber (about 1g per cup), especially when compared to snacks. But oil-popped and flavored popcorn is a different story. If you eat a whole bag of salted popcorn in one sitting, you’re easily going to exceed your daily recommended allowance of sodium. And a high-sodium diet has all sorts of risk factors attached, including high blood pressure.

5. Hummus This healthy dip is made from chickpeas, so it can’t be unhealthy, right? Well, not exactly. Store-bought hummus is actually laced with salt and fat. A supermarket study found that some types of hummus contained more salt than four packets of ready-salted crisps.

6. Flavored Yogurt And while you’re at it, go easy on the flavored yogurt with that granola. Flavored yogurts contain a lot of sugar, and many don’t even contain any fruit. For a healthier alternative, choose plain yogurt and add fresh fruit for more flavor.

Label Tricks Now that we’re on the topic of ridiculous health stuff, let’s talk about 10 ridiculous health food descriptions food marketers use to lure consumers into thinking they’re doing their body a great favor by consuming them. 124 Wellspring | March 2019

1. All-natural Just because something is all-natural doesn’t make it healthy. One mainstream company markets their vanilla ice cream as allnatural—but it’s very high in fat and calories. (Moderation is a good general rule.) Certain sugar-loaded drinks are all-natural, too, but they have no nutritional value, even though their marketers would like us to think otherwise.

2. Superfoods So-called superfoods, such as goji and acai berries, have been getting a great deal of press, but what lies behind this marketing hype? There’s no legal definition of “superfood,” so it’s a term that’s open to abuse, nutritionists warn. In other words, eat goji berries if you like the taste, but don’t expect them to change your life. Don’t think they’ll turn a bad diet into a good one. In fact, all fruits and vegetables are superfoods, because they all provide important vitamins, minerals, and phytochemicals that help keep us healthy. Some, such as blueberries and broccoli, contain such large amounts of these health-promoting substances that it’s good to include them as often as possible in your diet. However, this doesn’t mean you should stop eating more commonplace produce, such as apples and bananas. When it comes to fruits and vegetables, variety is the thing.

6. Whole What is a whole food? Have we been eating too many half foods? Important when it comes to grains, the “whole” labeling has gotten out of hand. Fruits and vegetables are whole foods, too, and they don’t need labels to tell us.

7. Diet Foods and drinks labeled “diet,” “low-carb,” or “sugar-free” are often filled with chemicals. Read the nutritional information. The labels are there to guide you.

8. 7-grain (or any number of grains) Watch out here: Some grains are more nutritious than others. Look for high-fiber and 100% whole-grain breads, and check that the overall product doesn’t include multiple sources of sugar and other flavors and preservatives.

3. Organic While organically-grown food is a great option, remember that organic chocolate ice cream is still dessert. “Organic doesn’t necessarily imply that a food is nutritious or that it’s hearthealthy,” says Cynthia Sass, R.D., American Dietetic Association spokesperson. “It can actually be a high source of calories, sodium, or any other number of nutrients that people should avoid.”

4. Energy-boosting That great energy booster, caffeine, is being added to everything from water to lollipops, but remember, caffeine-laden energy drinks and products are made up of mostly sugar and chemicals. For a natural energy boost, try taking a walk, having a healthy meal, or getting more sleep.

9. 100 calories It’s often not a filling portion, is it? So we wind up consuming more than we should. If you really need help with portion control, have an apple or a banana instead. Both have about the same amount of calories and are much more satisfying.

10. Healthy What’s healthy is a judgment call if ever there was one. People are on different diets, with different needs. One man’s healthy food is another man’s poison. Looking for what’s healthy at the supermarket? Skip the promises on a label and shop for fresh foods like fruits, vegetables, dairy, poultry, and fish.

5. Sun-kissed or sun-drenched Unless it’s hydroponically grown in an artificially lit greenhouse, almost everything is sun-kissed, including pure sugar. Adar II 5779 | Wellspring 125

Eat Well

Nutrition Facts in a Shell By Devorah Isaacson

Here’s the place to check out nutrition labels for the nutrient-dense produce that come in their natural peels-- just so you know what wholesome goodness you’re feeding your family and yourself !

THIS MONTH:

GRAPEFRUIT Principle

Nutrition Value

Percentage of RDA

Energy

42 Kcal

2.3%

Carbohydrates

10.7 g

Protein

0.77 g

Total Fat

0.14 g

<1%

Cholesterol

0 mg

Dietary Fiber

1.70 g

Folates

13 µg

Niacin

0.204 mg

1.5%

Pantothenic acid

0.262 mg

Pyridoxine

0.053 mg

Riboflavin

0.031 mg

2.5%

Thiamin

0.043 mg

Vitamin A

1150 IU

38%

Vitamin C

31.2 mg

52%

Vitamin E

0.13 mg

Vitamin K

0 µg

Sodium

0 mg

Potassium

135 mg

Calcium

22 mg

Copper

0.032 mg

Iron

0.08 mg

Magnesium

9 mg

Manganese

0.022 mg

Phosphorus

18 mg

2.5%

Selenium

0.1 µg

Zinc

0.07 mg

Vitamins

Electrolytes

Minerals

126 Wellspring | March 2019

As one of the victims of my fruit prep laziness, grapefruits could sit in my fridge for a week or two before I finally pay attention to them. When I do take the time to properly cut up and enjoy this fruit, I always ask myself why I don’t give myself this pleasure more often. This refreshing, juicy citrus fruit offers a lot more than fabulous taste, though. In fact, due to its high health-promoting phytochemical count, the grapefruit snagged a place on the American Institute for Cancer Research’s list of foods that fight cancer. Multiple studies, including one published in the Journal of Medicinal Food, reveal that even having just half a grapefruit per day may be beneficial for weight loss. In the study, a regiment of grapefruit capsules and grapefruit juice in 91 obese subjects resulted in more weight loss than the placebo groups, but fresh grapefruit was definitely the star. The consumption of half a fresh grapefruit before meals was associated with significant weight loss, along with improved insulin resistance. Another study published in the American Journal of Physiology-Endocrinology and Metabolism demonstrated how long-term intake of nootkatone, an organic compound in grapefruit, “significantly reduced high-fat/high-sucrose diet-induced body weight gain, abdominal fat accumulation, and the development of hyperglycemia, hyperinsulinemia, and hyperleptinemia.” The study concluded that not only can grapefruit’s nootkatone help to prevent obesity, but it can also improve overall physical performance.

According to the American Institute for Cancer Research, cell and animal studies have shown that grapefruit’s phytochemical naringenin and limonin have shown an ability to reduce the growth of colon, mouth, skin, lung, breast, and stomach cancers. The studies also showed that not only did proliferation slow down, but the highly desirable self-destruction of the cancer cells increased. It’s believed that these grapefruit compounds work in a two-pronged approach: “They decrease inflammation and increase enzymes that deactivate carcinogens.” With its standing among the top vitamin C foods, you’ll be hardpressed to find someone who doesn’t agree that eating grapefruit is a healthy way to start your day. The red and pink varieties are especially packed with bioflavonoids and provide you with an extra immunity boost. There are a variety of cosmetic and skin-cleansing products on the

FUN IN THE KITCHEN This grapefruit cocktail has the perfect mix of sweet and sour, with a punch of rum. Makes for a great addition to your Purim bar! Yield: serves 2 1 grapefruit

12 pre-checked mint leaves

1 Tbsp agave nectar

1 cup ice, broken into large cubes 1 lime

3 oz. high quality rum ⅓ cup champagne

market these days that have grapefruit as a star ingredient. Grapefruit contains natural acids that cleanse the skin when used in skincare products. Grapefruit is loaded with vitamin C, which acts as an antioxidant to protect the skin and also is essential to the formation of collagen, a major building block of our skin. Collagen production is key when it comes to keeping skin looking youthful and wrinkle-free. Pink grapefruit is also rich in beta-carotene, which does a great job at slowing the aging of skin cells and has been known to improve hyperpigmentation. Skincare experts also love how pink grapefruit contains lycopene, which is known to guard against sun-induced skin damage and mutation, as well as inflammation in general.

IN YOUR PLATE Here’s a plethora of ways for you to enjoy this detoxing fruit: • One great way to start your day is to enjoy a grapefruit first thing in the morning. In its fresh state, this fruit offers a fabulous flavor and hydration.

• Scooping its flesh from the skin is delicious, but have you tried tossing grapefruit into a salad or dipping it in dark chocolate? • Squeeze grapefruits into a refreshing, naturally sweet drink.

• This one’s an original take on this fabulous fruit. Broil grapefruit halves with brown sugar and honey for an effortless, nutritious dessert.

Juice the lime and grapefruit.

Place grapefruit juice and wedges,

mint, agave, ice, lime juice and lime

wedges into a pitcher with a cover.

Add rum and shake.

Spoon out the grapefruit and lime

wedges.

Fill eight 10-ounce glasses with ice

and pour half full with grapefruit/mint

mixture. Finish filling glasses with cham-

pagne and stir to combine.

Garnish with grapefruit wedges and

mint stems.

Well Informed

Wellness Platform By Rabbi Hirsch Meisels

BOOST YOUR ENERGY BY YOSSI & MALKY LEVINE

Power Shake Don’t you wish there was a magic pill that pumps the body with long-lasting energy? The problem is that energy production in the body is affected by a variety of factors, including mental health and emotional well-being. One simple way to gain more energy is to focus on your nutrition intake, especially your choice of fruits. Choosing the right fruit is critical to keep blood sugar stabilized and energy levels on surplus. Sucrose and sugar from fruit stabilize blood sugar because they are disaccharides, which means they contain both glucose and fructose, unlike starchy vegetables and grains that digest into pure glucose. Let’s not kid ourselves. When we think Purim, we think “it’s almost Pesach.” These are the days that we can all use an extra boost of energy. Give yourself a few-minute break to prepare this delicious, refreshing shake. It’s all about getting the right combination of fruits and veggies into your cup! You’re welcome.

128 Wellspring | March 2019

2 tangerines, peeled and cut into chunks 1 cup papaya, cubed ¾ cup mango, cubed ½ cup pineapple chunks 2 cups pineapple juice 1 avocado, optional

Add all ingredients to a blender and pulse until smooth.

Well Informed

Wellness Platform By Rabbi Hirsch Meisels

Papaya

Why these fruits for energy? Papaya supplements different aspects of health. It improves immunity, builds energy, and has anti-inflammatory benefits. One medium papaya contains about 4.7 grams of fiber, 120 calories, 30 grams of carbohydrate, 2 grams of protein, and can provide your daily need of vitamin C. Papaya decreases the risk of obesity, diabetes, and heart disease as well as promotes healthy skin and hair, increases energy, and decreases overall weight.

Avocados

Avocados are considered a superfood because of their significant health benefits. They’re rich in healthy fats and fiber. These healthy fats promote optimal blood fat levels and enhance the absorption of nutrients. They are stored in the body and used as energy sources. Additionally, the fiber in avocados accounts for 80% of their carbohydrate content, which helps maintain steady energy levels. Avocados are also a good source of B vitamins, which are required for the optimal function of the mitochondria in your cells, where cellular energy is produced.

Tangerines Whether you call them mandarin oranges, tangerines or clementines, they’re all different varieties that belong to the mandarin family. Like all members of the citrus family, they provide a boost of vitamins and minerals yet have few calories and not even 1 gram of fat. The good amounts of vitamin C in mandarins help optimize the absorption of iron in the intestines, leading to a better management of anemia and, consequently, less fatigue symptoms and more energy to enjoy everyday life. Mandarins contain almost all essential dietary nutrients, ranging from B vitamins and vitamins A and C to calcium, copper, iron, potassium, magnesium, manganese, and zinc. Eating tangerines on a regular basis will energize and invigorate your body.

Pineapples

If you want to rev up your diet and boost your health and energy, all you have to do is make mangos a part of your life. One mango contains almost half the daily fiber requirement for an average adult, and a great supply of potassium. The phenols that are in mangos act as antioxidants to fight the damage done by free radicals. There are also high levels of vitamins A, C, and E, which are antioxidants. While you enjoy this fruit, you are also helping your body repair and rejuvenate itself at the cellular level.

Mango

Pineapples are the perfect snack to curb your sweet tooth, but they also provide lots of essential vitamins. Pineapple has vitamin B6, which helps stabilize the body’s blood sugar, along with manganese and thiamin, which also aid in energy production. Eating pineapple—in moderation— throughout the day is a good way to help boost your energy when you’re feeling tired and sluggish.

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