Wellspring Issue #41 by The Wellspring

JUNE 2019 // SIVAN 5779 // ISSUE 41

New Column! Taste+Travel Enjoy the best of Italian cuisine with Charnie Kohn

My inner critic is killing me // Heart to Heart

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NE W! Editor In Chief Shiffy Friedman, LMSW, CNWC COPY & RESEARCH Nutritional Advisory Board Dr. Rachael Schindler Laura Shammah, MS, RDN Beth Warren, MS, RDN, CDN Tamar Feldman, RDN, CDE Nutrition Contributors Tanya Rosen, MS CAI CPT Shani Taub, CDC Health Advisory Board Dr. Chayala Englard • Chaya Tilla Brachfeld, RN • Miriam Schweid Fitness Advisory Board Syma Kranz, PFC Child Development Advisory Board Friedy Singer, OTR/L Roizy Guttman, OTR/L Coordinating Editor Liba Solomon, CNWC Feature Editors Rochel Gordon • Rikki Samson Copy Editors Shainy Bodenstein • Malka Winner Proofreader Faige Badian

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The Wellspring Magazine is published monthly by Wellspring Magazine Inc. All rights are reserved. Reproduction in whole or in part or in any form without prior written permission from the publisher is prohibited. The publisher reserves the right to edit all articles for clarity, space and editorial sensitivities. The Wellspring Magazine assumes no responsibility for the content or kashrus of advertisements in the publication, nor for the content of books that are referred to or excerpted herein. The contents of The Wellspring Magazine, such as text, graphics and other material (content) are intended for educational purposes only. The content is not intended to substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your health care provider with any questions you have regarding your medical condition.

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From the Editor shiffy@wellspringmagazine.com

There’s Always a First Time When a relative recently came to visit from overseas,

one of the photos she showed me caught me by surprise. Skimming through the snapshots of her young children, we came across one of her daughter lying on a doctor’s bed, needles pricking her skin. Knowing this relative was not into alternative treatments, I was shocked when she said, “That’s at the acupuncturist. Leah was suffering from seasonal allergies and we decided to give acupuncture a try. Her symptoms disappeared after the treatment.” Later, when I discussed this relative’s case with Ruchy Reese, the writer of this issue’s excellent cover feature on acupuncture, her first question was, “How does your relative know if her child is symptom-free because of the acupuncture or because of the cortisone the practitioner may have dipped the needle into without her knowledge?”

I couldn’t answer that—and my relative probably can’t either—which is why the article we present to you in this issue is just like any other Wellspring feature that covers a treatment method: we bring you a a comprehensive piece, with a considerable amount of objective, research-based, as well as anecdotal evidence, and we leave it up to you, the reader, to make an informed decision. When it comes to your health, only you, perhaps with the recommendation of a practitioner you trust, can

know what’s worth a try.

When you read about various treatments that you haven’t yet tried—or even considered, aside from making an educated choice about the efficacy of the treatment in your circumstances, you may find yourself facing another issue: namely, the apprehension of trying something new. Perhaps this was what impressed me when I first spotted that photo of the child at the acupuncturist. Whether or not acupuncture was the right solution was irrelevant—and certainly not my decision to make when it comes to someone else’s child. What impressed me so much was that someone who had been programmed to take one route all her life was ready to give something else a try when it came to improving her child’s quality of life.

As we explore in this issue’s Wellbeing feature on change, taking that leap is a sign of courage. It means we’re not constrained by our fear of the unknown, and that we can leave our comfort zone for the greater good of ourselves or our loved ones. Whether it’s trying a new treatment method, a different style of parenting, a novel summer vacation venue, or even an original recipe, moving past that block, which is essentially our fear, and embracing change is what enables us to grow in life. May this be a summer of growth and only positive, easy new beginnings for all of you.

Sincerely,

Shiffy Friedman

Well-Put! When you’re trying to get a sense of your doctor’s level of trustworthiness, you should feel that you’re more important to them than the money you’re bringing in. Dr. Shoshana Richelson, Cup of Tea

Sivan 5779 | Wellspring 13

Contents

JUNE 2019 SIVAN 5779 ISSUE 41 The next issue of The Wellspring will appear iy”H on July 16th.

WELL INFORMED 20 TORAH WELLSPRING By Rabbi Ezra Friedman 24 DENTAL HEALTH By Dr. Jacques Doueck, DDS 26 SECRETS OF A KOSHER DIETITIAN By Beth Warren, RDN 28 SPIRITUAL EATING By Rabbi Eli Glaser, CNWC, CWMS 30 HEALTH UPDATES IN THE NEWS By Esther Retek 34 FIGURES By Miriam Katz 36 HEALTH ED Anorexia By Laurah Shammah, MS, RDN 40 DEDICATED TO HEALTH 10 Questions for Fay Brezel By Sarah Weinberger

LIVING WELL 44 IN GOOD SHAPE This Summer's Top Fitness Trends By Syma Kranz, PFC 46 ASK THE NUTRITIONIST Calorie Clarity By Shani Taub, CDC 48 MEDICAL MYSTERY Why Couldn't I Eat? By Gitty Rosengarten 54 HEALTH PROFILE Client: Sarah L. By Rachel Esses

56 COVER FEATURE A Pointed Look at Acupuncture By Ruchy Reese 66 AT THE DIETITIAN Acid Reflux By Tamar Feldman, RDN, CDE 68 CUP OF TEA With Shoshana Richelson, Au.D. By Shiffy Friedman 74

MEMOS FROM A KINESIOLOGIST Smoother Speech By Miriam Schweid DIY Bad Breath Killer By Miriam Schweid

WELLBEING 76

FEATURE Exploring Fear of Change By Shiffy Friedman

86 CHILD DEVELOPMENT By Friedy Singer & Roizy Guttman, OTR/L 91

HEART TO HEART By Shiffy Friedman, LMSW

94 SERIAL DIARY By Zahava List

Springboard

Letters

On Lactose Intolerance, Strep Infections, ADHD, and More

Healing Strep Naturally Issue #38: Memos from a Kinesiologist

I found Miriam Schweid’s article on thieves oil to be fascinating. Some of my kids suffer from recurring strep as well as PANDAS, and are on antibiotics several months after the infection. I would love to try this as a natural alternative.

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.

Is it possible to get the thieves oil without eucalyptus because I am highly allergic to the smell? Thanks, Hinda F. Miriam Schweid responds:

Thieves oil is a combination of five oils: clove, lemon, eucalyptus, cinnamon, and rosemary. The smell of eucalyptus does not come through as it is only 10 percent of the ingredients. If you would still like to eliminate this oil, you can contact me to order a custom combination. Thank you and refuah shleimah.

On Feeling Grateful Issue #40: From the Editor

Just wanted to let you know that I read

16 Wellspring | June 2019

Shiffy Friedman’s poem, “Up With the Baby,” when I actually was doing exactly that — rocking my newborn back and forth, forcing my eyelids open. Thanks so much for the chizuk and the positive perspective. It filled me with the energy to push through the next few hours, during which I got to enjoy more of the issue’s excellent content. Keep up your great work,

_____

Chaya R.

My stomach was doing somersaults when I read the touching poem, “Up With the Baby.” My dear relative is the boy in the leather jacket. He usually sleeps through most of his day so he can hang out with the wrong crowd at night. His mother tosses and turns at night, and her worries don’t allow for much sleep. Thank you for thinking of us. Only when Hashem brings an end to this tzara will we be able to sleep well again. Thank you for a great magazine, R. H.

Taking the Courage Issue #40: Cover Feature

I’m grateful to the Wellspring team for tak-

*IT'S A STATEMENT, NOT A QUESTION.

WHEN YOU THINK OF MILK, YOU THINK OF GOLDEN FLOW * *IT'S A STATEMENT, NOT A QUESTION.

Letters

Quick Question

My six-year-old son was diagnosed with ADHD several months ago. He started off by taking Concerta on a low dose, and the dosage was then increased. He is losing weight (he was of average weight until now), stares blankly at us, and has lost his entire personality. He’s having a hard time with kriyah so we suspected that he might have vision issues, but an ophthalmologist said that he has 20/20 vision. We would love to help him deal with his issues in a more productive way. Can you help us figure this out so we can do something over the summer for him to have a successful year next year?

ing the courage to write about the issue of bullying in our community. I’ve read about this issue in various other places, but you did a fabulous job in explaining and clarifying the topic. Being in the field of chinuch, I see these behaviors day in and out. It’s a nightmare that I watch over and over again. Specifically, I appreciated seeing the wealth of ideas you offered to parents of bullied children. There’s no single correct solution, and as you wrote, each child needs a different approach. Thank you again for raising this issue. Rabbi L.K.

Gluten-Free Advances

18 Wellspring | June 2019

An ADHD diagnosis is not a simple matter. Although there are times when it’s necessary, the medication reduces the child’s appetite and often relaxes them to the extent that they become very spaced-out and unfocused.

Since you mention that your child may be having vision issues, you might want to explore vision therapy as an avenue for your son’s improvement. Ophthalmologists don’t always accurately diagnose children who need vision therapy or prism glasses, and many times these children are erroneously diagnosed with ADHD, which is why the meds don’t work for them. A child who has vision issues works doubly as hard: 20 minutes of reading is like 40 minutes for him! After 20 minutes, he may start to daydream and lose concentration, and this may be what helps lead to a possibly mistaken diagnosis. A simple eye exam from a reputable vision therapist may be all your child needs. The optometrist will prescribe vision therapy or prism glasses, which often leads to immediate improvement. I also recommend giving your son a nutritional supplement such as KidsActive, which will help him focus better. Try to keep him on a healthy diet with limited sweets and food coloring and, of course, eight to ten hours of sleep nightly is always recommended. Take care, Chaya Tilla (Tina) Brachfeld, RN, Health Kinesiologist

Issue #40: Updates

Kudos to Wellspring for always updating us with the latest in health. Being that I have celiac disease, one of the Updates in the last issue was particularly relevant. Bread has always been an issue for me, and I was glad to see new stuff coming up. In truth though, we really can’t complain. Our society has come a long way in catering to the needs of people like us. There is such a huge variety of food in the gluten-free aisle. There’s no lack of cookies, cakes and the like, but nevertheless it’s always good to read of new developments. Thank you again. B. Haberfeld

- F. K. , Brooklyn, New York

This Works for Lactose Intolerance Issue #40: Tidbits

As someone who has been diagnosed with lactose intolerance, I make sure to stay away from most dairy foods. I found Liba Solomon’s article on the dairy foods that could work for people like me to be interesting, though I admit that I would be afraid to try some of them for fear of having a re-

action. Since I used to be a big milk drinker and I wanted to still continue enjoying milk, I have found that what works for me, which was what my doctor suggested, is to have it with other foods. Most mornings, I get to have some milk together with my breakfast, without experiencing any symptoms. It’s when I drink it on its own that it doesn’t work for me. Thanks for a quality publication, K. Saf ir

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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Well Informed

Torah Wellspring: Spiritual Health By Rabbi Ezra Friedman

Kindling the Desire The power of one person’s love

At this time of year, we’re privileged to gain incredible insight into our spiritual and emotional health —

including our relationships with ourselves and others— from the brilliant words of Pirkei Avos. In one of the verses, our Sages discuss Aharon Hakohen’s venerable trait of “ohev es habriyos u'mikarban laTorah, he loved people and brought them closer to Torah” (1:12). These few words sum up the secret to bringing out the best in others and elevating them to the level we believe they could reach.

The only way to do so, and essentially the only way to propel someone to do anything we think they should do, we learn from our Sages, is to ignite the person’s own desire to do it. By igniting his will, he will obviously do it of his own accord. Even if it appears that when I coerce someone into doing something, they’re actually engaging in the behavior or deed, if it’s not emanating from their own will, it has no point. It’s like forcing a singer to sing a song he doesn’t want to sing. He may be a most talented singer, but what will that forced song sound like? Similarly, if the world’s top orator is coerced into delivering a speech, what quality will his talk have? The same is true in every case. Thus, the only way to encourage someone to do something is by inculcating in him a desire

20 Wellspring | June 2019

to do it. If he wants to do it, it’ll be done right.

These few words sum up the secret to bringing out the best in others and elevating them to the level we believe they could reach.

This is true in all areas of life, whether it’s in ruchniyus, like chinuch and marriage, or even in gashmiyus, like business. If I ever want anyone to do anything, the solution is not to bring them to do what I want them to do — it's only to kindle their own desire to do it.

Of course, the question that obviously follows is how we can ignite willpower in another person. In order to address this, we need to understand the fundamental motivator in people: The general rule is that if a person feels that he's good at something, he'll automatically enjoy doing it. And if a person enjoys doing it, he wants to do it.

If I feel that I’m good at learning, for example, I’ll love to learn and thus want to learn. If I feel like I'm a chessedik person, I’ll want to do good deeds. If I feel that Hashem loves me and that He wants to hear from me, I'll naturally love connecting to Him, and that’s what I ultimately end up doing, whether through tefillah or observing mitzvos. This applies to every and any skill that an individual feels he’s good at, be it singing, writing, painting, playing music, or the like.

So why is it that despite being good at a particular skill, many people are not motivated to engage in it? There’s no dearth of individuals who know how to write and, yet, don’t write, or who know how to learn, but they don’t do it. In their case, the issue is not that they can’t do it, only that they may not feel that they’re

If I look at my child and I see a particular strength in him, even if he doesn’t yet feel it, he, too, will soon recognize it in himself. good at it. In some cases, they may even be consciously aware that they are good at it, but there’s some kind of block separating their heart and their mind that doesn’t enable them to feel good at it. I could be a skilled public speaker, and everyone could even be telling me that I’m a skilled orator because my speeches are excellent, but if I still may not feel like a skilled public speaker. This is not the place to delve into how the dissonance between the mind and heart develops, but let’s focus on the outcome: Here is a person who has a positive attribute, but because he doesn’t feel that he has it, he doesn’t want to engage in it.

When an individual doesn’t feel his strengths and he thus doesn’t have a natural will to act upon them, how can this desire be kindled? If this person comes into contact with even just one individual who does see his potential and his strengths, this interaction could have such a powerful affect that the person himself starts to see his own strengths. When he sees that someone else believes in him, with time, he will start to believe in himself as well.

For example, if I look at my child and I see a particular strength in him, even if he doesn’t yet feel it, he, too, will soon recognize it in himself. Whether I notice his desire to do good, or I'm aware of a particular talent or skill, or I see a positive character trait, it’s my recognition of it that will eventually lead him to appreciate it on his own. If he believes that he’s a child who has a good heart, he’ll do good deeds and try to

be kind.

Expounding on the words, “knei lecha chaver, buy for yourself a friend,” commentators explain that one should spend whatever money it takes to have a relationship with a good chaver because the investment pays off tenfold (Avos 1:6). How is that? Our Sages define a chaver as an individual who looks at us with positive eyes and believes in our potential and strengths, which will then lead to our own recognition, and thus utilization, of our strengths.

We’re all familiar with the many stories of people who, in their youth, were not particularly recognized for a skill or talent — they may have even had a tough upbringing and no one would have believed that they would amount to anything — and then, later in life, they managed to make a profound difference in the world or break a record. When speaking of their history, they revealed that, at one point, there was this one person who came around and noticed their strength. It was this person’s belief in them that led to their own awareness of their strength. If noticing another person’s strengths is all it takes for them to want to bring it to the fore, how can we become that person who notices the good in others — in our children, our spouse, our peers, and everyone in our lives? Here is where Aharon Hakohen’s secret comes into play: “ohev es habriyos, he loved people.” The only way to recognize the strength in another individual is to love him. There is no other way.

If I love another person, I automatically see his positive attributes. A parent who truly loves his child will naturally be focused on the child’s strengths. On the other hand, when resentment and emotional negativity are present, all a person sees are the deficiencies in the other individual. This is why we find that an individual could have a long grievance list against another person, but as he starts to like him, or he learns that the other person likes him, the list not only becomes automatically eradicated, but he actually creates a new mental list of the person’s strong points.

Here’s why our love for another person is the first step in his or her motivation: When we love someone else, we see their potential. Our awareness of their potential enables them to see it on their own. And once they see that potential, they naturally want to use it.

This is precisely how Aharon Hakohen succeeded in bringing people closer to Torah. It was through his love for people, we learn in Avos, that he ignited in them a desire to be connected to the truth, because that’s what he saw in them. When he looked at people, he saw their desire to do the right thing. This is every Yid’s essence, after all. Every Jew, with no exception, has an inherent desire to be good and do good — he just has to believe in it. Those people couldn’t be in the presence of Aharon Hakohen, who saw their good, and not act upon it. When we love the people around us, something incredible happens.

Sivan 5779 | Wellspring 21

Well Informed

Torah Wellspring: Spiritual Health

If I love another person, I automatically see his positive attributes.

Even without us saying a single word, simply by seeing them in a positive light, they change. A child who feels his parent’s awe of him will naturally want to act upon it. Thus, our work is not to manipulate or coerce our children and others into doing what we think is right for them to do. Rather, if we invest in appreciating others, they will feel it. From there, it won’t be long before they’ll be doing what’s right, acting on their own will. All it takes is a bit of love to change things around. The following powerful account, which I once heard from Rav Yaakov Meir Shechter, shlita, was one of the most inspiring stories I ever heard, one that left me with food for thought for a long time. A frum businessman was once in England for business when he left his hotel room to catch a minyan. Walking down the street with $80,000 cash in his pocket, he was ambushed by three young men who pointed a gun toward his head, exclaiming, “Money or life!”

Being the clever Yid that he was, the man asked them, “Which of you here is the leader?” When they pointed toward the leader, the man pulled out his wad of cash and said, “Here’s the money I have for you. Before I give it over, though, I just want to speak with the leader for a few minutes.” The bandits had no issue with that and the head of the three stepped over to the side. “Let me ask you something,” the Yid started, “You’re probably about fifteen years old. You’re a human being. You look like a man with a heart. It can’t be that you’re just trying to be mean here. You probably

22 Wellspring | June 2019

need some cash for something important. Tell me the truth, then. Why are you doing this? What do you need all this money for?” The leader thought for a moment and said, “I’ll tell you the truth. We’re throwing a party tonight, and we want to buy some nuts and beer.”

“For that you probably need around twenty dollars, right?” the Yid offered. “Here, take this bill and go get yourself some beer and nuts. You’ll still be left with change.”

Incredibly, the kid said, “No problem,” and he let the Yid go. The Yid went to daven, and he thanked Hashem for the great miracle he just experienced. The next morning, after the businessman finished Shacharis, someone from his minyan came over to inform him that three goyim were waiting for him outside the shul. “Uh-oh,” he thought, “they probably got smart. How crazy must they be to give up on $80,000?”

Left with no choice, knowing that if he wouldn't go out to them they’d come in to find him, the Yid stepped outside and hoped for the best. There, the leader of the three stepped forward and said to him, “You gave us $20 yesterday for beer and nuts. Our total ended up being $15.50. I want to return the change to you.”

Incredulous, the Yid thought to himself, “I was shocked until now, but this is taking it to a new level. What's going on here?” In this state of shock, he asked them, “What brought about this gigantic change in you?” The teen explained, “Yesterday, before you

innocently asked your question and then offered to pay for our beer and nuts, you added a few words that — you may have not realized yourself — shook me to the core. You told me, ‘You’re a human being. You look like a man with a heart.’ When I heard these words, I was overwhelmed with a feeling I had never felt in my life. I started thinking, ‘Am I human? Do I have a heart?’

“In my earliest memories, I remember hearing my mother scream at me, ‘You thief ! You rascal! You coldhearted fool! What will become of you? You’re here to make others miserable.’ I never saw myself in another light. If I’m a person who makes others miserable, why would I do otherwise? That brought me to do everything I did until last night. But yesterday, I felt something else. With your words, ‘You’re a human being,’ I couldn’t do what coldhearted people do anymore. You gave me money to buy nuts and beer, and I thank you for that. Here’s the change.” This story powerfully portrays how even a non-Jew who never did any good in his life was so deeply influenced by another seeing the good in him. All it took to change that boy's life around was one individual who had a love for people and saw in a person something that others may have missed.

All it takes is for one human being to love another individual. That love then enables him to see the other person's beauty and strengths, which will eventually bring this person to see it in himself, and thus change forever. If we want the people in our life to do the right things and rise to their full potential, we can be that one person.

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Well Informed

Dental Health By Dr. Jacques Doueck, DDS

DRINKING WITH A STRAW CAN SAVE YOUR TEETH

FOR ADULTS AND TEENAGERS: The average American drinks 576 cans of soda every year. These drinks put you at higher risk for cavities and other oral-health problems, as they bathe the teeth in sugary and acidic liquids.

To minimize the risk of cavities, sip soft drinks and other sweet beverages through a straw that's positioned toward the back of the mouth. Itâ&#x20AC;&#x2122;s your throat that feels thirsty, not your teeth, so thereâ&#x20AC;&#x2122;s no need for beverages to reach the teeth.

Even when sipped through a straw, the beverage inevitably covers the back teeth. It's therefore advisable to rinse your mouth with water after consuming soft drinks and use toothpaste that contains fluoride. We have found MI Paste to be very effective in reversing or minimizing acid damage.

FOR CHILDREN: The convenience of sippy cups and other training cups results in many children toting their cups around with them all day. Having constant access to milk or 24 Wellspring | June 2019

with

Straw cups are a great alternative to an open-mouth cup (a cup with no lid), if your child still has frequent spills or isn’t quite ready for an open-mouth cup. Cups with straws allow parents to retain the convenience of a cup with a lid without the downsides of sippy cups.

TIPS FOR HEALTHY DRINKING • Reduce your soda consumption.

• If you do drink soda, use a straw.

• Don’t leave fluids sitting in your mouth while sipping. • Don’t drink soda, milk, or juice before going to sleep.

• Don’t brush immediately after drinking soda (the brush could damage the weakened enamel).

• If you have dry mouth, try to avoid acidic or carbonated beverages (plain seltzer and diet iced tea are also very acidic). • Use straw cups for children and get rid of sippy cups as soon as possible.

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.

Re a

e m R a l I rre

“We start the child by using straws daily for drinking thin liquids, and, as they improve, thickened liquids and purees are introduced. Narrower straws are preferred, because they require [tighter] lip closure. Wider straws are not as effective because they require less tightness of [the] lip seal,” she explains.

According to speech therapist Yael Sassoon, “We recommend the use of straws to address tongue thrust and lisping. This treatment encourages increased speech clarity. It is one of most effective tools in speech therapy and a good idea for many children. Drinking with a straw helps develop and improve lip closure, strength, and control.

So for all you whipped cream lovers (and isn’t that everyone?), there’s a new product on the market for you. And get this – it’s Tanya-approved, too. Mehadrin’s brand-new, ﬁrst-on-the-market, delicious Cholov Yisroel whipped cream is the perfect topping for your favorite i r y Re a l Cr Da desserts, drinks, or fruits. (It’s delicious straight from the can too – not that I’ve tried it…) ta b l e

The use of sippy cups has also been found to cause speech disorders and delays in speech development. If a cup, thumb, or pacifier interferes regularly enough for a good part of the day, it prevents the teeth from growing together, which can cause a “tongue thrust,” adversely affecting speech skills. This is especially true for children who may already have special needs or receive services such as speech or occupational therapy.

“No, I wouldn’t like an extra serving of whipped cream,” said no one ever.

sis

juice bathes a child's teeth in sugary liquids that can lead to cavities, of course. Worse still, kids tend to hang onto sippy cups, drinking more slowly and for longer periods of time through them, which increases their risk. It’s actually no different than sipping a can of soda all day; you’ll get more dental disease that way than if you drank the whole can at once. Neither children nor adults should constantly sip on sugary liquids like milk and juice, as doing so accelerates the process of tooth decay.

Made with real dairy and real cream, the end result tastes indulgent, but is totally guilt-free. The Mehadrin whipped cream will instantly satisfy your sweet teeth, without excess calories. So keep an eye out for that new bottle of whip in kosher supermarkets everywhere. It’ll be sure to delight you.

Well Informed

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

||| SECRETS OF A KOSHER DIETITIAN |||

SECRET

#15

TOO MUCH SALT

Love salty snacks? You’re not alone. But did you know that salt is hiding in things that don't even a taste salty? Instant pudding, for instance, contains it's it: culpr er lot of sodium. Packaged bread is anoth ge the highest source of added sodium in the avera person's diet. Sodium is an ingredient that you may be underesand timating in terms of how it affects weight loss the se increa wellness. Too much sodium can also feel you g makin s, amount of water your body retain bloated and gain water weight (weight that fluctu make just 't doesn m sodiu But . ates on a daily basis) n you bloated; in fact, researchers at London's Quee of gram extra every for that found rsity Mary Unive in salt you eat in a day — the amount you’d find obeof risk your those tiny restaurant salt packets — sity climbs by 25%. alFor healthy adults, the recommended daily those For day. per mg 2,300 is m sodiu lowance of n, with chronic health conditions, like hypertensio mg 1,500 diabetes, or kidney disease, no more than ver, of sodium should be consumed per day. Howe adult ican Amer ge avera the CDC estimates that the eats 3,400 grams every day. Why do we need sodium in our diet? Sodium, the main ingredient in salt, is an essential our part of our diet, and not just for flavor. It keeps helps it and rly, prope ng worki s muscles and nerve

26 Wellspring | June 2019

. But our bodies maintain the proper balance of fluids often re pressu blood high, too rise levels m when sodiu increases as well. In recent years, scientists have begun to investigate obewhether salt affects other health risks, including metour alters m sity. Experts speculate that sodiu fat, abolic efficiency, changing the way we process other are Here ds. poun the causing us to pack on findings they have found: t• In 2015, British and Chinese researchers repor on ed that body fat increased for children and adults day high-salt diets. Eating an extra gram of salt each in and 28% by increased the risk of obesity in children salt why know adults by 26%. The study authors don’t may has this effect, but other research suggests that it fat. burn change the way our bodies a • An Australian study linked high-salt diets with ren. lchild schoo in ty obesi of e chanc 23% increased s Those children may eat more because the salt make also the food taste good, the authors suggest. They meal, speculate that when they get thirsty after a salty availeasily the children are more likely to reach for able high-calorie sodas. , • Another Australian study, led by Dr. Russell Keast the in rise 11% an to salt tied and published in 2016, The amount of food and calories that adults take in. ting temp likely , flavor s food' ves authors say salt impro wise. other would they than more people to eat

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

How to Cut Salt in Your Diet

Focus on whole foods and prepare them at home. Processed foods and restaurant meals are typically loaded with added salt.

Go easy on condiments like salad dressing, ketchup, and soy sauce, which are packed with sodium.

Cut back on salt gradually so your taste buds can adapt. If you go cold turkey, your food will taste bland and unappetizing.

Season your food with fresh or dry herbs, like garlic and black pepper. The more flavor you add, the less salt you’ll need.

Try your food before you grab the saltshaker. You may not need to add more.

The Space Travel Study make us thirsty. In A new study challenged the notion that salty foods amounts of salt actualfact, researchers found that people who eat high ities of salt in their quant ly drink less water than those who have lower to overeat and gain us lead diet. They also become hungrier, which could weight over time. d access to a unique For the study, Dr. Jens Titze and his colleagues gaine cosmonauts — preparing group of subjects: Ten Russian astronauts — or -flight simulation, which for the rigors of space travel to Mars. The space t for the researchers to lasted for months, provided a stable environmen study how salt affected them. the researchers changed Their diet did not vary except in one key way: cts began on a diet that subje study The food. the amount of salt in their amount recommended included 12 grams of salt per day (about twice the researchers reduced their by U.S. dietar y guidelines). After several weeks, s of salt daily during the salt to 9 grams per day. The cosmonauts ate 6 gram final third of the study period. as their salt intake Unexpectedly, the cosmonauts drank more water s complained of hunger dropped. Another surprise was that the cosmonaut uing, the researchers exwhile on the high-salt diet. But that was intrig amount of salt. plained, since the only thing that changed was the did not understand why In the space-flight simulation study, the authors the higher salt diet, so on rier hung e the cosmonauts drank less and becam study revealed that This ch. resear their ue they turned to mice to contin a substance called ced produ livers their diet, salt when mice ate a highce. But producing urea urea, which helps keep the body's water in balan food, specifically protein. requires lots of energy. In other words, it requires astronauts’ hunger. the And that protein need could be what increased The Takeaway home, at an event, in a Once in a while, such as when you eat outside your than normal, it's possible restaurant, or you consumed more canned foods water weight from salt of for your body to accommodate the fluctuation If this happens, limit n. perso the on after a few hours or so, depending , get in a great workwater more drink day, added sodium for the rest of the r!), moderate carsaltie taste lly actua will sweat out to sweat it out (your balanced. The shift in bohydrate intake, but make sure to keep your meals water retention worse. your eating habits and schedule will only make the nt of food you eat, but If you’re on a diet and trying to reduce the amou culprit. Perhaps reducthe as salt of you always feel hungry, start thinking sustainably. and easily more plan ing it may help you follow your

Sivan 5779 | Wellspring 27

Well Informed

Spiritual Eating By Rabbi Eli Glaser, CNWC, CWMS

There's a recipe for righteousness incorporated right in the middle of the Hebrew alphabet. Each letter in Lashon Kodesh not only identifies a sound that helps construct a word, each letter also represents a profound idea. The letter tzaddik, for instance, denotes tzidkus, or righteousness. According to Rabbi Levi Yitzchak of Berditchev, the Kedushas Levi, the three letters preceding tzaddik — samech, ayin, and peh — formulate the blueprint for achieving this foremost goal in Judaism, providing a roadmap to righteousness.

The samech, with its enclosed shape, represents borders. It teaches us that we need to exercise control, instituting proper boundaries in our daily lives. What’s the first thing we need to place safeguards on? Our eyes, or einayim — one of which is called an ayin, the same as the letter. Our eyes are often the first gate, so to speak, of desire. Seeing creates cravings or yearnings that may not be in our best interest to pursue. Usually the food that goes into our mouths — or the words that come out — are preceded by whatever observations we make with our eyes, by whatever becomes part of our “vision.” “Out of sight, out of mind” is a most apropos axiom to apply here.

The letter that follows ayin is peh, which literally means “mouth.” Guarding our mouths and eyes, says the Kedushas Levi, is the simple and straight-

It’s All in the AlefBeis

forward instruction manual for attaining righteousness. Hashem embedded these instructions directly in the alphabet.

Boundaries and parameters are essential to achieving greatness. They're not restrictive burdens stymieing us from enjoying the sweetness in life. They're the principles and procedures that ensure we have a successful — and enjoyable — time in this world. Without them, a lifelong pursuit of pleasure would end in pain and despair.

Regarding this very idea, it says in Mishlei, “One who guards his mouth and tongue guards his soul from pain” (21:23). That verse begs a rather obvious question: Why must a person guard his mouth and his tongue? Doesn't that seem redundant? The Rambam answers with a

vital lesson, the root of which is found in these same four letters of the alefbeis.

Guarding one’s mouth, the Rambam writes, refers to refraining “from eating harmful foods, or from overeating,” and that guarding one’s tongue refers to “only speaking what’s necessary” (Hilchos Deios 4:15). Thus, just as it’s important for a Torah Jew to guard his mouth from evil or unnecessary speech, it’s crucial to be watchful of what he consumes. This same message is mirrored in the hem of the Kohen Gadol's me'il (robe). His garment was lined with bells and pomegranate-shaped tassels. The bells were meant to amend for the transgression of speaking lashon hara by making noise as the Kohen Gadol walked, atoning for the “noise” we make by speaking negatively about others. But what about the pomegranate? What was its significance? Rashi informs us that the pomegranates on the hem of the me’il resembled those on a tree that have yet to ripen and open (Zevachim 88b). That shape was meant to make it appear as if the pomegranate’s mouth was not open, as if it was refraining from speaking. Once the pomegranate opens its mouth, it begins to spoil, drying up inside.

Just as the samech is enclosed by boundaries and the pomegranates on the me'il were closed, we need to work on exercising self-control, shutting our mouths when appropriate, only speaking words that are helpful and kind, and only letting in food that is healthy and nutritious. That's the true path to righteousness — not as easy as ABC, but certainly achievable through samech, ayin, and pey.

Rabbi Eli Glaser is the founder and Director of Soveya. He is certified as a Nutrition/Wellness Consultant and Weight Management Specialist, with 25 years of coaching and counseling experience, and is maintaining a 130-pound weight loss for more than 16 years.

Soveya has offices in Lakewood and Brooklyn, and works with clients via phone and Skype around the world. For more information or to make an appointment, contact Soveya at 732-578-8800, info@soveya.com, or www.soveya.com.

28 Wellspring | June 2019

ROVED B PP

MINI SANDWICH FIT’N FREE

CA L PE ORIE R B S AR

TH E WI -FRE T L I REE, Y GU AT- F ENJO ICE EE! F R F ' ILLA VA N FIT'N D E T D W - FA R-AD UGA NI LO I S M O N ITH S. M W AFER CREA TE W A L O C CHO

NEW S U M M

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9 ‘ 1

Well Informed

Updates in the News By Esther Retek

MOMMY, THIS DOESN'T HELP ME LOSE WEIGHT How Ridiculing Children About Their Weight Brings on More Problems

With more fast food, fewer established meal times, and greater variety of junk food, obesity among kids is becoming increasingly prevalent. It might be your child, neighbor, or student who’s struggling with their weight. We often become judgmental and perceive the issue as a lack of self -control or a parenting problem, and in turn we can subtly, inadvertently direct a comment to the child regarding their weight issue. In addition to being insensitive, new research which was recently published in Pediatric Obesity indicates that this practice is actually also counterproductive. Conducted by Natasha Schvey, PhD, the study revealed that the body mass of children who said they were teased or ridiculed about their weight increased by 33 percent each year, compared to a similar group who had not been teased. The findings appear to contradict the belief that such teasing might motivate youths to change their behavior and attempt to lose weight. For the study, which involved 110 children who were an average of 11.8 years of age and were all overweight (defined as a BMI above the 85th percentile) when they enrolled, subjects completed a six-item questionnaire on whether they had been

30 Wellspring | June 2019

teased about their weight. One question was “Did people ever refer to you with names related to your weight?” The participants then continued with annual follow-up visits for the next 15 years, answering more such questions. The results of the study found that youths who had experienced high levels of teasing gained significantly more weight per year than those who did not. The authors theorize that weight stigma may have made youths more likely to engage in unhealthy behaviors, such as binge eating and avoiding exercise. Another possible explanation is that the stress of being ridiculed stimulates the release of the hormone cortisol, which leads to weight gain. It’s clear that the pediatric obesity challenge, identified as “one of the most serious public health issues of the 21st Century” by the World Health Organization, won’t be overcome by shaming overweight children. “It is important that the public is informed about the harmful effects teasing contributes to poor health,” says study author Schvey. “Parents, teachers, and providers all need to take an active role in addressing and reducing weight stigma facing youth today.”

M REA CE C EE I ND F A F E O AT Y T COL AM R CHO CRE S FO ILK E I M P AT. RIS OTH TRE THE MO E CE C S I L S R IB T Y T E S E H I M NC RES CRU , IR ERY UTT A B

NEW

NEW S U M M

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Well Informed

Updates in the News

TURN UP THE VOLUME Five Health Benefits of Music With the sefirah period behind us, and with weddings to attend almost every night, music is back into our lives full swing. Some of us, of course, find more pleasure in music than others, understanding its beauty and reveling in the lyrics. However, the benefits of listening to music (at a decent volume, of course) are plentiful. The effects of listening to music are not revolutionary at all, and you might be able to list some of its advantages easily, such as its ability to reduce stress, depression, and pain. But contemporary research, with compelling evidence, is providing evidence of a new array of effects that music has on us. Here are just five of them. So whether you consider yourself a music lover or not, it’s time to get the music on. Consider it an act of self-care!

1. Makes you happy “I don’t sing because I'm happy; I'm happy because I sing,” said William James. This quote is actually backed by research. Studies conducted at McGill University prove more clearly than ever that when we hear music, the brain releases a chemical called dopamine that has positive effects on our mood. This chemical also allows us to experience positive emotions more strongly. A study in the Netherlands found that listening to music while driving impacts safety on the road. It found that the music enabled the drivers to be happier and calmer, thus avoiding frustration and anger while driving.

2. Sleep Aid Over 30 percent of Americans suffer from insomnia. A study revealed that students who listened to classical music for 45 minutes before turning in slept significantly better than students who didn’t listen. Trouble falling asleep? You might just turn up some classics at bedtime.

3. Improves memory Research indicates that the repetitive elements of rhythm and melody help our brains form patterns that enhance memory. In one study, subjects were told to memorize Japanese characters; some of them were listening to music (experimental group),

32 Wellspring | June 2019

while others were not (control group). The results showed that participants in the experimental group tested better than those in the control group. In a study conducted by the University of Helsinki, stroke survivors who listened to music for two hours on a daily basis experienced better verbal memory, less confusion, more focused attention, and improved cognitive function.

4. Decreases the munchies If you’re finding it hard to keep to your diet, you may want to try this. Research at Georgia Tech University showed that playing soft music in the background while eating can lead people to consume less food. The results of this study suggest that music allows our taste buds to relish the foods more deeply, causing us to eat less.

5. Calms infants It’s not just the adults who benefit from the gift of music. Proceedings of the National Academy of Sciences recently published a study indicating that music and lullabies impact infants’ vital signs, improve their feeding behaviors, and help them develop a wide range of perceptual skills. The research further states that music may increase prolonged periods of quiet-alert states in babies. (I’ll do anything for that!)

CARAMEL BRITTLE CONE

IX EW L M N ME A L L AR K

C L MI ND UT A A ITH L AN W L E I P E N A ND VA N A ND S I E A SU AT NG I L P E. O P ON OC TO CH R C LE A T IT UG BR Y S ISP R C

NEW S U M M

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Well Informed

Figures By Miriam Katz

Acupuncture Stats Over

14 million

U.S. citizens have received acupuncture treatments

3.5

An estimated

million A typical treatment involves insertion of

needles

U.S. adults receive acupuncture treatments annually

5-20 34 Wellspring | June 2019

Treatment focuses on the

basic meridians (acupuncture points) in the body

The Global Acupuncture Market value was

$24,551.6 million

In most cases, the needles remain in place for

10-30 minutes

by the end of 2017

An acute problem normally improves after

8â&#x20AC;&#x201C;12 sessions

A chronic condition may require

1â&#x20AC;&#x201C;2

treatments a week over several months

There is

In 2003, The World Health Organization listed at least

scientific evidence that the meridians exist

conditions in which they say acupuncture has been effective,

including high and low blood pressure, sciatica, and inducing labor

11 1,200 clinical trials with more than

participants suggested that acupuncture may help with certain symptoms associated with cancer treatments

(Sources: CDC, WHO, NCCIH)

Results of a systematic review that combined data from

Sivan 5779 | Wellspring 35

Well Informed

Health Ed By Laura Shammah, MS, RDN

Test Yourself: Anorexia, from A to Z As the mental illness with the highest mortality rate, anorexia nervosa affects an estimated 0.5 to 3.7 percent of women at some point in their life. As a dietitian who works with many clients struggling in this area, I’ve noticed that while awareness of the condition is certainly increasing, there is a lot that is yet to be learned. Take this quiz to find out how much you know about this debilitating disease and how you can help prevent it in yourself and your children.

True or False: Anorexia is an emotional and potentially life-threatening disorder characterized by an obsessive desire to lose weight by refusing to eat. Answer: True.

The root of the disorder is not the refusal to eat; it’s the emotional disorder that leads to this outcome. While more women suffer from the condition than men, it is not an exclusively female disorder. Most people with anorexia struggle with low self-esteem, an unhealthy need for perfection, and/or untreated trauma. Thus, telling the individual to “snap out of it” or forcing them to eat may be a futile effort in bringing an end to the problem.

36 Wellspring | June 2019

Which of these may be a sign of anorexia? The individual: A. Is thin and continues to obsesses over getting thinner

B. Has a distorted body-image (feels fat even when thin) C. Loses or has thinning hair

D. Talks obsessively about food, cooking, or dieting E. Exercises excessively, even when tired or injured

F. Overemphasizes the importance of their body image to their self-worth G. All of the above Answer: G.

In a culture obsessed with thinness and dieting, it may be difficult to recognize when a person’s thinking or behavior has become dangerous. It’s crucial for parents to look out for these signs in their children and to reach out for help if they suspect the presence of an eating disorder, which can lead to severe repercussions, including reproductive issues and death.

There are two common types of anorexia:

Which of these gestures by parents may encourage the development of anorexia in their children? A. Allowing the child to determine when he or she is full B. Discussing the dangers of dieting

C. Using food for reward or punishment

Binge/purge type

The person struggling with this type of eating disorder will often purge after eating. This alleviates the fear of gaining weight and offsets some of the guilt of having ingested forbidden or highly restricted food. The compensatory purge behavior by the individual with binge/purge type anorexia may purge by exercising excessively, vomiting, or abusing laxatives. Restrictive

The individual suffering from restrictive anorexia is often perceived as highly self-disciplined. They restrict the quantity of food, calories, and often high-fat or high-sugar foods. They consume far fewer calories than are needed to maintain a healthy weight. This is a heartbreaking form of self-starvation.

D. Telling your child that you love them for their essence, not because of how they look

Answer: C.

Here are some more prevention tips for parents:

• Examine your own beliefs and behaviors related to body image and weight, and consider how your children might interpret the messages they get from you. • Encourage healthy eating and exercise.

• Talk about the variety of different body types and the fact that they can all be acceptable and healthy.

DON’T

• Label foods as “good” or bad”

• Encourage your child to engage in “dieting”

• Comment on weight or body types: yours, your child’s, or anyone else’s

• Allow teasing or making fun of anyone based on physical characteristics, including size

Sivan 5779 | Wellspring 37

Well Informed

Health Ed

Health Consequences of Anorexia The cycle of self-starvation denies the body the essential nutrients it needs to function properly. As a result, the body is forced to slow down all of its processes to conserve energy, leading to serious medical consequences: • Abnormally slow heart rate and low blood pressure, which increase the risk of heart failure

• Reduction of bone density (osteoporosis), resulting in dry, brittle bones • Muscle loss and weakness

• Severe dehydration, possibly resulting in kidney failure • Fainting, fatigue, and overall weakness

• Dry hair and skin; hair loss is common

• Growth of a downy layer of hair, called lanugo, all over the body, including the face, in an effort to keep the body warm.

True or False: If I don’t see my child engaging in disordered eating, she can’t have an eating disorder. Answer: False.

Although the behaviors associated with eating disorders, especially anorexia, are usually noticeable, just because you don’t see your child engaging in them doesn’t mean she isn’t struggling with the disorder. People with anorexia can do a good job at pretending to eat or hiding food they supposedly ate. Also, they may be bulimic, which involves binge eating and purging.

True or False: Anorexia only affects adolescents. Answer: False.

People can struggle with an eating disorder regardless of their age. While eating disorders are more prevalent during adolescence, many people who struggle with eating disorders and disordered eating in their teens continue to struggle into adulthood unless they receive treatment. Men and women at midlife and beyond are being treated for eating disorders, either due to a relapse, ongoing illness from adolescence or young adulthood, or due to the new onset of an eating disorder.

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. 38 Wellspring | June 2019

Treatment for Anorexia Frighteningly, many individuals who have anorexia do not believe they have an eating disorder. In such cases, treatment often must start off coercively, until the individual realizes how critical it is for their wellbeing and existence. Since anorexia is an eating disorder that is rooted in emotional issues, an optimal treatment plan is three-pronged, addressing the medical, nutritional, and emotional components involved. • Medical: The highest priority in the treatment of anorexia nervosa is addressing any serious health issues that may have resulted from the disordered eating behaviors, such as malnutrition, electrolyte imbalance, amenorrhea (loss of a regular menstrual cycle), and an unstable heartbeat.

• Nutritional: This component encompasses weight restoration, implementation and supervision of a tailored meal plan, and education about normal eating patterns. • Emotional: The goal of this part of treatment is to recognize underlying issues associated with the eating disorder, address and heal from traumatic life events, learn healthier coping skills, and further develop the capacity to express and deal with emotions.

Managing any eating disorder case requires a multidisciplinary team consisting of a medical doctor, a psychiatrist, therapist, family members, and a dietitian who specializes in eating disorders. Being part of this team allows each team member to be the most effective in their role and facilitates continued communication between all parties involved. As a dietitian who specializes in eating-disorder cases, I develop a therapeutic alliance that supports the client’s need for behavior change. These changes are to challenge the client's distorted and irrational thinking about food and weight, and to explore feelings related to hunger and fullness, metabolism and body image. It is imperative that the client engages in nutritional counseling without any fear of being judged. My clients feel my compassion, empathy, care and concern, especially knowing that I once struggled with an eating disorder and have overcome it successfully.

As the dietitian in the alliance, I’m responsible for designing a meal plan based on each client’s specific needs. I run a thorough assessment based on lab results, menses history, food recall, BMI, percent body fat, exercise regimen, and eating disorder history. A complete nutritional assessment shows current dietary intake, eating patterns, beliefs about food and weight, supplement use, and weight history. I encourage clients to express their emotions, feelings, fears around food and weight, and the goals they wish to accomplish. We gradually work through challenges and help the eating-disordered client replace the mental distortions that cause and perpetuate specific food- and weight-related behaviors. This helps the client come to understand that the overall goal is to return food and meals to their normal place in life as a source of nourishment and enjoyment.

I thank Hashem daily for the struggle I had with anorexia when I was young. Who would have thought that my battle would have brought me such great strength, happiness, and opportunity in the future? Although I wish people did not suffer with any eating disorder, I am so grateful to still love what I do after over 20 years. Specializing in emotional eating allows me to help my clients get a healthy body and mind. I have met so many wonderful people, built lifetime friendships, and learned so much from all my clients that I truly feel blessed. I find it so rewarding to help people find their way out of their darkest days and into a life full of normalcy, happiness, and food freedom. Sivan 5779 | Wellspring 39

Well Informed

Dedicated to Health By Sarah Weinberger

What motivated you to launch this organization? Working as a therapist, I noticed that clients dealing with various difficulties and life challenges often believed they were the only ones struggling with their particular issues. They had no one to open up to aside from their therapist once a week. Realizing the incredible impact an anonymous forum specifically designed for the frum community could have, I got to work, and OKclarity was born.

40 Wellspring | June 2019

At first, we were just a forum, and the response was excellent. People felt a sense of community and were able to be candid because of their anonymity online. In some cases, they were even more open online than with their therapist. I was soon inundated with private messages for referrals to professionals who work with the religious community. Thus, with the recent launch of our new and improved website, we created an exhaustive directory of professionals so members can search for professional help while remaining anonymous.

10 Questions for: Fay Brezel,

Cofounder and CEO of OkClarity OkClarity in a nutshell: OkClarity is an online Jewish mental-health platform. It features informative articles on mental health and wellness; a forum where one can anonymously share struggles and receive support and insight from other members and professionals; and a comprehensive directory of therapists, psychiatrists, and nutritionists who work with the community.

What is your current role at OKClarity? As the cofounder and CEO, I oversee the day-to-day operations along with an incredible team. This includes troubleshooting the occasional technical issues, collaborating with vetted professionals and organizations who share in our mission, and executing growth strategies so everyone in our community can tap into this valuable resource and help each other.

What is one great challenge you face in running this organization? The greatest challenge is when I can't fulfill my wishes as quickly as I'd like. There are so many ideas and opportunities I want to bring to fruition immediately, and I must keep reminding myself that patience is an important part of the process.

Sivan 5779 | Wellspring 41

Well Informed

Dedicated to Health

Can you share a story that highlights the work you do?

I don’t have many stories, but my inbox is very good at reminding me of OKclarity’s positive impact. Therapists are consistently thankful for having the online forum — something that was very much missing in our community. Some of their clients are active users, others benefit from reading forum threads, and yet others appreciate the articles.

Therapists often reach out to let me know that they’ve forwarded our articles to their clients and how helpful this has been. Anonymous forum members share that they’ve printed articles for their loved ones to read over Shabbos. And, more recently, I’ve been messaged that people have connected and are working well with therapists and nutritionists they found through our platform. I am so thankful for this feedback. It’s the fuel that keeps me going each day.

42 Wellspring | June 2019

He saw that people truly care, and he learned how others, too, have been in dark places and have seen the light again.

Can you share a recent positive experience you had? I recently received an e-mail from an anonymous user’s mother, thanking us for providing this space. Her son was in a severe depression and his reaching out to our forum community helped him immensely. He saw that people truly care, and he learned how others, too, have been in dark places and have seen the light again.

What’s the best part of your work? The best part of the work is definitely the positive messages that come my way. There are never too many reminders that our efforts are paying off and making a real impact on the lives of others.

I also light up when therapists share that they are now seeing well-matched clients who found them through our platform. Recently, a therapist related her shock at discovering that her profile on our platform showed up before her other online listings — with credit to our superior web developer. Other therapists shared that they immediately removed themselves from Psychology Today once they started listing with us. Rather than receiving spam referrals, they're now getting inquiries from clients they want to work with.

What do you wish people would know about mental health? I wish people understood that mental health affects one out of one. Mental health is as much about your relationship with yourself and others as it is about a traumatic experience. If you’re not looking after your own mental health, chances are someone else is suffering as a result. Let us all care for our mental health without contemplating whether our struggles are severe enough to require this kind of effort. It’s our responsibility to lead the healthiest physical and emotional life we can.

How do professionals benefit from being on the platform? Professionals benefit from the ability to build and maintain their online reputation via our search-engine-optimized listings. They also have the opportunity to share their wisdom while promoting themselves in a value-driven way through published articles and by responding on the forum, where their responses are highlighted and linked to their personal listing.

One of our goals is to provide professionals with a steady stream of ideal client referrals, and to match clients with their ideal professional. We are pleasantly surprised that this has already begun at this early stage.

How do you manage the stress that comes along with your taxing work? I try to take my own advice as much as possible. My routine is filled with “mental health habits 101,” like eating and sleeping well, doing exercise, engaging in meditation and lots of prayer, and keeping work at the office. I also seek out personal development and selfhelp literature, which keeps me on my toes as I work on tiny improvements. I constantly test and implement new productivity hacks and other healthy habits. Little changes, like checking and responding to my inbox once a day, free up more mental space than one would imagine.

What was the best compliment you’ve ever received? “I can’t believe no one has created this space for our community before. I can’t think of a client or colleague who wouldn’t benefit from this space.”

Sivan 5779 | Wellspring 43

Living Well

In Good Shape By Syma Kranz, PFC

Up to Date With Staying in Shape

This summer’s top fitness trends Just as fashion trends change over time, so do fitness trends. If you take a trip back in time and look through fitness history, you’ll see a number of trends and fads. There are some which are still with us in some form, while others have petered out quickly. Some exercise trends from the past that have survived until today include step workouts, kickboxing, and spinning. Sometimes exercise trends simply morph into another form, like cycling taking on a new persona as spinning. Every year, the editors of ACSM Health and Fitness Journal distribute a survey to fitness professionals worldwide to try to identify upcoming fitness trends. Here are some of the highlights from the survey.

Invigorating High Intensity Good news for HIIT lovers! High-intensity interval training still tops the list of fitness trends. HIIT routines are challenging, never boring, and let you get a workout in record time. Who doesn’t love that? In fact, HIIT training has dominated the list since the 2014 survey. The difference is that this year high-intensity interval training stole the top spot from wearable technology, which now in the number three position.

44 Wellspring | June 2019

Strength is an Asset Other trends are familiar as well. Along with highintensity interval training and wearable technology is group training, body weight training, and strength training. Of course, strength training is a staple, and a form of training that belongs in everyone’s workout arsenal. It’s the only way to reduce the loss of muscle mass that happens as we age.

Yoga Calm

Day to Day

Not surprising are yoga, functional training, and fitness training for older adults. We know that exercise increases flexibility and helps strengthen the core muscles but it’s also an excellent stress reliever. Plus, studies show that yoga training helps back pain sufferers and may lower blood pressure. So, yoga is good for your heart but in a different way than cardiovascular exercise. Yoga is also a good recovery form of exercise for those days when your body needs a rest.

And then there’s functional fitness training. The exercises we do should help us improve physical functioning in all aspects of our lives – from doing housework to moving furniture. That’s what functional training is all about, helping us improve how easily we do everyday activities.

No Time, No Space? Bodyweight! Body weight exercises are a good way to get in a workout when you have no equipment and limited space. These exercises, particularly push-ups and planks, have fitness benefits in their own right. When you do circuit workouts and add bodyweight exercises to the mix, you challenge

For Any Age Fitness training for older adults also made the top of the list. People of all ages need exercise, and the elderly are no exception. In fact, exercise is the best medicine for helping the 65-plus population set to remain functional. Exercise improves strength and power, which makes it easier to rise up out of a chair, and enhances balance skills to lower the risk of falls. Studies also show that it’s never too late to get benefits from it. Research carried out on nursing home residents showed that even 90-plus-yearold individuals can build muscle strength and size in response to strength training.

your muscles in a different way. When you’re short on time, you can even design a quick circuit workout using only bodyweight exercises. Bodyweight exercises are likely here to stay due to the fact that anyone can do them almost anywhere.

A Remedy to Recommend “Exercise as medicine” is an initiative that hopes to get health care professionals excited about exercise. With exercise offering so many health benefits, the healthcare community needs to be recommending and prescribing exercise more often. The hope is to get physicians and other professionals to refer patients to qualified fitness professionals and programs, where they can exercise in a supervised setting.

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.

Sivan 5779 | Wellspring 45

Living Well

Ask the Nutritionist By Shani Taub, CDC

Calorie Clarity

What exactly is a calorie and what role does it play in my body?

Question: The word “calorie” is thrown around very freely, but what exactly does it mean? I hear people saying “Too much, too little, healthy, not healthy, empty calories…” What exactly are calories and how do I distinguish between those that are good and bad for my health and weight?

Shani’s response: Simply put, a calorie is a unit of energy that food provides to the body upon digestion. You use the calories that you eat and drink for essential functions, such as breathing and thinking, as well as day-today activities such as walking, talking, and eating. As you consume these calories, the body automatically stores most of it within the liver and muscles for immediate energy reserves. Any excess calories you eat will be stored as fat, and the body begins to store consumed calories as fat within four to eight hours from the beginning of the meal. Consistently eating more than you burn will cause weight gain over time.

Every body needs a different amount of calories, with some of the calories from fat and some from protein, in order to function properly. Even within the span of a lifetime in the same individual, the amount the body requires fluctuates, depending on a number of factors including age, gender, body mass index, and activity level; and, in women, pregnancy or lactation.

As a side point, the calories we generally refer to in terms of our diet and exercise are actually kilocalories (kcal), which means that a food that contains 50 calories actually provides the body with 50,000 calories. Technically speaking, a dietary calorie is defined as the amount of energy required to raise the temperature of one kilogram of water by one degree Celsius.

No matter which way you look at it, a calorie is a calorie is a calorie. In other words, no matter where you’re getting it from, you’ll either burn it through essential functions or exercise, or it’ll be stored as fat. For this reason, I often tell my clients that even if they overeat on healthy calories, such as from fruits and vegetables, they will not lose weight. However, if you’re overeating on healthy calories, your body is at least getting the nutrients it needs. On the other hand, if you’re filling up on empty calories, which are calories derived from foods that contain little or no nutrients, you’re losing out on both ends. Foods with empty calories include those that are composed primarily or solely of sugar, fat, or oils, or alcoholic beverages. While consuming a small amount of empty calories won’t harm you, having too much of it will.

Just as a car moves on fuel, our bodies operate on calories. Give a car too much fuel and it can explode; give it too little and it won’t budge. There’s a certain range of calories your body needs in order to function at its best. But, if you’re waiting to hear that magic number, I’m sorry to disappoint you: It doesn’t exist.

Interestingly, considering nutritionally-empty foods as adequate nutrition was first scientifically demonstrated to be false by French physiologist Francois Magendie in the 1800s. Through experiments on dogs that are described in his Précis Élémentaire de Physiologie, he showed that eating only sugar, olive oil, or butter, led to the death of

46 Wellspring | June 2019

each of his test animals in 30 to 40 days. While counting calories gives you an idea of how many units of energy are entering the body, that doesn’t tell you anything about the quality of your diet. In order to ensure that you’re providing the body with what it really needs, you need much more knowledge than that — it’s important to know where the calories are coming from. 50 calories from a piece of chocolate are not nearly as nutritionally effective as 50 calories from an apple; and choosing foods that contain nutrient-dense calories is vital in maintaining a healthy lifestyle. Does this mean that if you count your calories you’ll experience

Calories Versus Calories from Fat

While it's true that many people eat far more fat and calories than is necessary, we all need a certain amount of both for growth and activities. Knowing the difference between calories and calories from fat will help you make wise food choices. According to the University of Maryland Medical Center, calories come from three general sources: carbohydrates, proteins, and fats. One gram of carbohydrates has four calories. One gram of protein has four calories. One gram of fat has nine calories. That explains the main difference between calories from fat and calories from the other two sources — fat is almost twice as dense in calories. Fats are also known as lipids; they are nutrients that your body uses as building blocks for nerve tissues and hormones. Fat can also be used as fuel by the body. When a person eats fat that is not used as building blocks or fuel, it is stored by the body in fat cells. From your body's point of view, it's saving for the future, planning ahead for a time when fat may not be available. Since fat has twice as many calories per gram than carbohydrate or protein, foods with the same serving size may

weight loss? Some people lose a lot of weight on a 1200-calorie diet, but many can’t if their diet is based only on measuring caloric intake. As a nutritionist, I don’t like to work with calories. If an individual takes in all their calories by eating processed foods like potato chips, candy, and chocolate, not only will they be continuously craving more, thus making maintenance almost impossible, but more importantly, they’re wreaking havoc in their body, depriving it from what it really needs. If you base your diet according to caloric restrictions only, even if you do manage to lose weight on it, it will eventually backfire. The body needs majority of its calories from healthy sources in order to function well and maintain weight loss.

have different numbers of calories. A half-cup of vanilla ice cream contains 178 calories from three sources: 2 grams of protein (2 x 4 = 8 calories), 15.5 grams of carbohydrate (15.5 x 4 = 62 calories), and 12 grams of fat (12 x 9 = 108 calories). A high-fat food has more calories than a food with protein or carbohydrates. Consider the same serving size of a half-cup of carrots: 1 gram of protein (1 x 4 = 4 calories), 8 grams of carbohydrate (8 x 4 = 32 calories), and 0 grams of fat. There are about 36 calories in a half-cup of carrots. The difference between fat calories and other calories is more significant when addressing excess calories, the calories that your body does not have to use immediately for energy. A fat calorie can be stored as fat by the body more easily than a carbohydrate or a protein calorie. If you eat 100 excess calories of nothing but carbohydrates, your body will expend about 25 percent of those calories just to convert and store the excess calories. That means it will store 75 calories as fat. If you eat 100 excess calories of fat, the fat doesn't need to be converted before being stored. Your body will use about three calories of the 100 to store the other 97 fat calories as fat.

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. Sivan 5779 | Wellspring 47

Living Well

Medical Mystery

My 5'6â&#x20AC;? stature awkwardly framed my thinning adolescent body. Within a few months, I didnâ&#x20AC;&#x2122;t recognize my new, emaciated self. I did not have an eating disorder, but how could I convince everyone of the truth?

48 Wellspring | June 2019

A Side Serving of Agony Why Couldn’t I Eat? By Gitty Rosengarten

Nothing about me is unusual, and that’s not because I’m prejudiced. I’m like any other teenager in every sense. As an eleventh-grader living in Cleveland, Ohio, I attend high school during the year and camp in the summer, and I keep myself busy with studies and friends. Sounds conventional enough. But I am different. Amidst this background of “normalcy,”

I've already undergone a journey of nearly two years in the mysterious and puzzling arena that is the medical world. It all began when I was about to enter high school, eager to settle into my place, having moved from Minnesota a short while earlier. Ninth grade commenced, and I started to learn the ropes of my new community. My class, consisting of seven girls, was very welcoming and accepting. I quickly

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Living Well

Medical Mystery

became one of them, and not long thereafter I slipped into a happy routine. But my newfound routine did not last long. Shortly after the school year began, I started experiencing extreme migraines — not the pop-a-Tylenol-and-gone type, but migraines that would accompany me all through the day, every day. I would go to sleep with them, wake up with them, and I even joked that I could feel them when I was asleep. A tight rubber band around my forehead became my new uniform. Too busy with my school work and social life, I didn’t give it much thought, and I put on my best façade, trying to get on with life. Subsequently, I started experiencing painful stomachaches. They were nothing alarming, but were really annoying. It was clearly connected to my eating, since every time I ate or drank something, the aches followed shortly thereafter, intensifying over the next few hours. At first, I was convinced it was just a stomach bug that would pass within a few days. But when that didn’t happen, I was left wondering what the culprit could possibly be. Having considerable stamina and energy, I forced myself to continue functioning despite my strange and painful symptoms, and my humor lightened my discomfort and helped convince everyone around me to dismiss their concerns. But not thinking about it didn’t relieve my pain. It was just getting worse. My parents and I weren’t very knowledgeable about health and medicine, but seeing that my pain was triggered by eating, we figured it was probably celiac or a lactose-intolerance issue. A visit to the local GI (gastrointestinal specialist), as well as the subsequent blood work, revealed that, surprisingly, my intestines were in perfect order. At that point, my parents remembered that I had had some minor stomach issues when I was younger, for which the doctor had prescribed Prilosec for a few months, which did offer relief back then. Hearing this, the GI figured my symptoms must be linked and decided to put me on a similar drug for six months, hoping that would be enough to relieve my symptoms. Since he

50 Wellspring | June 2019

Seeing that my pain was triggered by eating, we figured it was probably celiac or a lactoseintolerance issue. noticed our skepticism, he promised to take a scope test (also known as an EGD) after six months if the medication didn't prove effective. In the meantime, I went to see a neurologist regarding my migraines. There, too, a couple of tests all came back normal. The doctor, a little perplexed himself, reluctantly prescribed high doses of painkillers to alleviate my pain. At that point it was already more than half a year during which I was experiencing these symptoms, and we hadn’t come one step closer to finding the clarity we were so desperately seeking. Then it was time for camp. Armed with pills and meds of all sorts, I assured myself that all would be well. But it wasn’t. Camp turned out to be a disaster. I was in agony all day and night. Eating became the hardest chore. It wasn’t worth it for me to have even the slightest sliver of food, for the tradeoff was intense pain. As a result, I lost a lot of weight. My friends thought it was cool, but I knew something was wrong. Moreover, my headaches prevented me from participating in basic activities that my friends seemed to be enjoying. I tried hard not to be cantankerous and miserable around others, but there were times I just couldn’t hold back from expressing my pain. I lay in bed a lot, missing out on more activities with every passing day. As soon as I returned home, I went to the GI for the scope test. The results revealed ulcers in my esophagus, which my GI assumed were coming from the high doses of migraine meds. But other than that, nothing showed up. With no alternative,

we opted to try the FODMAP diet, recommended for people with GI issues. I was to go off gluten, dairy, soy, and some other food groups completely, but the plan resonated better with me than the thought of more pain. Surprisingly, as soon as I got off these foods, my stomachaches didn't disappear, but my headaches did — immediately. It felt amazing, liberating. And I was euphoric. Gluten became associated with headaches. If I was careful about avoiding gluten, I would avoid headaches, and if I wasn’t, the headaches were back. Throughout these two years, I was constantly visiting my GI. He kept testing me for different conditions, doing an exhaustive amount of blood work. But the results kept turning up with the same result: Nothing. I was experiencing searing abdominal and intestinal pain, but the tests did not reveal anything out of the ordinary. Baffled, my doctor referred me to a pain psychologist. “You're clearly suffering from a mental eating disorder probably stemming from anxiety, tension, or trauma,” he said. I felt confused and helpless. How could I, at all of sixteen years old, convince this doctor that psychological issues were not at the core of my problems? But the doctor held onto this erroneous belief that my pain was the result of stress, perfectionism, or anxiety. Being utterly depleted, I agreed to meet a psychologist. I visited the place a couple of times, each time despising it more than before. After a couple of visits, they sent me away; I had no interest in cooperating, so their work was in vain. With no one else to turn to, I returned to my GI, who agreed to see me a final time. We took a series of additional tests and did more blood work. Then he reasserted that if I would like to get better I must return to the pain psychologist. He expressed it with such certainty, but I was the patient, and I knew the truth. No one was able to convince me that I was not experiencing physical pain. I argued with him for a long time, confident that he was wrong. “If you think I’m not competent enough, you could gladly begin the same endless path with one of my colleagues,” he ended up exclaiming in anger. My parents and I left the office, drained and perturbed. By then I was completing tenth grade, with more days out of school than in, yet in no way closer to an answer. My mother,

not knowing where to turn next, sighed and said, “Let’s leave doctors aside, and try to figure this out ourselves.” I was left to fight my excruciating aches all alone. I went to camp that summer, hardly consuming any food, and losing lots of weight. Unable to function properly, I went home from camp as soon as I was able to. Seeing my pain, my parents agreed to try another round of testing. We weren’t going back to my former GI, and so began the events that would eventually lead to my personal salvation. The catalyst was a “random” GI specialist’s number we got. The office arranged for an appointment speedily and we looked forward to it, praying we would finally get somewhere. Just the prospect of having another chance got me excited. This GI was an elderly gentleman, and just by seeing my scrawny, pathetic figure he acknowledged my pain and consented that it was not psychological. Just hearing those validating words from him was a comfort. He scheduled another scope, and in addition to that, he suggested doing a CT scan, which ended up being the final test. This time, something suspicious showed up on the scan. It was what finally led us to discover the cause for my mysterious pain. After reviewing the results extensively, the GI informed us that he was considering some uncommon illness called MALS. Never having heard the term before, we ventured out to do our research. My first reaction was ecstasy. Seeing virtually every one of my symptoms listed was so validating. After so many months of being told that it was nothing, that it was psychological, that it was an outcome of my stress, my pain was something real. I had a classic case of MALS. MALS, median arcuate ligament syndrome, is also called celiac artery compression syndrome or Dunbar syndrome. It's a condition in which a certain ligament presses too tightly on the celiac artery (a major branch of the aorta) and on the nerves in the area. Beside the pain caused by this compression, it also hampers proper blood flow to the organs supplied by the celiac artery. It's a very rare condition, not easily diagnosed, and usually mistaken as a typical eating disorder. Since MALS is what medical professionals refer to as a “diagnosis of exclusion,” something only considered after all other, more likely, possibilities have been ruled out, the GI wasn’t going to be the one to officially diagnose. He sent me to the one MALS specialist in Ohio for further testing.

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Living Well

Medical Mystery

This doctor conducted numerous tests, including some psychological ones, imaging, and physical examinations. And on a Friday afternoon, half an hour before Shabbos, we got the phone call we had been waiting for: The doctor was on the line, saying that he’d like to discuss the MALS treatment protocol with us. I was officially diagnosed. I was euphoric. While I wasn’t done with this nightmare, I had an answer. The normal treatment for MALS is laparoscopic surgery. Minimally invasive, the surgery does not usually last longer than half an hour. The surgeon injects liquids that kill the extra nerves and most patients experience immediate improvement. I was scheduled to have surgery on the Monday after Purim of this past year. “You’ll be back in school in no time,” the doctor reassured me. In the end, the surgery took five long hours. Shortly thereafter, still scared to eat but feeling

ravenous, I ate a spoonful of yogurt — and waited. When I felt no pain, I stared at everyone around me in disbelief. I tried it again and again. Still no pain. I burst into tears of joy, and spontaneously looked upward, thanking Hashem sincerely. I sat there, lost in the moment, taking spoonful after spoonful — without a side serving of agony. It’s been several months since I underwent the procedure, and while my appetite still hasn’t fully returned, I see constant improvement. I’m grateful to Hashem for sending me the right doctor to lead me to my diagnosis, and I’m more thankful than ever for every swallow that I can take effortlessly. I’m forging ahead, determined to put this behind me. I also hope that the lessons I’ve learned from this experience remain with me. My ordeal gave me a new level of empathy that I don’t think I could have gotten any other way. I've learned to be less judgmental in the face of pain.

MALS 101 MALS is a very rare condition in which the median arcuate ligament, a ligament near the heart, presses too tightly on a major branch of the aorta that delivers blood to the stomach, liver, other organs, and nerves in the area. The ligament acts like a hammer and compresses the nearby nerves each time the individual breathes in. MALS was first discovered in 1963, and since then, doctors have conducted extensive research but have yet to find a definitive cause or a cure. Most doctors opt to treat MALS with laparoscopic surgery, but the operation only has a 60 percent success rate. MALS often occurs in younger women or teens, but very little is understood about the disease. Common symptoms of MALS: • Pain in the upper abdomen after eating. (This is often the first and most prominent sign of MALS.) • Nausea • Bloating • Vomiting • Diarrhea • Delayed gastric emptying

52 Wellspring | June 2019

CMY

SARAH L.

Living Well

Health Profile By Rachel Esses

Age: 32

Gender: Female

Weight: 193 pounds

Marital Status: Married

Location: Flatbush

Height: 5'6”

Occupation: Stay-at-home mom

Favorite health food: This might sound like an odd combination, but I like almonds dipped in almond butter. Almonds are great healthy fats; they also contain lots of fiber, protein, and magnesium. Almond butter is healthy, too, but it is very high in fat, so too much of it is not good for you. Just keep in mind that you're having twice the amount of fat and calories when eating almonds and almond butter together. I would suggest sticking to one or the other, such as 12 raw or dry-roasted almonds or one ounce almond butter. Favorite junk food: Potato chips Potato chips are one of the most popular high-fat snacks. They're deep-fried, high in fat and calories, and are bad for your health. As an alternative, have the baked potato chips, such as those from Cape Cod. Favorite exercise: Swimming three times a week. This really helps me unwind from the daily hard work of taking care of my kids, cooking, cleaning, and running errands. That’s awesome. Swimming keeps your heart rate up while reducing stress, builds strength and endurance, tones muscles, and helps maintain a healthy heart and weight. Favorite nutritious dish: Tilapia fish with parsley, spices, and a lot of lemon on top, plus green beans on the side. That sounds delicious. Fish is a great source of protein. As for the green beans, they are a good source of vitamins and minerals. My usual bedtime: 12:30 a.m. My usual wake-up time: 6:45 a.m. My biggest meal on a usual day: I rarely ever eat full meals, but if I had to choose I would say dinner. It’s really important to incorporate full meals into your diet that include a starch, protein, and vegetables. That allows you to have something from each different food group, and it helps keep you full in a healthy way. My usual dinner menu: Fish with a side of vegetables My weight loss saga: I actually have a hard time eating fruits. It’s not that I don’t like them, but I just forget to. Fruits contain many essential nutrients. Especially since you like them, I would suggest eating at least three fruits a day. A good way to have your fruit is scheduling when you will eat it. For example, plan to have a fruit with your breakfast or for your snack. Greatest weight loss challenge: Sticking to full meals. I usually eat part of a meal, and then rush to do other things. My weight/lifestyle goals: To lose 40 pounds—a dream! How I would treat myself if I get there: Get a new wig.

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.

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56 Wellspring | June 2019

A POINTED LOOK AT ACUPUNCTURE Is this form of alternative medicine a hoax or the magic itâ&#x20AC;&#x2122;s made out to be?

By Ruchy Reese

Sivan 5779 | Wellspring 57

Living Well

Cover Feature

“Can we just skip this test?” I ask, anxiously squirming on the examination table.

The needle being prepped in front of me is terrifying. Despite my apprehension, the doctor insists. When the first attempt at drawing blood fails, tears begin to prick my eyes. The next attempt brings nurses running when my blood pressure plunges and I nearly faint. Needles and I do not go together. And yet, there are those who voluntarily seek to puncture their skin, becoming human pincushions in pursuit of health. Enter the world of acupuncture: a world in which needles reign supreme.

• These days, nearly everyone knows what acupuncture is, at least superficially. It is a somewhat controversial form of treatment that involves inserting needles into specific parts of the body for improvement or maintenance of health. People have turned to acupuncture as an attempt to treat an array of conditions, including to relieve hay fever or chronic back pain, or even to turn a breech baby. When it comes to the needles, the claim is often made that, “It doesn’t hurt,” but I for one, don’t buy it. To me, a needle is a needle is a needle. But the truth is, once I actually saw an acupuncture needle, I realized that it’s quite different from the hypodermic syringes that make me quiver in the doctor’s office. Thinner than a human hair, and flexible, the most commonly used acupuncture needles look almost painless. Almost. For many people, the chance to be free from chronic pain or other medical issues trumps any fears they may harbor about discomfort. In fact, studies show that an increasing number of people worldwide are embracing acupuncture as an effective modality for various ailments — and many of them are doctors. Hospitals across the world are integrating acupuncture into their pain management programs. From Seattle Children’s Hospital to Stanford University’s two hospitals and many more in between, the medical practice of the east has found a home in the American west. Even the world-renowned Johns Hopkins and Memorial Sloan Kettering hospitals are now providing acupuncture treatments to cancer patients in the

58 Wellspring | June 2019

quest to ease their pain and nausea. In China, from where the modality originates, acupuncture is offered as an affordable anesthetic option for patients undergoing surgery, even complicated procedures, such as an open-heart operation. Truth be told, the modality is so respected in China that it is used for just about everything, though that wasn’t always the case. From the mid-1600s to early in the 20th century, the ruling Manchurian Qing dynasty banned acupuncture, considering it inferior to newer “Western” medical techniques, though acupuncture was still practiced by many in private. Later, it was banned again under the Kuomintang government, though the common folk continued to remain loyal followers. By the 1940s, acupuncture joined conventional Western medicine as a complementary practice in the Chinese medical world. In America, the practice of acupuncture was little known until it saw a sharp rise in popularity during the 1970s, after President Richard Nixon visited China, bringing with him journalist James Reston, who developed appendicitis while on the trip and required emergency surgery in a Chinese hospital. When he returned home, Reston wrote an article for the The New York Times detailing his experience with acupuncture for pain relief. He wrote: I was in considerable discomfort, if not pain, during the second night after the operation, and Li Chang Yuan, doctor of acupuncture at the hospital, with my approval, inserted three long, thin needles into the outer part of my right elbow and below my knees and manipulated them in order to stimulate the intestine and relieve the pressure and distension of the stomach. That sent ripples of pain racing through my limbs and, at least, had the effect of diverting my attention from the distress in my stomach. Meanwhile, Doctor Li lit two pieces of an herb called ai, which looked like the burning stumps of a broken cheap cigar, and held them close to my abdomen while occasionally twirling the needles into action. All this took about 20 minutes, during which I remember thinking that it was rather a complicated way to get rid of gas on the stomach, but there was a noticeable relaxation of the pressure and distension within an hour and no recurrence of the problem thereafter. While Reston confirmed what my needle-phobic self

People have turned to acupuncture as an attempt to treat an array of conditions, including to relieve hay fever or chronic back pain, or even to turn a breech baby. suspected — that pain can be part and parcel of the puncturing package — Shira Yael Klein, one woman I interviewed, tells me that the experience is worth it. “Yes, it did hurt, but not as much as you think it would. It was mostly a brief pain when the needle went in, then I kind of ‘felt’ the needle there, doing its thing, but it didn’t hurt. The ones in my face hurt more than the ones in the rest of the body. The needles also produced a weird tingly feeling, and the first session felt like ‘pops’ where the needle was inserted, then electrical currents running down my limbs and ‘popping’ in my toes, etc. Acupuncture affects nerves, and boy did I feel it. While this whole process wasn’t pleasant, the problems that they were treating were making me much more miserable.” Several other women I spoke to concurred with Shira Yael, that although discomfort is involved in acupuncture, for them, the results are worth it. But on the opposite end of the spectrum stand people like Ahuva Goldbaum who told me that acupuncture held no notable success at all. “I guess you might say we were hoping for a miracle, so it really came as no huge surprise that we didn’t see results. When our son was two months old, he had sudden cardiac arrest which we later found out was due to meningoencephalitis. He was left in a vegetative state, ventilator-dependent, tube-fed, etc. Shortly after he was discharged home, a relative who is an acupuncturist in the US strongly urged us to try acupuncture to restore his brain function, and he gave us the name of a practitioner he trusted in Eretz Yisrael, about a half-hour drive from our city. He also recorded a video showing him exactly where he thought the needles should be placed, recommending that we have it done three times a week, but the person we were seeing only had office hours once a week. After about a year with no results, the driver who had been

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taking us to the appointment every week offered to learn how to do it so that he could come to our house three times a week and give him the full, recommended treatment. We did that for another year or so with no results, and eventually we just stopped.â&#x20AC;? Likewise, a relative of mine claims acupuncture made no change in her condition, though to be fair, it caused no pain either. It seems that when it comes to anecdotal evidence both for and against the effectiveness of acupuncture, the pendulum swings two ways. Medical studies, however, are another story. Though thousands of studies have been done on acupuncture in the last 20 years, not all studies are worthy of our trust. To get a better overview of the research, I turned to the Cochrane Collaboration, one of the most reliable sources of information in regard to medical studies. (See sidebar for more information on the Cochrane Collaboration.) I pulled up more than 20 Cochrane reviews, which compare multiple similar studies under any given topic, and found only four in which acupuncture was considered an effective,

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proven treatment based on the data available. The reviews concluded that acupuncture may be moderately effective for postoperative vomiting, effective for tension-type headaches, and can be considered an effective treatment for migraines in some patients. Fibromyalgia, too, may benefit from acupuncture. Of the rest I examined, many reviews were inconclusive due to poor methodology, small trial size, or publication biases. Conditions for which acupuncture is not reliably documented to help, as of yet, include neuropathic pain, insomnia, asthma, high blood pressure, ADHD, epilepsy, dysphagia after acute

Shortly after he was discharged home, a relative who is an acupuncturist in the US strongly urged us to try acupuncture to restore his brain function.

stroke, autism spectrum disorders, urinary incontinence, traumatic brain injury, spinal cord injuries, and more. Though positive data is currently lacking in regard to many conditions, new, more reliable studies are surely being conducted, and reviews may conclude that acupuncture really is effective for many ails. Only time will tell. But that brings us to another question: Is Acupuncture Halachically Permissible? Whether or not we choose to look at medical studies or be swayed by personal stories of people who’ve “been there and done that,” are we even allowed to avail ourselves of this modality? To understand this question, we need to understand the concepts behind acupuncture. According to Chinese religions, there is an energy that flows through the universe. They believe this energy is found in everything, and though it appears that they do not worship the energy per say, they consider their thousands of idols to be manifestations of this energy. They call this energy “chi,” and they say it flows through all of us and through everything, and by way of breath and food, living beings absorb and expel this energy. Acupuncture is considered the way to balance this chi, causing the body to have proper energy flow. This is done by way of the channels believed to be in the body, which they call “meridians.” These meridians can develop blockages that need to be cleared out, and insertion of acupuncture needles are used to do this, as well as to balance the various aspects of energy in the body. On the topic of chi (or “ki” or “prana,” in Japanese and Indian religions), Rav Chaim Yisroel Belsky, zt”l, taught, as written in the sefer Shulchan Halevi: The types of healing methods… are based on one general principle called “Universal Energy.” According to its false comprehension, this force — this universal energy — extends from one end of the world to the other, surrounds every living creature with a special aura, and has a separate mind and independent will with the ability to benefit or cause harm (may Hashem save us from this false theory). Adherents of this worldview also believe that this energy is the source of life, and that an individual with the proper wisdom and specialized training has the capability to control this power. He can use it to help himself or affect others in beneficial ways, such as healing, curing imbalances, or confusion of the mind... Some associate this energy with known, scientific forms, such as electromagnetic energy, which operates on the atomic and subatomic levels. Others say it is a different form of energy, occupying the space between

What Is Cochrane? Cochrane is a global, independent, transparent network of more than 13,000 members who join together to review data in regard to potential harms or effectiveness of healthcare. It’s the gold standard in the evaluation of medical studies, with a goal of ruling out publication biases, conflicts of interests, sham trials, and poorly conducted studies. Cochrane does not accept commercial or conflicted funding, and the members are located across the globe. In short, Cochrane attempts to review all available, relevant data for conditions and treatment options, and offer a conclusion in regard to a trial’s reliability.

A Wide World of Acupuncture Although we usually think of acupuncture in terms of thin needles inserted into the hands, legs, or back, there are actually many forms of this alternative treatment. Acupuncturists can choose to apply needles to the entire body or to focus only on the face or scalp. Likewise, ear acupuncture is sometimes done with small needles that can stay in place for several weeks. Some practitioners choose to connect the needles to a source of electricity for electrostimulation. Cupping, too, is used by some. In this process, heated glass cups are applied to the skin before or during acupuncture to bring blood to the surface of the skin.

The Nine Needles Traditionally, nine types of needles were used in acupuncture, though nowadays, the thin filiform needle is most common. There was a needle for 1) superficial pricking 2) massaging 3) knocking/ pressing 4) puncturing a vein for bloodletting 5) draining abscesses 6) rapid pricking and 7) a long needle for thick muscles 8) a large needle for puncturing joints and 9) the standard filiform needle most commonly used today. The other needles have been largely replaced with surgical tools.

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the nuclear particles. Still others associate the energy with resonance patterns. However, one thing is clear, this energy cannot be defined in physical terms, and is like nothing we are aware of today. There is no instrument available that could measure this energy.

Up until that point, was acupuncture truly only a form of medicine? Would Rav Belsky say that such acupuncture is permissible?

During my research of this article, the question occurred to me that perhaps this chi and acupuncture, though historically entwined, are actually two separate issues. In a chicken-and-egg sort of way, I pondered: Which came first: acupuncture or the concept of chi? Did the creators of Chinese religions take normal function of the human body and build the concept of chi around it in the attempt to understand what they were experiencing? Is acupuncture able to be defined by science and legitimately separated from Chinese religious beliefs?

Up until recently, science hit a brick wall in explaining how acupuncture works, or, as referenced above, if it works at all. It has been hypothesized that the release of endorphins causes pain relief when acupuncture is used — but endorphins can be released through many other means, no needles necessary. Likewise, it has been suggested that acupuncture works with the nervous systems to target bodily functions both near and far from needling points, but little specific data has yet been provided to prove this. Perhaps the most compelling evidence we have of acupuncture’s effect on the body is research done by Dr. Morry Silberstein, as published in the Journal of Theoretical Biology, in which he asserts that insertion of needles at known acupuncture points corresponds with areas in which Group C nerve fibers (one of the three types of nerve fibers) branch out. While the role of C-fiber nerves in the nervous system are little understood as of now, it is suspected that interaction between the needle and the nerve create a pain-numbing sensation that can be carried throughout the body.

According to Professor George Lewith, a medical doctor and lecturer who also extensively studied acupuncture, there was a time when acupuncture was not applied to specific parts of the body — there was no concept of meridians. Over time, through careful observation of what caused certain sensations and effects in the body, these “channels” were mapped out. The professor writes: Acupuncture points are undoubtedly the end-product of millions of detailed observations and as they were developed… so each of them was given a name and Chinese character, depending on its therapy properties. Was it only after the developments of these “meridians” that chi was associated with acupuncture?

Let’s fast-forward to current times and ask the same question.

As for scientifically proving or disproving the rest of the theories about what acupuncture can or cannot do, only time will. Until then, if you’re interested in acupuncture, present the data to your Rav and ask how he rules, find a well-trained acupuncturist — and pray for siyatta d’Shmaya.

A Word of Warning

Sharp Tips for Acupuncture

There have been many documented cases of compounds sold by acupuncturists and other alternative practitioners that have contained undeclared, added medicinal ingredients. This is especially true in regard to steroids. Running the Skin Healing Gemach has exposed to me to incredible pain and suffering caused by these “magical” and so-called “natural” products that often result in severe pseudo-eczema when the product is discontinued or stops working. This has been seen especially with products from Asia, and in products targeting the skin.

If you pick to puncture, use these tips to increase your chances of a safe experience.

Likewise, there have been disreputable acupuncturists who have administered steroids without patient knowledge, resulting in life-threatening adrenal failure and skyrocketing blood pressure post treatment. These are serious risks to keep in mind when seeking treatment.

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• Consult your Rav. While many rabbanim rule that today’s acupuncture is permissible, there are those who maintain that it is a danger to the neshamah. • Only use a licensed acupuncturist. Using an acupuncturist from some storefront exposes you to greater risks of running into a charlatan who may administer medications unbeknownst to you. • Do your research. Only trust someone who is very well trained. Internal organs may be punctured if the needles are inserted too deeply.

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Q&A With Dr. Yehuda Frischman, DAOM, L.Ac. Though some rabbanim forbid acupuncture, others rule that it is allowed. Dr. Frischman, an erlicher Yid, follows their ruling and has used acupuncture for 19 years as a means of helping others heal. He practices in Yerushalayim but maintains his license in the States, where he frequently lectures and practices.

What does it take to become an acupuncturist? In the state of California, one is required to attend a certified four-year school of acupuncture and oriental medicine. To apply for admission one must have at least a Bachelor of Science degree or a Bachelor of Arts along with science prerequisites. After four years of rigorous academic and clinical training one is able to sit for the graduation exam and once one passes that, one can sit for the state board license. After passing this exam, one receives a masters in acupuncture and oriental medicine. These standards were established about 20 years ago. In addition, a select number of acupuncturists choose to study further — a minimum of another two years — for a doctorate degree, Doctor of Acupuncture and Oriental Medicine (DAOM). The course of study I took to complete my DAOM was over 4,000 hours.

Why did you decide to learn acupuncture? My late wife had been suffering from a seizure disorder that was not responsive to any Western medical treatment/ medicine for many years and we had gone to several hundred practitioners and doctors around the world. No one could help. My business was suffering and I lost my home. I had to face up to the message Hashem was sending. It was time to close my business and go to medical school. I chose Chinese medical school and craniosacral coursework from the Upledger Institute as they seemed to provide the most hope for diagnosing and treating my wife’s terrible suffering.

Do you recommend acupuncture only for individuals who have a medical issue, or as maintenance for healthy people, as well? Acupuncture is a valuable tool as part of a well-balanced regimen to promote health, wellbeing, and longevity. It is also effective in treating pain syndromes, both chronic and acute, by releasing the body's own pain relievers — endorphins — and treating emotional disorders by releasing serotonin.

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How do you find the area to puncture? Is there a feeling, such as a pulse, that you pick up on? In Chinese medical theory, there are 14 main pathways, called channels (aka meridians), that traverse the entire circulatory and lymphatic and fascial systems of the body, head to toe. There are specific points along these channels that address specific organic and global issues. On these channels are specific anatomical points that have empirically been shown to address specific physical and emotional issues. A trained physician or practitioner is able to feel differences in pulse and body temperature at these points.

Is there any medical condition that is unable to be helped with acupuncture that you are aware of? Conditions of severe depletion require nourishing from food and Chinese and other medicinal substances and formulas before acupuncture itself can be used. Then there are some iatrogenic conditions, caused by Western medicine, where the body has been irreparably damaged by pharmaceuticals and treatments.

According to your Rav, do we have to worry that there is any type of avodah zarah or kishuf involved in acupuncture? Acupuncture is nothing more than a tool. There is no issue of avodah zarah, no more than the use of a hammer or screwdriver or computer. When used prudently, it can build and increase kiddush Hashem in the world, and when used wrongly, it can do harm. One should always be careful with any medical issue to recognize that illness is a message from Hashem and not a mechanical process. When we relate to our bodies and the world mechanically, then we miss out on a tremendous opportunity to hear the messages Hashem has given us. As such, we should always look for a G-d-fearing person to help us address our medical needs.

Q&A With Jonathan Leibowitz, MD, PC Dr. Jonathan Leibowitz practices in the Borough Park section of Brooklyn, New York. In practice for over 25 years, Dr. Leibowitz did his medical training at The Mount Sinai Hospital in Manhattan and is board-certified in both internal medicine and nephrology. He is also certified by New York State for the practice of medical acupuncture.

What motivated you to add acupuncture to your medical practice? Although I am classically trained, I was always intrigued by alternative approaches to medicine. My only condition to incorporating these approaches into my practice was that they worked in a tangible way. I do not want to waste time “believing” in a system or treatment. Rather, I want to be able to see and measure the results, whether it be traditional medicine or alternative medicine/acupuncture.

When do you recommend that a patient consider acupuncture? In my practice I have found that acupuncture has a role in mainly treating pain. It is important to note that acupuncture is just one aspect of Chinese medicine and, if it is to be used beyond the treatment of pain, both the patient and the practitioner should adhere fully to all the principles of Chinese medicine. This includes the use of herbs and diet as well as certain exercises; it is generally not an à la carte menu. For example, although it can, at times, rapidly relieve wrist, shoulder, sciatica, and other pains, turning to acupuncture to solve all of life’s problems without getting to the source is not wise. We can’t subsist on kugel and cholent and expect acupuncture to cure our diabetes and high blood pressure. If an individual wishes to avoid traditional medicine, they must avoid the traditional lifestyle as well.

Are there any take-away messages you can share? People should understand that while acupuncture is generally safe, like all else in life, there can be certain side effects. Some people might get what is called “needle shock;” they pass out in response to needles. While this is not necessarily harmful, it can be quite disconcerting for both the patient and doctor. Another thing to keep in keep in mind is that while acupuncture is often advertised as “painless,” it isn’t necessarily so. Sometimes there is truth to “no pain, no gain.” Of course, the treatment should always be performed with disposable needles. The most important take-home should be that nothing can be done in isolation. While acupuncture is sometimes a great treatment, it is not for everyone nor for every condition. Dr. Frischman and Dr. Leibowitz can be contacted through The Wellspring.

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At the Dietitian By Tamar Feldman, RDN, CDE

ACID REFLUX Why long-term antacid use is dangerous If I would have to list the top 10 medications that my clients take, antacid medications would rank first or second on that list. Gastroesophageal reflux disease (GERD), or acid reflux, is the most common disorder in the United States. Studies show that 10–20 percent of individuals experience symptoms at least once a week, and the prevalence of GERD is increasing steadily. PPIs (proton-pump inhibitors) such as Nexium, Prilosec/Omeprazole, and Protonix, are among the most popular classes of drugs prescribed for GERD. Doctors wrote 114 million prescriptions for them last year, and Americans spend $5.1 billion yearly on Nexium, the most popular PPI.

You may have heard over the last five to 10 years that the FDA released some precautions against prolonged PPI use. While I’m glad the FDA finally issued these warnings, I can’t help but wonder how someone who had been taking a PPI for 20 years prior to these warnings feels about the “news.” If I were one of those people, I’d be incredibly angry, especially because the researchers who studied these drugs prior to their FDA approval sounded a similar warning many years ago — and it was largely ignored. When PPI drugs were first approved, it was recommended that they not be taken for longer than six weeks because of the exact same concerns the FDA is now warning us about. Well, due to this oversight at some level, it’s not at all uncommon to encounter people who’ve been on a PPI for two decades. If you were to ask the average person on the street what causes heartburn, he would likely answer, “Too much stomach acid.” So, when I explain to patients that GERD

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is almost always caused by not having enough stomach acid, they're initially doubtful. “If that’s true,” they say, “then why do my antacid drugs provide relief ?” Great question! The scientific literature has found that GERD is not actually a disease of excess stomach acid; rather, the source of the problem is that the acid is making its way out of the stomach and into the esophagus. Indeed, a University of Manchester study confirmed that low stomach acid is more to blame than high stomach acid when it comes to GERD symptoms and indigestion in older people. Having too little stomach acid makes it hard for the body to break down the food entering the stomach. That food then sits around in the stomach, causing nausea and burping. Whatever small quantity of acid is present then refluxes back into the esophagus. The question to ask in a GERD case is not why there's so much acid in the stomach, but rather what caused the low stomach acid.

Unfortunately, “solving” the problem of GERD by removing all stomach acid with a PPI medication can actually lead to serious digestive and health issues in the long run. The truth is, your stomach must be highly acidic to break down the food you’re consuming and to properly absorb it. The stomach was designed to be so acidic in order to prevent bad bacterial overgrowth further down the GI tract, as well as to rapidly break down proteins and fibers. Removing this vital acid sets people up for problems, including imbalanced gut bacteria, incompletely digested proteins, unabsorbed vitamins and minerals (with associated conditions such as osteoporosis), and a high risk for development of a leaky gut and autoimmune conditions.

Common Symptoms of Low Stomach Acid • Acid reflux

• Indigestion, bloating, gas, burping post-meal, nausea • Skin issues like acne, eczema, rosacea

• Weak nails and brittle hair, or hair loss • Chronic GI infections

• Osteoporosis, due to unabsorbed minerals

• Anemia, due to poorly absorbed iron and/or vitamin B12 • Dental problems • Bad breath

Common Causes of Low Stomach Acid • Natural decline after age 50

• Long-term use of acid-suppressing medication and Tums • Hypothyroidism

• Overuse of antibiotics or NSAIDs (ibuprofen) • H. Pylori infection

• Poor diet, leading to chronic inflammation • Stress

Curing a disease means eliminating its cause. When a disease is cured, the symptoms don’t return once the treatment is discontinued. Unfortunately, pharmaceutical companies aren’t interested in cures because they aren’t profitable. Below, I will outline how to treat the root cause of GERD through diet and lifestyle so you can wean yourself off antacid medications and fix your reflux for good.

Treating Reflux at the Root 1. Modify your diet. Eating large quantities of processed foods and sugars is a surefire way to exacerbate acid reflux, as this kind of fare upsets the bacterial balance in your stomach and intestine. If you have SIBO (small intestinal bacterial overgrowth, with severe post-meal gas and bloating), treat it to decrease the force of the gas pressure upward on stomach contents. 2. Remove food sensitivities. Common triggers are gluten, dairy, soy, and corn. Try removing all of the above in conjunction with the other recommendations, and add them back into your diet on a careful trial basis once you're feeling better, to test for reactions. 3. Take supplemental acid. While you're working to address your reflux, try taking apple cider vinegar (1 tsp in ¼ cup water) and betaine HCL capsules (1–2) before meals. 4. Help your body produce more acid. Decreasing the use of NSAIDs, consuming bitter green veggies before meals, and treating any zinc and B-vitamin deficiencies will help your stomach make more of its own acid.

5. Use agents that heal the esophagus and stomach lining. DGL (deglycyrrhizinated licorice root), aloe, and marshmallow root can all be effective with at least two months of initial use.

6. Try massage. If you have been told you have or suspect you have a hiatal hernia, learn from a chiropractor (or video clip) how to massage and maneuver the stomach downward. Do this daily. 7. Chew slowly. Thoughtful, thorough chewing signals to the stomach to start releasing acid. 8. Decrease stress. Never eat when you're upset, as stress decreases stomach-acid production.

I never recommend stopping PPIs cold turkey. Doing so can cause a severe rebound of symptoms. The majority of individuals are able to successfully wean themselves off antacids gradually while implementing all the above recommendations.

Coming up: Part 2, a case study of a GERD client who successfully weaned herself off long-term PPI use. Tamar Feldman, RDN, CDE is a highly acclaimed and experienced registered dietitian/nutritionist and certified diabetes educator. 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. Follow her @gutdietitian. Write to Tamar at tamar@thegutdietitian.com to join her whatsapp group for weekly gut health lectures.

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Health Personality By Shiffy Friedman

Cup of Tea With:

Shoshana Richelson, Au.D.

n her neatly cropped sheitel and black skirt, Dr. Shoshana Richelson practices in a field of medicine that suits her perfectly. “When I was deciding on a career path,” this young mother of two recalls of her post-seminary days, “I saw audiology as a good mix of medicine and counseling.” With both her parents practicing as doctors, Shoshana, a graduate of Bais Yaakov Detroit, was looking for something in the medical field but not so intense that it would necessitate the rigorous path of medical school. “I wanted to be able to spend time with my patients, to counsel them about their fears. One great perk about the field I ended up going with, audiology, was that it required me to attend the same undergraduate program as my friends who pursued a degree in speech/ language pathology, so I was able to stay in Maalot, the frum program in Michigan, and do it with them. I also wanted a career that would allow my husband to begin our marriage in kollel. In my practice, I get to help people with my medical expertise in the field, as well as to be there for them as a counselor, coaching them through decisions that may be difficult.” At the ENT (ear, nose, and throat) office where Shoshana works, she sees patients of all ages and stages who are exhibiting auditory issues. Once the tests

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OCCUPATION: audiologist SINCE: 2014 LOCATION: Southfield, Michigan PASSION: educating people about hearing aids and the misconceptions behind some of the fears

WISHES PEOPLE WOULD KNOW: how important it is to seek out a trustworthy audiologist to help them get the hearing aids that are best for thems.

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determine that the patient is in need of hearing aids, Shoshana is there for them through the process. Most notably, she makes sure every patient is fully satisfied with the process — not only emotionally, but also financially. In that vein, she offers a free one-week trial with hearing aids before any payment is made to ensure full satisfaction.

“Unfortunately, for every valid and honest hearing aid sale out there, there might be double the amount of hearing aids sold dishonestly. I have seen many patients come to me, frustrated that their hearing aids were offering minimal help. I hear horror stories from people who spent thousands of dollars for a pair of aids, only to realize that their hearing hadn’t improved. And then, I fit them with a new pair for under $2,000 and they can’t believe how well they can finally hear again. “It’s no wonder many of us have fears and misconceptions regarding hearing aids,” she notes. “This makes it all the more vital to see an audiologist whom you can trust.”

Who are the majority of Shoshana’s patients? “In general, I work with individuals who are 60 and up. One of the misconceptions regarding hearing aids is that they’re only for the elderly, which is not really true. For many, hearing loss starts in the 30s and 40s. When patients in their 50s start noticing that they’re having problems and they come in to have their hearing tested, many of them don’t want to discuss the option of hearing aids at all. I understand that the prospect of wearing hearing aids is frightening for most, but in many cases it’s vital. Besides, many of the misconceptions people have about hearing aids, such as that it squeals or that it’s always visible, are not true.” Some of the patients Shoshana sees don’t necessarily come in with hearing loss complaints; they were simply ordered by a physician to undergo a standard hearing test once they reached 50. “Many doctors feel that hearing tests should be standard for patients over 50,” Shoshana explains. “Lots of new studies are pointing toward the importance of proactive treatment for hearing loss. Recent research suggests that the sooner an individual gets treatment, the better their long-term success will be, especially because hearing loss is linked to depression and dementia. An individual with mild hearing loss is three times

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more likely than someone their age without hearing loss to get dementia, and with moderate hearing loss it increases to four times more likely. When the hearing loss is severe, the probability goes up to five times.”

While these numbers can be frightening, it’s important for those who are reluctant to deal with hearing loss properly to be made aware of it. “I always back everything I tell my patients with peer-reviewed, double-blinded independent research because I believe they should get the best quality of care.” When Shoshana first started out as an audiologist, her approach toward encouraging hearing aids was different. “Before the research came out, I did not push hearing aids to a patient who was against the idea. When we determined that a patient was experiencing hearing loss, I would tell them, ‘Whenever you’re ready, come back and we’ll fit you with hearing aids.’ However, once the research emerged, my approach has changed. I still don’t push, but now, I know that it’s in the patient’s best interest to be properly educated about the benefits of getting the aids sooner rather than later.”

Once Shoshana explains the research to her patients, many of them pursue the hearing aid option immediately. “If a patient says that they’re not experiencing hearing loss to the extent that they need hearing aids — they only struggle in background noise — I explain to them that their brain is compensating for them. In the short term, that’s great. They don’t feel that they need hearing aids so they don’t get them. But, research reveals that the long-term side effects of letting the brain compensate may lead to dementia.” The relationship between brain compensation and dementia is being explored through MRI studies, in which researchers noticed that in the presence of hearing loss, the frontal lobe of the brain “steps in” to compensate, minimizing its focus on what it should be doing, which is cognitive functions. “I tell these patients that in order to prevent these negative long-term effects, they’re better off getting hearing aids. Research shows that once hearing aids are in place, the frontal lobe gets freed up again to focus more on cognitive functions.” In manifestation of her sincere care for her patients, once Shoshana explains why hearing aids are important, she in-

quires how the patient feels about getting them. “Most often, the response I get is, ‘I don’t want to be seen with hearing aids.’ Many patients remember the chunky pieces that framed their grandmother’s ear. Of course, they don’t want to look like that. It helps when I tell them that things are different nowadays. Today, hearing aids don’t have to be seen. With the current technological advancement, they don’t squeal either. Today’s hearing aids also have rechargeable batteries, which enables people with dexterity issues to easily care for them.” For each patient, Shoshana finds out what bothers them, and then together they find a way to circumvent that. “Another big issue is the cost,” notes Shoshana. “People say that they don’t want hearing aids because they cost in the range of $5,000. For that, I tell them that we have hearing aids that start out under $2,000 for a pair. If a patient is employed, even self-employed, the state may cover a large portion and a set can cost as low as $100–$500. If they’re not employed, we check every insurance the patient has. While Medicare currently doesn’t cover hearing aids, often secondary insurances do.”

During a demo appointment, Shoshana’s staff lets the patient know if their insurance covers the hearing aids. To make it more accessible for those who are financially strapped, her office also offers Care Credit, an interest-free payment plan for up to two years. “People don’t even go to get their hearing tested because they think that hearing aids are so expensive,” she asserts, “but that doesn’t have to be the case.” Once an individual realizes that their hearing loss necessitates the implementation of hearing aids, how can they know if the professional they’re considering seeing is trustworthy? “It starts with the counseling,” says Shoshana. “Notice how you’re being spoken to about your hearing loss. If you’re just told that you need the top-of-the-line hearing aids and the practitioner doesn’t listen to your needs, you get the feeling that he’s just in it to make a quick sale, and you don’t want to be his patient. You want your audiologist to ask you deep questions, to understand exactly what you’re looking for. In my office, I give patients a thorough questionnaire to fill out. Even after we’ve determined what might be the best fit, I then give a free trial for one to two weeks. All my patients are satisfied because they don’t pay a dollar before they have a chance to demo hearing

aids.”

Also, make sure the professional mentions the 30-day return policy up front. By law, Shoshana points out, most states have a 30-day return period for hearing aids that don’t do the job for them. “Thankfully,” Shoshana reports, “more and more places are agreeing to trials because the competition is high. It’s certainly becoming more common. Even if your audiologist doesn’t offer a trial, know that you should definitely be able to return your hearing aids if they’re not helping you hear. If your doctor is trying to hide information from you, that’s a sign that he’s not having your best interest in mind.” In the past week alone, Shoshana has worked with two patients who both got hearing aids at another facility within the last year and were not satisfied. “They had almost given up on ever being able to hear again. I offered them a demo just to show them how much better their hearing could be. I reassured them that if they weren’t happy with the results they weren’t obligated to keep the pair. Both of them ended up coming back satisfied. Ironically, the pairs they had bought were much more expensive than what they ended up purchasing from me. It’s because of such horror stories that wronged people tell their friends not to bother getting hearing aids in the first place, but if you find a trustworthy person, your needs could be met. I want to spread this message to as many people as possible, not only those who come see me,” Shoshana stresses.

When you’re trying to get a sense of your doctor’s level of trustworthiness, Shoshana advises, “You should feel that you’re more important to them than the money you’re bringing in. At the place where I work, most of my patients are not Jewish. I’m grateful to make a kiddush Hashem every day. They have a lot of respect for me. Some of my patients travel over an hour to see me because they like what I do. This promotes their positive view of Yiddishkeit. They see my values and it creates a memorable experience for them.” In general, many patients return for a follow-up visit two weeks after their purchase. “If they have the necessary technology, I could completely program the hearing aids remotely. But depending on the patient, and especially those who

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Taking a baby to a wedding where loud music is playing can possibly affect the child’s hearing for life.

are elderly, some need help with learning how to take proper care of their pair. For those who are capable, I show them how to clean it properly so they don’t need so many follow-ups. We offer follow-ups every six months for those patients who want it.”

As a practitioner who’s been dealing with cases of hearing loss every day for the past five years, Shoshana knows a thing or two about an issue that’s more common than we might imagine. While she says that the cause for age-related hearing loss, presbycusis, is not conclusive, it’s possibly due to simple wear and tear of the organ. However, she does believe that there are measures we can take to prevent another kind of hearing loss — the one that occurs as a result of exposure to loud music. “Noise exposure is a huge cause for hearing loss,” she says, “especially in the younger population. Unfortunately, noise-induced hearing loss cannot be reversed. Taking a baby to a wedding where loud music is playing can possibly affect the child’s hearing for life. I have an earphone gemach, which was started in New York, where I lend out ear protection devices for infants. Still, I opted to leave my young children with a babysitter for my brother-inlaw’s wedding. Even with ear protection, you don’t to want expose your children to loud music. If you’re bringing your child to a wedding to save on the babysitting money, reconsider it — for the sake of the child’s long-term health.”

While being exposed to loud noise is unavoidable, Shoshana recommends using protective earphones or inserts, which can be purchased at a pharmacy or borrowed from a gemach. “Nowadays, there’s a gemach in every city in the U.S. with a frum population. When children are too young to keep the plugs in their ear, they should be wearing phones that cover the ears entirely. If your child is old enough to keep the plugs in, make sure to read the instructions properly before inserting to avoid sticking it in too deeply. Either way, you’re always best off not exposing your child to loud noise.”

While exposure to noise is a growing cause for hearing loss, there are other factors that affect hearing, as well. Fluid in the ear is one of them. “That’s a different type of hearing loss, though,” Shoshana notes. “Noise affects the cochlea, causing irreversible damage, while fluid affects the middle ear. When fluid enters the middle ear, it impedes the bone’s vibrations, thus reducing the decibel level. This is treatable by removing fluid through tubes. Once the fluid is removed, the hearing comes back.” Is there a way for this fluid to drain on its own? “If the child gets an ear infection every once in a while, the fluid does drain on its own through antibiotic treatment. But if a child is having four to six infections in a year, it is usually time to consider tubes.

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Constantly putting a child on antibiotics could make the child’s body resistant to the treatment, and allowing the fluid to settle there is detrimental for the child’s development. Children are most prone to language development between one and three years old. Research shows that at that age, a child acquires language at a much quicker pace than later in life. If they’re have hearing loss during this critical time, it may result in a speech delay, which may affect other areas of life.” For this reason, Shoshana reports, her 14-month-old daughter will be getting tubes shortly. “She has had about five ear infections, and I don’t want fluid in the ear to impede her development. Parents who resist this treatment because of misconceptions could be depriving their child of acquiring important skills at a time when it’s best for the brain to acquire them.”

For someone as passionate as Shoshana, being able to educate her patients provides her with a profound sense of fulfillment. “I like to fix a problem deeply. Hearing aids are only as good as they are programmed. If it is done right, it goes a long way in enhancing the patient’s quality of life. I rarely promote the most expensive hearing aids as most effective. If that’s not what’s best for the patient, I won’t recommend it. I treat other people’s money like I treat my own.

“One thing I do, especially when people say they can afford high-end, is that I offer them a free demo for the high-end choice. Then, I encourage them to buy the mid-level pair, reassuring them that if they miss the expensive pair, they could always come back within 30 days and pay the difference to receive the more expensive pair. In all my years that I’ve been doing this, only one patient came back to ask for the upgrade. Studies don’t necessarily show that more expensive hearing aids are more effective.” With her trustworthy, transparent approach toward every patient, I wonder aloud how Shoshana can make herself more available to the wider community. Although she currently only sees patients in her office in Michigan, I’m glad to hear that she’s considering working long-distance. “There are ways to program hearing aids through apps,” she explains. “It’s certainly something I’m looking into so I can be there for patients nationally and internationally.”

To Shoshana, taking the time to listen to her patients and finding out what really bothers them is a crucial component of her practice. “It goes a long way in not only helping them hear, but also in helping them feel heard and understood.” Shoshana can be contacted through The Wellspring.

Living Well

Memos from a Kinesiologist By Miriam Schweid

Smoother Speech A natural remedy for stuttering?

Being stuck in the supermarket line is never fun, especially not on a busy afternoon when the to-do list beckons. When this happened to me several weeks ago, my would-be purchases growing increasingly heavier in my hands, I noticed that the queue was being held up by a little girl. The child, who I recognized as a neighbor of mine, was apparently having trouble with the payment process. When the cashier asked for her phone number, no answer was forthcoming. Watching Toby’s face turn red and her apparent discomfort at the situation, and thinking that perhaps she was too shy or didn’t understand what she was being asked, I stepped in to intervene. It turned out that at nine years old, Toby certainly knew her family’s phone number. Instead, her inability to give it over to the cashier was due to her severe stutter, which only intensified under the stress of the cashier’s impatience and the growing line behind her. She simply couldn’t get a sound out of her mouth. After I suggested that Toby write her phone number on a slip of paper, she finally left the store with her groceries, feeling relieved and released. Several days later, I met Toby walking with her mother. They seemed to be having a fluent conversation with one another. When Toby waved toward me and filled her mother in on how we’d gotten acquainted, her mother, Leah, asked me if we could have a little chat. On a bench in the park nearby, Leah confided that she was at her wits’ end. Toby’s stutter was bad. She had been in speech therapy for four months, with very little improvement. Since that episode in the supermarket, she refused to run any errands and barely spoke in school. The teacher labeled her as inattentive and unintelligent, when the opposite was true. Leah thought she needed help as much as her daughter did. She was finishing sentences for Toby to help her in stressful situations, but that was not helping her. “What could be the cause of my

daughter’s suffering?” Leah wanted to know.

From my experience working with children and adults in similar situations, I suggested that perhaps Toby’s suffering was caused by underlying stress and anxiety. Stress has the ability to constrict the voice box and the muscles that produce sound. Until her anxiety, fears, and frustration would be dealt with, speech therapy may be entirely ineffective. Toby was being taught breathing techniques in therapy, but she was only performing them during sessions; in stressful situations, she could not apply them.

In a more lengthy conversion with Leah, I learned that Toby had been witness to a traumatic event some time earlier, which had served to increase her anxiety. Also, her self-esteem was shattered and she was afraid to answer a question, let alone initiate a conversation. I suggested that Toby take some B vitamins, inositol, and Bach remedies that target specific emotions, and that she should be encouraged to speak about what was on her heart. After two weeks on the supplements, and keeping up her breathing exercises, Toby is running errands again. Her speech is not yet perfect, but she is certainly a calmer child. Names and identifying details have been changed to protect confidentiality.

Miriam Schweid is a Brooklyn-based kinesiologist. She can be reached through The Wellspring. 74 Wellspring | June 2019

Living Well

Home Lab By Miriam Schweid

DIY

recipes for natural living

Bad Breath Killer Wish you could get rid of bad breath? Since causes of bad breath may vary from a tooth abscess or infection, to strep throat or indigestion, itâ&#x20AC;&#x2122;s important to investigate the culprit in your particular case. Until you find out what it is, make this natural, powerful mouthwash and use several times a day. This mouthwash, which is made with one main ingredient from your health food store, is also effective at healing gingivitis (gum disease) and cold sores. Â˝ cup water 20 drops Thieves Spray Combine in glass or spray bottle. Swish in mouth for 30 seconds, making sure mouthwash reaches all areas of the mouth. Dilute for children or make it more concentrated for yourself.

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Change How we can help ourselves and our children make transitions more pleasant

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Why Canâ&#x20AC;&#x2122;t Everything Just Stay the Same? Exploring fear of change How we can help ourselves and our children make transitions more pleasant

By Shiffy Friedman Sivan 5779 | Wellspring 79

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She sits in the aisle seat, camera focused on her daughter, catching snapshots from the momentous graduation.

It was just yesterday that her little Leah was a tiny bundle in her arms, clinging desperately to her for her every need. And today, as Leah is about to step over the threshold, bidding farewell to her carefree, preschool days, Mindy’s heart is filled with not only joy and gratitude, but also trepidation — a lot of it. While the tears don’t come for this mother, and no one can hear the quick beating of her heart, she’s filled with an uneasiness that she just can’t make sense of. What is it that makes us so afraid of change? Whether it is you, the adult, who is experiencing a change — be it a move, a birthday, a new job, welcoming a new child into the family, or marrying off a child — or your child — be it entering a new phase in school, going to camp, or even getting a new teacher — it is very likely that the change, no matter how exciting it is, will be accompanied by fear. From a rational perspective, there are many reasons why an individual might experience fear when change happens. There’s the obvious fear of the unknown, as well as the fear of letting go of that which is familiar. Whether the fear is founded in logic or not is actually quite irrelevant when it comes to dealing with it in a way that allows us to move on. We could spend hours dissecting an unpleasant emotion, delving into its origin and coming up with a logical way to explain why we feel the way we do, but at the end of it all, what are we left with? The fear is still there, kicking and screaming from every bone. I write these words on the heels of a very momentous birthday, as I move from one decade into the next. In the mix of the gratitude and excitement that I feel, there is certainly fear as well. There’s part of me that's desperate to hold onto the youth that characterized, until now, the decade I’m about to graduate from. But, ultimately, it’s not my understanding of why I want things to stay the same that will help me feel better about the gift that is my birthday. So what will make

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me feel better? While the focus of this article is about how to deal with the fear of change, there is one secret to dealing with all fears across the board: acknowledging that this is how I feel and not allowing myself to be led by it. For example, it’s very possible that an adult who’s about to move to a new community or spend their summer in a new place will experience fear in the process. That’s the child in her who craves the comfort of the known, of the familiar. This individual may chide herself for feeling afraid, in which case the experience will become only harder on her. That's because not addressing the fear will not make it go away. However, if she chooses to acknowledge that this is how she feels, the fear is given its space, and she has the opportunity to calm down. Essentially, every fear we experience emanates from a place deep inside that has been a part of us for just about as long as we know ourselves. It’s not the adult in you who feels fear at your daughter’s graduation or son’s bar mitzvah; it's only the child in you who loves the security and good feeling that staying with the “same old” provides. That’s totally normal. And so, the best way to deal with this fear is the way you would deal with it when communicating with your child. Suppose you sit with your daughter on the night before her first day of day camp and she says to you, “I really don’t want to go, Mommy. I want to stay home all summer with you,” or “I miss Morah Sarah, Mommy. Can she be my morah in camp, too?” The best thing a parent can do for a child in such a situation is to first give the fear the space it deserves. This child is obviously afraid of the upcoming change in her life. No matter how insignificant it may seem to an adult, to the child it is everything. And since emotions don’t have to be explained — they don’t even have to be legitimate — in order to be validated, what the child needs right now is very clear: to simply feel that her parent allows her to feel what she feels. “You really don’t want to go, Sweetie,” you might say. “You wish you could stay home. It’s okay if you feel that way.” Just as we react this way to our children, we could react this way to our inner self that is feeling afraid. Instead of chiding ourselves for feeling trepidation, we could be there

for ourselves. Does being there for the child mean allowing the child not to attend camp all summer long? Certainly not. It means saying, “I understand that this is how you feel, and it’s okay for you to feel this way, but going to camp is what's best for you right now.” The very same is true in dealing with our own fear. It’s okay for us to feel afraid that our child is entering shidduchim and about to leave our nest, for example, but it’s not okay if the fear propels us to turn down every offer. This is where differentiation plays an important role. Accepting that I feel fear will help me feel better; acting on that fear will not. And so, being there for ourselves — or our child who expresses fear of change, whether directly or indirectly — is vital; ensuring that the fear does not lead us is vital, too. Is Change Hard for Everyone? While change is a very broad word, defining a major transition like starting a new chapter of life after the loss of a loved one, as well as a seemingly minor switch in the schedule, even small changes can affect individuals in a very deep way. For some people, something as seemingly petty as a notice from camp that the program starts one day later than originally planned is enough to throw them off-kilter. According to Esty Frank, founder and director of the Brooklyn-based Stress-Free Living Program, who has guided hundreds of women across the globe toward leading more peaceful lives, not everyone has a hard time with every type of change. “Some people take it more in stride, but those who have a hard time usually have an extremely hard time. They may not realize it and they don’t have to understand it, but their fear of change is usually connected to deeper emotions than just the superficial transition.” For Hindy, a young woman who remembers herself having a hard time with change since childhood, even traveling or going to a friend’s house for a sleepover was an arduous ordeal. “I was a sociable, fun-loving kid,” she remembers. “And I really wanted to be a part of the fun, but my fear of change, as I understand it today, inhibited me from

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participating in activities that required the slightest shift in the routine I desperately clung to. The slightest change in schedule threw me off, triggering insecure, horrible feelings that I didn’t want to feel.” The way Esty sees it, people who have a hard time with change are very set in their routine or way of thinking. “The way they live their lives so systematically and 'programmed,' change becomes especially overwhelming. They can’t see where it fits in to what they’re accustomed to or what they envisioned. And so, when they’re put in a spot where change is forced upon them, such as when they get a notice from the day camp that they’re starting a day later, to them it’s not just, ‘Okay, so we’ll have one more day together.’ They become agitated, even expressing anger at the institution for making the change. For such a parent, when their child calls home in the middle of the day that he’s not feeling well, they panic. ‘Oh my! Where does this fit in?’ Even if they come to a sheitel appointment and the stylist is running late, they have a hard time with the change.”

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Usually, Esty notes, people who have a hard time with such changes are very successful in certain areas of life. “They can be very intellectual, capable, high-functioning members of society. For them, a day that goes off without a hitch is a good day. If something didn’t go according to schedule, it isn’t. Often, it’s this particular difficulty that eventually serves as an eye-opener into their inner self, where they need to ask themselves, ‘Why does change throw me off like that?’ “That’s when they start looking deeper, to notice why they set up their life in a certain way, perhaps so they could feel very in control. They notice that when they start messing around with that feeling and they start feeling out of control, they lose it. Realizing that they need to have a sense of control all the time serves as an opening to discovering more of what’s going on inside.” Hindy’s journey of exploration is the perfect example. Despite feeling underappreciated and not fully productive as a saleswoman in a local store, she was afraid to give up her job and aim for something more. “I knew I had more talent

“I understand that this is

my grandmother, we’re all this way. This is it,’ but that’s really not the case. When we have the right tools, we could live a peaceful, calm life.”

how you feel, and it’s okay for you to feel this way, but going to camp is what's best for you right now.”

and skill that I wasn’t tapping into, but I resisted change,” she says. Eventually, Hindy attended one of Esty’s lectures, where she spoke about how to deal with emotions that overwhelm us. When she realized that in Esty she had found someone who understood her deeply, she joined her program to help herself build perseverance and improve her self-esteem. Today, Hindy is the CEO of two successful businesses.

Beyond the Surface While extreme resistance to change is one obvious way for an individual to notice that he or she is struggling, it may actually be only a symptom of something deeper beneath the surface. “Being afraid of change does not necessarily emanate from a fear of what’s happening on the surface. It may very well be linked to underlying obstacles,” Esty notes. “The issue may become more apparent when the change happens, but change is not the main issue.” To explain how one superficial aspect of our lives can serve as a trigger to help us look deeper, Esty offers a comparison. “Suppose a woman was invited to a simchah and she doesn’t want to go because she 'doesn’t have what to wear.' Then, she thinks to herself, Is that really the issue here? Upon further introspection, she realizes that of course she has clothes in her closet; it’s just that nothing she owns will make her feel comfortable with herself in this particular crowd. She’s afraid to feel the emotions that will arise inside her if she does attend. In the same way, avoidance of change could very well be avoidance of other issues that we don’t want to face.” Thus, when we sense that we’re resistant to change, instead of not moving forward, it would be wise to ask ourselves, “What will this change force me to face that I don’t want to face?”

“I now realize that my way of dealing with my fear of change was resisting the change,” Hindy explains. “Then, when I learned that instead of analyzing the feeling, I should accept that I’m feeling overwhelmed and then move along anyway, I finally learned that I don’t have to be chained to my fear. Slowly but surely, I learned that I don’t have to live this way anymore.”

So, too, Esty points out, when parents notice that their child is particularly resistant to change to the degree that it affects their functioning, they should see it as a red flag. “Take this as an invitation to think about the other areas in your child’s life where they might be struggling,” she advises. “The child may be channeling all his resistance to change, but his issue might be in a totally different area. How is he doing socially? Academically? Does he feel safe in his environment? Struggles in any of these areas may become apparent when a child has a hard time with change.”

In fact, says Esty, we can change more of ourselves than we may believe. “Even if someone is born with a more anxious or more sensitive nature, there are certain techniques that could help them live not such an anxiety-driven life. People think, 'It’s embedded in me. It’s in my genes. My mother’s like this,

According to Esty, “as a parent or caregiver, the best way to deal with such a situation is to allow the child to experience their stress or fears. Don’t try to take it away or relieve them immediately. The healthiest way is to allow children to feel what they’re feeling. When an individual goes through

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a challenge, it builds perseverance. This ability to handle himself in an uncomfortable or unpleasant setting will help him eventually overcome any challenge in life.” She continues, “If I want to learn how to swim, for example, I will have to feel myself falling several times before I get it right. By experiencing the challenging feeling, I gradually learn how to do it right. Allow your child to be there in the difficult moment and only then should you work on it together with them. By immediately hushing the child or finding a solution, the parent is not allowing the child experience the difficult feeling.” Teaching a child how to ride a bike is another excellent analogy that explains the importance of letting children learn “on their own skin.” When the child is still in the learning process, Esty advises, “give him the space to feel upset or angry. Give him the space to release his inner tension, to kick the bike when he keeps falling off. Then, when you feel that you gave it enough time and acceptance, move into problem solving mode. Figure out the best way to empower your child to learn how to deal with the challenge and change at the time that he’s experiencing it.” What’s the best way to do so? By asking questions, says Esty. “Suppose a child first expresses excitement to go to camp. She signs up with her friends and she’s counting down the days until the buses pull up. Then, as the day inches closer, the child starts making a fuss that she’s not going. “The first thing a parent should do in such a case is allow the child to vent about it. Don’t stop her from saying, ‘I’m not going. It’s not for me.’ Then, after a day or two, say to the child, ‘Tell me, what can I do to make this experience easier and smoother for you? Would it help if I send you a Shabbos package? A letter? If I ask the staff to put you in a room with girls you know?’ By asking questions — and not giving solutions or forcing them to do what they don’t want to — we give the child the message that they’re going, they’re not backing out, but that we're there to support them. If we give in to the child’s copping out, we’re giving her a subtle message that when stress arises, we could always opt out, which is detrimental in leading a productive life.” Just as we would do with our children, Esty advises, we could do in our own lives when we recognize our resistance to change. “Allowing myself to do things that are extremely challenging and believing that this will bring me to a better place is one powerful way to help myself through change,”

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she says. “It’s what allows the brain to become more open to approaching what could become a simple task. If I think that the only way I could do laundry is if I do darks on Sunday, lights on Monday, and shirts on Tuesday, I’m stuck. The more I try to change the routine, to brainstorm something totally different, the more I open myself up to flowing along with the change. As the resistance dissipates as a result of my insistence to continue despite the hardship, confidence takes its place.” Esty explains, “Challenge yourself. Put yourself in a position where right now you’re unsure, insecure, and indecisive, and tolerate it. The more you allow yourself to stay in the unknown, the more your brain acclimates to change and develops confidence. When this happens, many things that seemed far away become more attainable because we feel better about putting ourselves through the change. If an individual feels unable to do so, they should find someone who can help them with the underlying symptoms.” While the outcome of putting ourselves through change is incredible, it’s important to note that it doesn’t immediately feel that way. “When you start out,” Esty points out, “You’ll have to accept that there will be a lot of inner resistance in the process. Don’t let the fear of the resistance overtake you. Persevere, and eventually you will break through your inner limitations.” Every transition is an opportunity for growth. When we see it as that, acknowledging that we’re afraid while simultaneously going forward gives us a chance to explore the beautiful new life Hashem has in store for us.

“Persevere, and eventually you will break through your inner limitations.” - Esty Frank

Is My Resistance to Change Healthy? When it comes to emotions, there is no “normal.” What one person finds overwhelmingly challenging may not perturb the next individual in the least. Rather, the reactions to the emotion are what determine whether the individual has an underlying struggle or not. Change is hardly pleasant for anyone, but while certain reactions to the fear of change are healthy, others are not. “If fear of change presents in physical manifestations,” says Esty, such as if the individual starts experiencing back pain, headaches, fatigue, or weakness when the change happens or even at the thought of an upcoming change, that’s a red flag. One woman I was working with was in the ER every time she married off a child. If change affects us in a way that we can’t function anymore — not necessarily that we’re lying in bed all day, but even if we find it very difficult to carry out basic functions — that’s not healthy. “An individual could have a very busy day and not feel overwhelmed and on others days, she could find that she’s not doing much and she still feels overwhelmed. This depends on how emotionally ready we are for the change. When we experiences physical symptoms during the period of change, we may not connect it to what’s happening in our lives. It’s important to connect the dots, to realize that if it affects us on such a strong scale, we need help in dealing with this stress.” Esty remembers working with a woman who became sick while renovating her home. “Other people love renovating their house. For them, it’s such fun! But for this woman, the change brought on physical symptoms because she simply wasn’t emotionally ready to deal with it. Change causes many symptoms that people misdiagnose as something else. They may believe it’s a medical issue, but that’s not the root of the problem. It could very well come as result of an unaddressed fear of change.” Many times, Esty points out, an individual could be very capable, but the internal emotion about something else is so strong that the person can’t carry out simple tasks. She brings Pesach as a case in point. “Many women find that before Pesach they can’t do simple cleaning. All year long they’re great at it, but the emotional stuff that comes up with the Pesach prep literally suppresses their physical abilities. “In the same vein,” she says, “there are so many things that we think we can’t do, but once we heal ourselves emotionally, they become so simple. I used to have a hard time making decisions when I shopped. Once I empowered myself, even if I didn’t focus on this area, shopping became a beautiful experience. As we get stronger on the inside, we’re able to do things we never thought we could.”

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Easing Into It

4 ways to prep your child for change ahead After you’ve given your child her space to express her apprehension about an upcoming change, here’s how you can be there for her in a tangible way:

1. Role Play

In the days leading up to an impending change, engage in role play. This may help decrease your child's fear of the unknown and familiarize her with a process that may be frightening to her. For example, if your child will be starting first grade, review what a day in school will look like. Assure her that it’s okay to feel nervous, shy, or afraid as she transitions into her new environment. If you'll be traveling and leaving the child with someone else for a few days, discuss how the process will work. This is especially helpful for younger children.

2. Questions

Instead of providing your child with solutions to make the change more pleasant, keep the conversation open by asking questions. “What do you think I can do to make this change easier for you?” This gives the child the feeling that even if she must go through whatever it is that she’s enduring, her parent is holding her hand through the process. This sense of comfort goes a long way in boosting a child’s confidence, which is key in determining how well she’ll do in her new environment.

3. Connections

If the upcoming change involves spending time in an unfamiliar environment, help your child make connections before she plunges into that new world. If she'll be attending camp for the first time, for example, encourage her to get together with other girls who will be spending the summer with her. With her consent, invite them for a play date or arrange for them to do something fun together. She'll hopefully foster a connection that will provide her with a sense of familiarity in unfamiliar territory.

4. Touch of Home

Another way to make your child feel more comfortable in a new environment is to send along an object, food item, photograph, or note that will provide her with a feeling of familiarity. If your child loves a particular food or is attached to something that makes her feel at home, have her take it along to her place of change. Esty Frank can be reached via The Wellspring.

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The Fixed Mindset Nature or nurture?

While every individual is born with a distinct personality, some more rigid than others, much of our approach to change is based on the presence (or lack) of fear that develops over time. While fear may emanate from a variety of sources, fear of failure is a major inhibitor when it comes to embracing change. The less afraid an individual is to make mistakes, the more open he is to new experiences and exposing himself to change. A child who grows up feeling that even if he fails, he'll still be loved and accepted, may embrace change more openly later in life than a child who’s afraid of feeling unloved due to his inability to succeed in new environments or circumstances. A fixed mindset may also be the result of a fear of the unknown, which often develops in children who don’t feel secure in their environment. This may occur as a result of strained or tumultuous parental relationships, secondary anxiety transmitted by a parent who is afraid of change, a school environment that feels unsafe to the child, frequent changes throughout the child’s youth, or a loss that the child perceives as profound. Fear of change that doesn’t incapacitate or lead to intense resistance is actually healthy. As mentioned in the article, it’s normal for a human being to crave security, to want for things to stay the same. It takes effort to recognize the fear, give it its space, and move into the new stage, environment, challenge, and so on. But if fear of change decreases our quality of life, instead of writing it off as a personality trait and continuing to suffer unnecessarily, it may be wise to ask ourselves, “What am I afraid of that is not allowing me to embrace this change?”

Wellbeing

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

Many Minds, One Heart Developing therapeutic partnerships to help children succeed

88 Wellspring | June 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

e’ve just celebrated Shavuos, the anniversary of the day when Am Yisrael stood at the foot of Har Sinai with the unique achdus of k’ish echad b’lev echad. Even though each person remained an individual, each with his or her own character and approach, each person also realized that together they were partners with every other Jew standing there.

Instead of seeing their differences as a reason to be at loggerheads, they saw their differences as a means of complementing each other, specifically arranged by Hashem to be that way. Every Jew realized that he needed every other Jew, each contributing his own unique role in the mission of Hashem’s nation. Fast forward 3,331 years. There are many modern-day applications of k’ish echad b’lev echad in achieving success as Jews. We’d like to share one that we’ve seen affecting one of our holiest missions: the raising of our children to be healthy, functioning ovdei Hashem.

All for One Every day for the past 20 years, we’ve been working with parents and professionals. We’ve seen firsthand, countless times, that the goal of raising emotionally and developmentally healthy children is largely dependent on productive communication between parents and the professionals they're working with in the medical and educational fields. Even 20 years ago, and all the more so in the decades prior, good communication was simpler. A pediatrician often knew a child from the time they were born through young adulthood. Because of the close relationship, and also due to the lack of information from other sources, the pediatrician was the trusted go-to for any medical or developmental questions. A good pediatrician knew his limits and would refer to a specialist for any issues that were beyond his training and expertise. The world has changed. Technological advancements have made a wealth of information available to anyone and everyone, for better and for worse. The insurance industry and technology has (not always, but often) made the relationship with a physician more perfunctory and technical, and less of an organic, long-term relationship. And what are the results? Parents have less trust in professionals. Professionals have less patience for parents. Both parents and professionals build and get stuck in firmly held convictions that leave little room for discussion. One

side doesn’t hear the other; the second doesn’t hear the first. And the children slip through the cracks. Although these slips are usually the exception and not the rule, when it comes to a precious neshamah, any slip that could have been prevented is one too many. So what can we do about it?

Take the Time to Understand Anyone who learns Gemara will tell you that when you’re faced with two contradicting opinions, the first order of business is figuring out the rationale behind each one. In other words, I can only address someone else’s opinion if I have fully understood it first. We were present at a heated discussion between an eighth-grade rebbi and a guidance counselor. The subject was whether to put 13-year-old Shmuly on medication for his anxiety and ADHD. The rebbi insisted it would be the best way to give Shmuly a chance at academic and social success. The guidance counselor thought other treatments should be tried first. The volume was rising, but the conversation wasn’t going anywhere. Then the guidance counselor paused. “Why are you so insistent about moving to medication before trying other treatments?” he asked. “Shmuly’s already in eighth grade,” replied the rebbi. “Next year he’s entering high school, and being in high school with severely underdeveloped social skills can spell disaster. When I taught in high school,

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Wellbeing

Child Development

I saw it happen several times, and I don’t want that happening to Shmuly. Other treatments might help, but they usually take longer, and he needs the help before it’s too late.” “I hear your point,” said the guidance counselor. “My concern is that the medication won’t help him. From my experience with children who have Shmuly’s presenting issues, psychiatrists end up prescribing one medicine for anxiety, another for ADHD, another to cancel out the effects of the ADHD medicine on the anxiety prescription, and these children end up on a cocktail of drugs that doesn’t get them anywhere.” “I see,” said the rebbi. There was silence, both of them thinking. In the end, they decided to refer Shmuly to a psychiatrist who would get to know Shmuly and become familiar his involved history and his current manifesting issues before prescribing any medication or referring to a particular treatment. What was the turning point that helped them move past the impasse? It was the guidance counselor’s question: “Why do you feel this way?” He had a sincere desire to understand the rebbi’s position. Once there was an attempt to understand, the door of cooperation sprung open. Shmuly will be much better off for it.

Keep Learning We’re living in exciting times. Neurodevelopment is a frontier of research. Every day we learn more about neurochemicals, their impact on brain development and functionality, and new ways of releasing and affecting them. Just as importantly, we’re also learning about their — and our own — limitations. Anyone working with children, be it in the field of medicine or education, or even a parent, can gain so much by learning more about this topic. Just being aware of the advances and discoveries in this field helps generate new ideas for helping, directing — and possibly saving — our children. A short while ago, we met a nurse practitioner from the frum community who was on a quest to help a 16-year-old patient cope with ADD, depression, and mood disorders. “After a year and a half of prescribing different medications with no significant gains, we both wanted to give up,” the nurse practitioner told us. “And then I thought, ‘Maybe I’m missing something here. Maybe there are tools and approaches that could be effective that I don’t have any awareness of.’ That’s when I decided to explore alternative ways of helping this girl.” We were impressed by this professional’s humility, admitting that she doesn’t have all the answers. And we were doubly impressed with her dedication, putting in the effort to learn new things and find answers.

90 Wellspring | June 2019

Look for Evidence Just because attention and focus issues have always been addressed a certain way doesn’t mean that needs to continue if another way might work better. And, at the same time, just because one person had success with an alternative treatment or some other method doesn't mean it will help every child, or even that it's worthwhile trying. Not infrequently, a parent will come to us asking if we can do craniosacral therapy, vision therapy, the Tomatis method, and so on. When we ask what makes them think this therapy would be a good idea for their child, the answer is often something along the lines of “I don’t know; my neighbor is doing it for her daughter and she says it’s helping.” When you really want to help a child, you need to be a bit of a Sherlock Holmes. If you’re a parent interested in a treatment, investigate it. If you’re an educator wondering how to best develop social skills in your students with Asperger’s, take a hard look at all the programs available. Put together all the scientific evidence, anecdotal evidence, and experiential evidence, giving each piece the appropriate weight, and apply it to the particular case of the child before you.

Be Leery of Black and White Warning: bad joke ahead. What’s black and white and red all over? A parent of an ADHD child who is pro-medication and a professional who is anti-medication (or vice versa) having a heated argument. Every individual — parent or professional — is entitled to have an opinion. The problem is when opinions turn into black-and-white, unshakeable convictions. “Yes, for sure put them on medication!” Or, “No, never use medication!” When you have a one-size-fits-all approach to treatment of developmental, behavioral, or emotional issues, someone is going to get shortchanged. Maybe it would be a shame to push 8-year-old Chaim onto ADD medications and their inevitable side effects when he might get along fine with occupational therapy and alternative treatments. Maybe 10-year-old Rivka is suffering socially and academically to an extent that waiting to track down an effective alternative treatment could have negative repercussions into young adulthood and beyond, and she should be given the opportunity to take medication. The only thing that is black and white is our Torah, written with black fire on white fire and given amidst the fire, smoke, and thunder of Har Sinai. For a member of Am Yisrael, belief in Hashem, the sanctity of Shabbos, the wrongness of giving false testimony in court — all those are not opinions. They are unshakeable convictions because the Creator of the Uni-

verse told us they are truth. The truth when it comes to helping children achieve their full potential is chanoch l’naar al pi darko. The “derech” can’t be something that contradicts Torah, obviously. But, beyond that, we do a service to our children when we are open to exploring what approach would truly be the best for each individual case. (A note to professionals: If you do have a no-budge policy on something, share that with parents before you decide to start treatment. Otherwise, it’s not fair to either of you.)

Be Respectful When you show others respect, aside from developing your own middos, you also achieve a very practical outcome: They tend to listen to you more. A mother recently told us about her daughter, who had a temporary (and foreseen) regression as a result of her treatment regimen with us. The girl’s school-based therapists, who were told in advance about the possible changes they would see in the child, were overwhelmed and complained to the principal. The principal called the mother and said, “Your child is deteriorating. Whatever you’re doing isn’t working. There’s no hope for her in our school system if you continue this way.” The mother shared how she felt frightened and intimidated — and she was a therapist herself, who understood what was going on with her child. As a professional, appreciate the power of the white coat (or black suit, or whatever symbolizes your position of authority). If you don’t take time to ask and understand with an attitude of respect toward the parent, you’ll shut down the lines of communication, and the child will be the worse for it. As a parent, give respect to the professionals you work with. First, show the therapist, or doctor, or educator that you appreciate her approach. Then, and only then, explain your concerns with that approach or express your desire to explore other options.

Don’t Wait Too Long When an individual is struggling, there are three possible outcomes: • He develops adaptive, positive coping mechanisms. • He develops maladaptive coping mechanisms. • He sinks, Rachmana litzlan. Children with sensory integration and other developmental issues that aren’t addressed are more likely to develop maladaptive coping mechanisms. They are at a higher risk for mental health issues later in life. This means that finding effective treatments should be a priority. This does not mean that the parent should panic. It does mean that the parent

should make sure to do appropriate hishtadlus and shouldn’t be negligent.

Obviously, most treatments don’t deliver instant or even close to instant results. A competent professional should know — and let the parent know — how long it should reasonably take to see results, and the maximum amount of time it could take to finally see results. If the maximum time has elapsed and the issue is still unresolved in a way that is affecting the child’s and her family’s functionality, it’s time to try something else — and possibly a different direction entirely. Don’t just let it go.

We once evaluated a girl who had been on and off different mental-health medications for years. Her parents had taken her from doctor to doctor to find some treatment that would address her self-harming behaviors and alarming statements like “I wish a wall would just fall down on me.” When we brought up the idea of an underactive proprioceptive system, and how the body can crave intense physical stimuli and pressure, the girl’s eyes simultaneously lit up with delight and burned with anger. “How come these women can understand me,” she turned to her parents, “and you and all those dozens of doctors can’t?” It’s never too late to receive treatment. That said, the more layers of frustration, maladaptive coping mechanisms, and anger a child builds up, the more difficult the treatment process is going to be.

There’s a fine balance here, and one that needs to be shared by the child’s parents and the involved professionals. On the one hand, don’t rush; don’t panic; have patience. At the same time, don’t neglect or wave away an issue. And don’t beat a dead horse. If you’ve given it the requisite time and patience, it’s time for a parent to look elsewhere and for a professional to refer elsewhere.

The Power of Together We are not raising our children in a vacuum. Each child has a team — parents, family members, educators, medical professionals, therapists and more — contributing to their growth and development.

Just because you are a team, however, doesn’t mean you automatically work as a team. That takes patience, respect, efforts at good communication, and the desire to learn and improve. When you’re on a team with people who each have their own unique characters, opinions and approaches, that can be challenging work. But it’s well worth it. Through this work you can harness the power of k’ish echad b’lev echad, the power of unity, of partnership in a joint mission, for the most precious mission we have: raising the next generation of Hashem’s chosen people.

Sivan 5779 | Wellspring 91

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Wellbeing

In Session with Shiffy Friedman, LMSW

Heart to Heart

My Inner Critic Works Overtime

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

Even when I do things right, I still criticize myself. It really bothers me. How can I stop it?

When was the last time this happened? And what did you tell yourself ?

This morning, I was cleaning my windows, which I don’t love doing, but I’m working on being more involved on the domestic front. Although I knew I was doing a good thing, I told myself, “You’re doing this so the neighbors can see that you’re a balabusta.” Even when I’m reading a story to the kids or making cookies with them, there’s this voice in me saying, “You’re only doing it because you want to feel like a good mother.” When I do things for my husband, such as preparing his favorite dinner, the same thing happens. I tell myself, “You’re only doing it because you want to feel like a good wife.” Yesterday, I gave my son a really nice compliment and I watched his eyes light up. But not a minute had gone by before I told myself, “Do you really feel this way about him?” Any time I do something nice for someone else, my inner critic tells me it’s because I want to impress, that it’s not real. Do you like the way you feel when you tell yourself these things?

No, of course not. If you don’t say this to yourself, and you tell yourself the opposite, “I’m doing this because I’m a good mother/wife/person,” how do you feel?

I feel good. It’s nice to get a compliment. If you feel good when you give yourself encouragement, what happens that makes you criticize yourself ? What’s the feeling that triggers this thought?

At the same time that I feel good, I feel anxiety. Anxiety about what?

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In Session

Vantage View Is there no place for self-rebuke? In Yiddishkeit, there is certainly a place to give ourselves rebuke upon committing a wrong. However, there is a very fine line between giving ourselves constructive feedback, which will facilitate our growth, and criticism, which will only bring us down and is essentially the voice of the yetzer hara. Viewing ourselves harshly, and being hard on ourselves and nitpicky even when we’re doing something right, is certainly not what the Torah considers constructive mussar. If self-rebuke brings us to do more wrong, it’s counterproductive and thus prohibited. Just as our Sages caution us about the many conditions necessary when giving mussar to anyone, we must keep those conditions in mind when we’re critiquing our own selves. Most importantly, am I saying or thinking it from a place of love? If my self-criticism is coming from any place other than true concern for my own growth, it’s not constructive and should be avoided.

94 Wellspring | June 2019

About being this good mother or wife or person.

Tell me more about this anxiety.

If I let myself feel that I’m a good mother, I’m scared that I’ll lose that good feeling soon. I’d rather knock it down now so I won’t risk falling later. And if you do fall, what will you feel? If you’ll get angry at your child tomorrow, for example, what feelings will that evoke in you?

That I’m a failure. I was a good mother until now, and look how I ruined it. Do you notice the cycle here?

Yes. Every time I’m afraid to feel like a failure, I put myself down.

Engaging in self-criticism can actually be an addiction, where we become dependent on the practice to the extent that it’s difficult for us to let go of it. And as with every addiction, when we incessantly engage in criticizing ourselves, there’s a place in us that wants it to stop, of course — but there’s also a place in us that wants it to continue. As much as we hate how we feel when we do it, there's some kind of benefit that we derive from this practice that's egging us on, ensuring that we keep putting ourselves down and continuing our critical practices. As a rule, every behavior we engage in serves us in some way, whether we’re conscious of it or not, and self-criticism is no exception. While there are several ways in which people benefit from self-criticism, such as “shielding” themselves from impending external criticism by ridiculing themselves first, in your case it appears that the reason you’re doing this is because you’re afraid to fail. Putting yourself down for doing the right thing is your way of avoiding maintaining that standard. It’s so important to you that you see yourself as perfect, and that others see you that way, that you’re willing to criticize yourself in order avoid feeling that you’ve failed or missed the mark. That may be how self-criticism, as absurd as it sounds, actually serves you. If you don’t criticize yourself, you’re adding onto your load: You now have to live up to another, “higher” standard. But if you discount what you’ve done, ridiculing yourself about your intentions or whether you’re being real or not, there’s nothing you have to keep up there. For example, if you wash the windows and only compliment yourself for it, you now have to live up to a new commitment: I am a woman who cares about her home enough to wash her windows. But, if you tell yourself, “Nah, you only did it for the neighbors,” there’s no perceived obligation there. On the contrary, it’s your way of telling yourself, “No, you’re not this woman who cares about her home.” And this way, you attempt to calm yourself that you don’t have another standard to live up to. An individual’s need to be perfect may be a result of one or more causes, most of which are tied to subconscious conclusions made in childhood. For some, the drive for perfection is a natural consequence of having grown up as the “good child” in the family. For many, it’s what they perceive as an important value based on the messages they perceived when were raised: “I love you because you’re perfect/good/smart/talented, and the like.” And for others, it’s observing how “imperfect” people, especially siblings, are treated or mistreated as a result of their “imperfection.” In all of

these cases, perfect becomes synonymous with love. “If I want to be loved,” the child concludes, “I must be perfect.” And this erroneous conclusion accompanies her through life, into adulthood, even when she's conscious of the fact that this belief is completely false. Even as an adult, the prospect of being imperfect is frightening. She thinks, “Who will look at me if I fail?” or “Who am I if I’m not perfect?” In an attempt to avoid feeling imperfect, which is essentially the emotion of feeling unloved or unsuccessful, this individual may engage in intensive self-criticism. If I tell myself that what I’m doing isn’t good, I don’t have to maintain it. Perhaps the most powerful point that comes across from our conversation is that it may appear that things are happening on their own — your inner critic is working overtime — but, in actuality, it's our choice. There’s a benefit that we derive, perhaps because we don’t know better or because we’re being led by fear, but it’s something we choose to do that ultimately ends up harming us. Thus, we conclude from this that the choice is yours. You could either choose to feel good and then immediately put yourself down as soon as the fear arises within you (so as not to feel that fear), or to give yourself the compliment, feel the fear, and tell yourself, “If I fall, I’ll get up again.” As much as you say that you would love to get rid of this harmful practice of self-criticism, you realize that by doing so, you will also have to let go of the crown of perfection. This is not a simple feat. For many years, you’ve been working hard to balance that crown on your head. One of the tools that helped you achieve that was self-criticism. Now, the question you must ask yourself is this: Am I ready to let go of this crown or do I want to continue exerting myself all my life in order to keep it in place? One or the other must go. The next time you do something right, which will certainly be very soon, pay attention to what happens if you simply compliment yourself. Yes, your deed may not be entirely altruistic, but in every good thing we do there are positive components. Focus on those. What will probably happen next is that you’ll feel afraid. Every time you don’t give in to the fear by shutting out selfcriticism, you’re bringing the volume of the critic down one tiny notch. The more attention you pay to the positive aspects of what you’re doing, giving yourself encouragement despite being afraid to do so, the less power you give to the inner critic. Hatzlachah!

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.

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Wellbeing

Serial Diary By Zahava List

Unveiled

Life with mental illness As a member of Overeaters Anonymous (OA), I didn’t only learn about the power of group support. It was during those sessions that I realized something that would ultimately lead to the birth of Chazkeinu, an organization that provides support to fellow Jewish women who have mental illness: by giving chizuk to others, I was helping myself.

After I was discharged from the psychiatric ward in the hospital, it was clear to me that many people in my community were aware of what had transpired. Especially since I still had a touch of mania even then, I was the one who informed some people of where I’d been. At a community event shortly after my hospitalization, an acquaintance came up to me. She started the conversation with the regular, “Hi, how are you?” But my response was anything but regular. “Oh,” I said, “Actually, I’m just out of the hospital. I have bipolar disorder.”

This was certainly not what she had expected to hear from me, but it was clearly meant to be. As it turned out, this awkward conversation ended up leading toward a deep friendship between us. It wasn’t long before this woman confided that her own daughter was going through a similar journey, dealing with a mental illness of her own. When we originally met, this woman wasn’t at the point where she felt open enough to talk about it, but as our friendship developed, we were able to be there for each other in a way that gave us both so much chizuk. That encounter was perhaps the first time that my high feeling led me to open myself up to someone else in a way that showed me how much sharing the details of my challenge with another individual made a difference to them and me. Because people knew what had happened to me, I ended up being the right address for many others whose mental illness was under wraps and were desperate for peer support. Every now and then, people would say to me, “I have a family member who’s going through something. Would you be open enough to talk about it?” Because I had shared my experiences at OA, I had learned how to express myself in terms of my own personal experience, so I was actually happy to be there for someone in this way. More than once, the “family member” I was asked to speak with ended up being someone I knew well and I would have had no idea what she was going through. In the case of the woman I met at the event, at the time I

met her she was struggling between wanting to be a support for her daughter and getting over the shock that someone she loved so much was going through something she could not relate to. The shame she experienced was overwhelming, paralyzing. From after the event, we made up to meet often. She would tell me what was going on in her life and I would tell her what it was like for me. She would come to me with her questions: “My daughter is doing this and that. Is it okay?” And I would reassure her, “Yes, this is part of the illness.” It gave her tremendous hope to see me getting myself together, moving into a stable time, when her daughter was still in the darker parts of the struggle. Speaking with this new friend also helped me see what my family members were going through as the caretakers when I wasn’t available. We connected deeply, with both of us gaining from the relationship in our own way. Giving to this woman brought purpose and meaning to my illness. After having been mentally and emotionally stable for three years, my husband and I were looking forward to welcoming our third child into the family, with the approval of our rav and my doctor. Although it had been five years since the previous birth, after which I did experience a relapse, and I had been stable for a considerable period of time, I didn’t know what the future would bring. Would this birth also be followed by a relapse or would I finally be a happy, healthy mother for my new baby and the rest of my family? In Hindsight

The more I gave support to others when I was in a time of need, the more I realized how much chizuk I was deriving from it. Today, as the director of Chazkeinu, I bring this up often to the women in our support group. One of my best coping mechanisms when I’m in a hard place is to stop and think, “Who can use a phone call right now?” When I give to others, I fill myself up in the best way possible. Instead of thinking, “Who will I reach out to that can make me feel better?” I think, “Whom can I help feel better?”

Even when I was in the hospital, confined to the psychiatric ward, being there for the people around me was still possible. Every one of us, from our own place, no matter what we’re struggling with, has the ability to do that. Giving from ourselves is always possible and always healing. 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.

96 Wellspring | June 2019

- rav noach weinberg zt"l

The New Look of

ISSUE 41

JUNE â&#x20AC;&#x2DC;19 SIVAN 5779

FREEZER FILLS Prep your meals today for a relaxed summer ahead

Hydration Boost

The shake you need to get you through the hottest of days Cucumbers aren't only saturated with water

New Column! Taste+Travel Charnie Kohn treats us to the best of Italian cuisine

Index Page

105

Summer Ahead FILL YOUR FREEZER

Page

Page 132 117 140

Page

Have it

Homemade

My Table

MIDMORNING SNACK

Boost

HYDRATION SMOOTHIE

SWEET-AND-SOUR SAUCE

FAMILY FAVORITES

TIDBITS

TASTE + TRAVEL

THYME FOR DINNER

FISH FOR THE FUSSY & FINICKY

10 FOODS FOR HYDRATION

THIS MONTH: ITALY

SWEET-AND-SOUR PEPPER CHICKEN

P. 121

P. 135

P. 138

P. 119

Buon appetito!

MADE IN

AGENZIA PIÃ&#x2122; DELIZIOSA

ITALY ITALY

. n a i l a t I y l c i t n Authe

some have well guarded trade secrets we just call them family traditions

HERZOG LINEAGE nine generations of patient winemaking

Dear Cooks, It’s officially summer, most people’s favorite season. For kids and adults alike, these months are packed with adventure, oomph and palpable energy. When we’re running on excessive adrenaline, though, we often fail to feed our body the nourishment it needs to thrive—which may be the reason for the lethargy many of us experience on those long summer nights. That’s why I’m excited to introduce you to Yossi and Malky Levine’s column this month: Fill your Freezer. With their genius recipes at your disposal, there’s no need to fret or assume that you must spend hours in the kitchen when the outdoors beckons. After stocking your freezer with these wholesome dishes, you can enjoy these summer days guilt-free, knowing that you aren’t neglecting your family’s nutrition. We bring you easy-to-make recipes that are packed with nourishment and will turn your summer cooking into a cinch. Whether it’s the Levines' fill-your-freezer recipes, or Chavy’s seasoned fish recipes (which I couldn’t resist trying as soon as I reviewed them), I think you’ll experience the joy of summer just by looking through these pages.

For many of us, summer connotes travel. Even if you’re not booking airline tickets, borrowing suitcases, and making sure your passport is valid (and if you are, too), we’re bringing you the tastiest destinations right here. We’re honored to welcome Charnie Kohn to our Seasoned team with her Taste+Travel column. Charnie needs no introduction; just turn the page, and you’ll become acquainted with her breadth of knowledge in global cuisine. Every month, she’ll be taking us to another country, filling us in on its signature foods— made healthy—that are worth a try in your own kitchen.

I often find that people resist trying a recipe if they spot some unfamiliar items in the ingredient list. Many of us simply don’t feel comfortable with foods that we aren’t accustomed to. Does “I’m ready to try any recipe, as long as I have these ingredients in my pantry,” resonate with you? How about switching things up this summer? Broadening your horizons when it comes to food can turn into an exciting adventure. In a column of global eats, you might come across items you have never used or food names that sound foreign to you. Challenge yourself not to skip over them. Summer is the season of freshness and hischadshus, of innovation and originality. Summer brings along new schedules, and routine gives way to creativity and spontaneity. I encourage you to take the plunge when you see these foods. Just getting the proper pronunciation for some of these items is a great start. Be courageous and daring—and have fun! Speaking of novelty, one indication of a great cook is if they can add their own spin to a recipe. Feel free to do that, and we would love to hear how your dishes turned out! A delightful summer to you all,

Est her Sivan 5779 | Wellspring 103

e xplore 96 points

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.

Summer Ahead Fill Your Freezer As the summer approaches, packing might be taking up a lot of your brain space. Whether it’s packing your kids for camp or your family for summer vacation in the mountains, you’re bound to have lots of cardboard boxes adorning your home. And if you’re not packing, I’m sure you’ll still get to see plenty of boxes around town. There’s another aspect of the summer that I’ve been thinking about a lot, and it includes food, of course (and some packing, too). The summer is a time when many of us like to relax and spend the day outdoors. Somehow, at the end of the day there isn’t much energy left to cook a healthy meal. Here’s where no-cook freezer meals come to the rescue! If you’re looking for a way to save yourself time while still feeding your family healthy meals, this is your answer. It may just change the way you make dinner forever. Consider yourself warned.

So let’s talk about freezer meals and get you stocked up for the summer. No-cook freezer meals are prepared in advance and frozen ahead of time — without any cooking. This saves lots of time, without compromising on freshness. Once ready, they’ll taste freshly prepared since they're only cooked for the first time when they come out of the freezer. Most of these meals can safely be stored in a standard freezer for at least three months. You’re best off setting aside one day to prep lots of freezer meals. Simply combine the ingredients in freezer bags, freeze, and just pull them out whenever you’re ready. I suggest labeling your freezer bag with the name of the meal, cooking instructions, and a “use by” date. Happy prepping! The Levines

Recipes, styling, and photography by Yossi & Malky Levine

Hearty Beef and Bean Stew I’m always in for a good slow-cooker meal, especially now in the summer when you want to spend your day outdoors, yet still come home to a healthy and nourishing meal. Your family will thank you for this. Yields 8-10 servings

1½ lb beef chuck, cubed 1 cup kidney beans 1 cup chickpeas 1 cup red lentils 10 oz tomato paste 1 Tbsp paprika 2 tsp cumin 2 tsp chili powder 1 purple onion, diced 5 garlic cloves, minced 1 chili pepper 1 cup corn kernels (canned or frozen) ½ cup barley salt and pepper, to taste water (as needed for cooking)

Soak the kidney beans, chickpeas, and red lentils overnight. Combine all ingredients in a gallon-sized freezer bag. Start with the tomato paste, spices and meat, and then continue layering in no specific order. Remove as much air as possible, seal and freeze for up to 3 months. When ready to cook, thaw in the refrigerator overnight or in a bowl of cold water. Add the contents of the bag to a slow cooker and add water to cover. Cook on low for 8–10 hours. Tip: After emptying the contents into the slow cooker, you may find the tomato paste and spices sticking to the bag. Add a cup of water to the bag, seal the bag, and shake to remove them — then spill into your slow cooker.

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Portabella Veggie Burger Portabella mushrooms and broccoli make this a burger even meat lovers can’t resist! It gets even better knowing you can forget about shaping them — and the time involved in that. Yields 9 burgers

2½ cups fresh portabella mushrooms, finely chopped 1½ cups riced broccoli 1 large onion, diced 4 cloves garlic, minced 1 tsp salt ½ tsp black pepper 1 cup whole-wheat bread crumbs 4 eggs 1 Tbsp olive oil (if using grill-pan method) Add mushrooms, broccoli, onion, garlic, salt, and pepper to a bowl. Toss to spread the seasoning over the veggies. Add the eggs and bread crumbs. Mix gently with a large spoon until the mixture is combined. To prepare for the freezer, place mixture in a gallon-sized freezer bag and flatten so it’s evenly distributed. Remove as much air as possible and seal. Lay the bag on a flat surface. Using a skewer or ruler, press lines onto the bag, creating 9 squares or portions. Freeze for up to 3 months. When ready to serve, heat a charcoal or gas grill to medium-high. Break the still-frozen patties along the score marks and set aside to defrost for a few minutes. Place the burgers on the grill, cooking for 5 minutes on each side for a medium doneness. Note: You can use a grill pan for this, too. Heat 1 tablespoon olive oil in the pan before adding the burgers.

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Veggie Meatball Soup This soup is full of veggies and protein and is a delicious dish your whole family will love. It’s super easy to make, and very satisfying to eat — practically a full meal. Yields 10 servings

Mini Meatballs: 1 lb ground beef ¼ cup whole-wheat bread crumbs 2 garlic cloves, minced 1½ tsp balsamic vinegar 1 tsp garlic powder ½ tsp basil ½ tsp salt ½ tsp black pepper 2 tsp fresh parsley, chopped Soup: 20 mini meatballs (recipe above) 1 onion, chopped 4 carrots, cubed 3 celery stalks, chopped 4 garlic cloves, minced 2 red potatoes, chunked 2 plum tomatoes, diced 2 bay leaves 1 Tbsp salt, or to taste ½ tsp black pepper 10–12 cups water (needed later)

Combine all meatball ingredients in a large bowl, stirring until well incorporated. Roll into 1-inch balls, placing in a single layer on a lined baking sheet. Freeze for 3–4 hours until solid. To prepare soup for the freezer, add all ingredients, except water, to a gallon-sized freezer bag. Add the meatballs last. Remove as much air as possible, seal, and freeze for up to three months. When ready to cook, thaw in the refrigerator overnight, or in a bowl of cold water. Add the contents of the bag to a large stockpot. Add the water, bring to a boil, and cook for 1½ hours. Remove the bay leaves. Remove the meatballs using a slotted spoon, place an immersion blender into the soup and pulse a few times, and then return the meatballs.

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GreenGoodness Chicken Packs Cooking dinner gets a whole lot easier with these chicken-veggie packs. Feel free to switch up the veggies to your family’s liking. You can prep a few varieties at once, as they last in the freezer for up to six months. Yields 6 servings

1 lb chicken strips (from any part of the chicken) 1 onion, sliced 10 oz frozen green beans 10 oz frozen broccoli 1 cup frozen green peas 1 zucchini, diced 1 sprig rosemary 2 Tbsp olive oil (needed after defrosting) shoyu sauce, optional toasted sesame seeds, optional Marinade: ¼ cup olive oil ¼ cup honey 4 cloves garlic, minced 2 tsp paprika 1 tsp salt ¼ tsp black pepper Place chicken and vegetables in a gallon-sized freezer bag. Make the marinade by whisking together olive oil, honey, garlic, paprika, salt, and pepper in a small bowl. Then pour that in the bag, and remove as much air as possible. Seal the bag, and shake to fully coat chicken and veggies. Freeze for up to six months. When ready to cook, thaw bag on the counter for an hour. Heat 2 tablespoons olive oil in a large skillet over medium-high heat. Pour contents of bag into the skillet and sauté covered for 10 minutes, then uncovered for 15 minutes, or until tender and cooked. Optional: Add organic shoyu sauce at the end of sautéing. Sprinkle with toasted sesame seeds when serving. Note: You can bake this, too. Preheat oven to 425°F. Line a sheet pan with foil, and pour chicken and veggies on it. Roast for 20 minutes.

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ZucchiniVegetable Quiche Treat your family with this satisfying pareve vegetable quiche. Any way you serve it, you won’t believe that a hefty slice of this flavorful crustless quiche is low-calorie and high-protein. The best of both worlds, right? Yields 6–8 slices

1 onion, sliced 2-3 Tbsp olive oil 1 red pepper, cut into strips 2 zucchinis, cut into strips 2 tsp fresh oregano, chopped ½ tsp smoked paprika 1 tsp salt ½ tsp ground black pepper 4 eggs ½ cup almond milk ½ cup white whole-wheat flour

Whisk eggs, almond milk, flour, and spices in a small bowl and set aside. Place the vegetables in a gallon-sized freezer bag. Pour in the egg-milk mixture and seal the bag, removing as much air as possible. Freeze for up to three months. When ready to use, thaw completely. Preheat oven to 350°F. Grease an oven-safe pie plate or pan and pour in contents of the bag. Bake at for 35–45 minutes, until lightly browned and well set in the center. Cool 5 minutes before serving.

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By Yossi and Malky Levine

Sweet-and-Sour Sauce While doing recipe research, I came across a recipe for a sweet chili sauce using pureed peppers. Inspiration struck. Why not spin that concept into a sweet and sour sauce? Boy was it worth a try. The consistency of this sweet-and-sour sauce is definitely thicker than the thin and syrupy sauce you might get from your favorite Chinese takeout place. But what would you expect? This sauce isn’t cornstarch and ketchup. Rather, it’s made of fruits and veggies pureed together with just enough sugar and vinegar to spike the flavors. Then we simmer it, thickening it to a saucy consistency. I love how incredibly versatile this sauce is. It goes well with rice, noodles, grains like quinoa and millet, vegetables, and more. Use it as a stir-fry sauce, pour it over chicken, drizzle it on rice or noodle bowls, or use it as a dipping sauce. Yields 2 cups of sauce 1 red pepper, roughly chopped 1 cup pineapple juice ¼ cup crushed pineapple ¼ cup rice vinegar or apple cider vinegar 3 Tbsp brown or coconut sugar pinch of salt 1 Tbsp cornstarch or arrowroot powder, dissolved in 2 tsp water Place red pepper, pineapple juice, crushed pineapple, vinegar, and sugar in the bowl of a food processor. Process until smooth. (Alternatively, you can use an immersion blender.) Transfer the mixture to a small saucepan and bring to a simmer over medium-high heat. Stir dissolved cornstarch/arrowroot into the simmering pepper mixture. Simmer, stirring, for 1–2 minutes, until sauce has thickened slightly. Taste, adding more sugar for a sweeter sauce. Refrigerate in a sealed container for up to a week, or freeze.

We know tomatoes

Field Fresh, Tuscan

The secret to authentic italian dishes, starts with the tomato.

By Yossi and Malky Levine

SWEET-AND-SOUR PEPPER CHICKEN Anything easy and baked (and good, of course) gets onto my permanent dinner rotation. This recipe features chicken, onions, and bell peppers just like your favorite takeout place, minus the chemicals. You can serve it over cauliflower rice and call it a night. Yields 8 servings 2 lbs chicken cutlets, cut into nuggets 1 cup tapioca flour 1 tsp salt 2 onions, roughly chopped 2 red bell peppers, roughly chopped 1 green bell pepper, roughly cut 1 yellow bell pepper, roughly cut 2 cups sweet-and-sour sauce (refer to "Have It Homemade" for recipe) Preheat oven to 350Â°F. Place tapioca flour and salt in a zipper bag. Then add the chicken nuggets and shake until chicken is well coated. Add more flour as necessary. Set aside. Place onions and peppers in a 9x13 pan. Lay the coated chicken nuggets over the vegetables, and pour the sweet and sour sauce over the chicken, covering it. Bake covered for 1Â˝ hours. Remove from oven, mix, and return to oven, baking uncovered for an additional 30 minutes.

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Fish for the Fussy and Finicky I often wonder how picky eaters come to be picky. Is it nature or nurture? Are some kids born fussier than others or are all kids born finicky but develop their palates with the help of a supportive parent? Although there are exceptions (children with sensory issues, those who have allergies, and so on), I find that the key to raising less-picky eaters is making all kinds of food available to little kids and including it as a normal part of their diet. Children are mini adults, after all. A classic example of an oft-avoided item is fish, something many children have an aversion to. I usually serve our preferred fish — salmon — once a week. When my oldest son was starting to eat solids, and after a talk with his pediatrician on when to introduce what foods, I said to myself, "Salmon is served at my dinner table almost as much as chicken is. There's no reason I shouldn’t encourage him to eat it in the same way I would a piece of chicken." And, as you may have guessed, he now eats fish the same way he would chicken. Interestingly enough, I never encouraged him to eat beef as much. Being that it's sometimes tough to chew, I would let it go and offer him something else. To this day, even though he'll eat his portion of beef, he's not a big fan of it. The same applies to vegetables. Whatever was introduced early and encouraged, they still eat well, while those vegetables that I wasn’t serving regularly or didn’t bother putting on

their plates are still not a part of their diet. At the same time, being a sneaky mom has not escaped me. I've added zucchini and cauliflower to potato kugel, hidden mushrooms in a meat mixture, and referred to roasted broccoli as "broccoli candy." Sometimes all it takes is respecting their quirks, and cutting the vegetable the way they like it or making sure that one food doesn’t touch the other. And, of course, anything on Mom's plate is just so much more enticing and appealing than if it's served on their plate. Whatever it takes to get them to eat more wholesome ingredients, it's important to keep putting healthy food in front of them. Studies show that children can be offered a food up to 15 times before they try it. I will admit that my kids are what most people would consider "not picky." They eat almost everything. But I think that’s because most of the "adult" foods they eat were always a normal part their diet. I know I'm on my way to success when my son goes around telling everyone that in our house the rule is that you have to taste everything on your plate. If you don’t like it, you don’t have to eat it. Happy cooking, Chavi

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Salmon, Two Ways Another way to appeal to children's palates is to keep the newly introduced foods as simple as possible. They may be easily scared away by dishes bursting with flavor or, as in the following recipe, the maple-glazed walnuts. Try dressing it down with a simple maple-mustard glaze, or giving them the option of eating it without the crust. The following is recipe for a side of salmon that works with both kinds of recipes. Feel free to make it with salmon fillet slices as well.

Maple-Glazed WalnutCrusted Salmon This beautiful side of salmon has the perfect balance of both sweet and tangy, infusing the salmon with a delicate brightness. The mapleglazed walnuts add the perfect crunch and flavor. Half a side of salmon, approximately 1.5 lbs (½ kg), or 5 slices salmon Serves 5 3 Tbsp maple syrup 2 Tbsp Tuscanini balsamic glaze 2 tsp creamy Dijon mustard 2 tsp chopped fresh dill 3 cloves garlic, crushed ½ tsp kosher salt ⅛ tsp black pepper 1 cup maple-glazed walnuts, chopped into small pieces (see recipe) Preheat oven to 400°F (200°C). Place salmon onto a parchment-lined sheet pan. Combine the rest of the ingredients —except for the walnuts — in a small bowl. Use a pastry brush to glaze the salmon with this sauce. Sprinkle walnuts over glazed salmon. For half a side of salmon, bake for 25 minutes. For fillet slices, bake for 18 minutes. Note: Double sauce recipe for a whole side of salmon.

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MapleMustard Salmon Sauce Just the right amount of flavor to satisfy both children and adults, this sauce can be used with the same amount of salmon, in place of the Maple-Glazed WalnutCrusted recipe above. 1 Tbsp maple syrup 1 Tbsp creamy Dijon mustard 1 Tbsp mayonnaise ½ tsp salt ½ tsp garlic powder 2 Tbsp black and white sesame seeds (optional) Combine maple syrup, mustard, mayonnaise, and seasoning in a small bowl. Use a pastry brush to glaze salmon with sauce. Sprinkle sesame seeds over salmon, if desired. Bake as directed above.

Maple-Glazed Walnuts I prefer making my own glazed nuts because I get to control the sweetness and the ingredients. But feel free to use store-bought honey- or maple-glazed walnuts, if you prefer. This recipe also works with cashews and pecans. 1 cup raw walnuts ¼ cup maple syrup ½ tsp kosher salt Preheat a dry skillet over a mediumhigh heat. Add the walnuts, maple syrup, and salt. Cook, stirring frequently, until syrup is caramelized and nuts are toasted, about 3–5 minutes. Cool before using.

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New Column!

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By Charni

e Kohn

Modern technology is slowly shrinking our world; wellsprings of information are now readily available at the touch of a button. The Social Age has changed so many aspects of our lives. For me personally, it has helped expand my knowledge about different cultures and cuisines. Food is such an essential part of cultural heritage and national identity. It connects us to people and places, and brings friends and families together. Additionally, proper etiquette, such as whether you should eat everything on your plate or whether slurping is appropriate or not, varies across the globe. Food is something that has always interested me, especially the eating part. When I got married, I discovered that I loved cooking as well. Once I started traveling, I realized how much I enjoyed learning about the variety of dishes native to the countries I visited. Why stick to chicken and potatoes when there's an entire world full of food out there? Every country offers its own array of mouthwatering flavors and exotic ingredients. In Taste+Travel, Iâ&#x20AC;&#x2122;m excited to share all the ethnically inspired recipes I've created, as well as some fun facts about each country we visit together. A lot of research goes into creating each installment, but I am by no means an expert. If I get something wrong about a country that you're familiar with, Iâ&#x20AC;&#x2122;ll be happy to hear from you!

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Ciao From Italy The first cuisine we'll be dining on is Italian. Native Italians take their meals very seriously and are definitely not into counting calories. A typical Italian meal consists of six courses. The opening course, aperitivo, is lighter than a typical American appetizer. It consists of food that opens one's palate and gets a person hungry for the meal to come. Pre-dinner alcoholic drinks, plus light and salty snacks, like olives, chips, and nuts are some of the foods you'll most likely find at this course. Antipasto, the second course, is what Americans refer to as an "appetizer." Italian antipasto includes foods like bruschetta, cheese and meat boards, focaccia, and other breads. The third course, primo, is actually the first of two main dishes. This is where the soup, pasta, risotto, and gnocchi come out. (Are you hungry yet?) It's always lighter than the second main course, known as secondo e contorno, which by definition is "seconds and side dishes." Beef ragĂš, chicken and seafood, usually paired with tomatoes, zucchini, potatoes, and mushrooms, may be found at this course; they're very popular Italian fare. Dolce is most peopleâ&#x20AC;&#x2122;s favorite part of the meal: dessert. Many of your favorite desserts may have originated in Italy. Some all-time classics include tiramisu, cannolis, and affogato. After a very heavy meal, a drink to wash it all down is often quite necessary. Digestivo, a sixth and final course, serves this purpose. As the name implies, digestivo helps the body digest all the food that was just consumed. The most popular form of digestivo is limoncello, an alcohol-based lemon drink. It's made by steeping lemon peels in vodka or other forms of alcohol for at least forty days.

Travel Tidbits > If you ever get a chance to visit Italy, don't look for fettuccine alfredo on the menu. It's just an American dish with an Italian name. (In recent years, some restaurants in tourist hot spots started offering it so as not to disappoint naive visitors.) The same goes for spaghetti and meatballs. > Tomatoes, pasta, basil, and cheese are common ingredients used in Italian cuisine. > This monthâ&#x20AC;&#x2122;s recipes are healthier takes on popular Italian dishes, using ingredients native to the country.

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Chicken Ragu Ragù is a meat-based sauce that's very popular in Italian cuisine. It's traditionally made with beef and served over pasta. The ragù I created is a quarter of the calories and double the flavor. Get a taste of Italy without all the excess carbs. Yields 8 servings

Cooking time: 1 hr, 50 mins

6–8 dark chicken cutlets cut in to 1-inch cubes ¼ cup olive oil, for sautéing 1 medium-sized onion, finely diced 1 small bunch of celery, peeled and finely diced 1 carrot, finely diced 4 cloves garlic, minced 3 Tbsp Tuscanini tomato paste 15 oz canned crushed tomatoes 1 cup water 3 bay leaves 1 basil leaf, shredded (or 1 cube frozen basil) 1 Tbsp honey 1 Tbsp salt 1 tsp oregano ½ tsp black pepper ¼ tsp crushed red pepper flakes 1 large zucchini

Heat oil in a large pot over medium heat. Sear chicken cubes for about two minutes on each side. Remove from pot and set aside. Sauté onions, celery, and carrots for at least fifteen minutes, or until soft. Add more oil if necessary. Add minced garlic to other vegetables, and sauté an additional 30 seconds. Add tomato paste and stir vigorously, until well combined. Pour in crushed tomatoes. Add 1 cup of water to the mostly empty can, swirl to loosen remaining tomato bits, and pour into the pot. Add all remaining ingredients except chicken and zucchini, and bring to a boil. Then turn flame to low, cover pot and cook for 1 hour, stirring occasionally. Remove bay leaves from the pot, and place seared chicken cubes in the sauce. Cover and cook for 30 minutes. Meanwhile wash the zucchini well. Use a regular peeler on the zucchini to create pasta-like ribbons. Once the chicken is done cooking, add zucchini "pasta" and cook for 3 minutes. Remove from heat. The zucchini should be somewhat cooked but still firm.

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Bourbon Poached Peaches and Mascarp one Parfait When researching Italian desserts, I quickly realized I would have to create my own recipe using Italian ingredients, because most of the popular desserts are calorieloaded. So I went to second-best or, in my opinion, even better than dessert: cheese. Italy is well known for its great variety of cheese. One of the most decadent is mascarpone. Mascarpone is an Italian cheese similar to cream cheese, but much creamier and better. Yields 25 3-oz cups

Cooking time: 20 minutes

For the peaches: 6-8 just-ripe peaches, peeled and cut into eighths 2 cups water ¼ cup bourbon ¼ cup raw agave syrup For the mascarpone: 8 oz mascarpone cheese 3 Tbsp raw agave syrup 2 Tbsp freshly squeezed lemon juice ½ tsp vanilla extract pinch of salt

To prepare the poached peaches, add the water, bourbon, and agave to a small pot. Bring to a low boil, add the segmented peaches, and cook for 10 minutes. Remove poached peaches from the pot and cool. Place all mascarpone ingredients in a bowl. Use a hand mixer and mix until ingredients are wellcombined and fluffy. To assemble, fill a piping bag with the mascarpone cream mixture and pipe a small dollop into the bottom of a 3-oz cup. Add some peaches (cut them smaller, if necessary) and top with some additional mascarpone. Repeat until each cup is filled.

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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!

Midmorning Snack This Month:

Nutritional opinions differ on whether to give the digestive system a break between breakfast and lunch or to provide the body with a boost of energy somewhere in the middle. Do you usually have a midmorning snack? If you do, what's your go-to choice?

Health Coach Jacqui Kimmel, PT: On most days, I do not have a snack. I make sure to have a balanced breakfast with all the macronutrients (protein, fat, and healthy carbs) and some fiber. This allows my blood sugar to remain stable and my satiation to last for about four hours. When our blood sugar and hunger hormones are balanced, we don’t crave snacks or pick-me-ups all the time. There is no need for a midmorning snack just because that’s what you’re “supposed” to eat! That being said, I am a proponent of listening to your hunger cues. So, if you're hungry, eat! A great midmorning snack is a fruit balanced with a bit of fat, like an apple with some nut butter, or berries with coconut cream.

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Shani Taub, CDC:

I usually have a fruit. It curbs my hunger and levels my blood sugar until lunchtime.

Dr. Rachael Schindler:

On most days, I have a midmorning snack if I eat a small- to medium-sized breakfast very early, like 6 a.m., and I won’t eat lunch until after 12, as I recommend to my clients. It’s never a good idea to go more than four hours between breakfast and lunch. Additionally, if I exercise in the morning, it’s better to have a nice fruit or veggie snack, with plant-based carbs and fiber, to hold me until lunch. Otherwise, in a portion-controlled diet, snacks are essential to keeping the metabolism moving forward. So I always keep a healthy snack available just in case I’m hungry. I don’t make want to make poor choices because of it.

Laura Shammah, MS, RDN: Fruit or yogurt is usually a good morning snack that holds me over until lunch.

Nutritionist Tanya Rosen: Always! I’m a huge believer in eating every 2-3 hours to keep your metabolism going and prevent hunger. I usually have a TAP muffin or cookie with a coffee.

Beth Warren, MS, RDN, CDN: I vote “Yes” for a midmorning snack! An apple with almond butter is my favorite pick. That helps keep me full and satisfied. I’ve notice how having this snack makes an impact on my hunger levels during the evening hours

Rabbi Eli Glaser, CNWC: The food plan that works best for me is simply three robust meals, with plenty of hydration (e.g., water) in between. I love the fact that once my meal is over “the kitchen is closed,” and I’m not mentally or emotionally invested in what possibilities are out there. I can actually live life between meals without the ever-present thought of grazing or having to grab something just because the feeling arises.

Tamar Feldman, RDN, CDN:

Always! Preventing blood sugar crashes is vital to staving off hunger and binges later in the day, and for those trying to lose or maintain their weight, the metabolism-boosting effects of a midmorning protein snack are significant. I’ll choose a highprotein muffin, a Greek yogurt with some fruit, a smoothie, or nut butter on a rice cake, and I recommend similar options to all my clients.

Compiled by Shiffy Friedman

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Eat Well

Nutrition Tidbits in the News By Esther Retek

10 Foods to Keep You Hydrated This Summer With the heat enveloping us and the humidity soaring, staying hydrated matters more than ever. Dehydration causes fatigue, headaches, faintness, and rapid heart rate, and whatâ&#x20AC;&#x2122;s more, prolonged dehydration can lead to serious complications. Experts generally recommend drinking several glasses of water to maintain optimum hydration levels. But while drinking water is important, there are numerous foods that can contribute a large amount of water to your diet, and make the difference to how parched you feel. Here are nine of the most hydrating foods to quench your thirst and thus allow you to appreciate these scorching days.

Watermelons

Cucumbers

This water-based fruit is considered the superstar hydrating food. With a staggering 92% water content, along with 8% of other essential minerals important for hydration, it is actually twice as effective in hydrating the body as water. Use this fruit to make ice pops for your kids so they can enjoy a hydrating, healthy snack.

Packed with even more H2O than watermelons, cucumbers boast a water content of 96%! Get yourself accustomed to munching on this ideal vegetable as a snack, and include them in your meals.

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Eat Well

Nutrition Tidbits in the News

Bananas

Milk

For all the sweet taste buds out there, here’s the fruit for you. Bananas contain 74% water, and loads of potassium, a vital element to prevent dehydration.

Who knew? Milk is actually better at hydrating the body than water, as the study of McMaster University found, thanks to its combination of calcium, high quality protein, and electrolytes. Opt for a cold glass of milk (glass always being more tempting than a plastic cup) along with your breakfast or lunch, and feel the hydrating effects all day.

Strawberries Of all the berries, strawberries have a whopping 92% water content. Be creative with their many uses, and if you only eat them frozen, enjoy them in smoothies, drinks, or just thawed.

Spinach With its 92% water content, along with various essential mineral salts, I couldn’t resist adding this to our list. Maintaining a balance of mineral salts allows your body to absorb the water properly, thus making this vegetable important for your diet. And your kids… check out Family Favorites to learn how to get them to like “adult” foods.

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Iceberg Lettuce With salad’s popularity in the summer, this shouldn’t be too difficult to integrate in your eating. It contains an incredible amount of 96% water, so get the crunching going.

Tomatoes It comes as no surprise that tomatoes are a staple of the Mediterranean diet. Being greatly nutritious, as well as having a water content of 94%, this succulent, juicy fruit(!) helps the body stay nicely hydrated. Put some cut up tomatoes or cherry tomatoes on your table, and watch them go!

Soups The reason soups get their place on the list is a no-brainer. Although many of us like to omit soups from our summer menus, consuming a bowl of soup provides the body with necessary water. Stick to the simple vegetable ones for optimal benefits, and have them blended so that the body will absorb them even faster.

More Than Succulent Flavor Health benefits of garlic and onions New research suggests many more benefits to the two key ingredients in global cuisine: garlic and onions. Now you could use these foods more than just for their flavor, but for their health benefits too. According to health research recently published in the Asia Pacific Journal of Clinical Oncology, these vegetables are important allies when it comes to safeguarding our health. Garlic already has a reputation as a natural antibiotic, but it’s always encouraging to learn about new research on these natural healing foods. In the recent study, researchers from the First Hospital of China Medical University report that these two vegetables have an anticancer effect and hinder the development of cancer. Both garlic and onions belong to the family of allium vegetables (which includes chives, shallots, and leeks too). The present study looked at 833 individuals who had been diagnosed with colorectal cancer, the third most common cancer among men women alike; each of them was

interviewed and their dietary habits were recorded. They were specifically assessed on the amount of allium vegetables they tended to assume on a regular basis. The researchers found the correlation significant: participants who ate the largest quantities of garlic and onions had the mildest diagnosis, compared with people who consumed low quantities of these allium vegetables. Based on these results, in the words of the senior researcher Dr. Zhi Li, “There seems to be a trend: the greater amount of allium vegetables, the better the protection.” Having them in greater quantities could be a simple, yet important, dietary change. Go for it! Sivan 5779 | Wellspring 137

Eat Well

Nutrition Facts in a Shell By Esther Frenkel

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:

CUCUMBERS Principle

Nutrition Value

Percentage of RDA

Energy

15 Kcal

<1%

Carbohydrates

3.63 g

Protein

0.65 g

Total Fat

0.11 g

0.5%

Cholesterol

0 mg

Dietary Fiber

0.5 g

Vitamins Folates

7 µg

Niacin

0.098 mg

<1%

Pantothetic Acid

0.259 mg

Pyridoxine

0.040 mg

Riboflavin

0.033 mg

Thiamin

0.027 mg

Vitamin A

105 IU

3.5%

Vitamin C

2.8 mg

4.5%

Vitamin E

0.03 mg

Vitamin K

16.4 µg

13.6%

Electrolytes Sodium

2 mg

Potassium

147 mg

Minerals Calcium

16 mg

1.6%

Iron

0.28 mg

3.5%

Magnesium

13 mg

Manganese

0.079 mg

3.5%

Phosphorus

24 mg

Zinc

0.20 mg

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As the produce market expands to include super-healthy vegetables like kale and asparagus sprouts, making them more popular, plain old veggies that have been filling our produce drawers for decades and centuries have fallen out of the limelight. But what’s there not to love in cucumber nutrition? It’s true that this fabulously popular vegetable (or fruit) is full of water, but that doesn’t discount its nutritional density. Technically, is a cucumber a fruit or a vegetable? Cucumbers are actually fruits, although they are treated more like vegetables. There are dozens of different cucumber varieties grown around the world, but the three main varieties of cucumbers that are most widely available today are: those used for slicing and eating raw, pickling cucumbers (kirbies), and seedless cucumbers.

Cucumbers offer valuable vitamins and minerals, and are one of the vegetables with very high water content. This means that it’s super-low in calories — with about only 16 calories per cup. Since the cucumbers are about 95 percent water, they do a good job of taking up room in your stomach and adding volume to your meals without weighing you down.

That helps you stick to an overall healthy, low-calorie or low-carb weight loss plan if needed, because you can eat more and feel satiated. Plus, cucumber nutrition can help quench thirst and prevent the desire to snack due to dehydration. Known among researchers for their anti-diabetic, lipid-lowering and antioxidant activity, cucumbers have a detoxifying, cleansing effect on the body. They’re also naturally “cooling” and a great way to prevent dehydration, constipation, and overheating. And that’s not all when it comes to cucumber nutrition. Helps Detoxify the Body

Cucurbitacins are a category of diverse compounds found in the plants of the family of Cucurbitaceae, which includes cucumbers. These compounds can support the digestive tract and liver. The liver is the main detoxifying organ that works to naturally remove toxins and waste materials from the blood and gut.

Cucumbers are also a natural diuretic food. This means they can help the body produce more urine to carry out toxins and waste. Therefore, they’re great for reducing bloating and uncomfortable water retention — one reason to fill up on cucumbers after a night of salty food or alcohol. Hydrates and Soothes Skin

Fresh cucumber juice has been used for centuries to naturally nourish damaged, dry, or sensitive skin. According to a study published in 2013 in Fitoterapia (a journal dedicated to medicinal plants and to bioactive natural products

of plant origin), cucumber slices or seeds applied directly to the skin gives a soothing and cooling effect against skin irritations and reduces swelling and redness. It’s even been used to naturally treat acne, scars, and other blemishes.

Cucumbers also have the power to provide sunburn relief by alleviating pain, blotchiness, and swelling following a sunburn. The fruits are considered a “refrigerant, haemostatic, and tonic, useful in treating hyperdipsia or thermoplegia.” In other words, they help stop bleeding, reduce heat buildup associated with inflammation, quench thirst, relieve dehydration, and help to prevent sunstroke. De-puffs Swollen Eyes

What can cucumbers do for your eyes? Due to their anti-inflammatory and diuretic effects, cucumbers can help decrease swelling and puffiness around the eyes. They can also help keep the skin around the eyes hydrated and, according to some people, make you appear more awake and less tired. Can you sleep with cucumbers on your eyes? It’s unlikely that they wouldn’t fall off throughout the night, but you can give it a try. Even letting cucumber slices sit on your eyes for 20–30 minutes can help. Cut cucumber slices and refrigerate them for a while, then sit back and lay them on your eyes. Some people also grind cold cucumbers to make a paste with lavender oil or chamomile oil and some raw honey.

ON YOUR PLATE! Unlike most vegetables, cucumbers actually taste better when eaten raw. Because they’re so high in water, they don’t usually come out well when cooked and tend to just turn into a soggy mess. So, the best way to enjoy them is on their own or in a salad, sliced, cubed, or julienned. *If eating plain old cucumbers gets boring, try making pickles with some vinegar. This process is what gives pickles its distinctively tangy, sour and salty flavor: Combine two regular cucumbers and toss with three tablespoons of rice vinegar, two tablespoons chopped herbs of your choice (like dill), and a pinch of sugar and salt. While pickles have some great nutritional components, such as fiber, vitamin K and even probiotics in some cases, you’ll still want to stick with one to two per day due to the salt content. The longer you let pickles sit, the stronger taste they’ll develop, but even just 30 minutes allows them to absorb some flavor.

IN THE KITCHEN Cucumber Lox Wraps

This is a fun way to use nutrition-packed cucumbers to replace carbs. Works great as a last-minute appetizer or to enhance your summer Shalosh Seudos table. 2 long cucumbers, cut in half and ends removed 1 cup smoked salmon (lox), cut into strips

Using a vegetable peeler, peel the cucumbers to form long strips. Blot the strips gently with a paper towel to remove excess moisture. Lay a strip of lox onto the cucumber strip, then roll it up as tightly as possible. Secure with a toothpick. Note: This recipe does not keep for long. Serve the rolls within an hour or two of rolling them.

SHOP & STORE: When shopping, look for cucumbers that are bright to dark green, firm, and don’t have any soft, water-logged spots.

• Is the skin of the cucumber good for you? Yes! Plan on eating the whole cucumber whenever possible, since the skin and seeds contain important compounds. Cucumber skin is a good source of vitamin A and has diuretic effects.

• When storing cucumbers, keep in mind that they do best when kept in very cold temperatures. Keep them in a plastic bag in the refrigerator and try to use them within three to five days. • If the cucumber is waxed, you can either peel the skin off if you’d like, or leave it on and give it a good scrub.

HYDRATION BOOST BY YOSSI & MALKY LEVINE

Summer is here, and staying hydrated is the name of the game. While water is your most important tool in the battle against dehydration, the combination of salts, minerals, and natural sugars in some fruits and vegetables can actually hydrate your body more effectively than a glass of water, while providing it with some much-needed vitamins. A smoothie is an excellent example of a drink that will do both of those things and, as an added bonus, is both tasty and refreshing. Smoothies are an ideal summer breakfast, as they are light, yet can contain enough nutrients to help you start the day on the right foot. Additionally, these chilled sweet drinks make perfect afternoon snacks, serving as a great replacement for that afternoon pick-me-up coffee you may be used to drinking. Give it a try. You may find the smoothie leaves you feeling even more energized than the cup of joe ever did. 140 Wellspring | June 2019

To determine how much water you should be drinking — and eating — on a daily basis, simply divide your body weight in half. For example, a 150-pound person would need a minimum of 75 ounces, or just over 9 cups, of water per day. 1 cup plain yogurt 2 cups chopped watermelon 1 cup chopped cantaloupe 1 cup frozen strawberries 1 cup grapes Place all ingredients in a blender. Blend until smooth.

Why these fruits for hydration?

Plain yogurt contains lots of water and nutrients that may boost several aspects of your health. A one-cup serving of plain yogurt is made up of more than 75 percent water. Additionally, it's rich in vitamins and minerals, such as calcium, phosphorus, and potassium, all of which are known to promote bone health. It's also a great source of protein.

Watermelon is one of those ultra-hydrating foods, thanks to the magnesium, potassium, and sodium it contains. A one-cup serving contains over a half cup of water, in addition to some fiber and several important nutrients, including vitamins C and A. Because of their high water content, watermelons have a very low calorie density. That means that a relatively large portion of watermelon contains very few calories.

is a melon thatâ&#x20AC;&#x2122;s extremely nutritious and may boost your health in several ways. One cup of cantaloupe is composed of about 90 percent water and delivers more than a half cup of water per serving. It also contains 2 grams of fiber, which works together with water to promote fullness and reduce your appetite. Cantaloupe is also rich in vitamin A.

Strawberries

Cantaloupe

are about 91 percent water, so eating them will contribute to your daily water intake. Furthermore, strawberries provide lots of fiber, disease-fighting antioxidants, and vitamins and minerals, including vitamin C, folate and manganese.

Grapes contain 81 percent water. The health benefits of grapes make them an excellent choice. Grapes are rich in antioxidants, including resveratrol and flavonoids. They may taste sweet, but grapes donâ&#x20AC;&#x2122;t elevate blood sugar, nor do they significantly increase insulin levels.

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Dictionary

Proton-Pump Inhibitors (PPIs) Definition: noun

a group of drugs, which includes Nexium, Prilosec/Omeprazole, and Protonix, whose main action is a pronounced and long-lasting reduction of stomach acid production.

“

Unfortunately, ‘solving’ the problem of GERD by removing all stomach acid with a PPI medication can actually lead to serious digestive and health issues in the long run.

”

- Tamar Feldman, RDN, CDE At the Dietitian

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