Wellspring Issue #38 by The Wellspring

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MARCH 2019 // ADAR II 5779 // ISSUE 38

Is Sugar Addictive?

Grin &Bear it

This Purim, you could prevent sugar overdose

Registered dietitian Laura Shammah shows you how

Pediatric illness is no fun.

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

4 courageous adults share how they did it.

Are You Kidding?

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

3 New Columns!

Dr. Jacques Doueck, DDS

Do I Really Need to Have My Wisdom Teeth Removed?

6 ridiculous health fads the masses are actually falling for

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

Heart to Heart

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

Not a Laughing Matter

One mother’s quest to find a cure for PANDAS

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2/10/19 4:08 PM

From the Editor shiffy@wellspringmagazine.com

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

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

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

Sincerely, Shiffy Friedman

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

Adar II 5779 | Wellspring 13

Contents

MARCH 2019 ADAR II 5779 ISSUE #38

WELL INFORMED 22 26 28 30 36 38

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

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

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

NEW COLUMN

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

NEW COLUMN

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

MEMOS FROM A KINESIOLOGIST Thieves Oil By Miriam Schweid

78 DIY Natural Cleaning Detergents By Miriam Schweid

50 WELLBEING 81

HEART TO HEART By Shiffy Friedman, LMSW

NEW COLUMN

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

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

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Springboard

Letters

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

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

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

18 Wellspring | March 2019

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

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

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

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

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

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

Quick Question

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

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

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

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

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

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

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

Take care, Miriam Schweid, health consultant and kinesiologist

Craniosacral Therapy for Tongue-Tie

Issue #35: Cover Feature

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

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

I Feel Normal Issue #36: Torah Wellspring

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

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

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

Adar II 5779 | Wellspring 19

Springboard

Letters

Herbs for Ligament Healing Issue #37: Cup of Tea

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

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

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

I was fascinated by Laura Sham-

20 Wellspring | March 2019

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

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

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

CMY

Well Informed

Torah Wellspring: Spiritual Health By Rabbi Ezra Friedman

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

We’re accustomed to hearing declarations regarding willpower

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

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

22 Wellspring | March 2019

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Adar II 5779 | Wellspring 23

Well Informed

Torah Wellspring: Spiritual Health

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

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

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

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

24 Wellspring | March 2019

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

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

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

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

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

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

with

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

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

lorie

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

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

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

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

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

Low

to go to kindergarten and work his way upward.

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

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

Raspberry

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

Well Informed

Dental Health By Dr. Jacques Doueck, DDS

FAQ

WISDOM TEETH

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

New Column!

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

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

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

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

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

Infection

26 Wellspring | March 2019

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

with chewing and swallowing.

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

-c

alorie

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

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

etn

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

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

Raspberry Plain Strawberry Vanilla Coffee Peach Mixed Berry Blueberry

Well Informed

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

||| SECRETS OF A KOSHER DIETITIAN |||

SECRET

#12

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

28 Wellspring | March 2019

ARE YOU USING TOO MANY ARTIFICIAL SWEETENERS?

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

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

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

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

A few reasons why this might occur:

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

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

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

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

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

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

Adar II 5779 | Wellspring 29

Well Informed

Health Updates in the News By Rikki Samson

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

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

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

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

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

30 Wellspring | March 2019

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Well Informed

Health Updates in the News

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

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

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

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

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

32 Wellspring | March 2019

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

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

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

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

Adar II 5779 | Wellspring 33

Well Informed

Health Updates in the News

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

34 Wellspring | March 2019

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

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

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

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

How long and how well you sleep has serious repercussions for your productivity, focus, and overall wellbeing. Adults require 7-9 hours of sleep per night while young kids could sleep as much as 13 hours. Give your body the rest it needs with one of Maxi Healthâ€™s formulas- Mel O Chew, (1mg, 3mg or 5mg) Sleep O Max, and Maxi L Tryptophan 500, and have yourself a wonderful night (and day!).

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

Well Informed

Figures By Miriam Katz

Pediatric Health Stats

asthma 1 12

84%

is the leading chronic childhood disease

out of every

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

school-aged children has asthma

Juvenile Diabetes: approximately

people under age 20 have type 1 diabetes

million

1.25

American children and adults have type 1 diabetes

only

About

Crohn's Disease:

780,000

36 Wellspring | March 2019

200,000

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

of diabetics have type 1 diabetes

Approximately

20-30%

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

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

20-40

children can also develop the autoimmune disease

8,000 10,000 and

(Sources: AAFA, CDC, American Cancer Society)

Multiple Sclerosis:

Between

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

Childhood Cancer:

10,590

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

childhood cancers make up less than

of all cancers diagnosed each year

leukemia, the most common childhood cancer, accounts for about

30%

of all cancers in children Adar II 5779 | Wellspring 37

Well Informed

Health Ed By Laura Shammah, MS, RDN

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

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

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

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

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

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

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

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

38 Wellspring | March 2019

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

B. Insulin release

C. Weight gain

D. Acne outbreak

Answer: B.

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

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

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

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

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

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

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

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

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

Adar II 5779 | Wellspring 39

Well Informed

Health Ed

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

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

Dextrose

Invert sugar Rice syrup Molasses Caramel

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

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

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

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

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

40 Wellspring | March 2019

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

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

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

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

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

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

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

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Well Informed

Dedicated to Health By Sarah Weinberger

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

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How did you go about creating the hotline?

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

10 Questions for:

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

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

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

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

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Well Informed

Dedicated to Health

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

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

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

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

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

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

What is your current role at Refuah KaHalachah?

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

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

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

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

Refuah KaHalacha's U.S. Phone Number:

718 564 6484

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

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

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

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

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