Friends With Diabetes

GoingF rward Friends With Diabetes סיון תשס ח 08 Summer Volume II Issue 4 10 Summer Camp Survival 24 FWD Around the Globe 28 Secret Revealed

We can hold our breath underwater for 24 hours. And that s just for starters. Introducing the Animas 2020 insulin pump. It performs so you can. Whether you re a world-class swimmer or the closest you get to water is getting caught in a downpour, the Animas 2020 pump is made so you can manage in any situation. First, Animas has the only insulin pump that s waterproof at 12 feet for 24 hours. Second, it can be adjusted to precisely match your body s changing needs day and night, at work and at play with the smallest increment of insulin available. And third, you have the power to dose more accurately because Animas has the only pump with a built-in, 500-item food database that s pre-loaded into your bolus calculator. All this and more, in the first insulin pump with a flat panel, high-contrast color screen for easy viewing. Why did we pack the Animas 2020 pump with this much performance? Diabetes shouldn t come between you Going ForWarD 2 Summer 5767 and your ability to be at your best no matter what life throws at you. And that includes water. Find out more about the Animas 2020 pump. Give us a call now at 1-877-YES-PUMP (1-877-937-7867) or visit us at www.animascorp.com. 2007 Animas Corporation RxOnly 2007/08

ריעים מתוקים Friends With Diabetes international swxc is under the rabbinical supervision of F.W.D. Rabbi M. M. Weismandl shlit a of Nitra Monsey, endorsed by many other renowned Rabbonim, and by leading medical professionals. The information in this publication is meant to be used in conjunction with, and under the guidance of, your health care professional. It is NOT meant to diagnose or treat medical conditions, nor as advice or prescriptions. It is provided for educational purposes only. In the event that you use the information Professional Advisory Board Dr. Henry Anhalt Director, Division of Pediatric Endocrinology St. Barnabas Medical Center Livingston, NJ Dr. Robin Goland Co-Director, Naomi Berrie Diabetes Center, Columbia University New York, NY Dr. Michael James Haller Pediatric Endocrinology University of Florida Dr. Kevan Herold Immunobiology and Medicine Yale University, New Haven, CT Dr. BatSheva Levine Children s Hospital, Boston, MA without your doctor s approval, you are prescribing for yourself, which is your constitutional right, but F.W.D. and the authors of this publication assume no responsibility. We strongly advise that you inform your doctor of any changes you wish to make. Please consult your physician for medical questions, and your Rav (Rabbi) for halachic (Jewish law) decisions. FWD does not assume responsibility for the kashrus of any products advertised in these pages. Dr. Noel Keith Maclaren BioSeek Clinics, NewYork-Presbyterian, The University Hospital of Columbia and Cornell. Dr. Lyle Mitzner Joslin Diabetes Center Boston, MA Dr. Alexander Perkelvald Diabetes, Endocrinology & Metabolism Beth Israel Medical Center Brooklyn, NY Dr. Robert Rapaport Director, Division of Pediatric Endocrinology & Diabetes Mount Sinai School of Medicine New York, NY Dr. Barak Rosenn Director, Division of Obstetrics and Maternal-Fetal Medicine St. Luke s-roosevelt Hospital New York, NY Dr. Svetlana Ten Director of Pediatric Endocrine Division Infants and Children s Hospital of Brooklyn at Maimonides Dr. Roy E. Weiss Chief of Endocrinology, Diabetes and Metabolism, University of Chicago Chicago, IL Dr. Don Zwickler Endocrine Associates of Rockland Pomona, NY 31 Herrick Ave. Unit B Spring Valley, Fall 5768 NY 310977 Going ForWarD (845) 352-7532 Fax: (845) 573-9276 RabbiMeisels@FriendsWithDiabetes.org www.friendswithdiabetes.org

Going Forward asks you to Come Forward! Do you have editorial and management skills? Going Forward Magazine is looking to hire an Editorial Director to help us upgrade, expand and enhance our publication. Our goal is to include a broader selection of interesting and pertinent topics, as well as to publish the magazine more frequently. Excellent opportunity for the right individual! Duties include: Planning magazine topics and layout Collecting/selecting and editing articles Writing articles and delegating work to writing staff Working with the designer Ensuring timely printing If you are detail-oriented and enjoy working on exciting and stimulating projects, please fax your resume to (845) 573-9276. All applicants must have experience with dealing with diabetes. Summer 5768 4 Going ForWarD

Foreword swxc Wi t h summer vacation upon us, many of us can easily envision the following scenario: An ambitious adventurer has set out on a long hike, when he stumbles upon a huge mountain. He starts his way up full of energy, but before he is halfway through he becomes quite exhausted and wonders how much longer he has to climb. He pushes himself forward with great effort, panting and puffing, and begins to doubt the wisdom of the entire undertaking. Just before he decides to give up and turn around, he finally sees the tip of the mountain up ahead. Although he still has a way to go uphill, he can see where his ordeal will finally end, and this gives him a new burst of energy to complete his climb. As he makes his final, laborious way upward, the thought of reaching the downhill road really soon gives him the strength to forge ahead. We at FWD feel much like the hiker in the above scenario, as we trudge onward, seeing the numbers of those who are diagnosed with type 2 diabetes and/or metabolic syndrome climb ever higher. This upward trend is sapping the strength of so many individuals and families, not to mention our organization s resources, to the point where we begin to wonder how we will all cope. How will we have the necessary stamina to deal with this growing problem? The good news is that we can finally see the tip of this scary mountain in the distance. We are seeing the beginning of the end of this disastrous upward climb. Our efforts during the past year to educate the public are finally bearing fruit, and we can finally foresee the day when the number of diabetes sufferers will.בעז ה decline, begin to Most people, when given the right information, are ready to make the necessary lifestyle changes to live healthy, fulfilling lives. The feedback we receive from all over is simply incredible! Thousands upon thousands of people have taken steps to improve their diets and habits in direct result of our ongoing lectures on the Kol M vaser info-line, as well as our lectures and articles in other places. Summer 5768 5 Going ForWarD

The most encouraging part is to see how eager people are to hear the truth. When Mosdos Pupa announced our lecture as part of their program during their annual dinner, it greatly enhanced the success of the entire event. Many thousands of people bought the CD of the lecture, eagerly listening to every word. Yes, people want to hear! Educating the public is a most pow-erful tool indeed, as this creates a consumer demand for healthier products. And man-ufacturers are beginning to respond to this demand. We are proud to say that a number of food manufacturers are exploring and experimenting with alternatives to high fructose corn-syrup and partially hydrogenated fats, in order to accommodate smarter, better-informed consumers. Schools, too, are reaching out to us for help in designing healthier menus for their students. As educators and parents begin to realize the effects diet has on children s behavior and their ability to learn, they are demanding that changes be made. Of course, our uphill climb is far from over. There are still some obstacles in the way to helping people implement these necessary changes. For one thing, government subsidiaries to schools and young mothers are still grounded in the pyramid guidelines, promoting lots of carbs, fruit preserves and low-fat milk. For another thing, some people simply find it difficult to forego their favorite coke-and-danish-lunch, often rationalizing their behavior by refuting our health (or disease) claims. In addition, it takes years to unlearn everything we ve been programmed to believe about desirable health habits and diet. Yet the tip of the mountain is clearly visible in the distance. We re still puffing and panting and drawing on our last reserves of energy, but with Hashem s help we will begin the downhill trend really soon. So keep on watching food labels, avoiding the bad stuff and eating well-balanced meals, and we will together! all march downhill בעז ה Rabbi Hirsch Meisels Going ForWarD 6 Summer 5768

דאס הארץ בלוטיגט מיר אבער טראכטענדיג אז א גרויס חלק פון היינטיגע געזונטע קינדערלעך גייען דאס אדורך טאג נאך טאג. נאך א וואונדער איז די קינדער זענען צוהאצקעוועט? ציבארדעוועט? ס איז נאך א חידוש אז זיי קענען נישט איינזיצן? ס איז נאך א קשיא אז זיי שלאפן איין ביים שיעור? ווילט איר הערן דעס סוד פון רוהיגע, פרייליכע, און צופרידענע קינדר? הערט די דראמאטישע דרשה פון אונזער געזונטהייט רעדנער הרב ר' הערשל מייזליש ביי דעם דינער פון די פאפא מוסדות אין מאנסי, קויפט דעם סידי וואס ווערט פארשפרייט דורך קרן שמואל ישעי', אין אייער ביהמ"ד אדער געשעפט. Summer 5768 7 Going ForWarD

Letters to the Editor Dear Rabbi and Rebbetzin Meisels We don t know how to thank you for the most beautiful event that you held shortly before Purim. We thoroughly enjoyed every aspect of your program. The speeches were terrific, and our son had a wonderful time and came home with some very special prizes, and the food was plentiful and delicious. To spend an evening with Rabbi and Rebbetzin Meisels, and with so many special families, all in the same situation, really gave us a lift. We can t begin to imagine the hours and hours of time it took to plan and co-ordinate this event. We are so appreciative of all that you do for us! We, also, want to extend a very belated Thank You for last summer. Rabbi Meisels set us up with someone in our neighborhood who could act as a backup for our son s care when we were away. Although, B H, he was never called upon, we met him and spent a long time speaking to him, before leaving for Eretz Yisrael. He was so kind and sincere in expressing his willingness to help, and we were able travel with Menuchas Hanefesh. Thank You so much! Thank you, also, for the wonderful publications. They are always filled with a wealth of interesting articles and very useful information. We really enjoy them and always gain much knowledge from them. May Hashem bentch you and your family with continued Nachas, Gezundt, Bracha V Hatzlocha. May Hashem give you the continued Hatzlocha with the ongoing Chessed you perform day in and day out for Klal Yisroel, through your amazing work with FWD! Thank you for everything! S. and R. Going ForWarD 8 Summer 5768 Rayim Mesikim is, A gift from above Blessed with the ability, to Blow a new life Into the hearts of Men, woman, kids and teens, Every single day. It really makes life with diabetes easier Sharing questions and getting advice. Especially with the patience, Listening ear and advice Rabbi Meisels offers. So, we thank you for your effort, To make Friends With Diabetes! Thanks Again, R. R. H אור ליום ה טהרה לסדר וטיהרו הכהן לכבוד הרב הצדיק וכו ר הרשל שליט א ראשית הנני בזה להכיר לו טובה על כל הטירחות שמטריח בשבילי [כמאמר חז ל אורח טוב אומר כל מה שטרח בעל הבית לא טרח אלא בשבילי.] אין הגליון מספיק להעלות גודל החסד שזיכה אותו השי ת להיות השליח טוב להכלל ישראל האמיתיים בתקוה להשי ת שאכן מעתה לא ישמע עוד ח ו כל כך מצרות ישראל. עלה ברעיוני לומר דבר חד וחריף, שיתכן, שהדמעות של כלל ישראל כבר עלה השמימה עד הכסא הכבוד, עד שהשי ת שם אותו לשליח טוב ונכון להדריך את כלל ישראל בהדרכותיו. ובצריך לאותו דבר היות שהוא הוא הצנור לזה בוודאי יגן עליו תחלה להתברך בבריאות השלימות ונחת דקדושה מכל יו ח היקרים יחי ובכל מילי דמיטב. Continued on הכותוב וחותם באלף תודות. הרוצה בעילום שם כמובן.

NOTE: This article does not provide medical advice; always consult a doctor or health care provider regarding medical care. Some of the most memorable summers are the ones spent dashing through sweltering hot days from the bunkhouse to the lake, to the sports fields, on to the dining hall and back to the bunkhouse. There's no reason for diabetes to get in the way of any of these treks or activities held across camp grounds. With proper planning, a safe and fun-packed summer camp experience awaits. Hindy*, who attended overnight camp for a total of five summers, was in seventh grade when she decided that she didn't want to miss out on the incredible summer experience her friends were raving about. At first her parents were apprehensive about sending her, yet they also knew that Hindy could manage her diabetes independently. An older friend who was planning to attend the same camp reassured her parents that she'd keep an eye out for Hindy, and that helped Survival Campers and staff share some tips By Rochel Baren Summer 5768 9 Going ForWarD

secure the decision to sign her up for one session. "Camp was great!" Hindy says. "Some of the staff knew about my diabetes - like the head lifeguard and the directors, and the camp nurse was there to help if I needed but really I was responsible for everything myself. I kept extra snacks in my bunk and my glucose meter safe under my pillow, and I checked my sugar regularly. I had no real problems, and after that year my diabetes was never an issue again. I went back for four more amazing summers!" FWD has been instrumental over recent years in assisting youth with diabetes to enter and attend camps smoothly and successfully. If your child encounters any problems when registering for summer camp with his or her friends, Rabbi Hirsch Meisels advises, "Don't take no for an answer get FWD involved and together we'll help your child enjoy camp like everyone else." Advance planning After all the mandatory camp paperwork has been filled out and submitted, there are some additional preparations that a camper with diabetes should make. Before the start of the session, it's important to be in touch with the camp nurse and physician (who should be full-time staff members) to ensure that every attempt is made to accommodate the camper's needs safely without compromising on the child's fun and fulfilling camp experience. According to Shelley D. Yeager, MA, LCSW, Executive Director of The Barton Center for Diabetes Education, Inc., " it is essential that the camp understand the diabetes management routine of your child and be completely willing to carry out every aspect of the routine without making the child feel isolated or interrupted from the camp s various activities If the child needs to take insulin, or eat certain foods or snacks at certain times, those needs should be accommodated without fanfare to enable the child to have a normal camp experience " It is recommended that at least one responsible adult staff member (in addition to the camp nurse or doctor) be well informed about how to take care of diabetes. For safety's Going ForWarD 10 Summer 5768

sake, the camper's counselors should not only be aware that s/ he has diabetes, but they should also know enough to recognize warning signs of hypoglycemia (or ketoacidosis) in order to help prevent any emergency situations. Whether or not to share your diabetes with other campers is a personal decision. Hindy felt that it would be much harder to keep her condition a constant secret and so she told her bunkmates early on. "I didn't want to spend the whole summer wondering who figured it out and who didn't," she says. "Once they knew, it didn't make any difference with friends, and everyone was fully supportive." Devora, on the other hand, never felt a need to tell any of the other campers. Parents should be very clear with the camp about the diabetes management decisions that their child is able to make independently. While most campers take responsibility for their own daily care, such as what to eat and how to work their own sliding scales or pump ratios, a formal plan should still be instituted for when the camper's parents or doctor should be contacted for advice. Mrs. Joan Skydel, RN, has had over fifty years experience as a nurse, with more than ten years experience as a school and camp nurse. As she sums up her role in relation to campers with diabetes, "I'm there in case of emergency, and I store extra supplies I need written orders from the child's doctor, even if they are managing [the diabetes] themselves, and I need a phone number to call for emergencies I've found though that Don t take no for an answer get FWD involved and together we ll help your child enjoy camp like everyone else. most campers we've had with diabetes took their condition with such maturity, and did everything themselves with no problem. I remember one camper who would call her father when she couldn't figure something out, and the three of us together would decide what changes to make to her pump settings, either due to the camp schedule or food. This worked out great." While the days leading up to camp are spent shopping, packing and labeling all personal belongings, effort should also be invested into keeping a log of glucose checks and insulin requirements. Entering camp with the correct treatment regimen complete with accurate insulin ratios, boluses and basal Summer 5768 11 Going ForWarD

rates makes it much easier to understand what changes are necessary once the go-go-go schedule of camp days gets started. Shelley Yeager therefore recommends that a detailed two-week diary should be kept prior to camp, including blood glucose tests, insulin doses, activities and snacks, so that there is a clear understanding of the child's routine and diabetes. "Knowledge is power in this regard," she stresses. Devora*, who attended overnight camp from eighth grade through twelfth grade, echoes this advice with her personal camp experience. "I had great summers at camp," she shares. "Yet looking back, I think that I wasn't prepared enough for all the insulin changes that would be necessary. I'd advise others to meet with a good doctor before camp, to make sure you have a few good weeks of control so you know at the start of camp that your basals and boluses are set perfectly. Then it's much easier to make the right changes, and you can be in touch with the doctor from camp, if necessary." Packing tips As with all trips away from home, it's best to carry along many more supplies than what you think you will need. A secure location for extra supplies and glucagon must be decided upon (generally the camp nurse's office), and it is crucial that extra bottles of insulin are kept in the refrigerator in the nurse's office. The extreme heat of summer and insulin are not a good match. For the same reason, insulin pump reservoirs should be changed frequently. Be sure to label all of these reserve supplies clearly with the camper's name. Plenty of snacks and quick sources of sugar should also be brought and kept i n t h e camper's cabin. Make sure that other campers know not to eat it during late-night noshing! Syringe, needle and lancet disposal is another thing to consider. The American Diabetes Association recommends bringing a hard plastic box with you that closes securely; this box should be stored with all of your personal possessions, yet not within easy reach where it could be opened accidentally. Campers should either bring the box home to throw out at the end of camp, or give it to the nurse's office to dispose of properly. Going ForWarD 12 Summer 5768

Be ready for changes Higher than usual activity level and less access to food between meals generally leads to a decrease in insulin doses across the board. Guesswork is never a good idea when it comes to glucose control, so more frequent monitoring is typically needed to make informed decisions about actual insulin needs. Devora recalls that she checked her sugar often during the busy camp days. "I couldn't predict the exercise level, daily schedule or the meals in advance, so I checked my sugar a bunch of extra times each day just to be sure of what was going on, and to prevent lows. I kept my meter in the bunkhouse, and it was helpful that I went to a camp with small grounds so I could always go back to check." Hindy found that outings to water parks or rafting posed a challenge for her. "One time when we went rafting, they told me it would be a two hour route. So I bolused enough for that time and then took off my pump and left it in a dry safe place. But unexpectedly the trip ended up taking longer and I was off the pump for five hours." Solutions should be worked out in advance in order to avoid such extremely dangerous situations. If your pump is not water-resistant, one idea is to bring a waterproof pouch to camp; these can be purchased easily at sporting-goods stores. Your pump, glucose meter and sugar can all be stored in this pouch and thereby be kept close by and dry even during water activities. Surprise trips, which make up some of the most exciting camp experiences, can be tricky when it comes to diabetes control. Campers with diabetes can request to be informed in advance about these excursions. Devora also recommends adopting a rule set by her family: Never go anywhere at all without winkies [or other sugar] and an extra infusion set in your pocket. That way you're ready for anything at anytime possibly the best motto for a safe and successful time at camp. Zip your bags and lock your trunk, and with these helpful tips in mind have a sensational summer! * Name has been changed to protect privacy. n Summer 5768 13 Going ForWarD

I wish there was someone out there to customize a weight-loss diet especially for me. I wish there was someone who would be able to figure out which foods work best for me. I wish there was someone who would be able to answer all my questions on dieting with diabetes. The Balanced Diet Program is truly a wish come true. For over eight years, people from many communities have turned to the Balanced Diet Program to have customized diets formulated especially for them, with their specific needs and preferences taken into consideration. The program has helped hundreds of men, women and children lose weight and control their health conditions without feeling deprived. The Balanced Diet Program began in Brooklyn, and after many years of success, it has expanded to Monsey and other localities. In addition to the office locations, the program offers a fax-membership whereby clients can communicate with the program counselor without having to travel out of town for personal consultations. Clients also have the option to call or fax their questions at any time of day, and to consult with their counselor whenever the need arises. The secret of the program s success is that it never forces clients into standard diet plans; instead, it focuses on working around each individual s needs and lifestyle. That s why the Balanced Diet Program is the ideal solution for people with health issues, such as diabetes. Measuring food and designing menus isn t all there is to the Balanced Diet Program. The program concentrates equally on the psychological aspect of weight loss. The strong connection between counselor and client helps dieters achieve success faster and easier than they ever thought possible, because a positive outlook and proper perspective on health maintenance is crucial for successful weight loss. The program has successfully encouraged many people to take control of their diets, especially teenagers. There must be a reason why people from all over trust the Balanced Diet Program. It is personal, effective and non-restrictive. Enjoy the bounty of Hashem s creation, while achieving good.בעז ה health Take charge of your health today, by calling 718-302-5622 or 845-352-2082, or reach us by fax: 845-371-2452.

rabbi meisels speaking to the parents Ask any parent to comment on the challenge of bedtime, and you re likely to get plenty of sighs. Ask any child about the same issue, and you ll hear the other side of the story. Although this daily routine is an integral part of every family schedule, parents and children have different adjustments to make when it comes to this issue. Any bedtimebedlam solution must tackle both the parental and childish feelings. The same is true about diabetes. When a child struggles with the challenges of diabetes, the parents struggle as well yet the challenges they face are very different. In order to be able to make the best of the situation and use diabetes as a springboard for growth and yes general good health and wellbeing, it is essential to address both the parents and children s concerns. Friends With Diabetes arranged for an important gathering that took place in Flatbush, New York, where close to 100 families joined for some encouragement, friendship, information and lots of fun. The event was a tremendous success, with people traveling many miles to join some coming from as far away as Canada and Chicago. Parents of children between nine and twelve years of age who have diabetes gathered for a lavish and relaxing dinner. The atmosphere was joyous and friendly, as old acquaintances tried catching up and new friendships were formed. Summer 5768 15 Going ForWarD

I enjoyed meeting the people I got to know at previous events, says Avi s mother, and it was also exciting to get to know new people. Everyone has their own story to tell, their own experiences to relate, and sharing all of this at a relaxing dinner table provides so (R-L) Mike Pirollo (Animas, NYC Westchester), Rabbi Meisels, Jim Vail (Animas Northeast) much encouragement, validation and helpful advice. The event coordinators put much thought and effort into designing individual programs for each group of participants. The parents could focus on the adult presentations while their children had a great time in their own separate boys and girls rooms. The women socialized among themselves, while the men schmoozed at their end, gaining chizuk from each other. At the adult side of the gathering, the parents joined a workshop on the topic of keeping their children s diabetes a secret or being open about it. Different views were shared and the pros and cons of each approach were aired out. It was very enlightening, comments Mr. D. from Brooklyn. Since our daughter was diagnosed, this was one of our most difficult decisions. Until now we ve basically been walking between the raindrops disclosing her condition only to her teachers and grandparents. The workshop definitely gave us a lot to think about. It was interesting to hear so many different views and opinions, says one Lakewood mother. Everyone has their own way of looking at things, and it was nice to discuss various points of view. The main presentation was a speech by Dr. Henry Anhalt who discussed in detail the benefits of pump therapy and the importance of continuous glucose monitoring. The booths from Animas and Dexcom that were present in the room Dr. Henry Anhalt lecturing gave the parents an immediate resource for more information and contacts on these devices. Going ForWarD 16 Summer 5768

A question and answer session followed Dr. Anhalt s presentation, as the parents raised important concerns and had their questions clarified. While all this was going on, the children had a fantastic time doing various activities. I liked the plaster painting most of all! one young girl said to her mother after the event. The children were also treated to an age-appropriate lecture by a diabetes educator, who explained various important concepts. The kids had a great time playing games, and everyone was most delighted with the prizes they received. As the evening drew to a close, friendly good-byes were shared along with plenty of number swapping. The parents and children left with loads of encouragement, important information, and very fond memories. K ISH ECHOD B LEIV ECHAD Frum diabetes-support organization hosts eighth annual boys shabbaton Monsey, NY On Shabbos Parshas Bamidbar, over 25 boys from around the nation and world converged on a single home in upstate New York. But while a shabbaton may not be news, it is when its participants all have diabetes and when they have assembled for the primary purpose of reminding each other, and those who haven t yet joined, that the ideal way to survive and thrive with diabetes is by bonding and sharing with other diabetics. The shabbaton is another regular project of Friends with Diabetes, commonly referred to as FWD, an organization for frum diabetics founded in the late 90 s and led by Rabbi Hirsch Meisels, a Monsey magid shiur and self-taught diabetes authority. Participants began trickling in Friday afternoon, with many arriving directly from regional airports, enjoying the cozy atmosphere, casual conversation and bevy of snacks and drinks at the FWD conference center, a converted home at 31 Herrick Avenue in Spring Valley. As the afternoon pressed on and Shabbos table set for 30 more young men arrived, a small surprise unfolded as two participants who attended the same yeshivah simultaneously learned the Summer 5768 17 Going ForWarD

other has diabetes, a fact kept secret until that point. At 3:00 p.m., with the two dozen bochurim ages 15 and up comfortably settled, the shabbaton s first formal event began with Rabbi Meisels welcome and opening remarks. Rabbi Meisels then introduced the first of what would be several speakers over the course of the Shabbos. Rabbi Chaim Leibish Rottenberg of Forshay, New York, dwelt in his talk on the subject on tzadikim who would trigger spiritual blessings of sustenance for Klal Yisroel by depriving themselves of physical food, positing that the same spiritual mechanism is at play when diabetics physically deprive themselves by their constant care and scrutiny of their food intake. The speaker concluded that this may be why today s frum world has so many diabetics, as their rigorous regimens spread the wealth for the whole world. You have a zechus, finished the speaker, and people should thank you for it. The group then davened minchah. Rabbi Meisels next took the podium, dwelling on the theme of achrayus when it comes to maintaining optimum diabetic health. We have a responsibility to stay healthy, he Going ForWarD 18 Summer 5768 Rabbi Rottenberg addressing the boys said. We are the first generation to show the world that Type 1 diabetics can and will live long healthy lives. Past generations weren t so lucky due to lacking three things: biomedical technology, knowledge, and social support. Today, it s medically proven that if you control diabetes you re the same as anyone else, and this is something that we will show the world but we have to take it seriously, we have to take care of our health. Towards his speech s end, Rabbi Meisels unveiled an exciting Shabboslong contest: a carb-counting competition with a Shas raffled off as a grand prize. Type 1 diabetics must calculate the carbohydrate content of everything they eat so as to compensate it with insulin injections, a constant chore that becomes surprisingly easy when diabetics have carb counts at their fingertips. Five carb-knowledgeable older bochurim volunteered as Carb Wizards, turning every meal and snack into an exciting carb-counting challenge that awarded raffle tickets to young competitors for correct or near-correct carb calculations. The competition motivated the boys to watch their blood sugar, or insulin levels throughout Shabbos, with one boy saying, I never had

such good blood sugars like this Shabbos! Indeed, Rabbi Meisels believes, a diabetic can eat anything anywhere so long as he or she knows the insulin level to compensate for the food s carbohydrate level. As a diabetic himself, Rabbi Meisels commiserated with the young participants and their perpetual travails, recalling how he too was constantly nudged by parents, teachers, nurses and doctors to maintain his diabetic health. To drive home the point, he quoted a vort from Chasidic great Reb Shmelke of Nickolsberg, who had a novel interpretation of the verse Tov lishmoi a ga aras chacham may ish shomai a shir kesilim. While the standard meaning is that it s better to listen to a wise man s rebuke instead of the fool s song, Reb Shmelke would say that the ga aras chacham, the wise man s lesson, emerges mayish shomai a shir kesilim from the man who listens to fools. The point, Rabbi Meisels said, was that one can learn something from everyone else s experience but that the best lesson comes when the chacham hears the shir kesilim, meaning, when the chacham has his own personal experience. That s what this Shabbos is for, he said at his speech s conclusion. To motivate you. Following Rabbi Meisels talk, the atmosphere of achdus once again came to the fore, as the Chasidish and Yeshivish young men from as far as Toronto and London and as near as Monsey and Borough Park bonded around the Shabbos table, enjoying divrei Torah and shmoozing well into the wee hours of the morning. Shabbos day was marked with the morning shachris minyan in the FWD center s beis medrash, followed by a delicious seudas Shabbos lunch marked by FWD s trademark Ahavas Yisroel and a special appearance by noted badchan and community activist Yoely Lebovitz, who sang, spoke, inspired, and cracked more than a few jokes. I had such a headache from laughing, said Rabbi Meisels. Diabetes has its rules: when you do this, this happens; when you do that, that happens but everyone likely has one exception to at least one rule in their personal experience, Rabbi Meisels explains. In this light, Rabbi Meisels reminded attendees throughout the day to think of unique personal experiences in which their diabetes was shown to defy the conventional wisdom. Dr. Andrei Kolesnikov, a member of Maimonides Hospital s pediatric endocrinology unit, was on hand as well throughout the Shabbaton, lecturing and providing hands-on assistance with using glucose monitors and other diabetes maintenance technology. Local educator Rabbi Chaim Nitzlich spoke at the meal s end, drawing inspiration from the recent annual Fleet Week visit by the U.S. Navy to Manhattan s West Side. One can learn mighty lessons from the Summer 5768 19 Going ForWarD

sailor s life, said Rabbi Nitzlich, from his impressive ability to get things done despite living and working in cramped quarters to how he salutes everyone above him. If only we would do for the Aibershter what soldiers do for the military, said Rabbi Nitzlich pointed out, concluding that in the military, you always have to shteig, you have to go higher in rank, and there s always a place to improve, leaving his listeners with what Rabbi Meisels later described as a very interesting, encouraging and motivating message. After the Shabbos afternoon break, two minyanim for Minchah were held, followed by a Shalosh Seudos discussion led by Rabbi Meisels on the rules and exceptions of diabetes, at which each FWD member rose to share their own personal rule-breaking experience. Everyone stood up and mentioned something, and it sparked such great discussions, recalls Rabbi Meisels. For example, does coffee raise blood sugar levels? For some, yes, and some, not but one boy claimed to learn for two hours while on ta anis dibur and then having an easier time controlling blood sugars. Another participant claimed lower blood sugar levels when he would drink a can of Diet Pepsi, said Meisels, while a third reported better blood sugar levels on Pesach. The Shalosh Seudos continued with nigunim, in turn followed by a dvar Going ForWarD 20 Summer 5768 The first thing you have to do is watch your health Torah by Rabbi Meisels. The rabbi quoted the Chasam Sofer, who pointed out that the building of the Beis Hamikdash does not override the observance of Shabbos but that saving lives does. Thus, the Chasam Sofer concluded, the kedushah of preservation of life supersedes the very House of Hashem itself. Bereishis bara, Rabbi Meisels concluded, noting that the Torah s second word can also refer to health. The first thing you have to do is watch your health. After Maariv and Havdalah, the group slowly dispersed for their trips back home, taking home far more than what they arrived with. Additionally, private shidduch meetings for the older bochurim were held after nightfall at the Meisels home. I was very much encouraged to take care of everything and stay on top of the latest technology. I didn t realize how much I could gain until I came and met other people who have it and are happy about it and not depressed, said Levi S., a 20-year-old member from Canada. Meeting guys in the same situation and discussing things about it, not only dealing with carb counting, but seeing other people and meeting people to whom it was nothing and they re happy, made me happier. This Shabbos is more than anything I ever had.

FWD STARTS NEW CHAPTER IN FIVE TOWNS Newest local community group to service Long Island, Far Rockaway, Queens diabetic community History was made yet again this past Tuesday, May 27, 2008, as several dozen FWD members and diabetic newcomers met at the elegant home of Rabbi and Mrs. Aryeh Z. Ginzberg, the spiritual leader of the Chofetz Chaim Torah Center in Cedarhurst for the inaugural meeting of FWD s Five Towns chapter. The group was initiated at the behest of Rabbi Ginzberg and a community philanthropist who asked why the Five Towns did not have a FWD chapter. The event, which began at 8:30 p.m., followed an informal meeting format, with Rabbi Meisels sharing extensive stories from his own diabetic background and outreach experience. These were interspersed by informative and thorough presentations and tips by our very own Mrs. Roni Pagano, our long-time certified diabetes educator, who was moved by the positive atten- Hey, FWD s: FWD IS NOW I N T H E FIVE TOWNS! The Five Towns Chapter of FWD recently held its first meeting and would like to welcome FWD s in the Five Towns, Far Rockaway and Queens to join us next time! Share and care, boost everyone s morale (including yours!), learn the latest tips and tech, meet old friends and make new ones! Guest speakers and special presentations For date/time/location information, call MEYER 917-642-3658 or FWD 845-352-7532 Next meeting late July!!! Summer 5768 21 Going ForWarD

dance which starkly contrasted the many lackluster meetings she had run in her past experience. How do you do it? she marveled aloud. With the majority of attendees already veterans of FWD and other diabetic-group meetings, considerable discussion was spent on how to get new members on board. I liked all the collaboration, all these people there saying, Let s get more people involved, says Mrs. Pagano when asked for the meeting s highlight. I think there will be twice as many next time. Indeed, the group plans to initially draw upon Queens large Jewish community, and then split it off into a group of its own once attendance swells as expected. Another topic of discussion was area physicians who treat diabetes. It s really not true that the best hospitals are in Manhattan, says Mrs. Pagano. We have quite a few good ones out here on the island. Mrs. Pagano also demonstrated several new insulin pumps, drawing on her years of experience as a salesperson for the Animas insulin pump company as well as her Maimonides Hospital-based diabetes educational work. An important part of the event, which Mrs. Pagano described as a part rally, part pep talk, was Mrs. Pagano s overview of her community diabetes outreach plan, which let s get more people involved consists of providing informative FWD diabetes brochures to nurses at boys and girl s yeshivos, pediatric offices, and pharmacies to distribute as needed, so as further FWD s mission of letting Jewish community members with diabetes know they are not alone. Rabbi Meisels took pride in noting that his FWD work inspired a concerned diabetic woman in Israel to single-handedly start a now-independent diabetes-support group in Jerusalem six years ago. That same take-charge spirit, Rabbi Meisels pointed out, is what fires and drives Friends with Diabetes. The special locals-only feeling was heightened when one attendee remarked that had he only had this kind of support fifty years ago, his life could have been vastly different. Mrs. Pagano also educated the diabetics on the basics for daily maintenance of general health and blood sugar levels. The Five Towns chapter s next meeting is planned to be held at the end of July, b ezras Hashem. The meeting lasted an hour-anda-half, and drew to a close with the group expressing happiness and excitement at having met, and high morale for the immediate future which is exactly what the meeting was for in the first place. Going ForWarD 22 Summer 5768

Rabbi Meisels inantwerp Diabetes lectures attended by over 1,200 men and women Antwerp, Belgium is home to a thriving frum community which offers its members a well-built communal infrastructure, including shuls, school, mikvaos, socialservices organizations, and, of course, its own Hatzolah chapter and FWD group. There was, however, one thing Antwerp did not have until recently an organized diabetes education effort. The Type 1 diabetics were nudging me for over a year to come and organize a group, Rabbi Meisels smiles and jokes. But that changed this past May 9-12 weekend, when FWD s membership, spearheaded by Mrs. C.S. Lefkowitz, joined forces with Hatzolah to organize a first-ever diabetes and health lecture event featuring our very own Rabbi Hirsch Meisels. With all expenses graciously sponsored by Hatzolah in keeping with its greater mission of health awareness, Rabbi Meisels landed at Brussels International Airport on Friday morning, May 9, 2008, where he was greeted by Mr. Chaim Lemberger, from the vaad of Hatzolah of Antwerp. He was then transported to the Radisson SAS Park Lane Hotel, a short walk from the frum community s center. Rabbi Meisels reports that he spent his first-ever Shabbos in Antwerp as a guest in a new home for each meal, not to mention davening in a different shteeble for each tefilah an experience that allowed him to lead a Pirkei Avos shiur on Shabbos afternoon and meet a lot of people. He even led an impromptu question-andanswer session in one shul that was sparked by one person s question; by the time it was over close to an hour later, over 30 attentive listeners were surrounding the rabbi. With posters having been plastered all over the frum neighborhood for well over a week before the main events, the turnout was tremendous, with a capacity crowd filling the hall at Agudah building for both of Rabbi Meisels lectures. Going ForWarD 23 Summer 5768 Going ForWarD 23 Summer 5768

The first, exclusively for women, saw over 600 grandmothers, mothers and daughters gather Sunday night, May 11, to listen keenly to Rabbi Meisels fascinating talk on proactive health. In his hour-long, factpacked discussion, the rabbi dwelt on what he considers the fastest-rising health threat metabolic syndrome and how to combat, reverse, eliminate and prevent it. As a still relatively unknown condition, Rabbi Meisels explained, metabolic syndrome has five indicators: elevated blood pressure, elevated blood sugar, elevated triglycerides, low HDL cholesterol, and excessive body weight. After walking the crowd through the basic definitions of each of the five, Rabbi Meisels pointed out why MS not to be confused with multiple sclerosis is of such concern: because it leads to many other conditions, such as fatty liver, and colon or prostate cancer, and may lead to heart attack and stroke. In other words, metabolic syndrome is considered a risk factor for heart disease, said Rabbi Meisels. Rabbi Meisels then explained that while all five indicators can be treated individually, like the many diets it s never too late to start taking care of one s health, and it s never too early that reduce weight and the pills and vitamins that reduce blood pressure or cholesterol, it would make far more sense to address the one thing that triggers all five: over-consumption of carbohydrates. If there s one thing that affects all of them, doesn t it make sense that that s the culprit? Rabbi Meisels rhetorically asked. Having presented the problem, the rabbi proceeded to the solution, one that he has seen work despite its defiance of modern-day nutritional advice: eating more protein and healthy fats. You can diet and lose weight on a low-fat diet, but your protective good cholesterol, HDL, will drop and your triglycerides will shoot up. So you subtract one metabolic syndrome point, but you add two others, he said. The speech concluded with the rabbi repeating his personal health motto: it s never too late to start taking care of one s health, and it s never too early. The talk was followed by a half-hour questionand-answer session. What was the most interesting question? One lady asked why don t I make a fuss about nash in every speech? recalls Rabbi Meisels in speaking to this article s Summer 5768 24 Going ForWarD Summer 5768 24 Going ForWarD

writer. Nash is a big issue, but not the biggest the schools putting out three servings of starch a meal, besides the bread and milk, is a bigger concern to me. The solution? Substitute some of the starches with proteins in every meal. The following morning, Rabbi Meisels met for the first time with Antwerp s Type 1 diabetes frum community for a first-ever private rally and pep talk. The get-together, held in a FWD member s private home, united 25 diabetics and their family members for a special session with Rabbi Meisels that covered all things diabetes, from the latest glucosemonitoring technology and to shidduchim to insulin-injection halachah and health and exercise. The special event concluded with Mrs. Lefkowitz expressing support, thanks and appreciation to Rabbi Meisels on behalf of Antwerp s Friends with Diabetes. The second speaking engagement, held the following night for men only, focused on metabolic syndrome again, but with a different approach. Rabbi Meisels opened his 45-minute speech by relating how, while once visiting Miami, he met with former open-heart surgery patients and was amazed Substitute some of the starches with proteins in every meal. at how their problems could have been predicted 20-30 years ago had they only scrutinized their HDL cholesterol levels. Rabbi Meisels used the story to illustrate an important truth to the 600-plus attendees: to eliminate metabolic syndrome in its five symptoms and all its related illnesses, one first must balance one s diet. Moving on, Rabbi Meisels discussed HDL cholesterolboosting techniques. These include exercise, quitting smoking, eliminating the consumption of trans-fatty acids (which depress HDL levels), and regularly eating eggs, which raise HDL levels. If all else fails, the rabbi advised, take the niacin B vitamin. And do your blood work, he added. It doesn t matter how old you are. It s so important. Like the previous night, the lecture was followed by a stimulating, informative question-and-answer session that lasted 30 minutes. So what was the trip s primary contribution? There is now a lot of discussion to continue the group, says Rabbi Meisels. Hopefully now that I jumpstarted it, it will last. n Going ForWarD 25 Summer 5768 Going ForWarD 25 Summer 5768

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Secret revealed I stepped into the fourth grade with an artificial air of confidence that concealed my inner turmoil. I must admit I was quite terrified of the twenty-nine youngsters who were still busy scurrying to their seats, despite the fact that it was nearly five minutes after their lunch hour was officially over. Good afternoon, girls, I said, waiting for them to settle down. It took a good few minutes until the classroom took on a semblance of order. I walked to my seat at the front of the room, and started taking attendance. The girls were whispering quietly, probably assessing my qualifications with their fourth grade expertise. I truly hoped they wouldn t give me a hard time. I was starting a substituting job, filling in for the Mrs. Miller who was on a six-week maternity leave. Since it was close to the end of the school year, spring fever was in the air and the girls were naturally less patient to sit through lessons. Even regular teachers often struggle to keep their students disciplined during the last few weeks of school. I knew that as a substitute, my chances of having a completely quiet and attentive classroom were very slim indeed. I designed the first lesson very carefully, hoping to capture the girls attention. I didn t stand a chance. The girls were playing a note-passing game, which took all of their interest and concentration. At first I tried to ignore their behavior and proceeded with the lesson, but as the giggles grew louder, I had no choice but to resort to tougher disciplinary measures. The next hour was quite a struggle, with the girls planning various tactics to distract each other and have some fun, while I plugged ahead, practically talking to the walls. Actually, there was one student who did pay attention. Faigy sat in the third seat at far right, listening attentively and respectfully. She took notes, and Going ForWarD 28 Summer 5768

even raised her hand to ask a question! Whenever I asked a question, she always volunteered to answer, although I tried to pick on other girls so that they should be forced to become part of the lesson. Okay girls, I concluded the first lesson, hoping the exasperation in my voice would be undetectable. Please take out your science books. I left mine at home, one blonde girl piped up from the back. We never have science on Wednesdays, another girl protested. The complaints kept on coming, while I impatiently tapped my pen on the desk. None of the girls took out their science books. Was this some sort of strike? Girls, I m embarrassed by your behavior, I finally said. Please act like mature fourth graders! Some girls smirked. Others snickered. It was sheer chaos. The butterflies in my stomach increased their intensive fluttering. I was beginning to feel lost. Faigy dutifully took out her science book and opened it to the page I had indicated. She turned around and addressed the classmates who sat next to her in a quiet whisper that didn t escape my ears. Why are you so insensitive? she demanded. Why are you giving her such a hard time? Do you really enjoy making another person suffer? Her friends looked chastised and quickly pulled out their science books. Slowly, more girls followed, and soon I was able to begin the lesson. I shot Faigy a grateful look, and she returned a look that reflected so much maturity and sensitivity. Twenty minutes later, I made a funny mistake as I explained a certain concept. The girls took this as an excuse to explode in laughter and disrupt the entire lesson. Once again, Faigy came to the rescue. She shushed her classmates, reminding them that it is impolite to laugh at someone s mistake. Substitutes have feelings, too, you know, she said. I was surprised to see the strong influence she had on her friends. Unlike most goody-goodies who are ridiculed and rejected, everyone seemed to respect Faigy very highly and desire her approval. It was easy to see why. Faigy was definitely an intelligent girl, probably highly popular among her friends, and in addition she had Summer 5768 29 Going ForWarD

a very charming personality. She spoke with confidence, and her very demeanor demanded respect. I wouldn t say that the rest of the day was smooth sailing, but the class was definitely much calmer. The next day, things were much better from the start. Somehow, I sensed that Faigy had spoken to her classmates and persuaded them to give me a chance. The girls listened and participated in the lesson, and I was beginning to enjoy my job. Later that day, I found myself thinking about Faigy. She was so much more mature and understanding than her classmates, almost as if she were several years older than her true age. She was so sensitive, so good-natured, and at the same time she showed such strength of character. What a great kid! I thought. I wish my children would be like her. The telephone s ring interrupted my thoughts. Hello? I asked. Hi, my name is Shaindy Rosen. My daughter Faigy is in the fourth grade you are substituting for. I must say that Faigy likes you a lot Obviously, her condition polished her sensitivities to others and helped her mature far beyond her years. and you re doing a great job. There is something I want you to know, however. Before she continued, I warmly complimented her on her daughter s midos and behavior. Mrs. Rosen thanked me, and then continued explaining the reason for her call. Faigy has type 1 diabetes. Since you ll be teaching her class for six weeks, I feel it s important you should know a few things about it I listened quietly as Mrs. Rosen explained her daughter s condition. Suddenly, it dawned on me that Faigy s special qualities were the direct result of her health struggles. Obviously, her condition polished her sensitivities to others and helped her mature far beyond her years. Faigy was definitely the type of girl that s every mother s wish. Although no parent would ever choose to go through such a nisoyon, ultimately, what Mrs. Rosen and Faigy gained from this heaven-sent trial was surely worth the price. Like a gem that was scraped and polished, Faigy s struggles brought out her sparkling inner qualities. n Going ForWarD 30 Summer 5768

םעד ףיוא "םוארדניס קילאבאטעמ ןוא סיטיבעייד" רעביא סעיצקעל עכילטנכעוו ערעזנוא טרעה עיניל ןאפעלעט "רשבמ לוק" שמעי ותחי נפשכם-א רשימה פון אונזערע לקעציעס פונעם פארגאנגענעם יאר = 1 מעטאבאליק סינדראום וויכטיגקייט פון טשעקן צוקער = 2 הימאגלאבין A1C טעסט חילוק פון די צוויי טייפס פון דייעביטיס = 3 ריסק פעקטארס פאר טייפ 2 דייעביטיס שעדליכקייט פון היי-פרוקטאז-קארן-סיראפ קאנטראלירן צוקער ביים אויספאסטן = 4 נאטורליכע היילונגן שווער צו פארלירן וואג מיט מ"ס וועלכע צייט טשעקן דעם צוקער, און וואס דארף עס זיין = 5 דער שורש פון מ"ס צופיל אינסולין און רעזיסטענס טייפ 2 דייעביטיס, איבער וואג, בלוט דרוק, און הארץ = 6 וויכטיגקייט פון עקסערסייז, און וויאזוי עס העלפט = 7 צוקער און קאלעסטעראל נומבערס אין קאנאדא און אייראפע ריכטיגע צייט צו מאכן עקסערסייז = 8 אינטערוויו מיט עקסערסייז סוחר = 9 מילגרוים און הארץ דיזיס = 10 הלכות פון טשעקן צוקער שבת און יו"ט פון פאסטן צוגרייטן צו א תענית וויאזוי אויסצופאסטן = 11 דער איינציגער דייעט וואס היילט מ"ס אן מעדיצין נידריגע קארבאהיידרעיטס. = 12 ציילן קארבאהיידרעיטס = 13 פארלירן פאטעסיום וויינען אן צוקער = 14 לאטקעס גלייסימיק אינדעקס עפעקטיוו קארבס שאגער אלקאהאלס = 15 ווער האט מעטאבאליק סינדראום? די וויכטיגקייט פון עסן גענוג פראטין = 16 ווייטעמין די דער גרעסטער מאנגל און די סיבה פון מערערע מחלות. = 17 מאגניזיום און קאלציום באלאנס = 18 סטודי וואס האט כלומר שט איבערצייגט שעדליכקייט פון עטקינס דייעט = 19 בענעפיטן פון סעטשורעטעד פעטנס קאלעסטעראל אין מאכלים = 20 שעדליכקייט פון טרענס פעטס, און פארשעלי היידראדזינעיטעיד אוילן = 21 מאנא אנסעטארעיטעד פעטס, אמגא 9 אוועקאדא און פאטעסיום = 22 שאלות ותשובות = 23 פסח: אלקאהאל און צוקער פון וויינען שיעורים פון כזיתים מצה = 24 סטודי איבער אייער, פאלטש דורך און אדורך האנה טאה ןוא טרעה.ןרעה וצ עיצקעל עכעלעוו סיוא טביולק ןוא,2 ךאנרעד 3 ןאשטנעטעסקע טקירד 212-444-1100 845-738-1100 Mazel Tov To Members and their husbands upon the birth of their baby 2854 438 Members upon their bar mitzvahs 376 1091 1092 1133 1202 2233 2411 2705 Members and his kallah upon his engagement 2444 Member and her chasan upon her engagement 60 Going ForWarD 31 Summer 5768

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