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Like going to sleep at night later than planned, it happens way too often for comfort that pieces of my kallah jewelry go AWOL.

The latch on that earring must be loose, I fret as I find myself once again on my hands and knees, scouring the floor of my closet for the missing piece of jewelry. I only wore those diamonds once a week, how could I have lost it? It was the second time already. Okay, it’s not here, I admit, getting up from the floor. An acrid taste fills my mouth, and something suspicious stings my eyes. Why am I getting so worked up over an earring already?

Determinedly, I turn away from the offending closet with the missing earring and begin dumping my carefully folded piles of clothing haphazardly into the suitcase lying on my bed. I blink, trying to clear my eyes from the suspicious moisture.

I knew why. It would just be another reason I couldn’t make my mother-in-law happy with me, despite all my efforts.

“Hello!” Moishy says in a cheerful whisper as he enters the room. “All done Maariv and ready to help you pack!”

“Forget it,” I say, too loudly. Oh no, the twins better not wake up! “It’s fine, I’ll manage.”

Moishy looks at me, amazed. “What happened? You don’t want my help packing?”

“I do!” I nearly shout, and hastily shut the door of the room so the twins won’t hear me. “It’s just so crazy! The house is flying, and the twins are going to wake me up at the crack of dawn tomorrow, and I’m going to be exhausted because I stayed up to pack. And then we’re going to travel up to the bungalow colony with two hyper kids going crazy in the car, and then they’re expected to be on their best behavior for 48 hours straight! Whose definition of normal is that?!!”

I yank open a dresser drawer, eyes smarting again.

I’m so not a kvetcher. I don’t know why this is pushing all my buttons so badly.

“At least if they had day camp tomorrow, it would be a little easier,” I mutter into the pile of towels. “This week is the most insane week for me, when Zevy and Mutty are home all day in between

school and day camp.”

Moishy’s been listening quietly, a little shocked at my unusual vehemence. He sits down on his bed, looking thoughtful.

“Wow.” He says, and I look up. I try to crack a smile.

“Okay, it’s not so bad,” I start, but he holds up his hand.

“No, you’re right, Chani. We did discuss that it would be hard for you. You only gave in because it meant so much to my mother that we should be there the first week of the summer. But it’s turning out harder than expected.”

“Yeah,” I mutter. “And don’t forget that the boys need to show up bright and early Monday morning in day camp, all ready for summer. After coming home super-cranky because they were away from home for two days.”

This last comment sparks something in Moishy’s mind. I can see the “I have the perfect solution!” look on his face before he even opens his mouth. Inwardly, I groan. What’s he going to come up with?

“So how about we come home Motzaei Shabbos?” he exclaims. “I thought it would be nice to stay over Sunday when the boys are home anyway all day, but if it makes it easier to come home Motzaei Shabbos, then let's do that!"

"Your mother’s never going to let,” I mumble. But the idea sounds promising. A whole day less in my mother-in-law’s space and another day to prepare the kids for day camp would be great.

“I’ll talk to her,” Moishy promises. “Will it make it easier for you?”

“Yeah,” I say definitively. “It’s a great idea.”

“Perfect,” Moishy says, cranking himself up. “Now what can I do to help you pack?” ***

Right after licht benchen is always my best time. Moishy watches the kids for an hour before Shabbos so I can get ready for Shabbos calmly, and I finally get to feel like a normal person.

I finish benching licht and settle down on the couch with my angelic-looking boys, still fresh from their baths, wearing adorable matching Shabbos robes. They cuddle up to me, Mutty with his thumb in his mouth and Zevy holding his sippy

cup.

“Good Shabbos,” my mother-in-law says, sinking into the recliner facing me. I feel her discreet eye looking me up and down, but I don’t really feel uncomfortable. I know I look good-my makeup is flawless, my wig freshly done.

“Those are such pretty earrings,” my motherin-law says thoughtfully, admiring the silver on my ears. And my heart sinks.

Of course, she would immediately find the missing detail and notice that I wasn’t wearing my kallah earrings, the diamond hoops she’d carefully chosen for me.

I look down at Zevy to hide my roiling emotions. I knew I could never do it right by my mother-in-law.

***

“Soooo nice!” Mrs. Golding, my mother-inlaw’s bungalow neighbor says approvingly. “Aren’t you lucky to have such a mother-inlaw? Right away she invites you to come stay by her, the first Shabbos in the country!”

I smile, making sure none of the irony leaks onto my face. “Yes, it’s really beautiful here,” I say. And it’s true. There’s something extraordinarily peaceful about being surrounded by nature. Even if I counted some very annoying comments in the last 24 hours, which makes me too uptight to enjoy any of the beauty around me.

Chani, does Mutty need a bib before he eats kugel?

Can Zevy eat the soup himself?

I thought Mutty stopped sucking his thumb. I see he’s still having a hard time with it. My mother-in-law’s comments revolve in my head like a colorful carousel, making me too uptight to enjoy any of the beauty around me.

Mrs. Golding nods approvingly once more before heading into her bungalow. I should really say summer home, because these bungalows are outfitted with the latest modern furniture and every amenity. I’m here anyway, I may as well enjoy it, I think. Both of my boys are pumping energetically on their swings, singing at the top of their lungs. They’re too little to know how to get themselves really high, but they don’t seem to care, and they keep pumping. I smile again, this time a genuine one.

Surreptitiously, I close my eyes, hoping no one will notice.

Crash!!

“Mooommmy!!!” Desperate shrill wailing shakes me instantly awake. What’s going on?! Zevy’s screaming, Mutty seems to be shrieking along for the fun of it, and I feel like every eye is on me.

I scoop a muddy, dirty Zevy up from the floor, where he’s tangled in the swing that broke loose on him. He’s flailing, thrashing desperately in pain.

“Sha, sha, sha, Zevy, Mommy’s here,” I croon as I check for bruises. He looks okay, just badly frightened and a little banged up.

“Okay, time for Shabbos party!” I announce, as I attempt to get up with Zevy’s 30 pounds on me. I nearly buckle, then steady myself. “Come with Mommy!” I tell Mutty, who’s stuck his thumb in his mouth. Uh oh, his grandmother can absolutely not see him doing that.

“Come,” I urge again, trying to take Mutty’s hand without losing my grip on Zevy, whose crying has subsided to whimpering.

“Mommy’s going to give you Shabbos party!”

Mutty looks as mulish as only a two-year-old can, obviously insulted that his twin is being carried while he’s expected to walk.

With another coax, he finally starts moving reluctantly. I shlep my dirty kids to the bungalow, hoping that my mother-in-law is still enjoying her Shabbos afternoon nap. But no such luck, of course. My mother-in-law is sitting at the table sipping iced tea, reading a book.

“Good Shabbos!” I say cheerfully, pretending I’m not panting and covered in dirt.

My mother-in-law looks up. A horrified expression covers her face at the sight of us, which she quickly wipes away.

“What happened?” she asks with concern. I squirm inside.

“Zevy fell,” I say unceremoniously. “But he’s fine, and now Zevy and Mutty are ready for Shabbos party.”

“Okay,” my mother-in-law says. “But don’t you think they’d like to get washed up first?”

I don’t grit my teeth, although I’d love to.

“Of course, I was just going to do that,” I lie. Then I take both kids to the bathroom, change them from head to toe, and wash them thoroughly in the sink, despite their protests.

It sounds easier than it is, because while I’m changing Zevy, Mutty’s emptying a toilet paper roll, and while I change Mutty, Zevy runs the water in the sink delightedly. I hope

that my mother-in-law’s not listening outside the door of the bathroom.

Finally, I drag both clean kids back to the kitchen. My mother-in-law has used the time to cut up watermelon, fruit, and chips artfully on the table. She smiles at the sight of them all freshly changed.

“I wanna ‘loupe!” Zevy announces dramatically as I settle him into a chair. He jumps up on the chair and reaches, sending three bowls flying and their contents skittering across the table and onto the floor.

I will myself out of the room, but of course I still find myself there two seconds later, watching my mother-in-law purse her lips ever so slightly, obviously trying not to make me feel bad.

“I’ll be outside on a lawn chair,” she tells me brightly. Her unspoken message is clear: Make sure the room is clean when I come back. I just hope Moishy told her outright that we are leaving. Tonight. Not tomorrow. ***

Moishy did tell her. But my mother-in-law is still disappointed.

“It would have been so much fun for Zevy and Mutty to get to go to the pool,” she says regretfully. “And I was going to show you where they could go feed the ducks by the lake. Such a pity. You were here so short.”

“I’m sure Mutty and Zevy would have loved it,” I say, matching my tone of regret to hers.

“I just think that they need to be back on schedule before they start day camp.”

I know that, despite all the wreckage my kids have created in her perfect bungalow, my mother-in-law really does want us to stay. Easy for her to say, when I’m the one running myself ragged to make sure nothing too destructive happens and to clean up their messes.

And anyway, she has a cleaning lady on Sunday afternoons.

“Are you sure you don’t want to change your mind, Chani?” she asks, and I feel put on the spot. What am I supposed to say?

“I think we’re going to pack up now and go, Ma,” Moishy says as softly as he can. “We had such a wonderful time. We’ll definitely be back!”

My mother-in-law’s wistful expression follows me all the way to the back room, and I feel horribly guilty. I know that she’s lonely here all week, with all her kids married and most of them far away. My father-in-law’s never home

and she’s not a social butterfly. But I’m too selfish to stay here. And I can never make her happy anyway.

I feel even more guilty when I hear her talking to Moishy when he goes back to the kitchen.

“Do you really have to go? I feel like you’re always rushing out.” She says, and I know what she means. We do always cut our visits shorter than she likes.

Now I really feel awful. “I feel so bad,” I stagewhisper to Moishy when he comes back.

“Don’t,” he says authoritatively. “Feel good. We came this Shabbos only because she asked, right? We do what we can. It’s fine if we go back now.”

I bite my lip. I’m not perfect, but I am trying. Is that enough, though? ***

Sunday morning brings a thunderstorm that starts in the early morning. I feel vindicated. No pool today anyway! Then I feel a pang. My mother-in-law will be cooped up inside all day probably, and wishing we were there.

I let the boys sleep a little later than usual so that by the time they’re awake, the storm has quieted and there are lots of large puddles left on the street for them to jump in.

“Who wants to go jump in the puddles?” I ask cheerfully immediately after breakfast.

“Me! Me!” They shout excitedly, and I relish the thought of them getting soaked and dirty to their heart’s content with no one around to criticize it.

“Let’s take out the rain boots,” I say, leading the way to the coat closet. I pull out raincoats and rain boots for the kids, then bend down to remove my own rain booties.

Something glistens up at me from the coat closet floor. I pick it up without thinking, and then my heart catches in my throat.

It’s my earring.

The diamond earring I received from my mother-in-law as a kallah.

Something in my heart lifts, as I contemplate the no-longer-missing earring nestled in my palm. I don’t know what it means, finding this earring now, of all times, in the most random spot where I never would have looked for it.

But when I look out the window, I see the sun peeking through the clouds. And suddenly, I’m pretty sure it’s okay that I’m not perfect. Because only Hashem is perfect. •

Camp Directory

PASTRAMI PASTRAMI

Hiccups Could Be a Sign of Something Serious

AT-A-GLANCE

· Hiccups can happen to anyone, at any age. Most are mild and stop within minutes, but in some cases, persistent hiccups may go on for months. These may indicate a significant health problem, including stroke, diabetes, kidney disease or cancer

· Certain irritations can trigger hiccups, such as eating or drinking too quickly, drinking very hot or cold liquid, carbonated beverages, consuming alcohol, overstretching your neck, or experiencing high levels of stress like fear or excitement

· Hiccups are an orphan symptom of cancer treatment, socalled as they are more common than most doctors know and are seldom evaluated. Chronic hiccups can lead to fatigue, lower food intake, weight loss, sleep deprivation and aspiration pneumonia, which may hasten death in cancer patients

· It’s crucial to learn how to live with chronic hiccups until they can be stopped. Avoid triggers that increase the risk of hiccups such as spicy food or carbonated drinks, sip water throughout the day to stay hydrated, and take small bites to lower the risk of aspiration

· There is anecdotal evidence that some home remedies can stop hiccups, such as breathing into a paper bag, sipping vinegar or swallowing sugar, gently applying pressure over the eyeballs, squeezing the fingernail on the pinky finger for 10 seconds or stimulating the vagus and phrenic nerve while swallowing

By a clinical nutritionist:

Hiccups can happen to anyone at any age. Although there is no consensus on the role that hiccups play in adults, researchers from University College London announced in 2019 that hiccups in newborns trigger brain signals, which may help the infant learn how to regulate their breathing.

Hiccups describe the sound that is triggered by spasms in the diaphragm. The diaphragm separates your abdomen and your chest, resting under your rib cage. It plays an important role in breathing. As the diaphragm moves downward it creates negative pressure in the chest and you inhale. When you exhale, the diaphragm moves back into place.

An involuntary spasm of the diaphragm causes you to suck in air and at the same time the glottis closes to prevent more air coming in. This causes the classic ‘hic’ sound of the hiccup. For most people, hiccups are self-limited and last for several minutes. They are usually nothing more than annoying. However, for others, hiccups can be persistent, lasting over two days, or intractable when they last over one month.

If you have multiple episodes of hiccups over a prolonged time, this is also considered chronic hiccups. Intractable or chronic hiccups can become a medical issue in and of itself. However, what is also known is that chronic or intractable hiccups in adults are associated with several medical conditions, including cancer.

Chronically Persistent Hiccups May Signal Something Serious

A 2022 case study presented in the Open Journal of Urology discussed the case of a 66-year-old man with a twoyear history of intractable hiccups. When he presented to the physician, he had no symptoms that were suggestive of kidney cancer. However, an abdominal CT scan revealed a welldefined mass on the right kidney that was growing into the perirenal space.

The researchers noted that 80% of intractable hiccups could be traced to an organic cause and the remaining 20% were linked to a psychogenic trigger. They wrote that “Pathologies in the adrenal glands and kidney, particularly the superior pole, irritate the diaphragm and phrenic and vagus nerves, activating the hiccup reflex.”

Tumors that irritate the diaphragm and phrenic nerve may trigger chronic or intractable hiccups. This can include liver cancer, pancreatic cancer or pancreatitis, bowel cancer, renal cancer and adrenal tumors. In addition to being a presenting sign of tumor growth, hiccups occur in as many as 40% of cancer patients.

Dr. Aminah Jatoi, a medical oncologist from Mayo Clinic Rochester, and two colleagues developed a survey to gauge health care providers’ understanding and awareness of the significance of hiccups in patients with cancer. Ninety completed surveys were returned from physicians, nurse practitioners, nurses and physician assistants.

The survey found hiccups were an under-recognized issue in cancer patients and even when it was recognized and treated, 20% of the health care providers noted that current therapies were not effective, and more treatment options are needed.

A 2013 paper suggested that refractory hiccups may be associated with hyponatremia, and physicians should consider this in their differential diagnosis when cancer patients

present with chronic hiccups. A 2021 paper noted that one-fifth of the cancer patients in their study suffered from hiccups and 54.1% of those had gastrointestinal cancer.

As The Atlantic notes, cancer patients may have two ways that hiccups are triggered. Those who have cancer close enough to irritate the phrenic nerve, such as tumors in the chest, throat or head may have a higher risk of developing chronic or intractable hiccups. Researchers have also found that the drugs used to treat cancer, such as chemotherapy and steroids, also increase the risk.

Other Medical Conditions Associated With Chronic Hiccups

As you have likely noticed, certain things can trigger mild hiccups that go away within minutes. Anytime you eat or drink too quickly, drink very hot or cold liquid, drink carbonated beverages or alcohol or overstretch your neck, you may trigger mild hiccups. Additionally, hiccups can start when you experience high levels of stress, such as fear and excitement.

In addition to certain types of cancer, chronic or intractable hiccups are also associated with other serious health conditions. As with the types of cancers that trigger chronic hiccups, these health concerns can irritate the diaphragm or phrenic nerve.

Stroke

Brain injury

Demyelinating disease

Mechanical irritation of the eardrum

Gastrointestinal or abdominal disorders

Growth on the thyroid gland

Diabetes

Electrolyte imbalance

Pleurisy

Pneumonia

Ear infection

Sore throat

Asthma

Pregnancy

Pancreatitis

Hepatitis

Bladder irritation

Kidney disease

Parkinson's disease

Some medications

A 2021 paper presented the case history of a man with Parkinson's disease who developed severe hiccups when taking dopamine agonists to treat the disease, but the hiccups did not occur when using Levodopa, a central nervous system agent. Corticosteroids, benzodiazepines, acid reflux drugs, barbiturates and opioids are also associated with drug-induced hiccups.

The Benefit of Treating Orphan Symptoms for Cancer Patients

Hiccups are one of the “orphan symptoms” in cancer patients, which are symptoms that are seldom evaluated in assessment tools. Yet, as The Atlantic describes Colleen Kennedy's experience during chemotherapy and radiation treatment for stage 3 lung cancer, the pain and discomfort can be overwhelming.

“She hadn’t expected the hiccup fits that started about halfway through her first treatment round. They left her gasping for air and sent pain ricocheting through her already tender body. At times, they triggered her gag reflex and made her throw up.

After they subsided, she felt tired, sore, breathless — as if she’d just finished a tough workout. They were, Kennedy, now 54, told me, “nothing compared to what we would consider normal hiccups at all.” They lasted for nearly a year.”

In most people, hiccups are transient

and appear to develop randomly. This makes them extremely difficult to study. A 2015 systematic revie found only 341 patients across 15 published studies who had been treated for persistent or intractable hiccups. Based on the paucity of data, the researchers concluded “This systematic review revealed no high-quality data on which to base treatment recommendations.”

While the condition may be difficult to treat, it can be very challenging for patients. A 2022 paper in BMC Cancer evaluated 320 patients and found the median age when hiccups were first reported in this group of cancer patients was 63 years and was notably more prevalent in men than women.

In the group of 320 patients, 89% who reported hiccups were men and only 11% were women. In 62% of the patients, hiccups were reported daily; nine patients had daily hiccups for over six weeks; five had symptoms for years.

Hiccups are a nuisance for most people, but chronic or intractable hiccups can lead to weight loss, lower food intake, sleep deprivation, fatigue and aspiration pneumonia. They can also trigger anxiety, depression and decreased cognitive function. In patients with cancer, some of these issues can hasten death.

Tips to Cope With Chronic Hiccups

When home remedies or off-label medications do not successfully stop chronic or intractable hiccups, it is crucial to learn how to live with them. Charles Osborne had a case of intractable hiccups that lasted 68 years. His was the longest-recorded case as confirmed by Guinness World Records.

Osborne was born in 1893 and developed hiccups after he fell and hit

his head. Kevern Koskovich described how Osborne managed his hiccups to the Smithsonian Magazine as he experienced up to 40 diaphragmatic spasms each minute.

“He’d flex his chest three or four times every minute,” says Koskovich, who knew one of Osborne’s sons and now lives in nearby Correctionville, Iowa. “You could tell he was hiccupping, but he wouldn’t make any noise. He heaved — that’s the best way to describe it.”

For unknown reasons, Osborne's hiccups stopped suddenly in 1990. He died in May 1991 at the age of 97. For most people, chronic hiccups are stressful and disrupt normal routines. Trying to explain the condition can help alleviate some stress.

Chronic hiccups make it difficult to sleep, which in turn lowers your energy level the next day and may trigger you to eat more to stay awake. However, the hiccups also make it difficult to eat and drink, which can lead to weight loss, dehydration and malnutrition. People with chronic or intractable hiccups find it easier to eat smaller amounts during the day as opposed to three larger meals.

Carbonated drinks and spicy food can trigger hiccups, so they should be avoided. It may be easier to drink small amounts of liquid throughout the day to stay hydrated. Since hiccups are unpredictable, they can increase the risk of choking on food or drink, so taking small mouthfuls can help prevent aspiration.

Home Remedies That May Help Alleviate Hiccups

When you're trying to get rid of mild hiccups at home, there are a few remedies you can try. The idea is to engage in activity that interrupts the

hiccup reflex, which hopefully stops the hiccups. If these remedies are not successful, or your hiccups continue to reoccur, it may be time to identify what is irritating the vagus or phrenic nerves.

Supra-supramaximal inspiration — Inhale and hold your breath for 10 seconds. Before exhaling, inhale two more times, each time holding your breath for five seconds.

Breathing into a paper bag — This raises your CO2 level.

Stimulate the vagus nerve — Pull on your tongue, drink or gargle a cold drink, place gentle pressure over your eyeballs, sip vinegar or swallow sugar. Stimulating the uvula or posterior nasopharynx with nasal vinegar or smelling salts, gargling or gagging may also stimulate the vagus nerve.

Compressing the chest — Bring your knees to your chest and hug them or lean forward while sitting.

Movement — Dr. Tyler Cymet, vice president for institutional effectiveness at the Maryland College of Osteopathic Medicine, has found some treatments that work up to 25% of the time, including breathing exercises, yoga and Pilates.

Acupressure point — Squeeze the surface of the fingernail on the pinky finger for 10 seconds.32 Dr. John Talbot believes this has worked on just over 50% of the people he’s used it on.

Nerve stimulation while swallowing — Ali Seifi was a neurosurgeon at the University of Texas Health Science Center when he invented the HiccAway. Seifi explains that sucking water forcefully through a bent device, or drinking through a thick paper towel, draws the diaphragm down while swallowing, which breaks the spasm cycle.

The glistening candles and table adorned in white, surrounded by gleaming faces and the sweet sounds of songs echoing into the night. Shabbos fills the air.

A slice of crispy challah, dipped into a delectable array of mouthwatering spreads, followed by a glass of exquisite wine.

Is there a more special time?

שודיק

Herrings + Potato Kugel + Sweet Lukshen Kugel + Yerushalmi Kugel

Salt & Pepper Kugel + Yaptchick + Chulent + Kishka + Liver Saute

Chopped liver + Gala (Ptcha) + Egg Kchel + Cake + Hot Pastrami

Brisket + Cold Cut Platters + kielbasa + Tounge + and much more

Any changes on the skin should be monitored and brought to the attention of a health ca re provider. It may be as simple as a scratch or as difficult as a skin condition that may need extensive treatment to correct.

There a re many causes for rashes, brea kouts and skin conditions. Rashes may vary in location, color, size, pattern and feel different to the touch. Some rashes a re topical while others a re a sign of an underlying condition and a re a symptom of an imbalance in the body that manifests in a rash. Your healthca re provider will examine the patient and review all relevant data to ma ke an informed decision based on their training and experience. Rega rdless of the reason for the rash it should not be left untreated without the advice of a health ca re provider. Even a minor rash that is caused by an external reason may become infected and/or become a breeding ground for bacteria and fungus that will ma ke it worse.

There are a variety of treatments for different skin rashes which include ointments, creams, medication and sometimes changing daily habits to avoid such rashes in the first place.

A rash may sometimes get worse before it gets better even as treatment is being administered and occasionally the rash will not respond to one course of treatment and the health care provider will try alternative methods to treat the rash.

On occasion, the health care provider will refer the patient to a dermatologist for further treatment.

Most common skin conditions that afflict patients upstate are Sunburns, Poison Ivy/Oak, Insect bites, Tick Bites, Diaper Rashes, Impetigo, and MRSA infections.

Don’t

OUR MAIN BUS TERMINAL IN THE CATSKILLS IS FOR OUR CUSTOMERS ONLY!

301 Bridgeville Rd., Monticello NY 12701

TO THE CATSKILLS

OUR LAST BUS STOP LEAVING THE CATSKILLS FROM THE MAIN BUS TERMINAL

We accept Packages on Friday from Williamsburg to:

• Kerhonkson

• Napanoch

• Ulster Heights AVAILABLE ONLY FROM BEDFORD AVE. COR. KEAP ST. $15 per package

We prefer you come at the first bus route, leaving 8:40 AM Last Friday Aug. 18,

We appreciate your business. For comments or complaints please email: coachbus@gmail.com

Cambridge & Holister (flatware)

Playmobil Ravensburger (puzzles)

Chazak (toys & books)

The Kosher Cook (kitchenware)

Violet Linen (tablecovers & linen sets)

Goody (hair accessories)

Plastico (disposables)

Sunlite (lighting & electric cords)