My son recently became bar mitzvah. I am writing to ask you as to what he should do in the future about fasting on the six annual fasts. Three years ago this summer, my son was in a swimming pool for a few hours. He possibly became dehydrated, and shortly after coming out of the swimming pool, all his muscles in his entire body went into spasm, and he was taken to hospital where he remained on a drip for two days. During this time he had frequent attacks of his muscles spasming. Each attack lasted for up to twenty minutes. The attacks resembled seizures, but were not seizures. The Doctors did not know what caused the spasm of muscles in his entire body, and suggested that maybe it was a combination of dehydration plus some kind of virus. Even after my son left hospital, he continued to have attacks, reducing in intensity and time for a month afterwards. We took him to a specialist after the attacks finished, but he didn’t know the cause either. Since then my son has had other attacks, although not nearly as serious as the initial time that required hospitalization for two days. He has had attacks of these muscle spasms after getting slightly dehydrated, and a different time after becoming frightened over something, and a different time after having two or more energy drinks that contain caffeine, and most recently after trying Ritalin for his ADHD problem. In the latter instance it took him about four hours to recover. Also recently, my wife and I took him to a paediatric neurologist who did an EEG and an EMG. Both tests were okay baruch Hashem, so he does not have epilepsy. Over the last year he has started each fast, and suffered anxiety over the possibility of bringing on one of these muscle spasm attacks. Up until his bar mitzvah, I told him to fast until he gets a headache or feels ill, and then to break his fast. What should I tell him to do now on Yom Kippur, Tisha B’Av, and the other four fasts?

Answer:

For fasts other than Yom Kippur it appears clear that he is not obligated to fast.

This is true even for Tisha Be’Av, from which cholim are exempt from fasting. The condition of your son, while it lasts, is a type of choli – a type of sickness, even it is anxiety related – and therefore he will not have to fast at all for Tisha Be’Av.

Therefore, your advice of fasting until he beings to feels ill is a good idea, and is in particular applicable for Tisha Be’Av, as we find concerning pregnant women who (according to many authorities) fast until they feel ill. See also here for a general discussion concerning performing mitzvos where there is a risk to health (se

The main issue here is Yom Kippur, for which it is forbidden to eat unless there is a concern of pikuach nefesh. From the description of the initial condition, this seems to be a possibility, because we cannot know what result fasting might have — but an expert medical authority should be consulted on the matter (you can ask again after consulting).

It is possible that the problem can be resolved by means of pills that can be taken during the fast, which will provide him with caffeine and other nutrients. This will also calm the anxiety, so that please G-d there won’t be any problem. Another possibility, though we wouldn’t usually prescribe it, is to us an infusion to ensure the body remains hydrated. The reason why this option will be considered for this case is the fact that condition it is so unclear.

In any case, the first move should be to consult with a specialist, in hope that we’ll be wiser after the consultation.

Good luck with the issue and best wishes.

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