Living Healthy
Spring 2012 • Vol. 5 No. 1
In Atlantic Canada
Migraines
Hope for headache
sufferers
Colon cancer
The home screening
kit that could save
your life
GET FIT
HAVE FUN
The benefits of
Nordic walking
Who will help me…
make breakthroughs in hearing replacement technologies?
give hope for the hearing impaired in Atlantic Canada?
You can.
Make a gift in your will to the QEII Foundation
and help further medical breakthroughs at the
QEII Health Sciences Centre, Atlantic Canada’s
largest and busiest health care facility.
Tracy, Dave and Beth Spencer suffered from an inherited hearing
disorder that rendered them deaf by adulthood. Thanks to
modern hearing technologies and the efforts of caregivers and
donors at the QEII and other partners, they can hear once again.
Dr. Manohar Bance –pioneering new solutions for
the hearing impaired at the QEII Health Sciences
Centre in Halifax, Nova Scotia
For more information visit qe2foundation.ca
or call Charles O’Neil at 902.473.4511
Cover photograph
by Perry Jackson
Contents
Departments
5 News
11 Ask the professionals
Lyme disease and ticks
How to properly dispose of medications
14
17 The wellness column
The health benefits of Nordic walking
Home screening for colon cancer
32 A patient’s story
35 Nutrition
What parents need to know about concussions
Turmeric: the spice of life?
21
Features
21
25
28
Mind over matter
Hope for migraine sufferers
Health care goes mobile
Mobile apps are taking health care out of the hospital
Happy surgery
An international team helps kids with cleft palate
32
Join us online
You can find Living Healthy in Atlantic Canada by going to
saltscapes.com, and clicking on the Living Healthy box.
See you there!
Spring 2012 •
Living Healthy In Atlantic Canada
1
Editor’s letter
Living Healthy In Atlantic Canada
In reading, and eating, great care is warranted.
We draw your attention to the nutrition column in this issue, which deals with the health
properties of the Asian spice turmeric (now being studied for its potential to combat a
number of ailments, including several forms of cancer).
Like most aspects of an unfettered free market society, our intense interest in our personal
health has manifested in a plethora of self-help literature, videos, websites and what have
you. We have no end of places to turn for information.
The flip side, of course, is what has become known as “information overload.” There is
so much information out there that the prospect of delving into it and working through it is
both daunting and time consuming.
Physicians now shake their heads in frustration as patient after patient shows up with an
armload of downloaded material under the arm, ready to debate the origin of symptoms and
the best treatment.
We have a responsibility to ourselves and to our families to become knowledgeable on
basic health. Those of us who do not possess a medical degree rely upon those who do
for advice and care. But while a little knowledge can be a dangerous thing, the patient
nevertheless has a responsibility, at a minimum, to take a thorough interest in, and some
responsibility for, understanding an illness and the necessary treatment.
It’s in the more effective area of illness avoidance that individuals bear the highest
responsibility and the most potential. Minimizing doctor visits altogether should be the
primary goal.
Increasingly, the importance of diet and the “you are what you eat” philosophy is
becoming clear. Poor dietary habits are implicated in a plethora of life-threatening illnesses
from heart disease to diabetes to cancer.
At a fundamental level, those foods that we should and should not consume are clearly
spelled out in any number of sources and ways—fruit and vegetables optimized; sources of
fat minimized. As with most areas of our highly complex modern world—things ain’t that
simple.
What’s been sprayed on those “healthy” apples, carrots and berries?
Will the insecticide used to delouse that farmed salmon hurt me?
Will the antibiotics fed to that mass production chicken hurt me?
Can I trust anything that is written on the outside of packaged goods?
Do the claims “low sodium” and “low sugar” actually mean anything?
Can margarine or breakfast cereal actually lower cholesterol?
Who will tell me the truth?
Well, there’s no shortage of people out there claiming to do so (and hoping to make a
killing with a best seller).
The most logical strategy we have encountered is among those people who carefully
consume a number of books looking for common findings and recommendations. It’s an
interesting exercise and one that does bear fruit (and we must ask ourselves if there is a more
important subject upon which to spend our time or money).
We are prepared to specify two books here to exemplify the process:
The Hormone Diet by Dr. Natasha Turner represents a highly credible and extremely well
researched linkage between diet and general wellbeing, with a heavy emphasis on what has
become known as “detoxing.” The jargon-avoiding text is highly readable and covers a wide
range of subject areas from healthy skin to cancer avoidance.
Never Fear Cancer Again by Raymond Francis, M.Sc., unfortunately has an off-putting
title—but the author survived a terminal cancer diagnosis and then used his expertise in
chemistry to make research his life’s work. The book offers both detailed and common sense
advice on reducing cancer risk from diet and supplements to something as simple as the vital
importance of a good night’s sleep.
By carefully scrutinizing, and comparing, the advice offered in two books like these (of
which there are many)—with different approaches to the same subject—an astute reader
can compile some very sound principles toward a healthy life.
Jim Gourlay
2
Living Healthy In Atlantic Canada •
Spring 2012
Volume 5 Number 1 Date of Issue: March 2012
Living Healthy in Atlantic Canada is a publishing
partnership between the QEII Foundation, IWK
Health Centre and Saltscapes Publishing Limited.
Editorial Board
Dr. Gaynor Watson-Creed, MSc, MD, CCFP, FRCP(c)
Medical Officer of Health, District 9 (Capital District Health
Authority)
Dr. Charles Lo, MD, FRCPC
Cardiac Radiologist, Capital District Health Authority
Dr. R.P. LeBlanc, CM, MD, FRCSC
Vice-President, Learning, Research & Innovation,
Capital Health
Professor, Ophthalmology & Visual Sciences, Dalhousie
University
Maggie Marwah
Director, Marketing & Communications, Capital Health
Bill Bean
President & CEO, QEII Foundation
Tanya MacLean
Director, Communications, QEII Foundation
Kathryn London-Penny
Executive Director, Public Relations, IWK Health Centre
Saltscapes Publishing Limited
Co-Publishers Jim & Linda Gourlay
Associate Publisher Shawn Dalton
Editor Jim Gourlay
Production & Creative Manager Shawn Dalton
Associate Editor Angela Mombourquette
Senior Designer Graham Whiteman
Designer Thom Knowles
Senior Sales Manager
Kerri Slaunwhite • kslaunwhite@saltscapes.com
Advertising Account Executives
Susan Giffin • sgiffin@saltscapes.com
Pam Hancock • phancock@saltscapes.com
Advertising Traffic Coordinator
Lisa Byrne • lbyrne@saltscapes.com
Talk to us
Send your letters to the address below, or email jgourlay@
saltscapes.com. Include your name, the name of your town
or city and telephone number. Letters that appear in the
magazine may be edited for length and clarity.
Living Healthy in Atlantic Canada is published twice a
year by:
Saltscapes Publishing Limited
30 Damascus Road, Suite 209, Bedford, NS B4A 0C1
Tel: (902) 464-7258, Sales Toll Free: 1-877-311-5877
Administration Valerie Blackmore • Donna Archibald
Contents copyright No portion of this publication may be
reprinted without the consent of the publisher. Living
Healthy in Atlantic Canada can assume no responsibility for
unsolicited manuscripts, photographs or other materials
and cannot return same unless accompanied by S.A.S.E.
Publisher cannot warranty claims made in advertisements.
Printed by: Advocate Printing & Publishing, Pictou, NS
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Living Healthy In Atlantic Canada •
Spring 2012
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News
New MRI scan for prostate cancer
QEII Foundation
Prostate cancer patients at the QEII Health
Sciences Centre in Halifax will soon benefit from
a dedicated MRI, thanks to a recent gift from
Prostate Cancer Canada to the QEII Foundation.
The $60,000 gift included the software
necessary to perform endorectal MRIs, a technique
that involves inserting a coil into the rectum to
obtain dedicated high-resolution images of the
prostate. Endorectal MRI is a common tool for
prostate cancer monitoring in Canada; it is much
more successful in detecting and evaluating cancer
than other MRI techniques, which involve body
coils that are placed externally on the patient.
From left: Steve Jones, president and CEO, Prostate Cancer Canada, Helene Vassos, chief
operating officer, Prostate Cancer Canada, and Dr. Derek Wilke, oncologist at the QEII Health
Sciences Centre, celebrate Prostate Cancer Canada’s donation to the QEII Foundation.
This is the first endorectal MRI at the QEII. It
is anticipated that about 100 patients will receive
this exam annually. The MRI will be used to
determine the stage of a patient’s cancer, and to
monitor patients.
Capital Health sees approximately 295 newly
diagnosed prostate patients a year, the majority of
which are treated at the QEII.
Expanding epilepsy monitoring
by Tanya MacLean
Thanks to a generous gift of $100,000 from
Canadian pharmaceutical company UCB Canada,
the epilepsy program at the QEII Health Sciences
QEII Foundation
by Sarah Metherall
Centre in Halifax is one step closer to expanding its
epilepsy monitoring unit from two to four beds.
The need for an expanded unit is backed by
the data—at least 16,000 people are living with
epilepsy in Atlantic Canada; approximately 16 per
cent of those individuals are potential candidates
for surgery. The epilepsy monitoring unit (EMU) is
the only dedicated adult unit that accepts referrals
from all of the Atlantic provinces.
“We are only able to study 40 to 42 patients
per year, given the limited number of beds and
the lengthy admission of one to three weeks per
patient,” explains Dr. Mark Sadler, co-director of
the epilepsy program at the QEII.
“The lengthy admission is required to record
a sufficient number of clinical events to allow for
precise diagnosis.”
UCB Canada‘s $100,000 gift marks the
beginning of a promising long-term relationship.
“We are on the threshold of a really big
opportunity, thanks to the generous gift from UCB
Canada,” says Dr. Sadler.
Electroneurophysiology
technologist Philip Godwin
observes a patient in the epilepsy
monitoring unit.
Studying mobility and balance in older
adults
by Jocelyn Adams
Taking note of mobility and balance in adults 65
years of age and older when they are admitted to
hospital can help physicians understand which
patients have a higher risk of dying, according to a
new study funded by the QEII Foundation and the
Dalhousie Medical Research Foundation in Halifax.
“Our study suggests that older people whose
Spring 2012 •
Living Healthy In Atlantic Canada
5
News
had forced the woman to miss many social events.
McIsaac was upset to realize that this woman,
like many patients, had been receiving the wrong
kind of treatment—gauze dressings. When she
received the correct treatment—compression
stockings— her wound healed in eight weeks.
“But she told me it was 45 years too late,”
McIsaac says. “The distressing thing is that 45
years ago, this treatment was available.”
McIsaac is on a mission to improve wound care.
She claims that poor wound care across the country
causes enormous suffering and wastes resources.
The problem, according to McIsaac, is that
health care professionals sometimes receive
inadequate training in wound care. Her company
helps organizations measure their wound care
practices against best practices, and make changes
to improve patient care and decrease costs.
She says that over a decade ago, her company,
working with Nova Scotia’s Department of Health,
saved the provincial health system $3 million in
one year. Health Outcomes Worldwide currently
has a proposal before the Nova Scotia government
that McIsaac claims will save $7 million within 12
months, and improve wound care for patients in
home care, long-term care and acute care.
“Our main aim is to improve patient care,”
McIsaac says. “But governments must recognize
there is a direct correlation between the cost of
care and the way care is delivered.”
mobility and balance deteriorated in the first 48
hours after admission had a much greater risk of
dying within 30 days, in comparison to people
whose mobility and balance stayed the same or
improved,” says study author Kenneth Rockwood,
staff internist and geriatrician at the QEII and
professor of Geriatric Medicine at Dalhousie
University.
The study included 409 people, 65 years of
age and older, who were admitted to the Halifax
Infirmary at the QEII Health Sciences Centre.
Findings revealed that 71 per cent of patients
whose mobility and balance worsened within
48 hours of admission died within 30 days.
In contrast, only four per cent of those whose
mobility and balance remained stable or improved
died within the same time frame.
Dr. Rockwood and his team hope the study’s
results will be used to increase observation and
tracking in older adults admitted to hospital. “Our
results confirm what good clinicians know, but that
often is not followed systematically in hospitals,
which often focus more on laboratory tests or
x-rays,” says Dr. Rockwood.
Measuring breast density
Health Outcomes Worldwide
by Carol Moreira
Corrine McIsaac’s Health
Outcomes Worldwide uses
specialized data collection tools
to improve patient care.
6
Improving wound care
by Carol Moreira
Nurse-turned-entrepreneur Corrine McIsaac tells a
sad story to illustrate how much poor wound care
costs individuals and health care systems.
The president and CEO of Health Outcomes
Worldwide, based in New Waterford, NS, says she
met a 100-year-old woman who had suffered for
45 years with venous leg ulcers. This type of ulcer
is wet and weepy. Over the decades, embarrassment
Living Healthy In Atlantic Canada •
Spring 2012
A measuring system being developed in Halifax
will help medical professionals refine their ability to
assess a major risk factor for breast cancer—breast
density.
Dense breasts have proportionally less fatty
tissue than others, and women with very dense
breasts can be six times more likely to develop
cancer than women with fatty breasts.
Currently, when a radiologist reads a screening
mammogram, he or she visually assesses the
density of that woman’s breasts and places her
into one of four loose categories. Low-density
breasts have a density of less than 25 per cent. The
other ranges are from 25 to 50 per cent, 51 to 75
per cent and over 75 per cent.
An automated breast density management
system, called Densitas, will evaluate digital
mammographic images as they are taken and assess
density down to the nearest percentage point.
iwkfoundation.org
feel
Jillian Hum
“The IWK helped me through some very difficult times. One thing
I want any teen facing depression or anxiety to know is that there
is a light at the end of the tunnel. You really aren’t alone.”
News
Diagnosing concussion on the spot
Pediatric care close to home
by Carol Moreira
by Laura Fougere
When NHL hockey player Sidney Crosby suffered a
series of blows to the head and a concussion that
forced him to sit out most of the past hockey season,
it boosted an important awareness of traumatic
brain injury.
Millions of people suffer traumatic brain injuries
every year. Typically, such injuries are difficult
and time-consuming to diagnose, but the makers
of a new portable detection device aim to make
diagnosis easier and faster.
The Halifax Consciousness Scanner monitors
the electrical activity of the brain to measure
five indicators of neural processing—sensation,
perception, attention, memory and language. This
indicates a patient’s level of conscious awareness,
which will help determine whether he or she has
suffered a brain injury such as a concussion from
a fall or hit to the head. It takes just five minutes
to perform a scan, which can be done at the
location where it may be immediately needed:
courtside, rinkside or on the sportsfield. The scanner
summarizes the result of its tests in a simple
number, so no expertise is needed to conduct or
interpret the test.
A new pediatric clinic has opened in the Spryfield
area of Halifax. The IWK Spryfield Pediatric
Clinic is part of a two-year pilot project sponsored
by the departments of Pediatrics and Primary
Health at the IWK Health Centre. The goal is to
build stronger connections between the IWK, the
Spryfield community and community partners
in the creation and delivery of children’s health
programs.
“The addition of a pediatrician in this
community provides a unique opportunity to
work side by side with family physicians and the
many community groups and organizations that
want to optimize children’s health in Spryfield,”
says Dr. Heather Rose, head of the IWK’s Division
of Community Pediatrics.
The clinic, which is located at the Community
Wellness Centre, provides pediatric consultation
services for a variety of health care issues such
as complicated asthma, failure to thrive and
development or learning problems, and offers
follow-up care for kids with complex health care
issues in collaboration with the child’s family
physician and/or pediatric specialist.
Department of Diagnostic Imaging at CDHA
“Densitas produces quantitative assessments
of breast density, fits seamlessly into the clinical
workflow and generates reliable real-time outputs,”
says system developer, Mohamed Abdolell, an
associate professor with Dalhousie’s diagnostic
radiology department.
Abdolell says it is vital to improve breast cancer
risk assessment and detection. In Canada, one in
nine women is expected to develop breast cancer in
her lifetime, and one in 29 is expected to die from it.
It’s important that individuals are diagnosed
in a timely and accurate fashion: if patients suffer
a second injury before the first has healed, they’re
at risk of developing long-term neurologic and
functional deficits. Current diagnosis often relies on
asking the patient to perform a simple task such as
blinking. Test results can be faked by patients (an
athlete, for example, who is eager to return to the
game) or misinterpreted by professionals.
“Brain imaging methods take direct measures
of the brain activity involved in consciousness,”
says Victoria Smith, business development officer
at Mindful Scientific, in Halifax.
The devices will be relatively small, combining
a specially designed headset with a portable
hardware box. Smith says the scanners are
currently undergoing clinical trials; it’s hoped
the devices will be available sometime next year,
and that concerned parents of athletes might be
inclined to purchase them.
To learn more about concussions and to read
one family’s story, see “Kids and Concussions,”
page 32.
Researchers at Dalhousie
University in Halifax are
developing a tool to refine the
measurement of breast density,
a major risk factor for breast
cancer.
8
Living Healthy In Atlantic Canada •
Spring 2012
News
“We want to recognize, support and utilize
children’s health resources that already exist in
the community and advocate for those that are still
needed,” says Dr. Rose. “We also want to offer an
opportunity for residents and medical students to
learn pediatrics in a community setting.”
The IWK Spryfield Pediatric Clinic operates two
days a week (Thursdays and Fridays). Referrals
for children who live—or who have a family
physician—in the area will be accepted.
Fast facts:
Canada is one of the world’s five leading
countries for neuroscience research, and Halifax has
among the most neuroscientists per capita of any
Canadian city
Emerging Professional
by Melanie MacKay
Dr. Jill Chorney, assistant professor of anesthesia at
Dalhousie University, and a clinical psychologist with
the Complex Pain Team at the IWK Health Centre
in Halifax, has received an Emerging Professional
Award from the Discovery Centre, in Halifax.
The award, which was presented last November,
recognizes the outstanding achievements of a
young professional in the fields of science and
technology in Nova Scotia. Dr. Chorney’s research
and clinical practice in pain management—
advancing the hospital and at-home care of
children with chronic pain—earned her this
prestigious award.
Dr. Chorney also recently received a Leaders
Opportunity Fund award, which provides funding for
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Donate today to ensure the latest
technology is available to save lives in
a new, world-class radiation clinic at
the QEII.
(902) 473-7932 1-888-428-0220
www.qe2foundation.ca
Spring 2012 •
Living Healthy In Atlantic Canada
9
SteveKaiserPhotography.ca
News
Dennis Langille, technical
manager of Michelin North
America, presents Dr. Jill
Chorney, IWK psychologist, with
the Discovery Centre’s Emerging
Professional Award.
research infrastructure from the Canada Foundation
for Innovation. These funds will provide her with the
opportunity to expand the infrastructure in her Child
Health and Perioperative Care Laboratory at the IWK
Health Centre.
To learn more about Dr. Chorney and her work,
please visit pediatric-pain.ca.
Improving access to mental health care
by Melanie MacKay
The Mental Health and Addictions (MHA) program
at the IWK Health Centre in Halifax is making
access to care a priority. To that end, the IWK’s
10
Living Healthy In Atlantic Canada •
Spring 2012
MHA team is implementing a clinical system
called Choice and Partnership Approach (CAPA)
to provide faster and more efficient services to
patients and their families.
Last November, Drs. Ann York and Steve
Kingsbury—psychiatrists from the United Kingdom—
visited the IWK to provide the Health Centre’s MHA
team with CAPA training. The CAPA philosophy,
which is centred around the active involvement of
children, youth and their families, says that having
a better understanding of the demand for mental
health services will allow health care providers
to better match their clinical care capacity to that
demand. The goal is to ultimately “do the right things
with the right people at the right time.”
The IWK’s MHA program is currently working
toward meeting with clients who have been
awaiting services for up to 18 months. When
families first meet with a clinician from the MHA
outpatients team, they will participate in a “choice”
appointment, which will give them an opportunity
to discuss the problem that is concerning the family,
and to develop a plan for the next steps.
When the system is fully implemented this
April, it is expected that the wait to see a clinician
will be reduced to four weeks.
The CAPA system has been used in the UK, New
Zealand, and Australia to help eliminate wait-lists
and to create a system of care that is responsive
to the needs of families. For more information on
CAPA, please visit capa.co.uk.
For more information about Mental Health and
Addictions services at the IWK Health Centre, please
visit iwk.nshealth.ca and click on “Care Services.”
Ask the professionals
Lyme disease and ticks
What you need to know before (and after) you take
that walk in the woods
As you and your dog stroll through
the tall grass or low shrubbery of your
favourite forest path, you might be
picking up more than the fresh scent of
balsam fir. Blacklegged ticks (also known
as deer ticks) are just waiting to hitch a
ride—on both of you, and if a particular
tick has fed on a bird or an animal with
Lyme disease, that tick can pass Lyme
disease on to you or your dog.
There are several species of ticks, but
only blacklegged ticks can carry Lyme
disease, and few of them actually do.
In Nova Scotia, blacklegged ticks are
considered established in parts of five
counties: Pictou, Lunenburg, Halifax,
Shelburne and Yarmouth. Since 2002,
67 cases of Lyme disease have been
reported in the province. Most people
and their pets are bitten by dog ticks,
which do not carry Lyme, so knowing
the difference between dog ticks and
blacklegged ticks could ease your mind
(see “Know Your Ticks,” page 12).
“Lyme disease is an infection
caused by the micro-organism Borrelia
burgdorferi,” says Dr. Lynn Johnston,
division chief for Infectious Diseases
at the QEII Health Sciences Centre
in Halifax. Symptoms of early Lyme
disease, which occur from seven to 10
days after the bite, are fever, fatigue
and muscle aches and pains, which
can make it hard to distinguish from
any number of other illnesses. A key
indicator, however, is an erythema
migrans (EM) or a “bull’s eye” rash.
Lab testing is not required to
diagnose early Lyme. “In the early
stages, the body has not had time to
form antibodies; this could take up to
six weeks after the initial infection,”
says Dr. Johnston. “Also, EM has a
characteristic appearance, so a clinical
diagnosis can be made on this basis.”
Donna D’Amour
by Donna D’Amour
Andrew Hebda, curator of zoology at the Nova Scotia Museum of Natural History, advises caution when removing a tick (see “Tick Removal,” page 12).
Patients are treated with an antibiotic;
this treatment has a success rate of more
than 90 per cent, and patients usually
recover in a matter of weeks.
For later-stage Lyme disease, when
the EM rash may no longer be evident,
physicians order a blood test to look for
antibodies to the disease.
Spring 2012 •
If Lyme disease goes untreated, it
could spread from the skin to the blood
and other areas of the body, such as
the central nervous system or joints.
Some people experience chronic fatigue
symptoms, even after Lyme disease has
been successfully treated and the B.
burgdorferi is no longer present.
Living Healthy In Atlantic Canada
11
Ask the professionals
Dr. Johnston says some people have
coined the term “chronic Lyme” to
describe chronic non-specific symptoms
such as pain and fatigue, with the
mistaken belief that active Lyme disease
is present. There is no good laboratory
evidence of this.
The best treatment is prevention: to
prevent tick bites when you’re walking
in an area where ticks may be present,
wear enclosed shoes and light coloured
clothing with a tight weave. Ensure that
your shirt is tucked in and tuck the legs
of your pants into your socks. Spray
your clothing and exposed skin with an
insect repellent that contains DEET (but
note that DEET should not be used on
children under seven months old; you
can find Health Canada’s guidelines for
DEET use at hc-sc.gc.ca).
If you find a tick on yourself or your
pet, you can go to your family doctor
or vet to have it removed, or remove it
yourself (see below right)—but beware
of some commonly-touted methods for
removal. Andrew Hebda, curator of
zoology at the Nova Scotia Museum of
Natural History, cautions people not to
put Vaseline, oil, or a lit match on the
tick. “Ticks breathe through openings
along their sides. If those openings are
blocked, the tick may come off, but not
before it empties its stomach contents
into your flesh.” He also says not to
pull too quickly or to twist the tweezers
because the palps (mouth parts) could
break off and remain in your flesh. This
could cause an infection. It could also
make identification of the type of tick
more difficult.
Know your ticks
Dog ticks
• Larger than blacklegged ticks
• Milky markings on reddish-brown shield
• Short, thick palps (mouth parts)
• Festoons (blocks) along perimeter of back
Blacklegged ticks
• No milky markings, small black shield
• Long, narrow palps
• No festoons on perimeter of back
Tick removal
• Do a tick check on yourself and your pet after a
walk in tall grass or low shrubbery
• Remove the tick within 24 hours
• Use clean tweezers or a tick removal tool
• Grasp the tick’s body as close to the skin
as possible
• Pull slowly to allow the mouth parts to fold
together and come out
• Wash the area thoroughly and apply an antiseptic
• If infection occurs, see a doctor (or a vet)
Sometimes you just need a little extra help while
recovering from an injury or illness, between hospital
and home, or when caring relatives are away.
The Berkeley’s respite care can provide you with all
of the comforts of home, plus the extra attention
that you need to help get you back to your routine.
Whether you stay for a weekend or several weeks,
our licensed, professional staff will provide you
with the service and attention you need 24 hours a
day, seven days a week.
Call Gloria to book your tour: (902) 802-0346
Care Comfort Companionship
www.theberkeley.com
The independence you want, with the assistance you might need. That’s The Berkeley.
12
Living Healthy In Atlantic Canada •
Spring 2012
From left to right: An unfed blacklegged tick, a
fed blacklegged tick, an unfed dog tick, a fed or
engorged dog tick. Blacklegged ticks are often
referred to as deer ticks.
Donna D’Amour
Until September of last year, a
province-wide passive survey was
being conducted by the Nova Scotia
Department of Health and Wellness; the
public, veterinarians and physicians
were welcome to submit specimens. The
Department of Health and Wellness no
longer needs to receive ticks for testing
or surveillance purposes. The focus has
now shifted from both passive and active
surveillance to solely active fieldwork,
studying areas where tick populations
are expanding. Department of Natural
Resources officials now visit sites
from which multiple ticks have been
submitted and check squirrels, mice, and
other small mammals for ticks.
To find out more about Lyme disease,
visit the Nova Scotia Department of
Health and Wellness site at gov.ns.ca/
hpp/cdpc/lyme.asp.
We’ve got you covered.
1-800-667-4511 | www.medavie.bluecross.ca
Follow us on Twitter @MedavieBC
Spring 2012 •
Living Healthy In Atlantic Canada
13
Ask the professionals
Don’t flush those drugs
How to correctly dispose of medications—prescription or otherwise
Medications—when used properly—
can treat our ills and help us to live
productive lives. However, when leftover
or expired medications are flushed down
a sink or toilet, or tossed into the garbage,
they can affect our water, our land and
the health of all the plants and creatures
that depend upon those resources.
“There are environmental concerns
with medications ending up in our water
table,” says Lucas Thorne-Humphrey,
clinical pharmacist at Capital Health
in Halifax and part-time community
pharmacist. “Our sewage treatment
plants are not equipped to deal with
medications. While some medications
break down quickly in nature and
in your body, others don’t. A lot of
medications do not degrade over time;
they exist in the environment for a long
time, which raises concerns.”
In addition to having negative
environmental effects, there’s another
good reason to take care in the disposal
of drugs: tossing unused drugs into the
garbage could make them accidentally
accessible to children, or to other people
in your household who should not be
taking them, as well as to pets.
His greatest concern is over the proper
disposal of unused narcotics. “You
really want to make sure they are not
consumed by someone who shouldn’t be
taking them,” he says.
Prescriptions that are not used
up within the period for which they
are dispensed should not be saved for
later use. “All medications lose their
effectiveness over time; however,
a medication like tetracycline [an
antibiotic used to treat bacterial
infections] can actually become
dangerous past its expiry date,” says
Thorne-Humphrey.
14
Donna D’Amour
by Donna D’Amour
Dispose with care: tossing unused drugs into the garbage could lead to accidental ingestion by pets or kids; flushing them contaminates waterways.
Impact on waterways
At a 2007 workshop conducted
by Environment Canada on
pharmaceuticals and personal care
products in the environment, it was
reported that at least 80 pharmaceutical
and personal care products (PPCPs)
such as analgesics, antibiotics,
antiepileptics, antidepressants and blood
lipid regulators have been identified in
outflows from water treatment plants
Living Healthy In Atlantic Canada •
Spring 2012
and in surface waters worldwide. The
report also suggested that the presence
of pharmaceuticals in Canadian waters
is increasing because people use more
medications today than they have in the
past, and discard more, either through
urine or feces or through improper
disposal of drugs.
The report says pharmaceutical
drugs are present in wastewater and
in Canadian rivers in parts-per-billion
Donna D’Amour
Pharmacist Lucas Thorne-Humphrey advises people
to go through their medications at least once a year
to collect any unused or expired drugs for disposal.
“There are environmental
concerns with medications ending up in our water table,” says
Lucas Thorne-Humphrey, clinical pharmacist at Capital Health
in Halifax and part-time community pharmacist
or parts-per-trillion, but because these
drugs are biologically active, even
tiny amounts can harm fish. Some
drugs, such as synthetic estrogens,
which are used in birth control
pills, are “endocrine disruptors”—
compounds that affect reproduction and
development. “An excess of estrogens
inhibits male fish sexual characteristics
and can dramatically decrease
fertilization success in exposed fish,” the
report says.
Long-term exposure of water
dwellers to even tiny amounts of
some of these drugs is a concern.
Research by Dr. Joanne Parrott of the
Canada Centre for Inland Waters in
Burlington, Ont, showed that when
fathead minnows are grown from
egg to adulthood in the presence of
as little as three parts-per-trillion of
synthetic estrogen, they are completely
feminized. The male fish express only
female characteristics, and are unable
to fertilize eggs. That amount of
synthetic estrogen is the equivalent of
dropping a single birth control pill into
10,000 litres of water. Dr. Parrott, who
is the Water Science and Technology
Directorate’s lead for pharmaceuticals
in the environment, says her future
research will focus on the effects
that a cocktail of pharmaceuticals in
wastewater can have on fish.
Proper disposal
The proper way to dispose of medications
in Nova Scotia, says Thorne-Humphrey,
is to bring them to a pharmacy;
such drugs will be incinerated (see
“Pharmaceutical Disposal by Province,”
page 16, for guidelines in other Atlantic
Canadian provinces).
He adds that it’s a good idea to go
through all of your medications, both
prescription and non-prescription (and
any pet medications) at least once a year
to collect unused or expired drugs for
disposal. Thorne-Humphrey says the
bottom line is this: “Don’t leave unused
or expired medications around the
house—and if you have any questions
about the safety of a medication, ask a
pharmacist.”
Spring 2012 •
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Living Healthy In Atlantic Canada
15
iStockPhoto
Pharmaceutical disposal by province
The Post Consumer Pharmaceutical Stewardship Association’s website
(medicationsreturn.ca) provides information on programs across Canada.
Throughout Atlantic Canada, pharmacies are obligated to take back any
medications brought to them for disposal. Municipal waste companies may also
take unused medications as part of their hazardous waste collection. Here’s the
breakdown by province:
• Nova Scotia has a province-wide Medication Disposal Program, which allows
patients to return medications they no longer need to their local community
pharmacies for safe disposal. There is no cost to the public.
• New Brunswick does not have a formal province-wide program for the
disposal of household pharmaceutical waste, but most regional Solid Waste
Commissions offer programs that allow the public to dispose of pharmaceuticals
in a safe manner; pharmacies in the province also offer free voluntary
pharmaceutical take-back programs.
• PEI has a free take-back program that allows Islanders to take unwanted
prescription and over-the-counter medications to local pharmacies for
environmentally safe disposal. Pharmaceuticals may also be taken directly to any
Island Waste Management Corporation drop-off centre for safe disposal.
• In Newfoundland and Labrador, some municipalities offer semi-annual
Household Hazardous Waste (HHW) collection days for residents to dispose of
hazardous waste materials, including unwanted pharmaceuticals, free of charge.
Pharmacies will also take your unused medications.
Basic Curry Sauce with Chicken
½ – 1 cup
8
1 ½ tsp.
1 tsp.
1 ½ tsp.
1 ½ tsp.
3
8 - 10
½ cup
1 ½ tsp.
Recipe for Success
vegetable oil, as required
medium onions, chopped
each of tumeric and curry powder
each of salt, pepper and crushed chilies
ground ginger
garlic, minced
fresh tomatoes, chopped
pieces chicken (drumsticks or thighs)
water
garam masala
Preparation time: 10 minutes
125 ml – 250 ml
8
7.5 ml
5 ml
7.5 ml
7.5 ml
3
8 - 10
125 ml
7.5 ml
Cooking time: 2.5 hours
1. Heat approximately ½ cup (125 ml) of vegetable oil in a large heavy pot or dutch oven.
2. Add onions, cook over medium heat, stirring often to ensure onions do not stick to
bottom of the pan or burn. Add more vegetable oil as required - up to 1 cup (250 ml).
3. After 20 minutes add tumeric, curry powder, salt, pepper, chilies, ginger and garlic.
4. Continue cooking for another 20 minutes or until onions are dissolved.
5. Reduce heat to low and simmer for 45 minutes.
6. Add tomatoes and cook until tomatoes are almost completely dissolved.
7. Add chicken and water, increase heat to medium and cook for 30 minutes or until chicken
is fully cooked.
8. Add garam masala in the last 15 minutes of cooking.
9. Serve hot with basmati rice and raita.
16
Living Healthy In Atlantic Canada •
Spring 2012
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The wellness column
(Illness prevention is the most effective health care)
Taking it all in stride
Nordic walking offers fun and fitness
for folks of every stripe
You’ve probably seen them: enthusiastic
walkers (often in groups) striding
confidently around the neighbourhood
or the park, proudly brandishing what
look like modified ski poles. These folks
are not wannabe skiers, waiting for
colder weather (well, they may be,
but that’s not always the reason for
the poles). They’re Nordic walkers,
taking part in an outdoor pursuit that
has quickly become a sport in its own
right—and one that offers a wide range
of benefits.
Dr. Gail Dechman, a professor
at Dalhousie University’s school of
physiotherapy, says the action of Nordic
walking is a lot like cross country skiing,
in that the walker coordinates arm and
leg movements and the rhythm carries
them along.
“You don’t have the sense of working
harder, but you use more energy than
you do by walking. For people interested
in getting fit or losing weight, using
more energy is key,” says Dr. Dechman.
She notes that although Nordic walking
is relatively new in Atlantic Canada,
people have been doing it in Europe
for decades. “There is a wide variety of
people who would benefit from it for a
number of reasons,” says Dr. Dechman.
“The elderly, who are concerned about
balance, people with Parkinson’s disease,
and the general public who want to lose
weight and have fun.”
For Patti Smith, 41, of Lunenburg,
Nordic walking has been a great
alternative to a gym membership.
“I was doing a Biggest Loser contest
with some friends at work and I’d been
walking, but I was looking for a way to
intensify my workout without going to
a gym—and I like to be outside,” says
Smith.
Perry Jackson
by Melanie Furlong
Nordic walking groups like this one, led by Michael Beazley, are cropping up all over Atlantic Canada.
She discovered Nordic walking on a
television program and found poles soon
afterwards at a pharmacy. “They came
with a DVD that showed you how to set
them up and use them.”
Smith regularly uses the poles on
a quiet country road near her home.
“That’s my main route. But if my
husband is out and my [young] son is
home, I walk around my yard. I’ve even
Spring 2012 •
got my mother and a girlfriend Nordic
pole walking.”
This kind of enthusiasm for the
sport is exactly what kinesiologist and
wellness facilitator for Capital Health’s
Community Health Team in Halifax,
Jeffery Zahavich, hopes to see this spring
when his team starts a new Nordic
walking program. Zahavich says the
four-week program will help participants
Living Healthy In Atlantic Canada
17
Dalhousie University
Dr. Gail Dechman, professor of physiotherapy at
Dalhousie University.
stress off joints and make
walking more comfortable for
those with arthritis
Perry Jackson
The poles can take
Nordic walking is a great way to get fit and have fun, says Michael Beazley, who says the sport has helped him recover from a back
injury. Left: gear up; good walking shoes and a set of poles are all you need to get started.
improve balance and engage their abs
and core muscles more.
“We have a walking program now,
but the population we work with
often has balance and other chronic
conditions,” says Zahavich. The benefit
of walking with poles is that using both
hands creates symmetry on either side
of the body, which is helpful for balance.
The poles also bring the walker upright.
“We’re trying to get people more
active aerobically and we’re excited to
challenge them and offer something
they haven’t tried yet,” says Zahavich.
“There’s a great benefit to Nordic
walking, in that it burns more calories
and builds more muscle mass.”
The rhythmic nature of Nordic
walking can be good for people with
various chronic conditions. “Those with
Parkinson’s have a hard time starting
18
their movement and sometimes they
freeze and can’t get going again,” says
Dr. Dechman. “Nordic walking is very
helpful for continuing motion.” She says
the poles can also be an aid to people
who are trying to lose weight because
they offer a sense of security and
balance. And for those with arthritis, the
poles can take stress off the joints and
make walking more comfortable. “Many
elderly people walk bent over,” says Dr.
Dechman. She says the poles can help
these folks walk more fully upright,
further decreasing their fall risk.
Health benefits aside, Nordic walking
is simply fun, and many Nordic walking
groups are cropping up. Michael Beazley,
who manages a speciality footwear shop
in Halifax, started Nordic walking five
years ago after a back injury. He now
organizes Nordic pole walking groups
Living Healthy In Atlantic Canada •
Spring 2012
for anyone who wants to try it—both
through his store and for outside
businesses or groups.
“I enjoy Nordic walking for the
benefits it gives me,” says Beazley. He
says Nordic walking has helped to relieve
strain on his back. “It also increases your
heart rate and you burn more calories
because your body has incorporated
everything into the walk: chest, laterals,
triceps, biceps, shoulders.”
He says the beauty of Nordic walking
is that it can be done anywhere—on
sidewalks, wet grassland, firm grass,
concrete, trails or sandy beaches,
adding that the poles have both rubber
and carbon tips for grip in different
situations.
“Anyone can do it, as long as you don’t
mind the looks you get,” he says with a
grin. “Once you start, you’ll love it.”
The wellness column
(Illness prevention is the most effective health care)
Home screening for colon cancer
A minor inconvenience that could save your life
They say it all begins with a conversation,
but it’s a conversation I didn’t want
to have, so when I received a home
screening kit in the mail through
Cancer Care Nova Scotia’s Colon Cancer
Prevention Program, I stuck it at the
back of a drawer, and left it there for six
months.
According to Dr. Bernard Badley,
medical director of the Colon Cancer
Prevention Program in Halifax, I’m not
alone in my reluctance to follow through
on a minor inconvenience that could
possibly save my life. Despite the fact that
colon cancer (also called colorectal or
bowel cancer) is the second leading cause
of cancer death in Nova Scotia, and
that home screening is the easiest, most
convenient—and most cost-effective—
way to find it early enough to have a
high chance of a cure, only 33 per cent
of Nova Scotians who receive the home
screening kit (see “How to Get Your Kit,”
page 20) actually complete it.
“Many people mistakenly believe that
you should only do a screening test if
you have symptoms,” explains Erika
Nicholson, director of Prevention and
Early Detection at Cancer Care Nova
Scotia. “This is not the case. Screening
is about looking for cancer before you
have any warning signs.” Nicholson
advises those receiving the kit to take a
few minutes in the comfort and privacy
of their homes to complete the test (see
“Taking the Test,” page 20), adding that
those few minutes have already saved
the lives of many Nova Scotians.
About four per cent of those
who do the home screening will be
recommended to have a colonoscopy,
a procedure in which a long, flexible
scope is guided via the rectum through
the colon. Just over half of these
colonoscopies will result in the discovery
Shirley Robb, Communications Nova Scotia
by Suzanne Robicheau
The home screening kit has already saved the lives of many Nova Scotians, and it’s not hard to do—once you get over the “ick” factor.
of either malignant or pre-malignant
polyps (growths on the colon or rectum),
about 90 per cent of which can be
removed during the procedure. Finding
these growths early is critical, because
the symptoms of colon cancer—which
can include rectal bleeding, prolonged
diarrhea or constipation, narrowing
of stools, unexplained weight loss and
exhaustion—are often not detected until
the disease is well established.
“We have been blown away by the
early test results,” says Dr. Donald
MacIntosh, a gastroenterology professor
at Dalhousie University in Halifax and
medical director of the endoscopy
program for the Capital District Health
Spring 2012 •
Authority. “Not only are we detecting
early bowel cancer when it is still
curable, but we are also finding many
polyps and removing them to prevent
colon cancer from even developing.
This, to me, is the main attraction of
bowel cancer screening.”
Screening is especially vital in
Atlantic Canada, where we have the
highest incidence of colon cancer in all
of Canada. It’s also especially important
for men, who have a 40 per cent higher
incidence of colon cancer than women,
yet are far less likely to do the home test.
“Screenings have been part of women’s
health care for the past 20 years,” says
Dr. Badley. “Men, on the other hand,
Living Healthy In Atlantic Canada
19
“Screenings have
Perry Jackson
been part of women’s health care for the past 20
years, “ says Dr. Badley. “Men, on the other hand,
aren’t used to them”
Dr. Bernard Badley, medical director of the Colon Cancer Prevention Program in Halifax.
aren’t used to them; they don’t go to the
doctor as often as women do and they
usually believe that bad things won’t
happen to them.”
In some ways, that described Ed
Branton, a healthy 65-year-old with no
history of major illness and no family
history of colon cancer. After a few days
of procrastination, the Martin’s River
man completed the test and mailed
in his samples. Three weeks later, he
received word that he would require a
colonoscopy. Initially apprehensive, he
felt more comfortable after he met with a
nurse from the screening program who
explained what to expect. “There was
nothing to it,” he says, “and it wasn’t
embarrassing—just a bit of discomfort
at the beginning, but no pain.”
Medication made the first part of
Branton’s 90-minute procedure seem
almost like taking a nap. More fully
awake near the end of the colonoscopy,
he saw images of the inside of his colon
on a video monitor and watched as the
doctor removed three polyps—one, a
very aggressive form of cancer. “They
caught it just in time,” he says. “My
doctor said that it’s likely that I wouldn’t
have made it to the next Christmas.”
20
Since then, Branton has rallied his
six siblings to take the test, knowing
that there’s a slightly higher risk in
people who have a first degree relative
(father, mother, brother or sister) who
have had colon cancer or a precancerous
polyp. He has also encouraged his friends
and been featured in a national news
story about the need for screening.
“I don’t have the words to explain
how important this home screening is,”
says Branton. “If I can convince even
one person to take the test, I’ll have done
something good.”
To learn more about the Colon Cancer Prevention Program,
call 1-866-599-2267.
© 2005 Terese Winslow
US Govt has certain rights
How to get your kit
There is no need to request a kit. The home screening
kit will be mailed to everyone in Nova Scotia between
the ages of 50 and 74. The program was phased in
across the province and has been expanded to all
district health authorities; Capital Health district, the
last to join the program, will be fully implemented
by next spring.
Your doctor may recommend a colonoscopy, depending
upon the results from the home screening kit.
Taking the test
The home screening kit comes with a collection pouch, two collection cards, two tiny wooden sticks and two
large squares of tissue paper. The squares of tissue are meant to be used in collecting your sample; however,
it’s important that the sample not touch the water in the toilet bowl, so my advice is to save the tissue paper
for gift wrapping and instead equip yourself with a roll of plastic wrap and two paper plates.
I assembled all of my supplies in the bathroom and went about my business while waiting for the mood
to strike. When it did, I returned to the bathroom, raised the toilet seat and draped the opening of the toilet
bowl with a very loose layer of plastic wrap, allowing the plastic to droop toward the level of water in the
toilet. I used a knife to poke a few small holes in the plastic to allow liquid to escape, then set one of my paper
plates on top of the plastic wrap, bending the plate’s rim slightly for a snug fit.
Once my “sample” was deposited on the plate, I used a stick to collect a pea-sized amount and apply it to
the top half of the collection window on the inside of one of the collection cards. Using the same stick, I took
another sample from a different part of the stool and put it on the bottom half of the collection window. Then
I smeared the two bits together, closed the card, and left it on the bathroom vanity to dry.
A second sample is required, so two days later—what can I say? I wasn’t in the mood—I repeated the entire
process. The day after that, I noted the dates of the samples, tucked my two collection cards in the pouch provided,
put the pouch and my participant information sheet into a postage-paid envelope, and mailed it to the lab.
Was it easy to do? Yes. Was it easy to write about it? Definitely not. But, like Ed Branton, I feel that if I
manage to convince even one person to take the screening test, I will have done a good thing.
~Suzanne Robicheau
Living Healthy In Atlantic Canada •
Spring 2012
Courtesy of Migraine Action, UK
A migraine is much
more than a headache—
but there are treatments
that can help
Mind over matter
by Angela Mombourquette
As Julia Phillips Smith and I speak, she is in the midst of a migraine
attack. “Right now, about halfway down my head, I’ve got a big,
L-shaped crushing feeling; it’s like a bear trap on my head and neck, and it
goes into my jaw,” she says. “I have numbness on my right-hand side; and
then inside, in my body, it aches like I’ve got appendicitis.”
But she’s felt worse. Today, despite all those symptoms, Smith is at the
office, working away at her “day job” in records management for the Nova
Scotia government. Outside office hours, Smith, who lives in Cole Harbour,
NS, is a self-published author of dark fantasy and historical romance novels.
Her first book, Saint Sanguinus, came out last November.
Spring 2012 •
Living Healthy In Atlantic Canada
21
Dalhousie University
Dr. Allan Purdy is a neurologist
at the QEII Health Sciences
Centre in Halifax, and a professor
of neurology at Dalhousie
University.
“If you are somebody
with a lot of migraines, you are going to have to learn
to live your life in moderation,” says Dr. Purdy. “Don’t
skip meals. Don’t sleep too little.
Try to do things normally”
Smith is one of thousands of Atlantic Canadians
who suffer from migraine headaches. Migraine
symptoms vary, but a typical migraine might feature
intense throbbing, usually—but not always—on
one side of the head; they can also include nausea,
vomiting, diarrhea, and sensitivity to light, sound
and smell. Migraines occur more frequently among
women than men (approximately 70 to 75 per cent
of migraine suffers are women), and can begin in
childhood, adolescence or adulthood. Typically, they
last from four to 72 hours.
Before a migraine attack some people experience
what’s referred to as an “aura”—most often a
visual disturbance, but sometimes a sensory, motor
or verbal disturbance. Auras generally last from 10
to 30 minutes and can take the form of vision loss
or seeing stars, flashes of light or zigzagged lines.
Smith says that when she experiences an aura (it
doesn’t occur with every migraine), there’s a prism
effect. “It’s like you have a suncatcher made out of
glass, and what you’re looking through is warped,
in a jagged circle.” Other times, she says, she feels
like she’s got a bunch of bees underneath her scalp.
Smith’s current migraine has been hanging
around, waxing and waning, but never entirely
disappearing, for almost two weeks now.
22
Living Healthy In Atlantic Canada •
Spring 2012
What’s helping her get through her workday
is a medication that is a combined Aspirin and
analgesic with a barbiturate—what she calls her
“big gun” painkiller.
“I don’t take it just for fun,” she says. “I have to
be on the edge of sanity. As soon as I start getting
symptoms, I medicate quickly. The quicker the
better, and then the easier it is to handle the growth
of the migraine.”
And as Smith knows all too well, migraines—
especially chronic, continuous migraines like
hers—are tough to treat.
“There’s acute treatment and there’s
preventative treatment,” says Dr. R. Allan Purdy, a
neurologist at the QEII Health Sciences Centre, in
Halifax, and a professor of neurology at Dalhousie
University. “Of the treatments in acute therapy,
people start off with simple things like analgesics,
ibuprofen, acetaminophen and Aspirin. But
they probably won’t treat a moderate to severe
migraine,” he says.
“After that, they have to move up to migrainespecific agents. The ones that have been available
for the last 20 years are called the triptans, the
most famous of which is sumatriptan, which was
the first one. These drugs are highly effective; very
specific for migraine attacks. They can constrict
blood vessels on the brain surface; they can
also stop swelling around the blood vessels and
therefore stop the attack.”
Dr. Purdy notes that about 70 per cent of
the people who use triptans will have a fairly
good response within two hours, which means
the headache has gone from very severe or
moderately severe to mild, or it’s largely gone
altogether. “That’s not bad, but 30 to 40 per cent
of people in placebo groups in trials will get the
same response,” he notes.
On the preventive side, there are drugs that can
be taken on a daily basis to reduce the severity or
frequency of migraines. “These drugs are very
powerful. They’re from very different classes—some
are anti-seizure drugs, some are blood pressurelike drugs and some are antidepressant-like drugs,
although they are not used for depression but for
pain,” Dr. Purdy says. “Their best benefit is to reduce
the number of headache attacks by 50 per cent per
month. So if you usually had six attacks, they could
take you to three. That would be the best outcome.
“But the real question for patients is, do you
want to take a drug every day that only has a
benefit of reducing the number of headaches by
50 per cent? Some of these drugs have a lot of side
effects, some of which are potentially serious.”
with permission R. Hargreaves
This lateral view of the head
and brain depicts what Dr.
Purdy refers to as “the wave of
cortical spreading depression of
a migraine attack, moving from
the visual cortex forward on the
brain.” He likens the movement
of this electrophysiological
hyperactivity to the Bay of
Fundy’s “tidal bore,” in which the
leading edge of the incoming
tide forms a wave that travels
upstream.
of relief with an entirely non-pharmacological
therapy: acupuncture.
“Right now I’m going every three weeks. When
I started, two and a half years ago, I went twice a
week and we have been dwindling it down as I’m
improving. I used to have a bottle of 60 painkillers
for a two-month period. I would force myself
to make it last that long, because I didn’t want
it to stop being effective. That was my greatest
fear—that what was working for me would stop
Caroline Ruyle
Besides, he points out, effective migraine
treatment is about more than medication.
Dr. Purdy says a key factor in coping with
migraines—or any kind of chronic pain—is that
patients have a sense of control, and that they
take some ownership of the factors that may be
influencing their headaches. Maybe, he says, a
migraine is telling you something about yourself
and your brain; it’s a form of reality check.
“Someday, I’m going to write an article called
‘Maybe a migraine is good for you,’” he says, with
tongue planted firmly in cheek. “Why would I say
that? Because if you are somebody with a lot of
migraines, you are going to have to learn to live your
life in moderation. Don’t skip meals. Don’t sleep too
little. Don’t sleep too long. Try to do things normally.
Try not to drink too much alcohol. Try not to be too
stressed. And guess what happens when people do
that? Their headaches are frequently better.”
Preventing migraines can also mean avoiding
certain foods. Chocolate, dairy products, red wine,
foods containing monosodium glutamate (MSG),
nuts, onions and meats containing nitrates can all
trigger a migraine reaction. In Smith’s case, she
says she’s been tested for all sorts of food triggers,
but none has come up positive; she also insists that,
apart from staying up late some nights to work
on her writing, her life is pretty much a picture
of moderation. “I’m actually a very easy going
person,” she says. “I don’t get stressed out.”
Lifestyle factors aside, she knows exactly what
triggers her migraines—and it’s not something
she can control. “My trigger is related to weather
patterns,” she says. “I am a better weather forecaster
than the Weather Network, because if a low
pressure system is coming in, I will start to feel it.
“I do feel at the mercy of that,” she admits.
“Having said that, I don’t just submit. It’s my life
and I’m going to figure out some way to do what
I want to do, even though I live in a world where
the rug gets pulled out from under me pretty
constantly.”
Unable to take triptans due to a severe allergic
reaction, Smith has found success and a measure
In her own words
I’ll describe a typical migraine for me. Keep in
mind that these symptoms have downgraded
over the two-and-a-half years I’ve been going
to acupuncture. Now—including tonight—I’d
say that, instead of the pain levels being at
a boiling point, they’re on simmer. You’d still
avoid putting your hand on a burner turned to
simmer, but it’s not red hot.
For the most part, my migraines start as
an increased heaviness and numbness on the
entire right side of my body. Think dentists’ Novocain, and then imagine one half of your
body feeling like that.
My migraine sometimes begins with
an aura, which, for me, looks like a clear
suncatcher or beveled glass. The aura begins
as a small bleary visual disturbance and
then continues to expand and flash like a
Spring 2012 •
marquee sign. It blocks my vision in that eye
(all symptoms occur on my right side). In most
cases, the visual disturbance is accompanied
by nausea. I also get a deep ache in my
right lower abdomen, even along with the
numbness.
I can’t look at anything flashy like
commercials, and every sound is painful. In
fact, if I shut my eyes I can see a flicking image
behind my eyes.
My scalp feels like there are about a dozen
bees crawling and buzzing just under my skin.
The middle right side of my head down to
my right shoulder, along with my jaw, feels like
a bear trap suddenly clamped shut on me; this
sensation stays there for the duration of the
migraine.
My right eye feels like someone is trying to
pop my eyeball out from the inside.
The only thing that happens on the left
side is that I start dropping things out of my
left hand.
I also have difficulty speaking, rather like a
stroke victim.
Throughout all of this, the internal pain
level inside my head is severe, as if a hot, heavy
piece of shrapnel lodged itself in my brain—
and stays there for up to 10 days, sometimes.
~Julia Phillips Smith
Living Healthy In Atlantic Canada
23
Paulette Phillips
Julia Phillips Smith undergoing
an acupuncture treatment for
her migraine headaches. She
says acupuncture has helped
bring her pain levels down from
a “boiling point” to a “simmer.”
working,” she says. “Now a bottle of 30 is lasting me
four months.”
Acupuncture as a treatment for migraines has
come under serious scrutiny from the medical
community in recent years. A 2009 review of
22 trials concluded that acupuncture is at least
as effective as, or possibly more effective than,
preventative drug treatment, and has fewer adverse
side effects.
Smith says she used to miss at least a half day of
work every two weeks, and one of her goals with
acupuncture was to change that. “Now,” she says, “I
don’t miss work.” She admits, though, that on a day
like today, it’s still a tough go, because she’s always
mentally fuzzy during a migraine. “What I’m doing
this morning are things that won’t take as much
“I don’t just submit...”
says migraine sufferer Julia Phillips Smith, “even
though I live in a world where the rug gets pulled out
from under me pretty constantly”
24
Living Healthy In Atlantic Canada •
Spring 2012
concentration for me. I’m still doing work, but I’m
not working on anything that I could goof up.”
Dr. Purdy says he’s optimistic about the future
for migraine sufferers—he’s even gone so far, in a
paper he wrote for the journal Neurological Sciences,
to suggest that a cure might someday be possible.
“The research has moved very much forward,
partly because now people accept migraine as
a neurobiological disorder; it’s not a problem of
depressed women,” he says, admitting that in
the past there had been some stigma attached to
the disorder. “It’s real, not imaginary. It can be
moderately to severely debilitating, and it costs the
Canadian economy something like $500 million a
year in lost time, so this is a major health problem.
And even the World Health Organization has
put migraine in the top five of the most disabling
medical conditions. So it’s a big deal.”
His advice to patients is to focus on the positives.
“There are very helpful and effective therapies—it’s
in your best interest to be your own advocate.”
Smith would agree. “It definitely rules my entire
existence, but I fight against it—otherwise you
might as well curl up in a ball and not do anything.
I definitely push through a lot of things, but it’s
because I’m stubborn,” she laughs. “Mind over
matter, that’s me.”
iStockPhoto
Health
care goes mobile
by Alison DeLory
New technologies and smartphone
apps are taking health care out of the
hospital and into the home
Kimberly
scottboweringphotography.com
Churchill learned the hard way to be proactive about her own health.
The 38-year-old mother from Portugal Cove-St. Philip’s, NL, has
had type 1 diabetes for 23 years. One day in 2003, she rushed out to work without having had
breakfast and might have died as a consequence.
On that day, she was a passenger in a car with some co-workers; when she stepped out of the
car, she suffered a grand mal seizure. “I fell down an embankment and split my head open,” says
Churchill. She learned the hard way that she has hypoglycemia unawareness, a condition in
which her blood sugar can drop dangerously low without any warning signs. Churchill says she
knew then that she needed to do a better job of managing her disease.
Kimberly Churchill, of Portugal
Cove-St. Philip’s, NL, says a
mobile app offers valuable
reminders that help her manage
her type 1 diabetes.
Today, in addition to wearing an insulin pump
and a sensor that measures her glucose (blood
sugar) levels every five minutes, a key component of
her self-management is an app she has on both her
iPhone and iPad, called Diabetes Buddy.
For $4.99, Diabetes Buddy helps diabetics track
the factors that influence their blood sugar levels.
Users input data such as the food and water they’ve
consumed, how much exercise they’ve had, and
their blood pressure and glucose readings. Users
can set targets and Diabetes Buddy will notify
them when they’ve undershot or exceeded their
targets.
“It’s been a great tool for me. I had huge
difficulty getting control of my diabetes after my
second baby. My sugars were high,” says Churchill.
Today, she has a two-year-old son and a baby
with special needs. “Taking care of myself is a
challenge.... There are days, honestly, when I can’t
remember the last time I changed the needle on my
insulin pump or my sensor. This app will tell me.”
Medical smartphone applications are just
part of a wide variety of new technologies that
are empowering patients to manage their own
care from home. Dr. Raymond LeBlanc, vice
president of learning, research and innovation
at Capital Health, supports giving patients tools
to track and manage their chronic disease, and
to communicate their concerns and symptoms
to their health care teams. “Anything that gives
a patient accountability, responsibility and
engagement can be empowering and can add
quality to the management of that patient’s
medical challenges,” Dr. LeBlanc says.
Spring 2012 •
Living Healthy In Atlantic Canada
25
Dr. Michael Dunbar, director of research for orthopaedics at Capital
Health is working on an app that will analyze a patient’s gait—
minimizing the need for time-consuming and costly office visits.
There’s an app for that
at
Smartphones and tablets aren’t’t just for email or
Angry Birds anymore—they’ree becoming health platforms. Here are some
medical apps that are currently available for smartphones and tablets:
• EndoGoddess: Hit your glucose targets and earn points that can
eventually be used for iTunes purchases; $0.99
• Bant: Record, analyze and share blood glucose readings; free
• Cancer.net (American Society of Clinical Oncology): Store your
questions, medications and symptoms, and browse articles, videos
and podcasts on living with and treating various types of cancer; free
• Proloquo2go: For people who have difficulty speaking; tap one of
8,000 symbols and it speaks for you; $189.99
• Hello Baby (pregnancy monitoring): Learn about each stage of your
baby’s prenatal development from four to 40 weeks; free
• Pill Finder (and Pill Identifier): Identify unknown tablets/capsules
based on physical characteristics including characters or number
printed on a medication, shape, color, size, and scoring; free/$0.99
• PocketCPR: Instructions on how to administer CPR; free
• Can’t Wait (Crohn’s and Colitis Foundation of Canada): Locate
bathrooms on a map or in a list, find the nearest bathroom and
review the features of each bathroom; free
26
Living Healthy In Atlantic Canada •
Spring 2012
Perry Jackson
Cutting-edge technologies
In Halifax, Kanayo Software is developing
Healthgraph Connect, a technology designed to
facilitate remote patient management. This tool will
transmit data from a device such as a blood pressure
cuff or oximeter (which measures the oxygen
saturation of a person’s blood) to that person’s
health care providers. Patients will also answer
questions posed electronically by the device and
their responses will be made available for analysis.
Kanayo is also working with the director of
research for orthopaedics at Capital Health, Dr.
Michael Dunbar, on an app that will analyze patients’
manner of walking, otherwise known as their gait,
to help determine the long-term health of their knees
and hips. The app will allow medical professionals
to follow these patients without requiring them to
visit
vis the
t hospital. Those now testing the app simply
mount their smartphones on their belts, turn on the
app and go for a walk. The smartphone accelerometer
(an electromechanical device that measures
acceleration forces) evaluates their gait and sends the
results electronically to Dr. Dunbar’s lab, where they
are analyzed. If necessary, patients will be scheduled
for a follow-up appointment based on the app’s
readings, just as they would have been had they been
tested at the hospital’s gait lab.
Dr. Dunbar says that by separating the patients
who need further medical intervention, like hip
and knee replacements, from those who don’t, this
particular innovation could save millions of dollars,
as well as many hours of patients’ time. In the near
future, a post-surgical patient may be sent home
from the hospital with a $200 cellphone loaded
with an app that prompts the patient to correct
his or her posture, reducing the need to make
numerous visits to a physiotherapist.
He also imagines further developments such as
having patients do prescribed exercise programs
using treadmills or gaming systems such as Wii or
Xbox Kinect in their homes. These systems would
have built-in alerts that signal patients when
they are exercising outside of their optimal zone.
The force plate currently used in the Wii system
(which retails for about $150) is almost as good as
equipment in the gait lab that costs $150,000, says
Dr. Dunbar.
He sees mobile health as a terrific option for
reducing the current burdens plaguing our healthcare system. In his own practice, wait times for
hip and knee replacements are currently about 18
months, and Atlantic Canada overall has longerthan-average wait times for orthopaedic surgeries.
Images courte sy of Kanayo Software
Kanayo Software is developing Healthgraph Connect, a program that will help physicians
manage patient care remotely. The screen shot shown top left offers a sample of what that
data might look like to the physician. Lower left: The mobile health app reminds the user to
check specific health variables and send them to the physician for monitoring.
Dr. Dunbar also sees Atlantic Canada as having
huge business development opportunities in the
field of mobile health technologies. “We should not
be humble about this. We can’t afford more of the
same. The solution must be disruptive. It must be
cheaper. We have the design expertise…. We could
be world leaders in this.”
Matt Clark at Kanayo Software also hopes the
potential for innovation of medical technologies
right here at home is realized. “In Atlantic Canada
we’re working hard to save as many health care
dollars as we can. There is low hanging fruit in
this industry. We only need the wherewithal and
investment to go out and pick it.”
A new kind of health care
Both Drs. LeBlanc and Dunbar acknowledge the
potential criticism patients may wage—that these
technologies will mean less face time between
patients and their doctors. That may be true, but
as Dr. Dunbar points out, more efficient models are
needed.
“I’d rather see patients who need to see me rather
than those who don’t. We need better ways of
teasing those out. Rather than 100 patients waiting
a year to see me, let me see the six that need to see
Choosing the app for you
If you’re trying to evaluate the usefulness of an app before you download it, first check out
online user reviews and ratings. Also, according to software developer Matt Clark, the apps that
charge a small download fee (often ranging from $0.99 to $4.99) are typically better than the
free ones. You may also want an app that’s been developed by, or in consultation with, a medical
association, and if it replaces a medical device, says Clark, choose an app that was created by the
medical device developer.
me right away, and support the other 94 with the
successful models of allied health professionals,”
such as nurses, physiotherapists and occupational
therapists.
“The strength of this approach is in using widely
available transformative technology—for example,
smartphones—but using them in a different
manner to deliver health care,” says Dr. LeBlanc.
Kimberly Churchill is a convert. And although
she notes that there’s no substitute for a doctor
or health care team, she says she’d recommend
medical apps, not just for diabetics like herself, but
for anyone with a chronic disease.
“It’s absolutely essential to be proactive and to
learn to be the manager of your own health,” she
says. “This technology can help you do that.”
Spring 2012 •
Living Healthy In Atlantic Canada
27
c
Pre
D.
iou
s
Happy
surgery
An international surgical team helps
kids born with cleft palate
by Donna D’Amour
“
Happy
surgery” is how Dr. David S. Precious refers to his team’s
work. For the past 16 years, Dr. Precious—professor of
oral and maxillofacial surgery and Dean Emeritus of Dalhousie University’s
faculty of dentistry—and his volunteer cleft lip and cleft palate surgery team
from Dalhousie University have been joining forces with a Japanese team
to provide free cleft lip and cleft palate surgery for children in India, Brazil,
Vietnam and Tunisia.
Children with cleft lip and cleft palate
have an opening between the nose and
the mouth caused by a failure of the lip
or the palate (or both) to fuse during
prenatal development. “These babies
have problems breathing, eating and,
ultimately, speaking, among other
things,” says Dr. Precious.
The team treats approximately 50
children during each mission. They also
train surgeons in the host country; the
ultimate goal is to put themselves out
of work by giving local surgeons the
skills to deliver the service to their own
people—an outcome that has already
been realized in a number of locations
since the program began.
Birth of a mission
Dr. Precious’ surgical missions began
shortly after he met a dynamic Japanese
surgeon, Dr. Nagato Natsume, who is
28
executive director of the Japanese Cleft
Palate Foundation. “He was interested in
the way we were changing the treatment
methods for children, which differed
from the standard practice of the day.
Up to this time, the correction had been
viewed more as a geometric exercise in
skin—making triangles and trying to fit
the pieces of skin together to look like a
normal lip.”
Instead, Dr. Precious uses a technique
learned from Dr. Jean Delaire of Nantes,
France. “We say muscle surgery is more
important than skin surgery. The best
results come from surgery that restores
function and dynamic elements to the
lip. It has to work properly as well as look
good,” says Dr. Precious. “If you try to
reconstruct the face anatomically and
physiologically, you will get a good result
functionally and you will also get the
best cosmetic result.”
Living Healthy In Atlantic Canada •
Spring 2012
He also points out that the technique
has the advantage of allowing the child
to breathe through both nostrils, which
doesn’t happen with the conventional
method. And because this method
means the child can’t damage the
surgical site, it’s not necessary to use
arm restraints after the surgery. “It is a
much happier and smoother recovery,”
he says.
Dr. Natsume asked Dr. Precious to
join his team on a mission to the remote
province of Ben Tre in South Vietnam.
During that mission, Dr. Precious was
asked to explain this approach and
techniques to the Japanese surgeons on
the team. After the mission, Dr. Precious
was pleased, but realized that he wanted
to do more—to include more surgeons
from Halifax so they could handle more
patients, and to begin teaching the
surgical techniques to the host-country
surgeons. He organized a team of
surgeons from the QEII Health Sciences
Centre and the IWK Health Centre to join
the Japanese team on what are now yearly
missions; their most recent mission was
to Tunisia in February, 2012. The team
includes four surgeons from Halifax:
Dr. Reginald Goodday, Dr. Ben Davis,
T. Uchiyama
International team of volunteers: Dr. David Precious (shown at centre,
with hands in pockets) stands with members of the November 2011
mission to Tunisia; next to him (from left to right): Dr. Goodday, Dr.
Morrison and Dr. Robertson. The Halifax team joined surgeons from
Japan on what are now yearly missions to perform cleft palate surgery
for kids around the world.
It is knowing
that he and his team are
making a difference in the
lives of children that makes
him happy, says
Dr. Precious
Dr. Curtis Gregoire and Dr. Precious;
three surgeons from Japan; one or two
anaesthetists from Japan; a surgeon
from the University of Western Ontario,
Dr. Mike Shimizu, who is a graduate of
Dalhousie; and one Tunisian surgeon, Dr.
Slim Bouchoucha, who has been part of
Dalhousie’s initiative right from the start.
Logistical challenges
Dr. Precious structures these missions
with the same precision and attention to
detail he gives to the surgeries themselves.
“This is a totally voluntary charity,” he
says. “The surgeons who provide the
treatment pay for their travel and donate
their time, money and expertise.”
Dr. Precious says it is important
for the team members to appreciate
the culture of the host countries. In
Vietnam, for example, a key decision
maker for the family, in terms of
whether a baby will have the surgery or
not, is often the maternal grandmother.
The surgeons respect that reality and
do not go against a grandmother’s
wishes. “My experience has been that
they make good decisions,” says Dr.
Precious.
While the surgery itself is very precise,
it is not high-tech and does not require
that the doctors carry heavy equipment
on the missions. “All we basically require
is a healthy baby, a good anaesthetist,
an experienced surgeon and the same
instruments we use here.”
The team’s latest initiative involves
advocating for patients with local
health authorities, encouraging them
to use existing resources in the most
effective way for patient treatment.
Transportation, for example, can be a
major problem for patients living far
from treatment centres. In Vietnam,
the team helped address the issue of
providing local transportation for
patients to the hospital.
Spring 2012 •
Treating kids
“Our goal is to provide treatment, usually
in two or three operations only, in the first
six and a half years of life,” he says. The
surgeries are performed when the child
is six months old, 12 months old and six
years old. Host-country surgeons are
responsible for follow-up care, an essential
component of the treatment; children
need to be seen immediately after surgery,
then at six months after surgery, and once
again by the visiting team surgeon when
he or she returns the following year.
The timing for this surgery is
structured to enable each child to
participate fully at school. The postsurgical result levels the educational
playing field for children who may not
have been called upon in the past by
teachers who did not want to draw
attention to the child’s differences.
“After these surgeries, the child is in
their peer group. They no longer have
a cleft lip or cleft palate, so they are like
other six-and-a-half-year-old children.”
Making a difference
Dr. Precious has received prestigious
awards—including the Order of
Canada—for his humanitarian work
over the years, but he says it is knowing
that he and his team are making a
difference in the lives of these children
that makes him happy.
Last Christmas, Dr. Precious received
an e-mail from a patient he had treated
in Vietnam in 1998 and again 1999. The
patient, now a young man, had moved
to British Columbia with his family and
was happy to tell his surgeon that he
was now attending university. He didn’t
remember much about his surgery, but
he wanted to thank his doctor.
Patients like that young man tell
Dr. Precious the surgery has been
life-changing, but the doctor says the
experience is life-changing for the
surgeons as well. “Giving children
something they wouldn’t otherwise have
is a special opportunity and a privilege,”
he says. “And seeing the local surgeons
and professionals as they become able to
treat their own people is very satisfying.”
Living Healthy In Atlantic Canada
29
Aher n A
IWK Health Centre
Children’s Building
Link Building
Children’s Emergency
Entrance
Dr. Richard
B. Goldbloom Pavilion
Women’s Building
CH Children’s Entrance
W Women’s Entrance
30
Living Healthy In Atlantic Canada •
Spring 2012
venue
QEII Health Sciences Centre & IWK Health Centre
Spring 2012 •
Living Healthy In Atlantic Canada
31
Soccer goalie Tim Auton suffered
a concussion and a fractured skull
when an opponent accidentally fell
on his head. He now wears head gear
whenever he plays. Below right:
Dr. Kevin Gordon
A patient’s story
Kids and concussions
A blow to the head can be serious—here’s what
parents need to know
by Shelley Cameron-McCarron
Thirteen-year-old Tim Auton was
playing nets for the Suburban FC boys’
soccer team in Dartmouth, NS, last
August, when an opposing player began
to drive toward the goal. Tim challenged,
running and sliding to grab the ball first.
Witnesses say the attacker tripped and
fell with his knee landing on Tim’s head,
which was on the ground.
“I couldn’t move; all I heard was
voices in the background. I could barely
see… I couldn’t move my fingers,” Tim,
now 14, told a reporter a few days after
the accident. “After a few minutes I could
feel my fingers and they helped me up,
and I had the biggest headache.”
Tim’s dad, Steve Auton, was at work
at a Halifax fire station when a parent
called from the field to let him know Tim
was down. When he finally reached his
wife, Lori, who was still with Tim at the
field, she told him the referees and coach
had told her to take Tim to the hospital,
because he had been knocked out. “I
insisted she call 911 and not put him in
our vehicle,” says Steve. “I knew it would
be a concussion at that point. She then
told me he was starting to vomit and
looked terrible. She hung up and called
911. I arrived at the field as Tim was
being loaded into the ambulance.”
Auton says the next four hours at the
IWK Health Centre in Halifax involved
a CT scan and continuous monitoring
by staff. “The doctors informed us
immediately that there was definitely
a concussion and most likely a skull
fracture; the concern was for bleeding
and brain swelling. Fortunately, neither
became a significant reality.”
Tim did have a skull fracture, but his
32
memory and motor skills checked out;
he stayed overnight at the IWK to ensure
that no bleeding or swelling took place
and to make sure he could walk, talk,
and eat. When he left the next day, it
was with instructions to do no physical
activity except walking for 12 weeks.
He was also provided with a checklist of
concussion symptoms, and was booked
for several more appointments with a
neurologist to follow his progress.
Signs and symptoms
A concussion, simply put, is a brain injury
that can be caused by a direct blow to the
head or neck, or by a blow elsewhere on
the body that causes a severe and sudden
movement to the head.
You can suffer a concussion without
losing consciousness, says Dr. Kevin
Gordon, a pediatric neurologist at
Dalhousie University and at the IWK,
and an expert in the field of concussions.
A loss of consciousness probably
indicates a concussion—or possibly a
worse brain injury.
In the case of an obvious head injury
incurred while playing sports, seek
medical help immediately, he says. And if
there’s a head injury, assume also there’s
a neck injury. If the injured person is
wearing a helmet, let them remove their
own helmet. If they can’t, don’t remove
it for them. Wait for the professionals.
Among the concussion signs to
watch for are dizziness, nausea, and
vision changes. Other symptoms can
include feeling like you are in a fog, and
a profound sense of fatigue. Symptoms
tend to show up almost immediately
after the injury, or within the first 24
Living Healthy In Atlantic Canada •
Spring 2012
hours. But the sure sign that you’ve
suffered a concussion is a headache,
and it’s a unique headache. “It’s there
when you wake up, it’s there all day,
it’s there when you go bed, and it’s
ready for you the next morning. Any
degree of physical or cognitive activity
[like reading or studying] makes that
headache worse.”
It would be rare for symptoms to
appear after a few days, but Dr. Gordon
says there are certainly markers to look
for in the days following a head injury.
If a child is showing any concerning
behaviour several days out—irritability,
nausea, extreme sleepiness, confusion,
anything that draws attention—it’s worth
a call to your health care provider. Always
err on the side of caution, he says.
After a concussion
The good news is that, for the vast
majority of people, concussions resolve
on their own, Dr. Gordon says, adding
that there’s virtually no evidence that
Perry Jackson
Signs and symptoms of
a concussion
• headache
• pressure in the head
• neck pain
• dizziness
• balance problems
• nausea and vomiting
• vision problems
• hearing problems
• ringing in ears
• confusion
• drowsiness
• fatigue or low energy
• irritability
• difficulty concentrating
• difficulty remembering
• feeling dazed
• feeling slowed down
• feeling more emotional than usual
• feeling “in a fog”
The good news is that
Perry Jackson
there’s virtually no evidence that a single, brief
concussion that recovers on its own will have any lasting effect,
says Dr. Kevin Gordon, a pediatric neurologist at the IWK
a single, brief concussion that recovers
on its own will show any longer term or
lasting effect. “We shouldn’t be as fearful
as we are now,” he says.
Part of this fear has been fueled by
recent media attention, particularly as
it relates to professional athletes. Sidney
Crosby, the star Pittsburgh Penguins
hockey player, is certainly among
the most high profile of concussion
sufferers. After receiving two serious
hits to the head just a few days apart,
concussion took him out of the game
for 11 months; he returned to the
ice in spectacular fashion, but was
soon sidelined when his concussion
symptoms returned.
Dr. Gordon says that, despite Crosby’s
protracted recovery, most concussion
sufferers recover quite nicely. The
cornerstone of concussion management,
he says, is physical and cognitive rest until
symptoms resolve, followed by a graded
program of exertion prior to medical
clearance. While recovery times vary, most
concussions resolve in less than 14 days,
Spring 2012 •
although kids can require a bit more time.
It is important, however, to recognize
when a concussion has been sustained,
and to allow it to heal properly before a
return to the sportsfield or to cognitive
activity. Evidence shows that sustaining
a second concussion before the first one
has healed is much worse than suffering
a second concussion after the first has
healed. The negative effects are not
simply added to, but multiplied. Even a
seemingly mild blow to the head when
post-concussion symptoms are still
Living Healthy In Atlantic Canada
33
Preventing playground injuries
Atlantic Canadian children aged five to nine are hospitalized more often for an injury from
a playground fall than for any other cause. Active supervision is your child’s best defense
against playground injuries, especially if your child is younger than five years old.
• Children under five should play on equipment that is less than five feet tall
• Parents should survey the equipment before children begin to play, and should be
aware that weather conditions can impact safety
• Older children should be taught playground rules—including what is safe and
appropriate behaviour
Billy Alexander
present can lead to irreversible changes
such as memory loss and concentration
problems, and can mean a longer time is
required for recovery.
Parents should seek medical attention
if a child’s symptoms persist beyond a
couple of days. Dr. Gordon’s ultimate
advice for parents? Become informed
about concussions, but don’t be fearful.
Perry Jackson
Prevention
Falls from playground equipment are
a common cause of serious injuries,
particularly in young children, says
Sarah Blades, health promotion
specialist with Child Safety Link at the
IWK.
Such playground injuries are the
number one reason children aged five
to nine are hospitalized, although these
hospitalizations are more for fractures
than head injuries. Between 2005 and
2009, the IWK Emergency Department
saw 138 children because of a head
injury sustained on the playground.
In Canada, public playgrounds
must meet standards for surfacing
materials that help to cushion falls, but
close supervision of young children,
especially those under the age of five,
can help reduce injuries. Blades says
parents should always be within arm’s
reach of young kids.
It’s also important that young
children play on appropriate
equipment. Children under age five
should be on equipment that is less than
five feet tall. If a child needs to be boosted
or lifted onto something, chances are
they’re not quite ready for it.
Off the playground, Dr. Gordon’s
advice is that kids wear appropriate
footwear for icy and snowy walking
conditions, and that if there are
Sarah Blades
Falls from playground
equipment are a common cause of serious injuries, says
IWK health promotion specialist, Sarah Blades
34
Living Healthy In Atlantic Canada •
Spring 2012
wheels underneath them or they are
on horseback, they should be wearing
a helmet. Multi-purpose helmets that
cover the back of the head are his top
choice, but it’s worth noting that helmets
themselves are not designed to prevent
concussions; they are designed to
prevent severe brain injury.
A parent’s advice
Today, Tim Auton is back on the soccer
pitch, but he now wears a rugby skull
cap. His parents say they were very
nervous his first time back. Tim says he
doesn’t remember much of the incident,
and his parents say it hasn’t changed his
style of play.
“All l would say to other parents is
that goalkeepers should wear head gear.
They spend time on the ground where
the kicking feet are,” says Tim’s father.
“Every keeper should have some training
at least in how to dive, slide, and protect
him or herself.”
He says coaches, clubs, and field
supervisors should have basic training
in head injury recognition, and all clubs
should have a mandatory “sit” rule—
meaning that a player should be taken off
the field and watched for a period of time
by coaches—whenever a head bump is
sustained by a player at the youth level.
Take it seriously, he says, and get a
professional’s opinion.
Nutrition
The spice of life?
Turmeric may add more than great flavour to your food—it may have
medicinal powers, too
We often hear about the potential
health and disease-fighting components
of “superfoods”—tomatoes, for
example, playing a role in prostate
cancer, cinnamon in diabetes control,
blueberries in Alzheimer’s disease. A
spice that has recently been gaining a
lot of “superfood” attention is turmeric,
also named curcumin, which is an
active ingredient found in turmeric.
Turmeric is a key ingredient in
many Indian, Thai and Persian dishes.
It’s typically added to recipes as a solo
spice or as part of a blend of spices in
curry powder. This spice is also used in
products such as mustard and broths,
mainly as a colouring agent. It comes
from the ginger family—this is evident
in its resemblance to fresh ginger, but
inside, it has a vibrant yellow flesh. It’s
most commonly sold as a dried bright
yellow powder.
Adding turmeric to dishes contributes
a mild subtle flavour with a bold dash of
colour.
The potential medicinal properties
contributed, on the other hand,
encompass the prevention and treatment
of various conditions and diseases such
as arthritis, joint and muscle pain,
gastrointestinal disorders, Alzheimer’s
disease, cancer and high cholesterol.
Curcumin is an antioxidant; antioxidants
are compounds that can protect the
body’s cells from damage caused by
activated oxygen molecules known as
free radicals. Note: although turmeric
and curcumin show potential for health
benefits, research is in early stages on all
fronts. Following are some of the potential
health benefits currently being studied.
iStockPhoto
by Maureen Tilley, PDt
Turmeric bears a resemblance to fresh ginger; when ground, it produces a bright yellow powder that is often used as a colouring agent.
• Arthritis and joint pain. The antiinflammatory properties in turmeric
may play a role in relieving arthritic pain
and other associated joint and muscle
pain. These claims are based on personal
testimonials and laboratory studies.
• Alzheimer’s disease. India has low
rates of Alzheimer’s disease, piquing
interest for turmeric’s potential role in
reducing the progression and risk of
this degenerative disease. In studies of
mice, curcumin appeared to help with
blocking the plaques and proteins that
cause problems in the brain during
Alzheimer’s disease. It’s thought
that curcumin may play a similar
role to that of NSAIDs (nonsteroidal
anti-inflammatory drugs—over-thecounter versions include Aspirin, or
Spring 2012 •
acetylsalicylic acid, and ibuprofen) in
decreasing the inflammation of plaqueinflamed areas. More research is needed
to determine any potential impact of
this sort in humans.
• Cancer. Curcumin’s antioxidant
quality, along with its anti-inflammatory
properties, has triggered interest in its
potential role in cancer prevention and
treatment—particularly in colon and
breast cancers. Research in humans is
limited and has showed varying results
but in a lab setting, curcumin killed and
decreased the growth of isolated cancer
cells. Similar results have been seen in
laboratory animals.
• Heart health. Curcumin may play
a role in decreasing the risk for heart
disease and associated heart attacks by
Living Healthy In Atlantic Canada
35
The double dose of turmeric in this delicious Curry Peanut Chicken (see recipe, right) may add health benefits in addition to great flavour.
decreasing the plaque formation inside
blood vessels caused by LDL cholesterol.
Turmeric may also play a role in
decreasing chest pain related to heart
disease.
• Digestion/IBS. The active ingredient
in turmeric may also play a role in
reducing symptoms associated with
indigestion, irritable bowl syndrome,
ulcerative colitis and Crohn’s disease.
Again, more research is needed.
To supplement or not to supplement
The amount of the active ingredient
curcumin that is found in dried turmeric
is about three to five per cent; many
supplements claim to contain 95 per
cent curcumin compounds. There is no
standardized recommended amount,
but according to the American Cancer
Society, some practitioners recommend
taking a teaspoon with each meal, and
this is generally a safe amount.
Two small studies in human subjects
revealed that a daily dose of 3.6 grams of
curcumin had no adverse effect; another
study found that a 10-gram intake
over a short period was well tolerated.
Because both studies were based on a
small number of people, the strength of
the study is questioned.
It’s safe to consume turmeric in
food, but large doses that you might
36
ingest in supplement form may cause
kidney stones, stomach ulcers, and
gastrointestinal upset. “Natural” health
care products may contain all-natural
ingredients, but they can still pose a risk
for side effects and drug interactions.
Some individuals are advised not
to take a turmeric supplement: those
on blood thinners or who have a
bleeding disorder, those who are taking
medications affecting the immune
system, those with a history of ulcers or
anyone who is pregnant or breastfeeding.
The bottom line is that whether you have
any underlying conditions or not, always
talk to your physician prior to taking
large doses of turmeric or any herbal or
dietary supplement.
Turmeric certainly has “superfood”
potential. The way I see it, turmeric and
curry in food provide distinct flavours
and colours, decreasing the need to
use salt, which is a benefit in itself. If
it provides all the potential additional
health benefits, that’s just a bonus!
Correction: In “Food Labels 101” in the Fall 2011 issue of
Living Healthy, we stated that a 4 per cent Daily Value of fibre
was considered high. The sentence should have read, “The
general rule is that a %DV of 5 per cent or less is considered
low while 15 per cent or more means that a product is high
in that particular nutrient (except fibre, where 16 per cent is
considered high).” We regret the error.
Living Healthy In Atlantic Canada •
Spring 2012
1
1
2
2
1
½
2
12
¾
½
3
tsp (5 mL) olive oil
large onion, sliced
cloves garlic, minced
tbsp (30 mL) curry powder
tsp (5 mL) turmeric
tsp (2 mL) ground cinnamon
tbsp (30 mL) peanut butter
drumsticks, skinless
cup (175 mL) low-sodium chicken broth
cup (125 mL) light plain yogurt
tbsp (45 mL) chopped fresh parsley
In a skillet, heat oil. Add onion and garlic and cook
for several minutes until onion is tender. Stir in
curry powder, turmeric, cinnamon and peanut
butter. Cook until fragrant and peanut butter is
melted.
Add chicken to skillet and cook for several
minutes until no longer pink. Add broth and
reduce heat to low. Cook about 10-15 minutes,
until chicken is cooked through and juices are
clear. Remove from heat and mix in yogurt. Top
each serving with parsley. Makes 6 servings.
Source: Hold that Hidden Salt! by
Maureen Tilley, PDt.
iStockPhoto
Curry Peanut Chicken
Time: 25 minutes
This recipe calls for turmeric and curry powder—
giving double the curcumin and lots of flavour. It
proves that you don’t need those high-salt, highfat bottled curry sauces to make a tasty meal. This
chicken is great over brown rice or whole wheat
couscous. Instead of drumsticks you can use
chicken breast, or make it vegetarian by using tofu
or prepared chickpeas and low sodium vegetable
broth. If you choose to use canned chickpeas, look
for a no-added-salt variety.
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The All-New CR-V. Yeah, it does that.
9.2 city/6.6 hwy/8.1 combined L/100 km. Fuel consumption for comparison purposes only and may vary with usage and accessories. See Dealer for latest EnerGuide
results published by Natural Resources Canada (when available). Multi-angle rearview camera with guidelines intended to provide assistance to the driver. Always
exercise appropriate care while reversing. Real Time AWD™ (Intelligent Control System™) available on LX and EX models and comes standard on EX-L and Touring
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with select smartphones. Your wireless carrier’s rate plans apply. Only use texting feature when conditions allow you to do so safely.
I wasn’t sure
...so I asked my
PROfile Pharmacist
There are so many
over-the-counter
products to choose
from. Some can
interact with other
medications or pose
an allergy risk.
If you have
questions, your
PROfile Pharmacist
can help you too.
For a PROfile Pharmacist near you:
SobeysPharmacy.com
lawtons.ca