Posts Tagged ‘lifestyle’

Prescription: Puppies

| September 27th, 2012 | No Comments »

I checked out a link on twitter today and loved the article so much I just had to write a bit about it

Written  by an animal loving leukemia patient the article shares her experience of getting ‘prescribed’ a puppy during her recovery.  She focuses on the many benefits she has experienced in her life and I think some of her points are ones that anyone who knows a cancer patient should think about.

 The puppy has provided a positive attention draw, she is no longer identified as the ‘bald-lady with cancer’, she is now ‘the (bald) lady with the sweet puppy’ to the general public and that is freeing, she is more than her diagnosis or disease, she is not just a receiver of care, but a giver of care.  

In her more intimate relationship with her boyfriend this has provided the both of them a focus for their attentions that doesn’t have to do with treatment or symptom management.  

Taking the puppy walking and to obedience classes also get her out into the wider world regularly, providing both stimulation (mental and social) and exercise (an important part of regaining her “normal” life).  

I particularly loved the idea of the comfort and cheer listening to the  puupy’s heartbeat and feeling his warmth bring to her.  I was reminded of new Mom’s being encouraged to hold their children close to their bodies to soothe them with their warmth, scent and the sound of their hearts.  Research has demonstrated that this snuggling lowers babies heart rates, reduces their stress levels and that they fuss less often – perhaps she is enjoying similar benefits.

If you know people going through cancer treatment – especially long and/or high-risk treatments – remember that though you and they need the opportunity to talk about the illness that your relationship goes beyond that and that they may already have had lots of opportunity to talk about their treatment.  Be open to talking about their disease and treatment but remember they are not just a patient, their your friend.

Once upon a time, because of the risk of cross-infection with your pet, or your pet bringing in dirt and contaminants the ill and the elderly were not encouraged to have pets.  In recent years that has been changing.  Cats, and sometimes dogs, can now be found in nursing and retirement facilities as group pets.  These animals provide the residents with company and entertainment.  HIV/AIDS patients, with their lowered immune function, were encouraged to give up pets they had, not  just avoid adding a pet, in earlier days.  Now the emotional and social benefits of having a pet to love and care for and to be cared for by have been show to improve immune function and reduce depression in patients.

 

More reading?…..

pets in elder care

you can even go to school to learn about it…

preterm infants (another immunocompromised bunch) and touch…

 

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Misssing the obvious…

| January 19th, 2012 | No Comments »

As a health and wellness professional I think of myself as well informed and a good clinician.  I encourage people to be thoughtful with their wellness and think about all aspects of a situation when making decisions.  I even offer my services as a wellness consultant to help other with this process.  This morning I had a moment when I was reminded that no one does it right all the time – especially when dealing with family.

One of my stepsons has eczema.  Until this fall he had been symptom-free for about two years.  Then he had a flare up  Since that time we have been struggling to bring the symptoms back under control.  They have abated at times and are in a moderate level of irritation right now.  We have tired some corticosteroid cream with not great results – for either the itching or the state of the eczema itself.  He is oatmeal bathing frequently which offers temporary relief.  We have got him off of dairy – mostly – as that helped in the past.  I modified some of my bare bottom bum cream with different essential oils, which has helped as much as anything.  I got him to add an Omega 3/6 supplement as that helped with some itching I had during pregnancy.  Overall, some symptom management has been our best outcome.

How does that moment I described fit into all of this?  I was putting cream on my own legs and thinking how dry they are with the colder weather, which led to thoughts of other skin drying activities, which led to thoughts of my stepson being in and out of hot baths multiple times a week.  Suddenly I wanted to kick myself.  In all the other suggestions we have tried, in all the recommendations, I couldn’t remember ever saying “moisturize after your bath”.

Such a simple concept, one anyone with dry skin will tell you is a necessity, and it never crossed our minds.  We shall see now whether it is the missing piece.  Will some intensive moisturizing help?  Post bath and – if I can convince him – overnight will be the next phase of treatment.  

Now eczema isn’t deadly, no permanent harm is likely to come of this, but as my stepson would attest, it is a pain, very distracting and not helpful to life as a whole, but why make this a blog?  I keen on reminding anyone I am imperfect, but I did want a reminder of what happens when I don’t slow down and think things through.   The other reasons are: to help others remember that lesson too, and to remind them too that when dealing with family, it is easy to forget some of the most basic things.  Dealing with family we can often be both more concerned and less careful than normal.  Not careless for their well being, but sometimes, in the rush of daily life, if you never sit down and give proper, systemic thought you can miss the obvious.  Next time you or one of your family members comes up against a wellness issue, give it the thoughtfulness it deserves.  And if the issue is a larger one be sure to give it its due and if you need too, get some support.

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What is Epigenetics?

| November 7th, 2011 | No Comments »

I love CBC radio.  On the weekend I was listening to “Quirks and Quarks” and a discussion of epigenetics caught my ear.  Naturally, I had to find out what this things was and how it works.

For many years the research into autoimmune diseases and chronic conditions like cancer has focused on lifestyle and environmental impacts.  These diseases have a heritable component but they are not absolutely genetic, leading researchers to try to identify why and this has led into the field of epigenetics.  Epigenetics looks at the small markers that attach themselves to our DNA, especially in utero and in early life.  These markers do nothing to change the DNA you are going to pass on to your child, they simple alter how that DNA expresses itself.  Think of them as the controllers – they can turn things on and off or make things louder or quieter.

In this new field evidence is beginning to show how things like childhood poverty, child abuse and mental illness may have physiologically identifiable marks without changing the DNA.  Further, exposure to certain substances can also create epigenetic changes even late in life.  Many of the substances considered carcinogenic act this way.  They do not alter your genes, they turn on, or turn up, genes you already have (‘genetic predisposition) increasing the growth and success of cancer cells.  This brings in the fact that they can not affect genes you do not have and if you have the gene and nothing turns it on, you won’t experience the effects.

I believe that I have seen this in action in my family.  My maternal grandfather and both of his daughters (my Mom and my aunt) have died of very similar, very aggressive lung cancers – but not my uncle.  In the cases of my grandfather and my mother they also died at about the same age (51 and 52), but my aunt survived until she was in her middle 60’s.   Strong genetic evidence – early onset, aggressive, similar patterns of meta – why did my aunt live the extra decade?  I believe the simple answer is – she didn’t smoke.  My grandparents and parent were smokers meaning life long exposure to the carcinogens in cigarettes.  My aunt, though she grew up in a smoking household didn’t smoke herself.  Epigenetically speaking, she didn’t turn up the gene.  With my uncle, he has passed his early fifties, and is a non-smoker, so the question is, did he get the gene at all?  Time shall tell.  To contrast this heritage, my maternal grandmother smoked her entire life, and lived until 80, never getting lung cancer.  No gene?  Seem so.

This is excellent reason for me and my sister – we can’t change our genetic inheritance (and there is not current test for a lung cancer gene, though they do know there is one) but we can choose our lifestyle.  Neither of us has ever smoked, neither of us drink as heavily as our parent or grandparent, we eat healthy diets with lots of fruits and veggies, and my sister (not so much me) has kept her weight low.  We our doing our part to ensure the volume stays down on our genes, only time will tell if we succeed.

On the human level the field of epigenetics brings weight to our life choices adding to the pressure many feel to “live well”.  The weight of a healthy lifestyle becomes a punishing burden as every choice seems to have dire effects not just for themselves but their children.  Women especially receive barrages of information and direction on what to eat, drink, and expose themselves to during pregnancy and breastfeeding.  I have felt that pressure, but ultimately I try to remind myself that I can only do my best and the stress of trying to manage everything carries as many negatives as a lot of the things we try to manage.   I also try to remember that this gives me power, I can impact how my body acts, I am not at the mercy of my genes, how I live, and how I teach my children to live will change what happens to us. 

From the perspective of the medical field epigenetics creates a field of unique, crafted interventions that has never existed.  We can begin to more clearly understand the most profoundly impacting life events and behaviours to allow both early intervention or to create uniquely personal watch lists given our histories.  How intriguing.

 

LINKS: 

 

epigenetics and poverty

nurturing rats and epigenetics

epigenetics of bipolar and schizophrenia

epigenetics of child abuse

 

 

 

 

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BC Generations – onsite visit

| October 21st, 2011 | No Comments »

The last step in the initial intake for participation in the BC Generations is to do the on site visit.  The visit was very quick, I don’t think I was even there 20 minutes.  I arrived a few minutes late (sigh) but was quickly signed in and there was the standard double checking to ensure I was who they thought I was by a young man at the front desk who had a package with my name and lots of coded stickers to put on my forms.    He gave me my blood and urine lab form and directed me to give my samples before the end of November.  He then led me to an adjacent room divided  into separate cubicles where a research nurse greeted me.

The nurse asked me a series of screening questions (pregnant – no; hand arthritis – no; pacemaker – no, etc to ensure they could do all the tests and get the right outcomes.  She then got to the tests.

First, my blood pressure and heart rate, twice, of course.  All good in the blood pressure department.  Next was a revisit of the waist and hip measures (only once) where I discovered that I had been too precise in following their waist measurement instructions – I would have like it they had used her explanation – measure at the belly button!  Then height, both standing and sitting (this will let them determine spinal shortening).  

Next – all the cool toys!  First a grip device – where I discovered that my left hand is puny and my right is super strong – enough to offset the left’s puniness in the combined total.  I guess I can now tell clients I have one strong hand when they comment on how strong my hand are!  After that, my most dreaded machine – BMI calculator.  I am not going to share the exact results of my weight, BMI and percent of fat.  I will say that I definitely have some losing to do!  And some really detailed motivational number.  I now know that my body fat is fairly evenly distributed (though my arms are the fattest – who knew!) and that my right leg and left arm are fatter and stronger than their opposites.  Finally I stuck my foot in this machine that assessed the bone density of my heel (calcaneus) bone.  Here again was some good news – very dense bones.  In part this has to do with weighing so much (the bones get denser to support your mass), and with being on my feet a fair amount for work (lots of weight-bearing). 

The sum up is that I am as fat as I thought, but I am not doing too bad in terms of strength, blood pressure and bone density.  Basically I am healthy enough that I can  lose the weight to fix the other measures with relative ease.  That is my own personal project though – not the BC Generation’s responsibility.

There you are, that is the total of my experience to date.  In future they may phone to ask me to participate in specific studies (which I can decline if I choose) or to come back in for a repeat of the on site visit I had (or perhaps some similar type of visit).  They now have my permission to check in on any testing results I get within the medical system.  Not to big an impact on my life given how much could come of it – an hour or so of my time now to provide information for studies over the next 25 years.  

 

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BC Generations – the forms

| October 20th, 2011 | No Comments »

My first step as a participant of the BC Generations project is the intake form.  This is a fairly thick bundle of papers you receive in the mail a few days after signing up.  Along with the intake you receive information about the project, its purpose, and a release for you to sign saying you understand and agree to participate. 

Going through the form probably took 20 minutes.  Most of the questions are quite easy to answer, though I found it interesting they always give you the option to say “I don’t know”.  First you give your vital statistics (name, age, gender, etc.) you answer questions about you lifestyle (servings of fruit and vegetables in a day, amounts of exercise within a week and its intensity) and other health habits like amount and type of drinking and smoking.  These are easy, you just have to think about your habits a bit – which I found a bit revealing.  For instance, I discovered that I do not eat as many fruits and vegetables as I thought.  My activity level, which I knew was low, registered even lower as so many of the things I do involve shorter spans of activity than they were looking for.

The next section if the intake is family history and make up, along with the medical stuff.  You are asked to identify you ethnic background and where your parents and grandparent were born.  A bit more thought there, but still pretty easy.  They also ask about the make up of your family of origin (who you grew up with) and your current family and relationship status (married or not, kids or not, etc).  This section finishes with the questions I expected sooner – your history of illness (or not) and that of you parents and biological siblings.  Here things get a bit more specific and you need to think a bit – for me my sister was the trickiest as I have never had been a caregiver for her.  Depending on how close you are to your siblings (who they lump together in one set of questions) you may have to ask them – or choose the “I don’t know” box.

The final section of the questionnaire is the one I have been dreading.  Having put on weight lately I was dreading taking measurements and writing down my weight numbers.  This part is a bit of a bother as they want you to do two measurements of both and I found the waist location description not great.  I made it  through this though I disliked the numbers as much as I expected.  

Overall, pretty easy.  I only had to go looking for one piece of information (the DIN of my prescription – and I am guessing most everyone would have to go reference that one) and the need to find a tape measure – and my dread – meant that the questions got answered a few days before the measurements got taken.  

 

 

Next – the on site intake….

 

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BC Generations Project

| October 7th, 2011 | No Comments »

I have signed up to be a human lab rat. The BC Generations Project is a 25 year study hoping to follow 40,000 BC residents between the ages (at the start) of 35-69. The BC Generations Project is part of a greater, Canada-wide project called the Canadian Partnership for Tomorrow that is hoping to reach a total of 300,000 participants in total. I will be chronicalling my progress through this project over the time – I don’t guarantee the whole 25 years, but at least the first few.

The BC Generations project will use the data and biospecimens collected in aa number of studies over the next decades that are all attempting to understand how to prevent cancer and other chronic disease. I love this project. I also feel bad for it. The researchers are looking to capture some of the most elusive data out there. Trying to connect which specific part of your life increases your risk would be difficult. Trying to find out how the different aspects of you life act together to increase or decrease your risk of disease over someone else is even more difficult. They will have to try to tease apart genetic, environmental and behavioural factors and decide which are the lynch pins. With the real possibility that there are no lynch pins – but rather an calculus level equation of factors that add, subtract, multiply and divide to land you with a negativeor a positive.

This is the reality of medicine as we are coming to understand it. No one thing is the answer, all things are the answer – and your answer is different than anyone else’s.

Initially, BC Generations will be collecting asking lifestyle questions, collecting physical data (height, weight and waist/hip ratio) and physical samples (blood, urine, and saliva). This data and the physical samples will be stored together for future use. By entering the BC Generations Project participants also allow researchers access to their health records and they may be contacted in the future for follow-up.

 

By collecting together such a large pool of samples spanning ages, genders, locations and lifestyles the BC Generations Project and the Canadian Partnership for Tomorrow is creating a resource of incalcuable value to both present and future medical researchers. Data can be extracted for fair-haired, healthy eating women across Canada, or 48-year olds with a history of maternal diabetes that live in urban settings, or 69 year-old males with heart disease in their fathers. The options are myriad and when you add in the ability to track progress over time you have a tool for the future that will offer the future a gift of knowledge about how time, behaviour and family history come together.

My first step will be to fill out the intake form (book) prior to my physical assessment. Next I have an appointment to have samples taken. From there? Who knows, but it should be a heck of a ride. I get the opportunity for a free health assessment and a chance to contribute to the evolution of preventative medicine in my province and my country.

If you want to volunteer, or just learn more about the project, go to their website.  Give some thought to what a wonderful legacy this could be.  As an orphan whose parents both died middle-aged of cancer, I consider my participation to be a gift to my son and his future children (should he have any), a gift I may never have another opportunity to give.

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A new gig for me…

| September 13th, 2011 | No Comments »

My baby...back when he was...

(more…)

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E-patients

| June 29th, 2011 | No Comments »

I love TED Talks.  A few months ago now my husband introduced me to TED and I have become a huge fan.  I follow TED on facebook so that every day I can see what is up in that world.  Their talks range in subject matter from recycled fashion to architecture to engineered silk to transplants and pleuri-potent cells.  I never know what I might find on TED or how it may thrill me.

Today, I got an extra big thrill from “e-patient Dave” (aka Dave deBronkart).  You wouldn’t think Dave is a cancer patient, would you?  He is a man of about 60 who was diagnosed 4 years ago with a cancer that gave him 6 months to live.  Through networking with other patients online he managed to find a treatment that has allowed him to live on in good health for four years so far.  A treatment his doctor did not know about.

The reason I found Dave so thrilling is that he is advocating for the type of proactive patient behaviour that I want to support and encourage.  Dave emboldens patients to go out and find for themselves the information they need.  To be “e-patients” that is: equipped, engaged, empowered and enabled (as coined by Dr. Tom Ferguson).  To make themselves heard as the vaulable resources they are in their own care.

The services I offer as a wellness consultant are aimed at supporting people in becoming e-patients.  I can give you the tools and support to jump start you in this role.  I can also offer ongoing support, advocacy and time to your quest to become the star in your health care.

We need doctors and health care professionals to provide us with services and exercises the skills they work very hard to master and maintain…and they need us.  Doctors need us not as mute recipients of their skills but as vital contributors to our care.  We need to offer our expertise about ourselves.  We need to gather resources and information that best serve us and our needs so that our health professionals can better serve those needs.

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Antibiotic Resistance…why should we care?

| April 13th, 2011 | No Comments »

MRSA bacteria

I know that I am always happy, intellectually, to have my doctor seriously look at my symptoms and bring up their own knowledge of what bugs are circulating (“…we are seeing a lot of viral infections right now…your symptoms look like that”) when I go in to see about the sore throat, achy body and fever I am suffering. I am delighted that the doctor is taking a stand and trying to be thoughtful about applying the right ‘cure’ and I will not be contributing to the next MRSA infection. Emotionally, I am less happy that I have to suffer when virus is the answer. An article in the April 2-8 edition of The Economist about superbugs, antibiotic resistant bacteria, kick started that intellectual part of me. The article focuses on the ways in which resistance evolves, the costs and risks of super-bugs, and our options for dealing with them – and whether they are palatable. One surprise for me was finding out that Alexander Fleming, the man responsible for identifying the Penicillium mold and its ability to kill bacteria, predicted this risk in his Nobel prize speech in 1945. The article also provided a very pointed reminder about the role economics and human nature play in the medical system and its problems.

The emotional dismay at having to put my life on hold and feel yucky often overwhelms my intellectual knowledge, and I am not alone in that. We know antibiotics exist so we want them to fix all our sore throats and runny noses. Antibiotics are not miracles, we and our doctors know this, but we do not like it.   Doctors lack, even today, the ability to do rapid screening of infection sources that would ensure they never give someone with a virus an antibiotic. This also mean they lack a test result to toss in the face of our emotionalism and make us accept that our aching throat is simply going to be around for 7-10 days and we need to endure.

This is one of the main options examined in “The spread of superbugs”, in The Economist. Patients need to accept that not all infections respond to antibiotics and that using them, necessarily or unnecessarily, creates resistance in bacteria.   The benefit of curing the bacterial infection does outweigh the risk of creating resistant bacteria that can, at least in the case of streptocci bacteria,

streptoccus pyrogenes

endure for up to a year. The same risk/benefit analysis does not apply to treating viral infections with antibiotics. This also ignores the possibility for yeast infections resulting from the depletion of our enterobacteria and the co-occurring impacts the depletion on our digestion and the health of our intestinal tract.

A second issue is the lack of new antibiotics, especially those to treat drug-resistant bacteria, being brought to the market.   Here is where economics start to come in.   Unlike anti-depressants or blood pressure medications antibiotics are a self-eliminating drug. Once you take it you should not need to take it again for some time. The other aspect that cuts into profit, especially for the super-bugs antibiotics, is that the majority of infections occur in poor countries. We tend to hear about outbreaks in hospitals and care facilities, which are the primary hotspots here in Canada, but in poorer countries the problem can be more widespread. Where lack of education about antibiotics and the sale of poor quality and strength drugs are problems, the development of resistant bacterial stains is more common. The same lacks which allow these practices to flourish impede the ability to afford the more expensive treatment needed to treat infections.

Another issue that will directly impact our quality of life here in the first world is the elimination of many non-vital but life improving and functionally beneficial operations. I had never thought of what the potential consequence of an increase in frequency in antibiotic resistant infections in our hospitals might be in terms of our medical care beyond the increased costs. Tummy-tucks and eye lifts are not the procedures I am talking about. I mean cataract surgeries and what the article calls “orthopaedic surgeries”, which I suspect include knee arthroscopies and joint replacements. In a world with an ageing population that has come to expect a level of physical function into their golden years this is daunting prospect.

MRSA - what it looks like to you....

 

 

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Personal Health History

| March 28th, 2011 | No Comments »

Do you contact the medical system on a regular basis?  Is your condition complicated?  Do you have difficulty remembering all the details of your medication and history?  Does this describe someone for whom you feel responsible?

If you have answered ‘yes’ to one or more of these questions then developing a personal health history may be something you want to do.  For yourself or someone you love a personal health history (PHH) is a tool to help you successfully navigate your care and your wellness in today’s often overwhelming world of health and wellness.  The personal health history brings together the information you need to have at your fingertips in an organized, easily tracked manner, allowing you to have confidence in your ability to ensure your own health care.

For more information about how I can help you create your own personal health history, click here.  For those of you who would first prefer to learn a bit more about the personal health history, contact me and we can chat a bit, or we can arrange for me to come and talk to a group of you and your friends about the personal health history and wellness care to answer your questions.

I am also happy to do workshops, where we can work together to create a PHH for yourself and/or your family.  If you are interested in hiring me to do a workshop, please contact me.

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