Canadian Healthcare News April

1 | www.cdnhcn.ca | Canadian Healthcare News

CanadianHealthcare

NewsApril 2013

Informing Communities with Reliable Healthcare News

WIN A LIMITED EDITION KARYN CHOPIK BRACELET

“HEALTHY PETS” NOT YOUR TYPICAL

MOTHER’S DAY

WEIGHT AND THE HORMONE CONNECTION

“HEALTHY HOMES”PROPER PRUNING &

CONTAINER GARDENING

Contest

2 Canadian Healthcare News | April 2013 |

ContestLike us on Facebook for a Chance to Win a Karyn Chopik LionHeart Bracelet| Karyn Chopik | 3

FeatureWeight and the Hormone Connection

| Dr. Bal Pawa, B.Pharm, M.D. and Dr. Nishi Dhawan, M.D., CCFP | 4

Healthy HomesProper Pruning | Shell Busey | 6

Container Gardening is an Easy, Weed Free way to Garden | Susan Watson | 7

Healthy PetsNot your Typical Mother’s Day| Dr. Nikki Licht | 8

Canadian Healthcare News

Publisher & Editor: Marilyn [email protected]: Krysta MukaiProduction: Vic [email protected] & Distribution:Perri Noble & Susan Watson

Sales & Editorial: [email protected] AvenueLangley, BC V3A 3V6Phone: 604.533.0376Fax: 604.648.8731

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Contents April | 2013

Disclaimer:

Canadian Healthcare News does not assume responsibility for any claims made by its advertisers

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Permission to reproduce any part of this publication must be approved by the publisher. All pictures, articles or emails sent in become the property of Canadian Healthcare News.

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Healthy Business5 Ways to Keep your Employees Happy/Healthy | Denise Hannen | 10


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Women have always felt more vulnerable to weight gain especially around their period, during stress, after a hysterectomy and at menopause. Finally, Scientists are discovering proven links between female hormones,

hunger, weight loss, and fat metabolism. Traditionally, physicians have been using the “calories in vs calories out” to counsel their patients on weight loss. The hidden key to weight loss may be in balancing your hormones and not just counting calories and push-ups. Hormones are very powerful chemical messengers, secreted by various glands in your body. They can send an instant twitter message to your tissues to execute changes in body function such as digestion, reproduction, immune systems etc. A very complex cocktail of some 200 hormones and chemicals circulates in the blood at any given time. They can modulate what, when, why and how much we eat. The most influential hormones for weight loss are insulin, cortisol, thyroid, leptin and ghrelin. These hormones are in turn affected by estrogen, progesterone and even testosterone. Thus it is important to understand the hormone connection and how to keep them in optimal range for ideal body weight.

InsulIn

Secreted by the pancreas, insulin is released in response to high blood sugar levels. When a certain weight threshold is reached or there is a genetic predisposition, one can become resistant i.e. insulin does not work properly. This can lead to adult onset type 2 diabetes, characterized by abdominal weight gain and abnormal blood sugar levels. When insulin is secreted in higher amounts, you feel hungrier and you eat more. Willpower does not exist when insulin is high.

CortIsol

This is the well-known fight-or-flight hormone. Most women have many demanding roles, and a never-ending to-do list -all this while being sleep deprived most of the week. Stress activates the release of

cortisol (and adrenalin). Cortisol automatically ramps up the appetite and increase cravings for sweets and carbs. These foods cause the insulin levels to spike, resulting “stress fat” which is concentrated around the belly. This visceral fat then predisposes you to hypertension, diabetes, and cardiovascular disease. Cortisol levels are also affected by sleep; several studies have shown that even partial sleep deprivation can elevate levels.

thyroId This hormone regulates almost every cell in the body. It is responsible for many functions including rate of metabolism, cardiac activity, body temperature and regulation of other endocrine tissues.

leptIn And GhrelIn

These two hormones have been recently recognized to play a major role in weight and energy regulation. They send signals to the brain causing a cascade of neurotransmitters to be released which influence eating behaviour.Leptin signals us to stop eating if we’re full. In obese patients this hormone level is quite high in the blood as there may be “leptin resistance”.Ghrelin -- the only hunger hormone identified to date -- counteracts leptin and other hormones and tells the body it’s time to be fed.Unfortunately, we can’t count on these hormones to switch off when we’ve gotten what we biologically need from our food: Recent research suggests that these hormones of fullness and hunger play a role not just in our need for food but also in our pleasure of eating.

estroGen, proGesterone And testosterone

As we age, our hormones decline. These sex hormones play a significant role in metabolism and maintenance of muscle mass, which decreases

Feature

Weight and the Hormone ConnectionBy: Dr. Bal Pawa, B.Pharm, M.D. and Dr. Nishi Dhawan, M.D., CCFP


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as our hormone levels go down. Female sex hormones also execute complex actions on weight and food regulation. Deficiencies and fluctuations in estrogen and progesterone may drive women to “binge eat” or crave high carb foods. As we know there is no “Miracle Diet Pill” we can give our hormones a better chance by creating a stable environment in which they can work.

stress

Reset your stress-o-meter by putting in place effective strategies such as reframing and meditation so that you are not experiencing stress-related hormone cravings. Notice your eating patterns. Do you tend to over eat when anxious, bored, or overwhelmed? Become more conscious of your “feelings” preceding the behaviour. Research confirms that lowering stress not only lowers stress hormones, in fact it optimizes the function of all the other hormones.Research shows that people who practice yoga three times a week tend to gain less weight over a 10 year period than those who do not. Stress reduction can happen in many ways –find a hobby that engages you - music, dance, theatre. Laughter is often the best medicine.

MIndful eAtInG

Using all of your senses to register the food on a multisensorial level. Look at it, smell it, and savour the unique flavours. You will end up eating less when you are in the moment and focused on what you are doing. Taking three deep breaths before putting food in your mouth is another way to stay present. Researchers have found that fast eaters produce different gut hormones that do not send signals to be brain that they are full.

Be mindful of what you put in your body -Think a diet high in fiber, complex carbs, and low-glycemic-index foods like whole grains and fiber-rich vegetables and fruit, as well as unsaturated fats, which will take longer to metabolize and help you stave off cravings and regulate your blood sugar levels. Avoid highly processed foods and watch for hidden fats, salt and sugar in the ingredient labels.

exerCIse Westcoast Women’s Clinic recommends exercising an hour per day, five days a week, to combat hormonal weight gain. Exercise lowers cortisol levels and raises your endorphins giving you a natural “high”. So go do something thrilling. Strength training can also help with hormonal balance as it improves the muscle to fat ratio. Muscles burn more calories than fat at rest thus improving your metabolic rate. Remember, not all cycles have to be vicious. Research shows the more you exercise, the better you sleep, which can make you less hungry. Also, the more you sleep and exercise, the better your mood and stress levels may be, so you’re less likely to get the neurochemical cues that might lead you to overeat or eat mindlessly.If you have “done all the right things” and are still frustrated it may be related to a hormone imbalance. Get the help you need – get informed, see your doctor.

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HealthyHomes

With the days getting noticeably longer many people have a greater desire to get out and work in their yards to prepare for spring. If you’ve been curious about the proper timing of pruning your trees or shrubs,

the dormancy plants undergo in winter makes this time of year an opportune time to carry out such activities. Although pruning can be carried out at all times of the year it is best done before spring advances when trees are dormant, without leaves and sap is not flowing. Pruning can provide the following benefits:•Achieve increased flower and fruit production in fruit trees & flowering shrubs;•Maintain good health and form by removing dead, diseased, damaged or crossing limbs in all trees, shrubs & hedges;•Eliminate hazards and improve structure through abatement, restructuring or structural pruning in both mature & young trees.

Whether you plan to do this yourself or hire an arborist there are a few points you should

consider:•Do you know the type of pruning you

plan to carry out and the results that it will create in that tree?•Properly pruned and cared for trees will be more attractive, healthier and less susceptible to storm damage in addition to adding more value to your property.

•Improper pruning can permanently damage a tree from which it may never

fully recover. Topping or heading cuts are examples of these where the top of the tree

or the tips of the branches are removed only to

create more unwanted or hazardous growth.•Be informed and read up on ISA’s guidelines for tree care and pruning by going to www.treesaregood.org•If you have any hesitation in doing the work yourself call a professional for a quote or consultation. Certified arborists are trained in many aspects of tree care and their priority is to maintain safe & healthy trees.

Use care when selecting a tree service and ask the following questions:•Are they an ISA (International Society of Arboriculture) certified arborist?•What standards are they performing their work to?•Do they have references and addresses of recent (similar) work to view?•Do they have specific liability insurance to cover the work they plan to do?•Is their WorkSafe BC (WCB) in good standing?

To ensure the health of our street trees, many municipalities require that trees are pruned in accordance with the International Society of Arboriculture Best Practises and Standards. Make sure to check with your municipality before you attempt to prune any street trees.

proper pruning

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Container gardening allows you to garden where there is no soil, on a large deck, walkways, apartment balconies, around townhomes. Weeds are very seldom invasive in containers and pots that are raised off the ground make

gardening easier on the back. This makes container gardening perfect for seniors and those who don’t have an actual garden. There are very few plants that cannot be grown in a suitable size container and many apartment dwellers are becoming adept at growing their own vegetables and herbs in containers. Container gardening is simple, easy and inexpensive, especially if you recycle or re-use containers you would normally throw away. You can plant in just about anything that will hold dirt…. tea pots, rusty old buckets, rubber boots, wooden clogs, coffee and tea tins, packing crates, animal watering troughs, ladders, chairs, stools, old wheel barrels, toy trucks, little red wagons, sinks, toilets, bath tubs, and the list goes on so be inventive and try something with items you have!Containers look best in groups and since most pots are easy to move, you can change the look of your garden or deck just by switching the pots around. A pot of summer color can lighten up a dark corner or fill in a bare spot in the garden. Containers can serve as focal point, whether on the ground, hanging from a wall or on a pedestal.Combining permanent trees and shrubs with annual summer flowers will give your pots a very full look. The size of plants you choose will depend on the size of your container. Containers that are too large for your space will overpower it and likewise, containers that are too small will seem lost to the eye. And be sure to vary the height of plants so your arrangement doesn’t look top heavy or flat. Analyze whether you have a sunny or shady location and purchase your plants accordingly. Local nursery staff are trained to give you great advice on which plants to choose. What I can’t emphasize enough is to make sure the container has good drainage. This may mean drilling holes and putting 3 - 4” of rock in the bottom of the planter. Once you have your containers filled, you cannot neglect them. Containers require more watering than land plants and they need to be pruned and fertilized to get the most growth, foliage and bloom from them.

Pots bring plants closer to eye level for greater visual enjoyment and allow trailing plants to tumble over the side making containers the most beautiful, easy gardening ever!

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Container Gardening is an Easy, Weed Free way to Garden

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When I was asked to contribute a story relevant to Mother’s Day I realized immediately that I would have a lot of difficulty narrowing down what to focus on. There are just so many different angles that I could

explore! An article written from the point of view of an emergency veterinarian is unfortunately not going to focus on the perfect breakfast prepared by perfect children and the family outing that occurred without incident, but on the perils of Motherhood and Mother’s Day.The obvious theme is motherhood itself. I currently have a small dog whelping in a quiet room not far away so that we can monitor her closely and are ready to intervene if she needs any help. Most dogs have puppies without intervention, but there are definitely cases where Caesarian sections are life saving. Some breeds routinely need Caesarian sections, and if you are considering breeding your dog I urge you to research as much as you possibly can to decide whether this is something that your dog needs to undergo, and whether you are prepared and knowledgeable enough to be sure this is going to be a positive experience. Most of our pets are spayed and neutered prior to maturity to avoid motherhood, and unless you are convinced that you are contributing valuable genetics to the dog population it is very important to spay and neuter

your pet. As everyone knows, there are a great many wonderful pets without homes, and even the most closely monitored pet has been known to suddenly gain weight and then deliver unexpected puppies in the bottom of a closet. Spaying or neutering prior to maturity also helps prevent illnesses later in life such as prostatitis and perianal tumours in male dogs, and mammary tumours and uterine infections in female dogs.Mother’s Day itself should be about family, food and hopefully small tokens of appreciation. Occasionally it involves time consuming and possibly expensive visits to your local emergency clinic as well as the stress of having a sick pet. Chocolate comes to mind as the present I would personally most appreciate on Mother’s Day, and quite a few of our patients come to see us after they ate the chocolate that was inadvertently left on the table or counter. The better the quality of the chocolate and the more cocoa it contains the more toxic chocolate is to our pets. Initial symptoms include vomiting and diarrhea, and if enough caffeine and theobromide was present in the chocolate you may see hyper-excitability, pacing and agitation. Severe toxicities can result in muscle tremors, seizures, cardiac arrhythmias and death. The amount of fat ingested can lead to inflammation of the pancreas, causing ongoing vomiting, diarrhea, depression and can also require specific hospital care as it can be quite a serious disease.The rule for ALL toxicities is to contact your veterinarian and Pet Poison Control as soon as you realize your pet ate something they shouldn’t have. Pet Poison Control charges a fee to consult specifically on your pet and the type of toxin ingested, and they provide excellent information to you as well as your veterinarian. Prevention is the key to successful treatment of toxicities. There are some treatments common most toxins which we then follow with medical care specific to the type of toxin or the symptoms your pet is showing. Pets that have eaten chocolate are often made to vomit to remove further chocolate, and if the amount eaten is within a toxic range they are placed on intravenous fluids, sedated to control agitation and abnormally high heart rates and other symptoms are treated as they occur. Should your pet need to see the veterinarian for the ingestion of particularly good quality chocolate, I find it very helpful if you bring some of this chocolate with you so that the veterinarian and veterinary staff can sample the chocolate to evaluate it accurately.Lilies are another lovely Mother’s Day gift that you may wish you’d never been given. Cats are particularly sensitive to the toxic effects of lilies, and I have seen cats that only groomed lily pollen from their fur develop symptoms of toxicity. While I wish all lilies were sold with a

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sign saying “Do not purchase if you own a cat”, the lily suppliers seem to be a bit resistant to this idea. Initial symptoms include nausea and abdominal pain, and cats are often described as hiding more and moving around less, and not wanting to eat or play normally. Within hours to days the lily toxin can damage your cat’s kidneys, and these cats develop increasing abdominal (specifically kidney area) pain, are urinating more but not wanting to interact or eat. They may drink more, or they may sit at the water bowl wanting to drink but not feeling well enough. Vomiting, severe lethargy and occasionally not urinating at all are seen as the kidney damage worsens. Successful treatment relies

on early recognition of the problem and taking your cat to a veterinarian for aggressive treatment as soon as possible. The ideal treatment may include having your cat vomit if it hasn’t already, followed by several days of intravenous fluids at a rate high enough to attempt to flush the toxin through your cat’s kidneys and minimize damage. The perfect treatment for a life-threatening

toxicity is to treat aggressively enough that we prevent all symptoms, and for you to question whether this was all necessary since no symptoms developed.Mother’s Day also can involve children, which start as fragile and adorable babies that require you to give up large amounts of sleep in order to care for them. There are pitfalls of having pets and babies, and if there seems to be any conflict I highly suggest consulting your veterinarian on how to convince your pet that your new child is wonderful and should be tolerated. Children also need to have rules about pets, both how to treat their own family pets and how to treat strange pets. Not all dogs are friendly, and not all children are gentle, and it is important to recognize the signs that a situation is about to escalate well before there are injuries to either pet or child. Picking up small pets is something every child likes to do, and although it does keep the orthopedic surgeons in the veterinary world happy and employed this may not be exactly what you as the pet owner had in mind.As children get older there are some further perils of motherhood. As some parents may have discovered for themselves, every adorable infant can grow into a mysterious and inscrutable teenager. Of course, most of you have wonderful teenagers, and you are likely not the topic

of this part of the discussion and can only imagine the pain and dismay of having an emergency veterinarian inform them that “fortunately their pet’s symptoms are consistent with THC ingestion”, and then have the previously-regarded-as-perfect-teenager fess up to having said toxin in their possession. Small doses of marijuana cause symptoms such as sleepiness, wobbling sideways and falling over while walking, and flinching when you reach for your pet’s head. Often our patient’s heart rates are slightly low, their pupils are smaller than normal and they are holding their eyes slightly closed as well as dribbling urine. We say “fortunately”, because there is no organ damage associated with small amounts of THC ingestion. Large doses can result in much greater concerns as the sleepiness progresses to a coma, and it is possible for dogs and cats to die from severe overdoses. The extremely large amounts ingested are often due to ingesting baked goods such chocolate brownies, where we have to be concerned with the chocolate ingested as well as the butter potentially contributing to pancreatitis, or cookies containing raisins (also toxic to some dogs) or pot butter. Pot butter generally causes severe toxicities as it is often very potent, and dogs that get into this will eat the entire container and can develop fatal pancreatitis as well as severe THC toxicity. If your pet is showing abnormal symptoms that you can’t explain, I would suggest having your pet checked by a veterinarian, and your teenager questioned. Dogs displaying these symptoms without any chance of THC ingestion can have eaten or developed far more serious conditions, and it is important to know the probability that we need to treat for mild THC ingestion as opposed to these other, more serious conditions. At our clinic we see on average at least one marijuana toxicity every week. Marijuana is just one of many on list of possible drugs. Our in-house urine drug tests contain five popular drugs and we are looking at expanding that to a ten panel test.Mother’s Day evening should include some quiet contemplation over a glass of red wine after the kids are asleep, and hopefully the dog is snoozing on the sofa beside you. For this Mother’s Day I wish that you have adorable infants, tolerable teenagers and wonderful pets not currently eating anything they shouldn’t.


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Forget big bonuses and raises - its not the money that keeps employees happy. Companies can �nd a number of creative and less expensive ways to keep employees motivated. Here are the top �ve.

1. Room for Advancement is the most important component in keeping employees happy. Sta� are unhappy if they come to a job that o�ers no room for growth or advancement. �ose employeeswill take more sick time and start looking for another job. So, to provide opportunities.

2. Mentoring & Training are more likely to engage employees than any other action. Be sure to provide adequate mentorship for new employees and empower longer term sta� with the ability to learn something new. Training shows employees you care which boosts wellbeing.

3. Communication with employees helps to alleviate concerns they have about their job and helps feel more secure. Communication in person especially helps make sta� feel valued at work while it also prevents underground gossip from becoming the main source of information.

4. Autonomy. Workers crave autonomy and are happier at work if motivation comes from within. Workers who perform duties their own way also waste less time waiting for approval. �ey will engage more, produce more and be more committed if what they do comes from the core of who they are.

5. Good Environments are critical to employee satisfaction. Reducing the length of meetings, playing music and providing food at lunch improves overall morale and recognizes employees for their hard work. Sharing lunch together also breaks down barriers and encourages bonding between one another and management.

Statistics indicate that bene�ts/payroll savings can be almost $5 for every dollar spent on making workers healthier. Even small businesses can inexpensively bring a healthy culture to their company. Here are the top �ve.

1. Make exercise a work goal by giving sta� an incentive to exercise with one another during breaks. Promote active team building retreats and give sta� the ability to log workouts for a small year end cash bonus.

2. Serve healthy snacks in the o�ce lunchroom. Studies show that the people who are most active have healthier diets and don’t miss work. Fruit is inexpensive and is a much better option than going out for co�ee and a doughnut.

3. Give a health - related bene�t to be applied toward anything health and �tness related. Sponsoring an employee in a team sport, marathon or other activity boosts a healthy competitive spirit, boosts company loyalty and branding to the community showcasing your wellness leadership.

4. Communicate with internal newsletters and paycheck inserts to keep the idea of health and �tness regularly in the minds of employees. It shows them you care about their health! Again, management communication with employees is essential. If you set programs up, but don’t encourage them with active communication and participation the program will fall �at due to lack of commitment from the top.

5. Walking Maps that measure out a short walking route around the neighbourhood or placing chairs in a quiet area so employees can take breaks to decompress and regroup when times are particularly stressful. Even having a massage therapist come into the o�ce once a week for inexpensive 15 minute massages that employees themselves pay for is an excellent option.


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