WThe first line of defence
e’ve all heard that firefighters are at a higher risk than everyone else for cancer. But how much higher is the risk and for which types of cancers? What research is being done to confirm the links between fire fighting and cancer?
For that mater, since we are working with the Breast Cancer Society of Canada this month to increase awareness of all cancers, and breast cancer in particular, are female firefighters – whose physiology makes them more prone to certain cancers – at an even higher risk for cancer than their male counterparts? Has anyone tried to find out?
The National Institute for Occupational Health and Safety (NIOSH) has some answers. Its 2013 study shows the rate of a rare cancer called mesolthelioma, which is believed to be caused by exposure to asbestos, two times greater among firefighters than the rest of the population. And firefighters, a study says, have higher incidences of cancers of the respiratory, digestive and urinary systems.
Part of the problem, according to the NIOSH research, is the flame-retardant coatings used on combustible products. The coatings, when they burn, are toxic. But to convince the manufacturers to change the formulas, advocates need proof – proof of the link between firefighters and higher cancer rates. And there’s the kink in the hoseline. In the United States, a bill before the Washington State senate to ban toxic flame retardants stalled in the chamber; at least someone had championed the cause. Lawmakers want that elusive proof: proof requires studies and statistics; and studies and statistics require research, which requires cash.
Here in Canada, there are champions. As Jay Shaw writes on page 8, Winnipeg firefighter and union president Alex Forrest is, perhaps, the fiercest advocate for research to confirm the link between fire fighting and cancer. Forrest is frustrated with the lack of funding for research. Forrest’s global campaign for funding for research is something every fire department in Canada needs to get behind.
Additionally, the Fire Chiefs Association of BC is funding a review of literature available on cancer in female firefighters. The project started when an FCABC committee considered ways to get more women in fire fighting. Committee members wondered if women stayed away from fire because of a perceived higher risk of cancer. The committee asked Canadian researcher Dr. Ken Kunz if he believes female firefighters have a greater risk of cancer than males.
“Almost certainly,” Kunz told FCABC president Tim Pley. “Women have body parts that are more likely to attract carcinogens.”
And that, Pley said, was a game changer.
“If women are at higher risk of cancer because they are firefighters, then fire-service leaders owe it to current female firefighters to look into the issue, determine the risk, and then look for ways to mitigate that risk. And, if we are considering encouraging more women to enter the firefighting field, we owe it to them to determine the risks that we might be asking them to assume.
“Hopefully,” Pley said, “we can encourage other organizations to fund deeper research on this topic.”
As is the case with fire, prevention is the first line of defence against cancer, and our writers – experts on health, fitness and nutrition – have provided a thorough account of all the things you can do to decrease your cancer risk.
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Power tools to fight breast cancer
Firefighter and photographer Kim Fitzsimmons said the best accessories a girl can have are confidence and a Halligan. When it comes to breast cancer, and all cancers for that matter, the best accessories a firefighter (woman or man) can have are confidence and information.
We’re all familiar with the tools we use in the fire service. But how familiar are we with the tools we can use to deal with cancer? The main tool in the fight against cancer is knowledge. Knowledge is, indeed, power.
As we learn more about breast cancer, so too can we learn about the ways we can prevent, fight, and recover from cancer. Firefighters, particularly female firefighters, however, are at a higher risk of breast cancer than everyone else.
By harnessing the tools we have at hand, we can launch a full-scale attack on breast cancer. The toolbox is full:
• Prevention strategies – health, fitness, diet, lifestyle, effective protective equipment
• Early detection – screening, self-examination, regular medical checkups
• Treatment – understanding the range of options, risks, and benefits of the many treatment options available
• Recovery – self-identity, confidence, selfesteem
• Sharing – our experiences, learning, information, and knowledge with others
• Support – networks, both formal and informal, to support our colleagues that are on this journey
screened for breast cancer? We’re quick to ask about flu/cold symptoms or how the kids are doing; let’s deepen the conversation. Nutrition – eat up: You are what you eat; think about healthy eating and fitness opportunities together at work – whether you ride the trucks or work in communications, prevention, or administration. Exercise – get up: According to the National Cancer Institute, women who exercise four or more hours a week have a lower risk of breast cancer. And, says the institute, the effect of exercise may be greatest in premenopausal women who have normal or low body weight.
Screening – pull up your top: Talk to your doctor about breast cancer, your occupation and risk factors, and check out the details of your provincial breast-screening program. For example, in Ontario, the Ontario Breast Screening Program now screens women between 30 and 69 who have been confirmed to be at high risk.
CAROL-LYNN CHAMBERS
Many people avoid the topic of cancer out of fear, but fear never solved a problem.
From knowledge we can make informed choices about how best to help ourselves and others. Just as firefighters must choose the right tools to approach a structure fire, we can make knowledgeable choices about tools we can use to battle breast cancer.
And just like every decision firefighters face when the tones go off, the tools we pull out of the toolbox can be different for different situations. But one element remains consistent: our ability to reach out, talk to others, and help each other as well as ourselves.
Many people avoid the topic of cancer out of fear, but fear never solved a problem. Usually it is fear of the unknown – what if I get breast cancer? What if it isn’t caught early? What will others think? How will this affect my femininity/masculinity? What if I die? How long can I keep this a secret from my friends and family? More questions than answers. But fear never extinguished a fire – nor will it eradicate breast cancer.
It’s time to start reading and talking about breast cancer; it’s more than pink ribbons, T-shirts, and fire trucks. Dealing with cancer means being informed and taking action to prevent and support, just as we do for other situations in the fire service. Here are some ideas: Start the conversation – speak up: The brotherhood and sisterhood of the fire service is a solid foundation from which to start. When was the last time you asked colleagues if they have been
Support – step up: The Firefighter Cancer Support Network (FCSN) provides support and assistance to fire department members and families. Although FCSN started in the United States, it is also accessible in Canada.
Protection – suit up: Simply put, protection is prevention. Wear your SCBA and other PPE. Contribute - ante up: Get involved in local events that help to raise awareness and funding for firefighter cancer research and treatment. As an example, each year Canadian members of the IAFF have raised more than $55,000 for breastcancer awareness.
Learn more – read up: There are generally three reasons why we don’t do something – we’re unaware, unable or unwilling. In this case, we can become aware about virtually every aspect of breast cancer, we just have to be willing. The wide range and accessibility of screening and treatment programs, as well as supportive tools such as presumptive legislation in most provinces (which supports firefighters and their families financially), go a long way to helping us be able to take the necessary steps from diagnosis to recovery.
IAFF general president Harold Schaitburger recently captured this message poignantly: “The connection between fire fighting and cancer is real, and there is scientific data to support our position. But we cannot stop there — we must continue to learn more so we can prevent our members from contracting this horrible disease and help them if they do.”
As firefighters know from training, a tool is useful only when you know how to use it, and actually take it out and practise with it. Let’s do everything we can to increase our knowledge of breast cancer so someday we can truly say we got this.
Carol-Lynn Chambers is the president of Fire Service Women Ontario (www.fswo.ca) and a section manager with the Ontario Office of the Fire Marshal. Contact her at Carol-Lynn.Chambers@ontario.ca and follow FSWO on Twitter at @FSWOntario
Proving the link
The struggle for
funding to study fire fighting and cancer
By Jay Shaw
Have you ever wanted to climb to the top of a skyscraper and shout out your message, scream at the moon, or yell at the top of your lungs? Did you happen to see The Onion story about the climate-change scientists who said they just wanted to remind everyone that wind, solar, hydrogen, and other alternative energy sources are ready to go, and have been for a while, but they’re just waiting for consumers to force politicians to come around, listen, and stop our dependency on fossil fuels.
The Onion, of course, is a satirical publication, but the story triggered social-media conversations about how difficult is it to move ever-so-slightly forward toward green energy and reduce damage to our planet when the answers and solutions have been under our noses for some time.
The situation is the same for firefighters and cancer. If you’ve been on the job for more than a few years, it would almost be impossible for you to not know someone who has died from occupational cancer, yet we’re still trying to prove that the increase in cancer rates for firefighters is caused by exposure to toxins while performing our duties.
I don’t think firefighters need any more proof than the funerals they attend and the plastic, smoldering piles of merged household consumables that form unique shapes, colours, and compounds while they burn, cool and solidify. But these observations are anecdotal and are founded on emotion, and that’s just not the kind of evidence that makes change happen quickly.
The problem is multi-dimensional. First, not all firefighters who contract cancer are treated equally. And although seven of 10 Canadian provinces have presumptive legislation of varying degrees, in P.E.I., Quebec and Newfoundland there are no laws that assume that certain cancers are work-related. What’s more, the presumptive legislation that does exist is not consistent from province to province. While the International Association of Fire Fighters (IAFF) and other groups have been pushing for more thorough and balanced coverage for firefighters who die from work-related cancers, the provincial bodies that distribute workers compensation benefits are demanding more proof that the cancer was indeed contracted on the job. Even more frustrating is that fact that funding for research into firefighter cancer is pretty much non-existent, which makes it difficult to prove that the high incidence of cancer among firefighters is indeed connected to the job.
One of the world’s leaders in this battle to recognize the link between fire fighting and cancer is United Firefighters of Winnipeg president Alex Forrest. Forrest has fought tirelessly for change. For more than 15 years, Forrest has travelled to almost every corner of the globe to lobby and empower scientists, lawmakers and fire de-
partments to move the agenda forward. While Forrest would rather direct the conversation to legislation and research, it must be noted that many of the wins thus far can be attributed to his steadfast determination.
I sat down with Forrest to talk about the progress and challenges that firefighters face regarding occupational cancers. Forrest puts a positive spin on the situation.
“There has been progress,” he said. “Only Quebec, P.E.I., and Newfoundland are our remaining provinces that do not have presumptive legislation. Forty of 50 U.S. states now have some kind of legislation and the rest of the world is listening, as Australia and Europe have been very proactive in moving occupational cancer in firefighters to the forefront.”
In Canada, most of the progress can be foundationally linked to the Manitoba model, which is considered the gold standard; Manitoba was the first province to acknowledge that certain cancers are job related, and eliminate the often-lengthy workers compensation process to prove the link between fire fighting and cancer.
Forrest explained that one of the sizeable challenges is proving the science.
“One of the biggest problems we have now is with the chemical companies that make compounds and plastics that are supposed to help us, but their products are killing firefighters once they reach
their ignition temperature and start to off-gas their toxins,” he said.
“The very same chemicals that are supposed to add fire-retardant properties are doing the opposite. These companies don’t want any research or information that says their products are toxic. When you have lobbyists and endless financial resources to push your agenda you will always have trouble fighting for your cause; our research is so new, and is still being questioned by scientists who are working for the chemical companies.”
It is not just the chemical companies; several issues have seemingly conspired to create roadblocks to research and funding hoops that have slowed progress.
Funding for research comes primarily from government grants, private industry, and special interest groups that want to solve a problem by creating a profitable solution. The scope and scale of firefighter cancer is small compared to the volume of illnesses and diseases experienced by everyone else, so attracting the right scientists and the necessary research dollars is a challenge.
Doctors cannot tell whether cancer has occurred naturally in the body, as a result of on-the-job exposure to toxins, or from other causes. Therefore, scientists must use statistical methods and labora-
tory research to show that firefighters are at a higher risk than others for cancer.
Cancer, for those of us who are not doctors, is actually a group of similar diseases in which the ability of our cells to regulate tissue growth is changed or damaged. In different areas of the body, the cancer cell can have varying effects based on the makeup of the cancer and the organ or system it has attacked. But if we follow what we know is certain from years of research into tobacco use, scientists know that the smoke from tobacco created from the burning of the product mutates the DNA of our cells, and the cells are no longer able to control how fast they grow or reproduce. This, of course, happens with many exposures that may take years to genetically alter cell DNA. When these newly-formed cancer cells group together to make tissues, we get a tumor. The tumor may or may not have the ability to spread to other areas of the body, which is how a tumor is classified as malignant or benign.
To understand the research in this field more clearly, I spoke with Dr. Tee Guidotti, a leading expert on occupational and pulmonary medicine. Guidotti is a diplomat of the American Board of Toxicology and has trained at Johns Hopkins and worked as a professor at
There is plenty of anecdotal evidence, particularly the number funerals for firefighters who have died of cancer, to support a link between fire fighting and cancer, but lawmakers and manufacturers of goods that produce toxins want empirical evidence, which requires funding for studies.
PHOTO BY LAURA KING
George Washington University. Guidotti has researched mortality in urban firefighters in Alberta and helped the FDNY firefighters make their claims of cancer from the 9-11 attacks. Guidotti explained that the link between the toxic fire smoke and the increase in firefighter cancers is real.
“The etiology is clear,” Guidotti said. “We know it is happening, but the number and interaction of the toxic chemicals in the fire smoke is what is so complicated. Fire smoke is just as complicated as tobacco smoke but chemically it is a little different. It has its own profile of effects and cancer risk in the way DNA is affected.”
Guidotti said firefighter cancer is hard to study, technically. Firefighters tend to be healthy and smoke less than most people, which offsets some of the elevation in cancer rates. Fire department records don’t capture the differences in individual exposure, and doing studies is difficult without this critical information.
“The problem,” he said, “is that although we have lots of studies on firefighters, they don’t tell us everything we need to know. There are lots of uncertainties and because any one study is usually small and local, it often does not reflect the true risk for firefighters as a whole. We need more research that addresses gaps in information, such as individual exposures over time and what happens with and without SCBA. We don’t need more studies as much as we need studies that really drill down on specific exposures and specific cancer types, and this will take more funding. We know that every exposure to a fire is a dangerous and poisonous event. We need to use the same studies that document cancer risk as guides for prevention, so that future firefighters are better protected.”
Forrest is optimistic. He said he is confident there will be more research and better recognition of the link between toxic smoke and firefighter cancer in the next few years.
“Monash University in Melbourne, Australia, is doing a study of mortality rates in firefighters right now that will be very comprehensive,” Forrest said.
That study will complement the NIOSH firefighter cancer mortality study, the Nordic firefighter cancer mortality study and the Philadelphia firefighter cancer study, which, Forrest said, have all basically proven what the fire services has been saying all along.
“When all this research is reviewed and presented to the International Agency for Research on Cancer (IARC), which is a branch of the World Health Organization (WHO), we’re hoping that the WHO will make some very strong supportive policy statements that will remove some of the road blocks for research and proper compensation for the firefighters that are dying everyday.”
Firefighters are not scientists but we understand bureaucracy, and while all of these studies say basically the same thing – that there is a consistent, proven link between firefighters and increased rates in cancer – the studies lack some consistency, particularly the types of cancers that were studied and how the studies were conducted.
Imagine having to prove something so common, so obvious. How do you know that something is actually good for you, bad for you, or just even what it claims to be? It takes years of science, data, statistics, studies, more research and studies, and replications of the same studies to move a mountain just one inch. Now, imagine how frustrating it is for families to hear this when they know in their hearts that the diseases their loved ones have been diagnosed with were caused by the very jobs they love.
It is the responsibility of every firefighter to keep this momentum moving forward by talking about it in the halls, learning about the research, and following the preventative measures that we have been given. If we hold up our part, the researchers can do theirs and the mountain will start to move.
Only once the pile of evidence is more clear than any air we breathe and stronger than any cancer cell, will we start to provide the care, benefits, and proper compensation for those who have been afflicted with this disease.
Jay Shaw is a firefighter and primary-care paramedic with the City of Winnipeg. Along with multiple fire and emergency services courses and certificates, Jay holds a master’s degree in disaster and Emergency management from Royal Roads University and is an independent education and training consultant focusing on leadership, management, emergency preparedness and communication skills. Contact him at jayshaw@mts.net and follow him on Twitter @disasterbucket
The best protection against cancer-causing toxins on the job is proper PPE during all fire-ground activities, including overhaul.
PHOTO BY LAURA KING
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Cancer prevention through diet and exercise
From its inception, fire fighting has been synonymous with a fair amount of occupational risks and health hazards. As unfortunate as that is, I’ve always found this risk factor to be a unique aspect of the job. We all sign up knowing the risks associated with the job, and most of us truly love our careers nonetheless. Few professions carry this degree of inherent danger, coupled with the level of pride for which the fire service is famous. Today, the hazards have changed but the danger is still very real. The spontaneous nature of our careers place us in less-than-ideal situations. Most of the hazards we deal with are fairly obvious, short-term hazards. In this issue of Canadian Firefighter, we’re looking at a long-term threat in the form of cancer.
As with many things in life, there are factors related to cancer that we can control, and factors we cannot control. Our individual well-being is no different. We’re going to examine cancer prevention from a lifestyle perspective and explore the variables we can change in the hope of building a better, longer life.
First and foremost, cancer is a brutal disease that has likely touched each one of us, whether you’ve been personally affected or experienced cancer through a distant relative. Not all health problems are avoidable, and curing cancer – despite billions of dollars put toward research – still eludes our world’s greatest minds year in and year out. This disease, perhaps more than any other in this world, may best be treated through prevention.
visceral fat is easily eliminated through diet and exercise. Feel healthy, look healthy and become healthy in the future with a proper weightmanagement plan.
Alcohol: More and more research is done on alcohol each year. That may come as a surprise to some, as alcohol is generally well understood in scientific circles. The reason is because of the common consumption of alcohol throughout the population. It’s probably safe to say most of us consume alcohol from time to time – which is perfectly fine. It’s alcohol abuse that is linked to cancer. Drinking heavily, and especially drinking heavily in the long-term, is what’s believed to cause alcohol-related cancers.
BRAD
While none of us has complete control, studies have shown many cancers are directly caused by our lifestyles.
While none of us has complete control, studies have shown many cancers are directly caused by our lifestyles. Choices such as poor diet, lack of exercise, smoking and excessive drinking are all major contributors to this disease. In fact, researchers estimate almost 30 per cent of all cancer deaths are attributed to smoking. Findings also state that onethird of all cancers can be linked to poor diet, lack of exercise and obesity. While the numbers may not blow you away, it’s important to recognize there are changes you can make to help prevent this terrible disease.
Smoking: To me, being a non-smoker seems like the most important preventative cause of cancer in our world today. Approximately one-fifth of all cancer cases can be linked to smoking. The single best thing you can do for yourself in the battle for prevention is to be a non-smoker.
Maintain a healthy bodyweight: This notion goes hand-in-hand with taking proper care of yourself. Keep an eye on how your body stores fat. The old “spare tire” adage is often the brunt of our jokes, but it is actually quite dangerous. Fat begins to store itself deep beneath your skin and sits against vital organs. This is called visceral fat, and the more you carry the more likely you are to develop insulin resistance (type 2 diabetes). Visceral fat is also linked to increased risk of cardiovascular disease and several other metabolic issues. The good news is
Sun exposure: Until I started researching for this subject, I didn’t realize skin cancer was the most prevalent type of cancer in Canada. Good news though – it’s also one of the easiest to prevent. Just be smart in the sun and use your common sense. Basically every recent study released warns against indoor tanning, with major researchers claiming it can increase melanoma risk up to 75 per cent.
Nutrition: Nutrition seems to be our most powerful tool for longevity in this world. It seems so many illnesses and diseases are prevented, caused, or alleviated by what we choose to eat, and what we do not eat. The prevention plan is nothing out of the ordinary. Eat a healthy, balanced diet every day. Eat as much fresh food as possible. Continue to eat the recommended intake of fruits and vegetables, fibre, and, of course, drink plenty of water. Eat foods rich with antioxidants. Avoid processed foods and items high in simple sugars (junk food).
When you choose ingredients and prepare meals, keep these basic health tips in mind:
• Avoid cooking oil in high heat. Superheating oils and fats can actually produce carcinogens while you cook.
• Opt for healthier methods of cooking, or switch to an oil that handles the high heat better, such as coconut oil.
• Choose your fats wisely. Avoid products containing saturated and trans fats.
• Make sure you thoroughly wash all fruits and vegetables. Washing won’t completely remove all pesticide residues, but it will reduce them.
Give your body the vitamins and nutrients it needs to sustain itself. Increase your personal cancer awareness and give your body every advantage it deserves. Eat well, train regularly and get plenty of rest when you need it. As always, take care of the gift that is your body, and set yourself up for success.
Brad Lawrence is a firefighter with the Calgary Fire Department and a certified personal trainer who specializes in training and nutrition for emergency responders. Email Brad at bradmlawrence@gmail.com
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Taking steps to raise awareness
Three Breast Friends put one foot in front of the other and set off on an adventure they never expected. Cancer had touched all of us in one way or another, so we chose to support the Weekend to End Breast Cancer benefiting Toronto’s Princess Margaret Hospital. We each had people in our hearts for whom we would walk 60 kilometres over two days to raise money for research and be part of making a difference by raising awareness of cancer.
Our first thought was whether we could each raise the $2,000 registration fee. Working as a team we came up with a plan: we would ask family and friends for support, sell chocolate-covered almonds, and we would host a car wash and use the employee donation match program. So many great ideas but what would be the quickest way to reach our goal?
Our families and friends were on board with our quest and supported the cause. Selling chocolate was a very easy task; who does not love chocolate? We partnered with our local volunteer fire station; it would provide the location and the firefighters if we provided the car-washing woman power. Our local newspaper ran a story – including a photo – about our passion to raise money for a great cause. In a small town that goes far; customers were pulling up just to make a donation without receiving our services of a shiny, clean car. Once the fundraising started, our second thought was, can we really walk 60 kilometres?
and prostate cancer. That is why it is so important for us to conduct self-examinations. Do you?
We arrived in Toronto before the sun was up. Looking around in awe, there was a sea of people smiling, stretching, and gathering in teams. The motivational sendoff speech had us stepping a little higher and a little prouder as we walked through the Princess Margaret gates. As we walked along the streets there were horns honking and people waving and showing support. Our goal was to walk 32 kilometres the first day. Walkers were sharing their emotional stories, wearing photos of loved ones on their shirts. Some were dressed in outfits that certainly injected humour into our day. Everyone had a story. A huge thank you to the many volunteers stationed at the rest stops who supplied encouragement, entertainment, snacks and any medical aid required before sending us on our way.
We need to be diligent about our health – go for your annual physical . . .
We needed to break in new shoes while scheduling walking times that worked best for three busy women. Using our log book we tracked our walks, going a little further each week, changing the route from pavement to trails, up hills and over side roads. According to guidelines recommended in our registration package, altering our route and the terrain was the best way to prepare for the journey. Our walks became social chat sessions and we did not feel the kilometres we put behind us.
We reached our fundraising goal and our training was complete, although two of the women for whom we were walking passed away prior to the walk. We thought we were ready for this adventure.
We need to be diligent about our health – go for your annual physical, do self-examinations, follow up on any and all concerns. Studies show that firefighters face higher-than-average risks of several types of cancer, including colon cancer and brain cancer. Firefighters are exposed to many potentially cancer-causing chemical released from burning materials. According to the Canadian Cancer Society, it is expected that two in five Canadians will develop cancer in their lifetimes. Males have a 45 per cent lifetime probability (or a one in 2.2 chance) of developing cancer; females have a 41 per cent lifetime probability (or a one in 2.4 chance) of developing cancer. An estimated 191,300 new cases of cancer are expected to be diagnosed in Canada in 2014. More than half of these cases (52 per cent) will be lung, breast, colorectal
Sunday morning at 8 a.m., we were packed up and ready to complete the final 28 kilometres and see what the day would bring. Or so we thought. Bagpipers lined the path out of the campground to send us on the second leg of the walk. Some neighbourhoods were just waking up, not wanting to miss the opportunity to witness such an event. People offered coffee, juice or simply thanked us for what we were doing and sent Sunday morning blessings. Our route took us past Toronto’s Princess Margaret Hospital where we shed tears as doctors, patients and their families showed their support for our efforts. Determination to complete the walk is what drove one of the Breast Friends. With six kilometres left to the finish line and blisters between her toes, she pulled a pair of Crocs from her knapsack, changed her shoes and we were back walking. We knew this was nothing compared to what some of the struggles the survivors had gone through.
Our families arrived to watch us cross the finish line and attend the closing ceremony. Walking through the gates and watching the crowd was surreal. There were cheers and tears everywhere – some of the tears being shed were of sheer joy, some were of sheer pain. The participants were sent to a holding room to don their T-shirts to identify survivors, supporters and volunteers. The stadium was filled to capacity with chanting and cheering as we made our entrance. At this point, our emotions were on momentary overload. We were not sure how any of us could still be standing never mind running through a corridor to the floor area reserved for more than 5,000 participants. The biggest roar erupted when the final group walked through the entrance holding hands and making a chain of survivors.
We did it! And what an adventure it was.
Margo Tennant is a fire and life-safety education officer with Brampton Fire and Emergency Services in Ontario. Contact her at margo.tennant@brampton.ca
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Strength of character
Advocacy, knowledge, prevention are keys, say cancer survivors
Cancer is a sensitive subject. Toronto Fire Services Deputy Chief Debbie Higgins spoke with breast-cancer survivors Rayanne Dubkov, Donna Johnson and Monica Rosmarin, who agreed to share their stories of strength and perseverance, love, and loss. The stories are poignant, and offer wisdom and insight about physical and mental health, instinct, courage, leadership and family.
Rayanne Dubkov
Toronto Fire Services
My name is Rayanne Dubkov. I joined Toronto Fire in March 2001 and was promoted to captain in March 2013. Prior to this, I worked for Greater Manchester Fire and Rescue (England) from 1988 until 2000.
I am a healthy person; I work out regularly and watch what I eat, especially working shifts.
My nightmare started in November 2012 when I found a lump in my left breast while doing a self-examination. I made a doctor’s appointment the following day, and he scheduled me for a mammogram and ultrasound.
The results came back indicating a cyst, and advice to come back for a check up in six months. On June 12, 2013, I went for a second ultrasound, still not worrying, as they told me not to, right?
Sitting in the doctor’s office the next morning with my husband was the longest 20 minutes of our lives. The doctor confirmed I had breast cancer, which had spread to the lymph nodes. The next six weeks were a whirlwind, going from one specialist appointment to another to see how far the cancer had spread. The final result was stage-3 breast cancer and stage-2 cancer in my lymph nodes.
The tumour had grown so large that I had to have six months of chemotherapy before surgery, and then five weeks of radiation.
Chemotherapy was exhausting and it was a little alarming to see the nurses’ protection – all gowned up, masks on, double gloves to administer the drug – and you just sit there letting it go into your veins. The three days following chemotherapy I had home care during which I was hooked up to an IV for hydration for five hours a day.
Surgery and hair loss were the worst for me; I felt ugly, and those were the times when I wanted to give up. Hair loss is total-body hair loss, so eyebrows and eyelashes. Bonus though: no more shaving legs or armpits. I was told that hair loss would start approximately 12 days
after the first treatment and they advised that when my hair started falling out it would be easier to shave my head rather than let it fall out in clumps, as it would be less emotional. I was in hospital when this happened so a hairdresser came to the hospital and shaved my head – that was one of the worst days for me.
The chemotherapy also affects all fast-growing cells, so it affected my fingernails and toenails; luckily, I only lost part of one toenail.
Radiation was five times a week for five weeks; the last one was Monday, April 28, 2014.
Twelve months of my life were taken up with hospital appointments, specialist appointments, and treatments.
Now it was time to get back to living, back to work, back to normality. Small things are achievements and steps closer to normality, such as having to have my eyebrows waxed and having my hair cut for the first time – and the hairdresser using a hairdryer!
It really isn’t ever over; there is always fear that it is going to come back. I have regular checkups with the oncologist. I have been told the type of cancer I had was very aggressive and I am at high risk for recurrence, so I have decided to have preventative surgery to remove the other breast followed by reconstructive surgery.
Monica Rosmarin Toronto Fire Services
Ihave been working in the fire-prevention division of Toronto Fire Services since 1994.
In June 2013 I was diagnosed with breast cancer.
I believe everybody knows their bodies and knows when things are just not right. I had symptoms for a year prior to my diagnosis. My family doctor sent me for a number of mammograms, which required follow-up tests and ultrasounds. Nothing showed except a thickening of the tissue that they were “keeping an eye on.” I eventually convinced myself it was just hormones, because the tests revealed nothing.
The pain got worse and the signs became very visible. I went to my doctor to get an X-ray for a previous ankle break. I showed the doctor my breast and within two days I was at the surgeon’s office for a biopsy. The results were positive. The cancer mass was 22 centimetres and had spread into two lymph nodes; it was never detected because I never had a lump! My surgeon, the radiologists and oncologist said they had never seen anything like this. By the time I had my surgery, the cancer had been there so long it was in my chest muscle. Following surgery, my doctors suggested I take chemotherapy followed by radiation (which was referred to as “an extra insurance policy”) even though the doctors believed they had removed all the cancer.
I have finished my treatment but continue to take tamoxifin as a preventative measure.
I am blessed and so thankful for my co-workers who worked for me because I didn’t have any sick time left due to all my clumsy adventures with broken bones, and my friends who were there laughing with and supporting me.
I have realized through this that you need to push for what you believe and be persistent with your doctors. My case was unusual, but hopefully now the doctors know what to look for when the next patient comes along.
Donna Johnson
Greater Toronto Airport Authority
Iwas diagnosed with breast cancer in 1999 after serving 12 years as a firefighter and then as fire captain. When my family doctor first gave me the news, it was hard to immediately digest. I have been on my own – a single mom – for decades and both of my parents have passed on. In my fire department, I was the first female firefighter and first female captain.
A million questions were going through my mind. I had one child in university and the next one was to go the follow year –would I be able to support them? I was too young to retire; how would my work place react? Am I prepared to die?
I was lucky to have a wonderful and capable oncologist with a sense of humour. When we met, the first thing he said was that the
cancer had not spread from the breast and I was not going to die (at least not from this cancer).
However, I was not so lucky with my first surgeon; he performed two operations after the biopsy, telling me that he got all the cancer and that I could return to work, but each time my oncologist saw the X-rays he sent me back for another operation. It was a rollercoaster ride of emotion until finally being told I had to have the entire breast removed – a mastectomy.
This was a terrible blow to me as a woman, being 45 and single. Although it was a shallow initial reaction, I never questioned the advice to “just get rid of them if they are going to kill you.” But that doesn’t mean I didn’t cry over the loss.
Once I stopped feeling sorry for myself, I went on the computer and read stories of other women’s struggles and what they did to handle the situations in which they found themselves. The strength of their testimony and frankness was a very powerful motivator and catapulted me into action.
I called a plastic surgeon’s office to find out what my options were after the mastectomy and was told that the best results are attained when the surgeon performing the mastectomy and the plastic surgeon are in the same operating room doing the reconstruction at the same time. This is common practice now; however, this was all new in the late 1990s.
I presented this option to my first surgeon and he was having none of it. He said that I should wait three years “to mourn the loss.” I started doing my own online research and found a team of surgeons who agreed to do reconstruction at the same time as the mastectomy.
There are options even in this procedure. You can use your own body fat to form a new breast or you can opt for an implant. In my case, I chose the latter, as the surgeons said it would be less invasive and require less recovery time.
The time span from my first diagnosis and the final reconstruction was a little over a year. I was lucky to have friends who helped me during my total of five operations and recoveries, and, of course, my children were there to help me with after-care, meals and housekeeping.
During the time I was away from work, I was reluctant to let anyone know the true reason. Women officers were still new at that time and we were always being watched to make sure we were up to the job. I had a young crew with whom I did not share intimate information. When I was initially facing only a lumpectomy, I thought I could just be off sick and that no one needed to know, but when it became more serious and I was to have a mastectomy, I told the fire chief.
I think about how I could have contracted this disease. There was cancer in the family, but no breast cancer. I was fit, working out at least five days a week, and had low body fat.
No matter what the cause, I don’t really think about my cancer that much anymore or what I could have done to prevent it. I am pleased that now there is so much more information that women can access to make better informed choices. Knowledge is the key to any good outcome and I am pleased that there is so much more information for both women and men.
Debbie Higgins is a deputy Chief with Toronto Fire Services, the treasurer for Fire Service Women Ontario and a board member with the Ontario Association of Fire Chiefs. Contact Debbie at dhiggins@toronto.ca and follow her on Twitter at @debbiejhiggins
Simple steps toward cancer prevention
Almost 30 years ago, October’s breast-cancer awareness movement helped bring cancer prevention into the mainstream. Five years ago, Movember was created and it increased awareness of cancer in men and made cancer education and prevention top of mind. The statistics do not lie; every one of us has had a brush with cancer, whether it was a family member, friend, or a work colleague who got cancer, or a personal diagnosis. Cancer news is never easy to receive. According to the Canadian Cancer Society, each day an average of more than 500 Canadians are diagnosed with one or more forms of cancer.
During my six years as a firefighter and 12 years as a naturopathic doctor, I have observed countless connections among cancer patients’ depleted bodies, their toxic environments and the cancers they have. I have made it my life’s work and passion to seek and find advanced knowledge, training and therapies to treat my cancer patients. If you don’t know by now, all my cancer patients are treated using natural treatments.
The Canadian Cancer Society website goes on to say that cancer is the leading cause of death in Canada and is responsible for 30 per cent of all deaths. An estimated 191,300 new cases of cancer and 76,600 deaths from cancer will occur in Canada in 2014.
If you sit down and look at all the research associated with the risk of getting cancer, firefighters’ occupations and lifestyles would put them on the top of the list. It is time for firefighters to intensify efforts to improve their lifestyles and prevent cancer.
mune system. Taking the time while you are a young firefighter to improve your health is the best way to prevent cancer.
There so are many things you can do to lower your overall risk of developing cancer. Don’t think of it as a full-time job, or even as an inconvenience, to pursue a healthy lifestyle. Too often in our clinic we hear regrets from patients who should have done something differently and chosen to live better lifestyles when they had the chance.
We now know about half of existing cancers can be prevented by living a healthy lifestyle.
Naturopathic doctors use a number of risk-assessment tools to estimate a person’s risk factor for getting cancer. Academics and researchers have developed a greater understanding of what causes cancers to form and grow. To help assess cancer risk, we look at information such as age, health history, family history, lifestyle and diet.
Firefighters are already trained to think in a risk-averse way; making a good decision on a fire scene can mean the difference between being safe, becoming injured or dying. A firefighter can make smart personal-health choices to eliminate the risk of developing cancer. We now know about half of the existing cancers can be prevented by living a healthy lifestyle. Prevention is key to reducing the number of cancers in our population.
Part of a cancer-prevention plan is to look at every single risk factor in a health history and address these issues with a treatment plan that will help to decrease the risk of ever getting cancer. Comprehensive plans should be created to treat body weight, educate on diet and address genetic deficiencies, environmental risks, family history, hormones, occupational exposure, personal history of past cancers, physical activity, sedentary lifestyle, stress, exposure to the sun, tobacco, alcohol, viruses, bacteria and other infectious agents, vitamin D levels, and a poor im-
Here are a few of the simple things you can start doing at home. The most popular anti-cancer diets all follow very basic nutrition principles that are essential to prevention and treatment of cancer. No more processed food; if something comes in a package, it won’t help out your immune system – it is that simple. Eat more vegetables and less meat; take this rule one step further and eat more raw vegetables, maybe even take your raw vegetables and juice them. A key to juicing is to juice vegetables and not fruit. And finally, remember to get rid of the sugar in pasta, bread, cereal, muffins, cookies and sandwiches. Sugar feeds the cancer and slows down your immune system.
There are several nutritional ingredients that have the capacity to prevent and treat cancer. Tumeric and green tea in high doses have direct anticancer properties and can block cancer growth and the spread of cancer. A high dose of vitamin D can improve immune function to fight the cancer. An ingredient called modified citrus pectin can prevent cancer growth and metastasis of cancer cells.
Years of research have found that an intravenous vitamin C dose greater than 15 grams has an amazing ability to combat cancer. A vitamin C dose above 15 grams is shown to have a pro-oxidant effect by generating hydrogen peroxide, which in turn selectively destroys cancer cells.
The integrative cancer medical model combines the best of standard, conventional treatments and natural therapies. Research now clearly shows that cancer patients have improved outcomes and reduced mortality when they use natural therapy and change their lifestyles, such as increasing fitness therapy, changing diet, doing counselling, and participating in yoga and meditation. Clinically, we see this as a favourable outcome for our cancer patients. Here is a great opportunity to have firefighters begin a lifestyle-transformation away from cancer. Make it your health mission to take up the cancer prevention challenge.
Dr. Elias Markou is in private practice in Mississauga, Ont., and is the chief medical officer for the Halton Hills Fire Department. Markou was a volunteer firefighter for six years and is now a firefighter health expert and blogger who is regularly featured on television and radio and in print. Contact him at dmarkou@mypurebalance.ca
ELIAS MARKOU
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A workout dedicated to those who have fought
This column is dedicated to the men and women of our fire service and the families who have been affected by the devastating disease of cancer.
Every person is affected by cancer and every firefighter considers his/her increased risk. I commend the Government of Ontario for including breast cancer in its presumptive legislation. We continue to fight the risk. Departments deter or disallow smoking, we use our SCBAs in every IDLH and if you’re one of those firefighters who is dismissive about using yours, wake up! We try to eat well, to avoid carcinogens and, of course, we try to keep fit.
There are many departments that fundraise and advocate awareness. IAFF local 268 (my union) annually supports breast and prostate cancer in the month of July by wearing pink and blue T-shirts; it’s a great way to raise money and promote public awareness. We still have much work to do in the fire service, but we are making ground and that’s a great reason to celebrate with this workout. Yes, this is a celebration workout. You can even go out for a beer (or ice cream if you are at work) when you are done. Ask for a pink one.
of two and competes to see who can complete the workout the fast est. It’s a great incentive, and who doesn’t love bragging rights?
Time to celebrate – you will need some great music playing dur ing this workout. Enjoy!
1. Air squat or weighted squat – Add an extra jump after each air squat or a press after each weighted squat.
DEAN
I commend . . . Ontario for including breast cancer in its presumptive legislation.
There is one minute in the centre and at the end of this workout to dance. That’s right, dance. I was inspired at my CrossFit gym a number of months ago when a workout was dedicated to a young, vivacious member who had passed away. Her enjoyment of life was infectious and she made everyone smile. After every exercise, everyone in the gym danced their butts off for one minute in her memory and went on to the next exercise. It was amazing. So, if you hate dancing, too bad, and if you like dancing, stick the one-minute dance in as often as you like during this workout. You’ll enjoy it, or you’ll at least laugh, and we all know laughter is the best medicine.
Now, don your pink T-shirts and find some pink socks. This is a partner workout. Round up the team and break into twos. This is much more fun with peer support and, of course, friendly competition always makes us work harder. If you don’t have a partner, use a standard 90-second or two-minute time frame to complete the exercises and then run/jog in between.
The workout
During this partnership workout, one partner will do the exercise while the other runs/jogs/walks 400 metres. When your partner returns, he/she does the exercise while you run, then move on to the next exercise. The longer it takes your partner to run, the longer you do the exercise. Payback, however, is great. If you are too quick on the run, go farther or you can shorten the run if it’s not your strong suit. Run around the block or set up lines in the station and run back and forth until 400 metres is covered. My crew splits into three teams
2. Travelling push-up – Put a piece of tape or chalk line on the floor. Push up on one side of the line then use your arms to travel to the other side and repeat.
3. Skip/double-unders (double skip)/box jumps – It’s your choice which one you do, but don’t skimp on effort.
4. Iron cross sit-up – Place two rolls of highvolume hose on the floor, put your heels on top and your arms straight out to the side. If you are able, come all the way up until your chest touches your knees. It’s tough.
5. Both partners dance for one minute – Cel ebrate in the name of someone who has fought cancer. Yes, you will laugh and feel foolish, but humility never hurt anyone.
6. Burpees – Hands off the ground at the bot tom and a little jump at the top.
7. Inverted push-ups – Get in a push-up posi tion with your toes on the two rolls of highvol. Start to walk your hands in toward your feet until your butt raises in the air. The closer you are to your feet, the harder it gets. You are really looking to activate your shoulders so get in as close as you are able with good form. Now push up.
8. Dips and curls – Sit right on the edge of the high-vol with your legs straight out. Place the heel of your hands by your side and do 10 dips, then bring your feet in or stand up and complete 10 curls. Use whatever you like – weights, hose roll, highrise pack, SCBA. Alternate between dips and curls.
9. High-vol raise – Place one high-vol roll on edge between your feet. Squat down, grab the roll and lift it up as high as you can. Put it back down and repeat.
10. Both partners dance for one minute – Send me some pic tures of your workout. I’d love to see you dance!
Now you can go for a beer or eat ice cream. Send me some pictures of that as well. If you send enough photos, I will create a Facebook page.
Sherry Dean is a career firefighter/engineer with Halifax Regional Fire & Emergency Service. She is an NFPA level 1 instructor with hazmat technician and special rescue certifications. Sherry has more than 20 years of experience in fitness and training including the Scott FireFit Challenge, competitive bodybuilding, team sports and personal training. Contact her at deansherry@bellaliant.net
SHERRY
Sub-level rescues – part 3
We are continuing to look at sub-level rescues with a focus on rescue tactics. In the July issue, we reviewed the use of a charged hoseline for rescuing a downed firefighter. Here, we examine rope as a rescue device.
Almost every fire apparatus carries a bag of life-safety rope. When setting up the RIT staging area, always include a bag of lifesafety rope. Life-safety rope is stronger than utility rope and therefore is optimum for rescues, although, if utility rope is the only rope available, it will work. (However, nylon utility rope will not work in this type of rescue or situation; it will fail because of the extreme heat to which it will be exposed, the weight of the firefighter being rescued, and the tension being applied for the haul. Braid-onbraid utility rope is the preferred type of utility rope for this type of rescue.) Life-safety rope is eight millimetres (mm) in diameter or larger. The best diameter to work with is 12 mm or 1/2 inch as it is easier to handle while wearing structural firefighting gloves than eight mm or 10 mm rope; it is also the most common diaameter of rope used by fire departments on their apparatuses.
When rescuing a firefighter from a sub-level area, use a basic handcuff knot. This knot is easy to tie and can be made with gloves on and in the dark. Practise tying the knot in different situations such as zero visibility and while wearing gloves. The advantage of the handcuff knot is that it has large loops, which are easy for rescuing firefighters to handle while wearing gloves and provides access points for the downed firefighter. The handcuff knot is essentially a clove-hitch knot with a slight adjustment – the two loops are pulled through each other in a bow-like fashion (see photo 1). (Detailed instructions on how to tie a handcuff knot are available on YouTube: https://www.youtube.com/watch?v=HMtzGyd9cCc)
One bag of rescue rope will generally suffice for a sub-level rescue. Ideally, rescuers want to have 100 feet or 30 metres of rope. From the one bag of rope, rescuers can set up at least two pull lines with one set of loops or four pull lines with two sets of loops so that two firefighters or four firefighters can pull up on the rope.
The trick to making two pull lines or four pull lines is setting up the rope in a V fashion alongside the hole or opening through which the downed firefighter has fallen. The lengths of the V shape form the two pull lines and allow a firefighter to tie a handcuff knot at the end/bottom of the V. If four pull lines are desired with two sets of loops, then two Vs are set up with each V on one side of the opening (see photo 2). In the photo, the black mat represents an opening in the floor. Notice how the lines are flaked out in relation to the opening with the loops already pre-tied for deployment.
The lengths of the V need to allow for extra rope to be lowered down into the hole, secure the downed firefighter, and then hoist him back up. The hoisting operation requires a good length of rope so that the rescuing firefighters can pull the rope hand over hand. Do not worry about having too much rope on one side or both sides; the extra rope will provide additional slack for the operation.
If the fallen firefighter is conscious and free of any entrapments or injuries, all that is required is to lower a set of ropes down to him
Photo 1: A basic handcuff knot is used when trying to rescue a firefighter from a sub-level. It is easy to set up and can be made with gloves on and in the dark.
Photo 2: Four pull lines are created with two sets of loops, each fashioned with a V on one side of the opening.
PHOTOS BY MARK VAN DER FEYST
Photo 3: The rescue crew exerts a large amount of energy in a short amount of time hoisting the fallen firefighter.
Photo 4: If the firefighter is conscious and can assist himself, he can take the lowered handcuff knot(s) and put them around one foot.
or her with a handcuff knot pre-tied. The fallen firefighter then takes the handcuff knot(s) and puts them around one foot (see photo 4). The downed firefighter then crosses his other foot over the foot on which he has put the handcuff knot(s) to ensure that the knots will not come off. The firefighter then grabs the ropes with both hands and readies himself for hoisting. The firefighter needs to make sure that he has a firm grasp of all the ropes so that they will remain taut and in one place. If the ropes slacken and move, the operation will not work.
By keeping his body stiff, the fallen firefighter can be hoisted up quite quickly (see photo 3). Once the fallen firefighter is at the top of the opening, he can be pulled out and away from the hole.
The rescuing firefighters work in unison in order to use the ropes effectively. The rescuers also maintain constant communication with the downed firefighter to address the psychological aspect of the rescue operation. Rescuing firefighters may need to shout step-by-step instructions to help a traumatized, downed
firefighter and ensure the operation is a success. The fallen firefighter may be confused and may need some coaching to put on the handcuff knots, secure them to his body and then maintain a stiff body while being pulled up.
This technique works great when there is rope available for the rescue, and that means having the rope bag available at the RIT staging area. Simple rope work helps raise a fallen firefighter up and out of a hole or opening in a floor. Practising this technique will prove its worth.
Mark van der Feyst is a 15year veteran of the fire service. He works for the City of Woodstock Fire Department in Ontario. Mark instructs in Canada, the United States and India and is a local-level suppression instructor for the Pennsylvania State Fire Academy and an instructor for the Justice Institute of BC. He is also the lead author of Pennwell’s Residential Fire Rescue book. Email Mark at Mark@Firestar-Services.com
Meal options to help combat cancer
In some way, shape or form, cancer has touched our lives; maybe you have experienced a personal battle, or perhaps you have watched a friend’s struggle or stood by a family member who has fought the disease.
Based on the regularity with which cancer strikes, the odds are we all will have an encounter with the disease in one way or another. I’m very excited and proud to contribute to this special pink issue to help promote awareness of breast cancer. I watched closely as two grandparents and my childhood best friend’s mother succumbed to the disease. I also witnessed cancer ‘victories’ after two members of the Waterloo Fire Rescue family beat Hodgkin’s lymphoma. Cancer is everywhere around us, and the line of work that we all are in makes us even more susceptible.
What if I told you that by adopting a healthier lifestyle and adding few simple ingredients to our diets, we could reduce the risk of cancer-caused deaths by 60 per cent? Wouldn’t you try every little thing possible to save yourself, your family and your friends? I thought so. So, let us rock our pink T-shirts and chat about some cancer-fighting super foods.
Some foods, such as green tea and tomatoes, have long been touted as cancer fighters, which they definitely are, but your overall eating habits offer the strongest protection. Being in the emergency services, we need all the protection we can get. The best strategy for us is a diet rich in plant-based foods such as vegetables, fruits and whole grains, accompanied with omega-3 fats such as those found in salmon, whole grains and nuts. Cutting back on saturated fat, trans fat, and sugar also helps build the body’s internal army, making it an inhospitable place for cancer cells to live. It’s never too late to start building your cancerfighting arsenal and the more frequently you can use these ingredients, the better:
Dark leafy vegetables and cruciferous vegetables – Cabbage, broccoli, Brussels sprouts, cauliflower, kale, spinach and collards are all rich in anti-cancer properties such as diindolylmethane, sulforaphane and the element selenium. Releasing these powerful chemicals is important so do not overcook these greens. Try them raw in flavor-packed salads
Patrick Mathieu is a 13-year veteran of Waterloo Fire Rescue, where he is acting captain. He has won several cooking competitions and has helped raise thousands of dollars for charities by auctioning gourmet dinners at the fire hall. Contact him at stationhousecateringco@yahoo.ca
or chopped thin and pan-fried for just a few minutes.
Green tea – Drink a lot and drink it often, hot or cold. Green tea has epigallocatechin gallate (EGCG) and catechins. EGCG slows cancer growth so make sure it is the real-deal green tea (usually from Japan).
Oily fish – Salmon, sardines and mackerel are cancer-fighting specialists. Omega-3s, vitamin A and vitamin D are abundant in these fish and are proven cancer fighters.
Ginger and tumeric – These spices are like good-tasting medicine. Ginger has powerful anti-inflammatory properties and can slow cancer growth. Turmeric – the spice that forms the base of most curries – is from a root in the ginger family. Add them to your spice rack and use them often.
Berries – Don’t get too caught up on which berry to select because they are all extremely healthy. Most berries contain ellagic acid and other polyphenol antioxidants, which inhibit tumor growth. Add them to salads, breakfasts and, of course, desserts.
Nuts and seeds – Low in saturated fat, nuts and seeds are already a good addition to any plant-based diet, but two really stand out in the cancer-fighting world: walnuts and flaxseed. Eating small amounts of walnuts can cut the risk of breast cancer in half, according to a recent study. Flaxseeds have cancer-fighting potential due to their fibre, omega-3 fats, and lignans (a beneficial plant compound).
Tomatoes – Especially cooked ones! Research shows seven to 10 helpings a week cuts prostate symptoms by 40 per cent and has an influence on many cancers such as lung, colon, cervix and breast. Lycopene is the prime active ingredient; it is also found in pink grapefruit, strawberries, peppers, carrots and peaches. Lycopene helps reduce bad fat levels in the blood stream and is a strong antioxidant.
The fun fighters: Red wine and dark chocolate – red grapes contained in wine are flush with resveratrol – an antioxidant found in
some plants that may help inhibit the growth of cancer. Dark chocolate containing more than 70 per cent cacao is loaded with potent antioxidant flavonols, polyphenols and proanthocyanidins, all of which help to slow the growth of cancer cells.
The key to using diet to help prevent or curb cancer growth is to adopt a healthier lifestyle in general. Keeping these foods readily available in your home or fire station will make it easier to whip up something nutritious and delicious. I’ve included a cancer-fighting grocery list as well as a couple recipes to help get you started. We are in the business of helping people and saving lives, so why not start with our own and the ones closet to us.
Cancer-fighting grocery list
Vegetables:
• Broccoli
• Cabbage
• Cauliflower
• Carrots
• Kale
• Mushrooms
• Sweet potatoes
Fruit
• Avocados
• Chili peppers
• Figs
• Grapefruits
• Grapes
• Oranges and lemons
• Raspberries
• Tomatoes
Seeds and Nuts
• Flax
• Walnuts
Herbs and spices
• Garlic
• Rosemary
• Tumeric
Beverages
• Red wine
• Green tea and black tea
Cauliflower and Brussels penne in spicy, pink sauce
Ingredients:
• 3 cups chopped canned San Marzano tomatoes with juices
• 1½ cups cream
• ½ cup freshly grated Pecorino Romano cheese
• ½ cup coarsely shredded Fontina cheese
• 2 tbsp ricotta cheese
• 1 jalapeno pepper, seeded and chopped
• 2 cloves garlic, minced
Directions:
• ½ onion, chopped
• 1 tsp crushed red pepper flakes
• 1 tsp sea salt
• 1 medium cauliflower, coarsely chopped
• 1 lb fresh Brussels sprouts, stem removed and halved
• 1 lb whole grain penne or rigatoni pasta
• 3 tbsp unsalted butter
1. Preheat the oven to 500 F and bring five quarts of salted water to boil in a stockpot.
2. In a mixing bowl, combine the tomatoes, cream, cheeses, peppers, garlic, onion and salt. Drop the cauliflower, Brussels and pasta into the boiling water for five minutes. Drain, add them to the mixing bowl with the tomato mixture, and toss to combine.
3. Transfer the mixture to a large baking dish. Top with dabs of butter and bake for seven to 10 minutes, or until bubbly and brown on top.
Dark chocolate pink sorbet
Ingredients:
• 8 ounces Greek 2 per cent vanilla yogurt
• 8 ounces mascarpone
• 12 ounces frozen mixed berries
• 2 ounces 70 per cent or more dark chocolate squares, plus more for shavings and garnish
Directions:
• 4 tbsp pure honey, more or less if you like
• Mixed fresh berries for garnish
• 1 tbsp red wine, optional, use only if you are planning on freezing
1. Place dark chocolate in the food processor and pulse for 20 seconds or so until chopped somewhat. Add the remaining ingredients and blend for about 30 seconds. Top with fresh berries and dark chocolate shavings. Enjoy!
2. Keep leftovers in the freezer. If you think you may have some left over, add one tablespoon of red wine to the mix to make sure the yogurt doesn’t freeze rock hard.
Relax to maintain a healthy life
This column is dedicated to my mom, who passed away recently after a short battle with cancer. My writing is by no means a scientific study on cancer or cancer-causing environments; rather, my thoughts here are more of a philosophy for living a healthy life around cancer and in general.
Life is too short to stress about life, sickness and death. I have witnessed too many friends, family members and firefighters die from cancer. It is heartbreaking that the statistics for surviving cancer have not drastically improved over the years. In fact, the Canadian Cancer Society reports that 29.9 per cent of deaths in Canada are due to cancer. The society also estimates that more than 191,000 new cases of cancer will occur this year alone. Firefighters have an elevated risk for cancers due to our jobs and the environments in which we operate. Some say that firefighters have double the risk of developing cancer compared to other occupations. So, the facts show we are in an extreme danger zone to start with; therefore, finding preventative measures to give us the best shot of a long, successful life are crucial.
I cannot speak from experience of having had cancer, but I believe that living life to its fullest will allow for a more peaceful experience for those who go through cancer and for living life in general. Live with no regrets, and if you have regrets, release them, move on and enjoy life.
should do that – all I mean is take time off, time away from your stressful environment to relax and rejuvenate your system.
I have found that by taking mini-vacations or, as some call them, “mini-retirements,” I can stay more focused and relaxed year-round than by taking a month off at a time. Mini-vacations don’t have to be weeks off – I am talking about a weekend away or a weekend simply releasing the stresses from your job. Frequent mini-vacations will be more mentally rewarding than longer but infrequent breaks. With just a few days away from the normal hustle of life or work, we can quickly re-energize our minds and bodies to effectively handle stress and problems we face day in and day out. In this case, quantity may indeed be better!
Frequent minivacations will be more mentally rewarding than longer but infrequent breaks.
We should be taking care of ourselves from Day 1 and taking care of ourselves doesn’t strictly mean physical fitness and healthy eating, but, more importantly, it also means maintaining a healthy mind. Today’s world can be very stressful and the “S word” can kill you in so many ways. Fire fighting is one of the most stressful and traumatic careers to experience, so it is in our best interest to find ways to move through it, live amazing lives and continue to enjoy what we do. Stress can be a silent killer of our passions, which can lead to an end to the best job in the world – fire fighting.
Stress has not been scientifically identified as a direct cause of cancer, but it has proven to be a factor that leads to living an unhealthy lifestyle. A stressful lifestyle is known to lead to cancerinducing behaviours such as alcoholism, over-eating, and smoking, which have all been proven to be cancer-causing. Stress can also have a profoundly negative effect on the ability to cope with cancer, making you vulnerable for other illnesses.
There are many books on how to manage stress, but I have found one simple ingredient that has allowed me to work in a stressful environment while keeping a healthy lifestyle: taking a break.
I have heard this term from others in the fire service and I agree that everyone should take mini-vacations. Not everyone can afford to take glamorous vacations all the time, and I don’t mean that everyone
Another great addition to your mini-retirement is a digital blackout. A digital blackout – also known as unplugging – is a short time away from email, Internet, texting, and social media, to enjoy the other wonders of life. The problem is that many of us – me included – deal with Nomophobia, which is short for no-mobile-phone phobia – the fear of living without your mobile phone. Studies have shown that, on average, users check their mobile smartphones every six and half minutes. I enjoy being extremely socially connected via social media, as I see great potential – personally and professionally – in the wealth of information available through my phone. I have also recognized that occasionally taking a short digital detox is a healthy decision. Of course you go through withdrawal, but then there is a sense of total relaxation. In today’s world, total relaxation is hard to come by. Use these mini-retirements and digital blackouts to refocus on the things in life that matter – family, friends, and health.
Many of you probably have faced burn-out or near burn-out. I have; I love my job in the fire service and I love working day and night to make the service better and prepping myself to be the best I can, but this can be a dangerous path, if it is followed without caution and awareness. I am aware that I work at the hall and also at home, but I also now recognize when a short battery boost is required. The beauty with short but frequent reality breaks is that they are brief and you can be back in the saddle quickly.
I challenge you to take a micro-vacation now, hit the reset button, disconnect and reap the immediate rewards to your mental health and productivity. Why wait to fight the cancer battle when you can fight to live a healthy life now?
Arjuna George is a 17-year veteran and the deputy fire chief of Operations on Salt Spring Island, B.C. Email him at ageorge@ saltspringfire.com and follow him on Twitter at @AJGeorgefire
ARJUNA GEORGE
Effective and efficient primary-search techniques
By Tim Llewellyn
This edition of TimBits takes some of the lessons from the truckcompany operations classroom series and boils them down into a short primer. The focus is on primary searches and how to make them more effective, and also how to keep firefighters safer.
The techniques are not groundbreaking; rather, they’re an accumulation of best ideas from successful and busy companies. These techniques are not necessarily taught in the recruit and pre-service academies, and by no means am I advocating that new firefighters jump right to these practices. First, learn and master the basics, then move toward advanced methods, under guidance from trained and experienced firefighters.
When performing primary searches, firefighters always need to go into the structure with a plan of attack. Obviously, the search starts immediately inside the entry door, but where does it go from there? The search plan is dictated by the location of the fire. The rooms and the hallway immediately adjacent to and on the same floor as the fire are the areas with the greatest hazards; the search needs to start in these areas.
Upon entering, firefighters should search the common pathways from the entry door to the fire area. Once in the area of the fire, search the spaces close to the fire first, and then move to rooms farther away from the fire. If you are ordered to perform a search above the fire floor, figure out from the outside as you are entering where the fire is located. Once you get to the floor above the fire, proceed immediately to the area directly above the fire and start the search there; continue to search away from the area directly above the fire.
In recruit school, we were taught to perform searches by holding onto the wall as we made our way around the room; each firefighter would stagger behind the lead firefighter, extending outward while holding onto the firefighter up front. This is an effective way to search, but it is not very efficient. A more efficient way to search rooms is by using the oriented-search technique. Oriented searching involves one firefighter holding a position – this is called the oriented position (typically at the door or entrance to the room, or on a hoseline) – while the other firefighter(s) is directed into the room or area to search. Proponents of this technique strongly encourage the oriented firefighter to carry and use a thermal-imaging camera (TIC) to keep track of and direct the searching firefighters to areas outside of the camera’s range. The oriented firefighter – who is usually the officer of the crew – can not only keep track of the firefighters better with a TIC, but can also continuously monitor the fire conditions and other fire-ground activities.
The firefighters going into the room to search should leave their tools on the ground near the oriented firefighter; this frees their hands so they can search more effectively. If the tools are needed, they can easily be retrieved.
In training, we too often set ourselves up for failure by learning and practising searches in large, open, unfurnished rooms with stiff mannequins as victims. We are told that we can “extend the search” by using tools to probe the darkness. In training, if our tools run into something stiff in the concrete-block room, we know that we have reached the victim and we have achieved the goal of the training exercise. But searching does not work this way in furnished houses. Could you tell
the difference between a 10-kilogram (22-pound) toddler and a foam dog bed on a thickly carpeted floor at the end of a Halligan bar with zero visibility? Probably not. It is more likely, in fact, that you will not feel either the toddler or the dog bed through the resistance of the Halligan on the carpet. Fire victims are found with hands, not tools.
When firefighters finish the search and exit the room, they can retrieve their tools and carry them to the next work area. If a searching firefighter finds and extricates a victim, then he or she knows that the tools have been left in a known location and can be retrieved later. The main idea behind this modification is for firefighters to use their hands to search for and save lives, not to drag tools.
Try these ideas in training to see if they work for your department. If they do, pass them on to a friend. Now let’s go practise realistic searches!
A fire-service veteran since 1989, Tim Llewellyn is a firefighter for the Allegheny County Airport Authority in Pittsburgh, Penn. He volunteers for the Adams Area Fire District in Pennsylvania and is an instructor for the PA State Fire Academy, the Allegheny County Fire Academy and the Pittsburgh International Airport fire training facility. Email him at llewllyn.fire@gmail.com
Photo 1: The officer of the crew (in the oriented position) uses a thermalimaging camera to keep track of and direct the firefighters searching the room.
Photo 2: The thermal-imaging camera should also be used to monitor fire conditions in areas adjacent to the search team.
PHOTOS BY TIM LLEWELLYN
By Randy Schmitz
AA rundown of vehicle safety features
s driver comfort and safety become more important to car buyers, it’s crucial for rescuers to understand the myriad occupant-safety devices in today’s vehicles.
Rescuers need to stay current with vehicle technology and be aware of any hidden hazards and dangers such as inadvertent airbag deployment. Although rescuer-induced, post-crash airbag deployment is rare, there have been two documented cases in which rescuers have been injured from airbag deployments and one documented close call. All three incidents took place while the 12-volt electrical system was still intact, and the vehicles were severely damaged.
The seatbelt is the most significant safety feature designed in the last 40 years to protect vehicle occupants from harm; airbags are a close second. Most new-model vehicles are made with driver and passenger frontal airbags, side-impact airbags in the seats, and roof-curtain airbags. Six airbags are standard in typical vehicles. Many higherend vehicles have knee bags and rear-seat side-impact airbags as well; eight or 10 airbags are becoming more common.
Pedestrian protection
Luxury vehicles such as Mercedes, Volvo and Jaguar have cutting-edge safety technology. Volvo, along with a few other car manufactures, is attempting to address the global increase in pedestrian fatalities. Head and neck injuries are the most-common in pedestrian incidents; these injuries are caused when the pedestrian’s head hits the windshield and A-pillars after he or she has been struck by the vehicle at the lower extremities.
In the new Volvo V40, seven sensors inside the front-bumper area send a signal to the vehicle’s electronic control unit (ECU), which detects a human leg bone and differentiates it from another vehicle’s front end; when this type of signal is received, the outer airbag is deployed (see photo 1). Pyrotechnic devices then trigger the release of the hood’s hinges and raise the back of the hood up about 10 centimeters to create a cushioning effect for the pedestrian’s body. This increases the space between the hood and the firewall and helps to reduce the impact when the pedestrian hits the hood. The speed of the vehicle must be between 20 kilometres per hour (kph) and 50 kph for the system to be in effect.
Seatbelt systems
Ford Motor Company has broadly released an interesting advancement in seatbelt design and safety called the inflatable seatbelt, which was originally launched on the 2011 Ford Explorer. This ground-breaking, injury-reducing technology lowers the energy impact during a collision on smaller occupants seated in the vehicle’s rear, where there are no secondary-restraint devices such as airbags. The design phase of the inflatable seatbelt took the better part of 10 years, but the result has proven to be extremely successful. The concept is simple: during a frontal or side-impact crash, the belt inflates to create a cushion between the belt itself and the occupant’s chest; the system spreads out the forces exerted by traditional seatbelts. The system is similar to a tubular, miniature airbag; upon deployment, it uses cold, high-
Photo 1: The new Volvo V40 includes a pedestrian airbag that deploys when sensors in the front bumper detect a human leg bone.
Photo 2: The Mercedes Benz belt bag includes Velcro edges for seamless deployment.
Photo 3: GMC’s centre airbag is designed to prevent occupants from colliding during a side-impact crash.
Photo 4: Ford Motor Company, in collaboration with TRW Automotive, is set to release its largest airbag yet called the sideimpact curtain.
pressure gas stored in a small cylinder near the bottom of the seatback to inflate the belt when crash sensors determine the need for additional protection. The deployment time to full inflation is about 40 milliseconds and the airbag stays inflated for several seconds before it starts to release the inflating product through specialized pores built into its fabric. Ford plans to offer this technology in all its vehicles over the next several years. Mercedes Benz is about to release its own version of the inflatable seatbelt called the belt bag in its S-class sedan (see photo 2). The system consists of an accordionstyle airbag fitted inside the seatbelt, but with Velcro edges that allow for seamless deployment; this, accompanied with beltforce tensioners and limiters built into the rear-seat system, give greater protection for those seated in the back of the vehicle.
Airbag advancements
An industry-first, General Motors Company (GM) has developed a method to reduce occupant collisions inside a vehicle during side-impact crashes. Named the front-centre airbag, this system is active in the new 2015 GMC Yukon and three of GM’s top sellers: the Buick Enclave, GMC Acadia and Chevy Transverse (see photo 3). So far, the airbag system is available for front-row passengers only. The system looks similar to a standard, side-impact airbag when deployed, however, it is attached to the inner side of the driver’s seatback and is designed to act as an energy-absorbing protective barrier between two occupants to prevent them from colliding into each other during a side-impact crash. The airbag is shaped like a figure eight and wraps around the driver slightly with a thicker top for increased head protection; the airbag stays inflated for
roughly five seconds after deployment. In addition, the system provides extra protection in a rollover situation. One of the biggest risk factors in side-impact collisions is when occupants’ heads slam together as a result of being violently thrown into each other. Now, in conjunction with the inflatable roof-curtain airbags, the passengers are protected from both sides in a side-impact situation. According to the National Highway Traffic Safety Administration, nearly 29 per cent of fatalities of belted front occupants in side-impact, non-rollover crashes are caused by these incidents. Advancements such as these are certainly capable of lowering these statistics.
Mercedes Benz is taking a serious approach to the same occupant-fatality issues. Its injury-reducing technology is called interseat protection. Similar to the GM centre-seat airbag, within fractions of a second a lattice-like inflatable structure pops out from the edge of the seatback to create a separation between the occupants.
The Toyota Scion iQ rear-window curtain airbag is designed to inflate during a rear-end crash and protect the rear-seat occupants’ heads. This interesting addition to Toyota’s Scion fleet first debuted in 2012 and is quite impressive. The curtain-style airbag deploys from the roof lining just above the rear-window frame; it then envelops the rear headrests to provide increased head protection.
Toyota’s Yaris and iQ, and Subaru and Renault all have airbags on the front driver and passenger lower seat cushions; these airbags deploy during a frontal collision to keep occupants from slipping out from underneath the seatbelt. When a vehicle occupant slides out from under the seatbelt, a submarining effect can occur, during which
Photo 5: TRW is developing an airbag that deploys on the outside of the vehicle.
PHOTO COURTESY OF TRW AUTOMOTIVE
the unrestrained driver or passenger hits the dash, steering wheel or the frontal airbags. Types of injuries depend on how the person is seated and whether or not the seatbelt is worn properly or tightened enough to offer protection. When the seat-cushion airbag deploys, it forces the front part of the lower seat cushion upward, which places the occupant’s pelvis in a position to keep him or her from slipping forward.
Ford is set to release its largest airbag yet, the side-impact curtain, in collaboration with airbag manufacture TRW Automotive (see photo 4). In 2015, Ford will include this jumbo airbag in its 15-passenger transit wagon. This side-impact curtain measures 4.5-meters long by one-meter high to encompass all five rows in one deployment. The system is part of Ford’s safety canopy technology and has been in the works for the last four years. This airbag is the largest in any vehicle to date; it specializes in minimizing injuries to the head, neck and torso during side-impact crashes and rollovers. Large passenger vans are susceptible to rollover. Once the crash sensors detect an impact or rollover, two large inflators release 120 litres of compressed gas into the bag in a fraction of a second.
Ford has added an interesting change to its 2015 Mustang. Until now, Ford housed a knee bag inside the traditional glove box. When the knee bag deploys in a frontal crash, the whole front section of the glove box – with the airbag attached to it – deploys to protect the passenger’s lower limbs from hitting the dash. Now, moving away from traditional fabric material used by most manufactures, Ford has come up with a flexible, plastic, bladder-type inflation unit that is attached to the door of the glove box. Upon deployment, a gas inflator fills the bladder, moving the glove-box door forward; this change offers greater protection for the knees as the knee bag covers a larger area. Rescuers should expect to see this new knee bag as standard equipment in the Mustang, along with the eight other airbags within the vehicle.
External airbags have not yet surfaced, but some airbag-manufacturing companies such as TRW are working on technology that deploys an airbag on the outside of the vehicle rather than the inside (see photo 5). The airbag deploys from the lower rockerpanel area during a side-impact crash and can inflate within 20 to 30 milliseconds; this creates a barrier between the driver and passenger of a vehicle that is being hit on
the side from another vehicle. According to a TRW spokesperson, “the 200-litre bag –which measures 15 to 20 centimetres (cm) deep, 70 cm high and 200 cm long – rotates upwards when deployed, shielding both the front and rear doors up to the belt line. To ensure a rapid deployment in 20 to 30 milliseconds, two inflators are used. TRW has patented a unique inner structure to make the bag stiffer, while the bag’s pressure depends on the manufacturer’s strategy.”
Another attempt to increase safety is an experimental project from Mercedes Benz called the braking bag. The idea behind the bag is to slow down a vehicle prior to a collision to reduce impact force; this is considered a pre-crash initiative in which sensors determine distance and imminent-crash forces from the involved vehicles. Think of this as an additional braking system. An airbag placed near the front axles and undercarriage is deployed in a pre-crash situation to slow down the vehicle, similar to an emergencybraking system. This means the rate of deceleration is improved by more than 20 milliseconds, which reduces collision severity. The moment the bag deploys it raises the front end of the vehicle up about eight centimeters, which improves crash-force compatibility with the other vehicle by minimizing the nose-diving effect to better allow restraint systems to perform at optimum levels.
Today’s vehicles are designed for greater passenger safety but, due to the degree of vehicle diversification, this information can only serve as a guideline for rescuer safety. The array of designs and features in today’s cars makes it very difficult for rescuers to become familiar with all the potentially hazardous components. Vehicle restraint-system familiarization can only emphasize safety to address the hazards. Responsibility for overall efficiency and the safety of those involved ultimately rests with the officers and crew members attending the scene.
Randy Schmitz is a Calgary firefighter who has been extensively involved in the extrication field for 21 years. He is an extrication instructor and has competed internationally. He is the education chair for Transport Emergency Rescue Committee (T.E.R.C.) in Canada, a T.E.R.C. & WRO International extrication judge and a tester and evaluator for manufactured prototype products for extrication equipment. He can be reached at rwschmitz@shaw.ca. Follow him on Twitter at @firedog7
Dropping the it-won’t-happen-to-me mindset
Iconsider myself one of the lucky ones. I haven’t had to (and God willing, won’t ever have to) deal with a breast-cancer scare, or any other kind of cancer scare for that matter.
Members of my family have fought, and lost, the battle with the dreaded c-word, but I wasn’t there to see the daily struggles that so many loved ones have had the unfortunate experience to witness. I guess I’m lucky in that respect, too.
But I wasn’t totally oblivious to what was going on; I would hear updates on their condition from other family members, nodding in agreement at the severity of it all, and wondering why cancer exists and why it’s so often incurable, especially in this day and age of technological advancements.
I wonder now if I waited until the last minute to write this column because I really didn’t want to delve into this topic. I discussed it with my husband (whose mother passed away earlier this year from cancer), and realized that I avoid talking and reading about cancer because I don’t want to think about it.
I admit to being ignorant about many things cancer related. I don’t know the difference between chemotherapy and radiation treatment. I don’t understand exactly what cancer does to a body, or the cells in your body, except to damage them, often beyond repair. I also don’t know if positive thinking is enough to help someone beat cancer, or why cancer takes some lives and not others. I don’t know which cancers are the worst types, or which are the “best.” I heard someone say recently that a certain type of cancer has the highest survival rate. It seemed to me, if you were going to get cancer, this would be the type to get.
we just don’t think it will happen to us?
In a conversation with the same captain while writing this, he told me that dangerous readings of hydrogen cyanide were present at training grounds similar to the one we often use, which used the same materials in the burn buildings: straw and lumber.
I must pause for a moment to wrap my head around the magnitude of what I’m learning while writing this column, which serves as evidence to my reluctance to dig into this topic. As ignorant or obtuse as I choose to be about the whole cancer thing, it’s obvious that awareness is key. Smart firefighters protect themselves.
I understand that there is a certain amount of risk inherent in fire fighting, but I wonder how much of it is avoidable.
You don’t get to choose what type of cancer you get. But is it possible that we are inadvertently creating the conditions in our body for cancer to exist based on the lifestyles we chose? Studies show that certain behaviours tend to cause certain types of cancer; smoking leads to lung cancer, too much time in the sun can lead to skin cancer, and – the one that should be of utmost concern – fire fighting can be linked to all kinds of cancer.
That last one scares me the most, and it’s the one I probably have tried hardest not to think about. It’s something that has been gaining attention in the media and the fire service due to the spotlight on presumptive legislation – something else that I know very little about.
I recall one training night at our fire hall when the captain spoke about hydrogen cyanide and its presence in virtually every fire to which we respond, along with the importance of wearing BA during overhaul and keeping ourselves protected. The thought of a chemical that can be inhaled or absorbed through the skin rattled me at the time, but it eventually slipped to the back of my mind. I am careful to wear a pack during overhaul, but I’m sure there are other situations in which we are guilty of not protecting ourselves fully. Is it because
Other research led me to stumble across a female firefighter on a Facebook group who had just been diagnosed with breast cancer and was scheduled for a double mastectomy in the next few days. She had just turned 38. I wanted to comment in the group, but struggled with the words. Eventually, I wrote “sending thoughts and prayers.” At the time, my words seemed kind of lame, insignificant and small because they didn’t come close to conveying what I truly felt for this woman I’ve never met.
Later that day, I received notification that she “liked” my comment. I smiled to myself. Maybe it wasn’t insignificant after all.
The same comment thread from this woman’s post led me to another Facebook page, FirefighterCancerSupportNetwork, so I thought that may be another good resource for this column. It turned out to be the Ohio chapter, and I wondered if there was a Canadian chapter, but before I got any further, a post on the page caught my attention. It said, “Cancers among Ground Zero Workers Skyrocketing,” and went on to say that “more than 2,500 Ground Zero rescuers and responders have come down with cancer and a growing number are seeking compensation for their illnesses…”
Something else to wrap my head around.
As I said to my captain, I understand that there is a certain amount of risk inherent in fire fighting, but how much of it is avoidable. Are we doing enough to protect ourselves?
Think about your family at the next call. Protect yourself. Protect them. Protect each other. Be proactive about it and drop the it-won’thappen-to-me mindset. I’m sure the people who are currently diagnosed would tell you the same, because it has happened to them.
To all the people who are living with cancer, I genuinely send thoughts and healing prayers your way. I hope that you win this unthinkable battle.
Jennifer Mabee-Grigg has been a volunteer with the Township of Georgian Bay Fire Department in Ontario since 1997. Email her at jhook0312@yahoo.ca and follow her on Twitter at @jenmabee
JENNIFER MABEE
Turnout gear made with GORE® moisture barrier technology enabled lower body core temperatures in a broad range of conditions firefighters face, providing the best option for heat stress management.*
104.0°F Heat Stroke & Fatality
100.9°F Impaired Decision Making
100.2°F Diminished Motor Control
99.9°F Heat Exhaustion
99.5°F Missed Audible Signals
98.6°F Normal Body Temperature
