Health Care Part 3 - July 2014

Page 1

JULY 2014



Part 3


Inside this supplement Dementia: still masked by shame and stigma Pages 2-3 Don’t let bad air quality make you sick Page 4 Questions answered on health coverage Pages 6-7 New technique could heal teeth painlessly Page 8 Home improvements for those with dementia Page 9 Taking asthma medications during summer Page 10 How is asthma different from allergies? Page 11 Relay for Life: The burden of cancer Page 12 Recognise anxiety as a human experience Page 13 Raising awareness on sun protection Pages 14-15 What you can do to keep your mouth healthy Page 16

The Bermuda Sun publishes twice weekly and is a subsidiary of MediaHouse Limited. We are members of the Inland Press Association, International Newspaper Marketing Association and the Newspaper Association of America. We are located at: 19 Elliott Street, Hamilton HM 10; P.O. Box HM 1241, Hamilton HM FX Tel: 295-3902 Fax: 292-5597. Visit our website:

Bermuda Sun 19 Elliott Street, Hamilton, Bermuda HM 10 Tel 295-3902 Fax 292-5597 E-mail This special supplement is produced and published by Bermuda Sun Limited and printed in Bermuda by Island Press Limited.

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Understanding dementia, a disease BY ELIZABETH STEWART Action on Alzheimer’s & Dementia

Dementia…the “big D”, “old-timers”, “senior moments”, “losing our marbles”…we joke about memory loss but, in fact, dementia is a serious disease that we must start taking more seriously as a society, and, with an aging population, one that needs a plan for the future.

So what exactly is this word dementia? Dementia is a general “umbrella” term that describes the symptoms associated by cognitive decline such as memory loss, problems with language, impairment of judgment or reasoning and confusion with time and place, to name a few. It affects a person’s ability to perform daily tasks that we take for granted, such as dressing, bathing, eating, writing, speaking, walking, and so on. What the medical community knows is that dementia does not discriminate. It is an equal-opportunity destroyer: black, white, rich, poor, we all face the same risk. There are over 35 million people worldwide living with dementia, with this figure set to rise to 115 million by 2050. If dementia care were a country, it would rank between Turkey and Indonesia and be the world’s 18th largest economy. Every four seconds someone worldwide is diagnosed with dementia and one out of three people over the age of 65 will die with some form of dementia. Dementia and the associated symptoms are caused by one of a number of diseases. The most common of these is Alzheimer’s, which accounts for approximately 60 per cent of all dementias. Here, plaque and tangles within the brain kill off neu-


ART WORKS: Art therapist Kendra Earls works with dementia patients in care homes including Westmeath and Matilda Smith, as well as at WindReach, on a weekly basis.

‘Dementia is not a natural part of aging and while increasing age is, in fact, a risk factor for Alzheimer’s disease, you should not expect to get dementia just because you age.’ rons, leading to cognitive decline. The next most common forms of dementia are vascular dementia, caused by problems in the supply of blood to the brain and often signified by strokes, and dementia with Lewy Bodies, which may account for around 10 per cent of all cases. Then there are the less common forms of dementia such as Frontotemporal dementia, Cruetzfeldt-Jakob

disease, Parkinson’s disease and Huntington’s disease. There are in fact over 100 diseases that cause dementia, each with their own physical characteristics and nuances. Dementia is still often incorrectly referred to as “senility” or “senile dementia”, which reflects the formerly widespread but incorrect belief that serious mental decline is a normal part of aging. Dementia is not a natu-

ral part of aging and while increasing age is, in fact, a risk factor for Alzheimer’s disease, you should not expect to get dementia just because you age. Early onset Alzheimer’s disease, typically defined as a diagnosis in those under 65 years, has been seen in individuals as young as 30. Alzheimer’s disease is a progressive and incurable disease of the brain, meaning that symptoms will worsen over time and if the person lives long enough will eventually lead to death. Those with the disease live an average of eight years after diagnosis but survival can range considerably, up to 25 years, depending on age and other health conditions. In Bermuda, the estimated number of individuals living with dementia in our society is 900 to 1,000 and since setting up the charity Action on Alzheimer’s &



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‘still masked by shame and stigma’ ‘People retain the capacity, ability and need to give and to receive love from others; the ability and need to feel joy and happiness; the need to feel useful and to feel self-worth, and the need to feel respected and valued.’ Dementia in 2012, we have become aware of people living with dementia in Bermuda who are 40 years old to 90-plus years old. They are from all walks of life, backgrounds and races. Amongst these are teachers, musicians, dancers, politicians, lawyers, bus drivers, former Olympians –– people you would know, I’m sure, if I said their name. Thanks to those who are speaking out about the disease, including the many celebrities and their families who have faced dementia, there is an increasing awareness around the world but it still falls short.

Hidden Dementia is a segment of health that has been ignored, hidden and still remains largely undiagnosed and untreated. It is the cancer of 30 years ago. The word that is not mentioned; the secret people keep. This disease is at the back of the race for society’s attention. It is not well known like other diseases like diabetes, cancer and heart disease and doesn’t seem to have the same tangible element. Instead, it is the disease still masked by shame and stigma. People would prefer to hide a loved one’s struggle from others rather than stand up and be the voice for others. Friends who might have once been there tend to keep a fearful distance from

those who they know with dementia. People whisper the words Alzheimer’s and dementia, when instead we should be shouting about it. I recently attended the Alzheimer’s disease International Conference in Puerto Rico, where a number of individuals with a diagnosis of dementia spoke about what it was like living with dementia. There was Kate Swaffer, from Australia, diagnosed at 49-years-old and living with Alzheimer’s disease for the past four years, who told us that every day felt like a “permanent exam”. Then there was Richard Taylor from Houston, Texas, a former neurologist and now a regular at speaking engagements, who was diagnosed with vascular dementia and said we needed to live every day in the moment and to stop treating people with dementia like they were already dead.

Living with dementia What we know is that people have the ability to “live well” with dementia and to lead fulfilling lives, and we as a society need to enable those with dementia to live. There still remains the view, however, especially with those who are older, that nothing can be done for someone with dementia, that they are unaware of what is going on around them, so no real effort needs to be made to support them. We know that the emotional centre of the brain


RESPECTED AND VALUED: Elizabeth Stewart providing art therapy to a patient at Westmeath. remains intact throughout the life of the person and imaginations are intact to the very end of the person’s disease. People retain the capacity, ability and need to give and to receive love from others; the ability and need to feel joy and happiness; the need to feel useful and to feel selfworth, and the need to feel respected and valued. Meaningful activity, engagement and a sense of self are needs that we all have and these do not disappear with age or with a diagnosis of dementia. Pharmacological interventions for behaviours viewed as challenging by the healthcare community are being replaced around the world with non-pharmacological interventions such as art, music, laughter and physical exercise, which are shown to be equally, if not

more, effective but without the associated risks of offlabel prescription drugs, including premature death. Action on Alzheimer’s & Dementia was created to support, educate and advocate for those living with dementia and those who are caring for people with dementia. Our mission is to improve the quality of life for those with dementia and their caregivers and our vision is to see a Bermuda where everyone is supported in the best way possible to live a full life right to the end. I think this is what all of us would want for ourselves and we need to work together to ensure Bermuda is prepared. n

FOR MORE information, visit or contact alzbermuda@

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Don’t let bad air quality make you sick BY STEPHEN SAVAGE Sales and marketing manager, EFF-Tech

If you spend a lot of time coughing or sneezing but aren’t ill, your symptoms could be due to poor air quality at home. For the majority of us, living in Bermuda means dealing with mould inside homes, which causes dampness and is a factor in poor air quality. Bad air can trigger coughing, chest tightness, a sore throat, watery or itchy eyes, shortness of breath and even a full-blown asthma attack. Experts say the air quality in your home can be worse than outdoor air quality in many cases, which can come as a surprise to many people. Indoor air can be filled with multiple pollutants. These tiny particles, many too small to see, make their way into your home’s air and into your lungs. Particles like dirt, dust and pollen enter your home through open windows, doors and cracks. Bacteria and mould easily find their way into your home and constantly reproduce to stay alive. These can all contribute to poor air quality.

Pets If you have pets, unfortunately they are known to be common allergen sources that cause bad indoor air quality from their dander, hair and saliva. Pet dander is made up of microscopic particles that shed from the animal’s body. Mitsubishi Electric Cooling and Heating’s ductless HVAC systems are perfect for ensuring the air quality in your home is clean and healthy. Mitsubishi provides superior indoor air quality systems to remove allergens such as pollen, pet dander, dust, mould and mites from the air. Ductless systems use a


BAD AIR: Pets are known to be common allergen sources that cause bad indoor air quality from their dander (microscopic particles that shed from the animal’s body), hair and saliva. sophisticated multi-part filtration system to reduce airborne contaminants from the air. This combination of filters traps common indoor pollutants and other particles that plague allergy sufferers, providing a healthier breathing environment for homeowners and their families. The technology makes it easy for homeowners to clean and maintain the system. The indoor units have hybrid catechin pre-filters that are easily accessible in the unit, allowing the maintenance process to take only

a matter of minutes. Each unit has its own filter that last up to 10 years, to prevent cross contamination of air from room to room, which saves money and is beneficial for the environment as well.

Allergen filtration In addition to the ductless system, Mitsubishi Electric Cooling and Heating also offers allergen filtration. The design includes a large hybrid catechin prefilter that absorbs odourcausing gases. A blue-enzyme, antiallergen filter also helps to reduce germs and bacteria

like the ductless systems. Some systems also include a platinum catalyst deodorizing filter to further reduce unpleasant odours. Your home should be a retreat filled with clean, healthy air that is easy to breathe, so let Mitsubishi help you today. n

STEPHEN SAVAGE has more than 23 year’s experience in heating, ventilation, and air conditioning (HVAC) and refrigeration. For more information on EFF-tech products and services, please contact Mr Savage at 249-3570 or



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By the Research Unit, Department for National Drug Control Suite 304 Melbourne House | 11 Parliament St. | Hamilton HM 12

Respondents were asked if they favour laws preventing persons from serving alcohol to minors in their homes or on their premises. More than two-thirds or 68.4% admitted to being in favour of such a policy.

Tel: 292-3049 | Fax: 295-2066 |

Lowering the Legal Alcohol Limit

A Public Health Priority

Not many respondents favoured lowering the blood alcohol legal limit from 0.08 to 0.01. In fact, only about one in four or 25.7% said they were in favour of lowering the blood alcohol legal limit from 0.08 to 0.01 (62.5% were not in favour).

The protection of the health of the population, by preventing and reducing the harmful use1 of alcohol, is a public heatlh priority, and one of the objectives of the Department for National Drug Control (DNDC), Ministry of National Security. Last November the DNDC undertook the fifth National Household Survey on Drug Use and Health among the Adult Population in Bermuda. As part of this survey, several questions on alcohol policy were asked of respondents; the results of which are highlighted in this article. Alcohol Advertisements Under the Alcohol Advertising (Health Warning) Act of 1993, all displayed alcohol advertisements must contain the health warning “Excessive alcohol consumption may be harmful to your health”. Residents were, therefore, asked if they had noticed alcohol advertisements with this health warning in the 30 days prior to the survey. Almost half or 49.2% of them said they had “never/not at all” observed this warning. A combined 36.2% of residents admitted to seeing the warning sometimes or a few or couple of times; while only 3.7% said they have, in fact, noticed the health warning all the time. Serving Alcohol to Minors When asked about the minimum drinking age in Bermuda, a large proportion (96.5%) of respondents knew the minimum drinking age in Bermuda to be 18 years or older while 3.1% did not know a person should be 18 years or older to be sold alcohol by a licensed establishment in Bermuda. World Health Organization. (2014). Global Status Report on Alcohol and Health, 2014. Harmful use of alcohol is defined as drinking that causes detrimental health and social consequences for the drinker, the people around the drinker, and society at large, as well as the patterns of drinking that are associated with increased risk of adverse health outcomes.

Roadside Checkpoints When questioned about roadside sobriety checkpoints, the majority were in favor of these checkpoints (83.1%) while13.0% of the respondents were not in favor. The DNDC and it is prevention partners CADA and PRIDE support the long-term goal of reshaping Bermuda’s drinking culture to produce healthier and safer outcomes. The optimal package of recommended interventions comprises of enforcement of advertising bans and the minimum legal drinking age of 18 years; licensing controls through the implementation of an Alcohol Bureau of Control (ABC) model; a drunk-driving mass media campaign; lowering the blood alcohol legal limit; social host liability laws; and random breath tests. Bermuda has a window of opportunity to significantly expand and implement activities to reduce alcohol-related harms. The DNDC encourages residents to challenge the current cultural norm of alcohol misuse by reducing risky drinking behaviours within the family environment and the larger community, for example, don’t drink and drive and don’t serve alcohol to minors.



Source: Department for National Drug Control. (2014). National Household Survey on Drug Use and Health, 2013.

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Ten most frequently asked questions BY JENNIFER ATTRIDE-STIRLING CEO of the Bermuda Health Council

Dimensions of health coverage in Bermuda

We tend to realize how important health is when we get sick. Everyone, whether young, old, female or male, at some point will need to visit a doctor, dentist or other health professional. What nobody wants is a large bill for care they really need. Health insurance can provide some protection from potentially large bills, especially in the case of unexpected catastrophic health events. Here we answer some of the most frequently asked questions on this important topic.

In Bermuda the law requires that all employers provide health insurance for their employees and non-employed spouses. This includes selfemployed persons. The same law, the Health Insurance Act 1970, gives us, the Bermuda Health Council (BHeC) the responsibility to monitor and enforce compliance with this law. Luckily, most employers comply in full, but if you are worried about your employers’ coverage of your health insurance, you should speak with them in the first instance, or with your health insurer; failing a resolution, you should contact BHeC.

2. How are my premiums set? Health insurance works by grouping a number of people together to collect premiums and pay claims on their behalf. Their premiums are combined so that if one person in the group is injured or ill, there will be enough funding available to cover the care they need. This protects all group


1. Do I have to have health insurance?

members from the risk of illness, because the grouped funds are greater than what a single individual could put aside. It naturally assumes that not everyone will be sick at the same time. The premium is set based on the demographics of the members, the amount of health services they have used in the past, are likely to use in the future, and the range of benefits covered. Because of this, the coverage is valid only while the premium is being paid.

3. What role does Government have in regulating premiums? The Government sets the rate for the Standard Hospital Benefit (SHB) annually based on claims made the previous year, and any changes in covered persons, services and fees. The SHB is the basic building block of your health insurance premium. It is also the minimum

benefits package that must be included in any health insurance policy sold in Bermuda (see illustration). It will cover most hospital services and some out-ofhospital benefits. Private and public insurers, however, usually add benefits above the SHB to their plans and will base their full premiums on these additions.

4. So what am I covered for outside of the hospital? Your insurer will provide coverage for supplemental benefits in your policy. These may include, for example, your visits to the doctor, the dentist, physiotherapist and prescription drugs (see illustration). Each health insurance policy provides different benefits, so check with your insurer before booking an appointment.

5. What are HIP and FutureCare? HIP and FutureCare are

the Government’s affordable health insurance plans. These policies include the SHB plus supplemental benefits such as dental visits and doctors’ visits (see illustration). FutureCare is available to seniors only.

6. Shouldn’t my insurance cover my entire health visit? Your health insurance coverage, whether with a private insurer or Government, doesn’t always cover the entire cost of your visit. The balance is a co-pay, which should be paid by the patient at the time of the visit. Co-pays are used to help keep your premiums down, and to make sure each person shares the cost of the health care they receive.

7. Why is my child’s health insurance cheaper than mine? Government subsidizes



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about health coverage in Bermuda the SHB portion of health insurance policies for all of Bermuda’s children, indigents and seniors. Government will cover 100 per cent of the child’s SHB and for the indigent. So, if children are on their parent’s health insurance plans, then the insurer will only charge for supplemental benefits. For seniors Government’s subsidy coverage varies. For seniors aged 65-74, 70 per cent of the SHB is covered; for seniors aged 75 and older, the subsidy will cover 80 per cent. As with children, a senior’s health insurance premium does not include the Government’s subsidy contribution.

8. How much can my employer deduct for health insurance? Employers must pay the Standard Hospital Benefit (SHB) premium to the insurer on behalf of the employee and non-employed spouse, but may deduct half of it from the employee’s salary. In addition, when hired, an employee must be given a written statement with the name of their insurer, the date it came into effect and the policy number. An employee, however, must also keep their employer informed of all facts related to their status and that of their nonemployed spouse.

9. Why does the cost of health insurance keep going up? Every year the Government and each health insurer review the previous years’ health claims and any future changes in membership, benefits and fees. Based on these results, they will set the next year’s premiums to ensure that they can cover the claims that may be made. Bermuda, like many other countries, is struggling

with an ageing and more unhealthy population. For the SHB, a declining population combined with an increase in hospital services and claims has led to premium increases. In 2014, however, due to a number of benefit changes, the premium for the SHB went down by $23.99 per month.

10. What is being done about health costs?

BHeC and the Ministry of Health, Seniors and Environment are actively working on ways to ensure a sustainable health system. This has included caps on hospitalization charges and changes in benefits and subsidies. Everyone, however, can help in a few ways; for example, staying healthy, following your doctor’s instructions to control or maintain any health issues,

and using the emergency room only for emergencies. In order to reduce our health costs, we must all work together to reduce unnecessary use of services. n

FOR MORE information about health insurance in Bermuda, please visit our website on: http://www.

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New technique could heal teeth painlessly BY LAUREN RAAB Los Angeles Times (MCT)

Instead of having to drill and fill cavities, dentists could head them off at the pass with a new technique that accelerates a tooth’s natural healing, King’s College London announced this week. The technique, called electrically accelerated and enhanced remineralization, is being developed by Reminova Ltd., a spinoff of King’s College London. It is painless and could be brought to market within three years, the college said in a statement. “The way we treat teeth today is not ideal,” Nigel Pitts, a professor with the college’s Dental Institute, who worked on the project, said in the statement. “When we repair a tooth by putting in a filling, that tooth enters a cycle of drill-

ing and refilling as, ultimately, each ‘repair’ fails.” Instead, the college said, the new technique, administered in dentists’ offices, would use “a tiny electric current to ‘push’ minerals into the tooth to repair the damaged site”, in essence reversing the decay. Natural, small-scale tooth repair happens all the time, said Edmond R. Hewlett, a professor at the University of California, Los Angeles School of Dentistry who was not involved in the project.

Mineral loss When a person eats or drinks something sugary or particularly acidic, such as citrus juice or certain sports drinks, some microscopic loss of mineral takes place in the tooth’s outer enamel, he said. But saliva contains the building blocks of enamel: calcium and phosphate.

“If you have that occasional short exposure” to sugary and acidic foods, Hewlett said, “the saliva will put back the mineral that gets lost. “There’s this constant balance that’s shifting back and forth in your mouth every day.”

Cavities When that balance is not maintained and too much of the mineral is lost, however, the tooth develops a caries lesion — which can turn into a cavity, King’s College London said. To fight that decay, people use products to shore up the minerals in their tooth enamel. “Fluoride is a remineralizer that’s been around for a long time,” Hewlett said. “When it does go into the enamel, it renders the enamel harder to dissolve.” That’s why fluoridated

water, toothpastes and mouthwashes have an effect. Newer products, such as creams dispensed at dental offices and specific over-thecounter toothpastes, contain calcium and phosphate as well as fluoride, he added. That’s not always enough. Not everyone uses those products, and even if they do, sometimes caries lesions — and subsequently cavities— form anyway. Electrically accelerated and enhanced remineralization would take the reversal of decay to the next level. “Not only is our device kinder to the patient and better for their teeth, but it’s expected to be at least as cost-effective as current dental treatments,” Pitts of King’s College said. He said the technique could be used to whiten teeth as well. n


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Home design improvements for those with dementia BY MICHELE SMITH Interior designer, managing director, OBMI

According to Robyn Stone of Leading Age, “The number of people with Alzheimer’s disease and other dementias is expected to double by 2030. But that’s no reason to start building more ‘memory care units’. Instead, it’s time to start thinking outside the box about how we can design and deliver the very best services and supports to help older people and their families cope with these devastating conditions.” Even though memory loss plays a large part in dementia, it also affects how that person sees the world and functions in it. Erratic behaviours in differing forms require individual care packages for each person and family. From the mundane to the creative; aiding memory in day-to-

day living; and reinforcing personal identity are vital for dementia patients. Creating soothing and comfortable environments is essential for good care. n The bedroom should be cosy with family photos around the room for memory stimulation. n Colours between floor, walls and ceiling should have a good contrast to avoid tripping. Avoid patterns wherever possible. n Doors should have closers for ease of access and emergency exiting and should be wide enough for ambulatory services. n Washroom placement should be visible from the bed and sitting locations in the bedroom. Use personalized furnishings and bedspreads for familiarity. n The bathroom should have additional lighting at the WC and sink areas, with grab bars and easily accessible toilet paper

holder, towels, and so on. A portable shower seat in the shower with a continuous levelled floor and mobile partial dividers at the shower should be allowed for. n Sitting areas should have rest spots near entrances, which are familiar and comfortable. Locate a wheelchair area near the entry under a counter so as not to clutter the room. A contrasting chair rail, which acts as a grab bar around the room, is a good visual guide from area to area as well. Again, familiar family photos mounted at eye level and large enough to see, should eyesight also be impaired, will help memory and make the area familiar and homey. n Increased lighting options should be thought out. Alternative activities including puzzles, reading and simple games should be accessible. Contrasting

door colours and, again, on the floor and walls, will ease way finding. n The kitchen can be a dangerous room regardless of whether you have any ailments. Precautions with open stoves, low ovens and closed cabinets should be considered with care. Open shelves are good so items are in view, hood coverings for stove elements, and wall ovens for easy reach should be taken into account when in use by any person with dementia. Appliances with simple controls and large numbers should also be selected. It may just take some minor changes and alterations to your home, but in the long run caring for loved ones with dementia is not an easy task, so any way to make their living environment more conducive for memory retention and safety, the happier everyone will be. n

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Summer break does not apply to asthma medications BY LIZ BODEN Asthma educator, Open Airways

The summer break from school is here and for many children with asthma, this can be a wonderful time of year. There are fewer colds and viruses, which so often trigger an asthma attack. However, for some children, this is not always the case, as some say, “asthma is a constant companion”. This is not a time to forget about asthma treatment. Don’t use a family vacation or summer camp experience as an excuse to stop the preventer/control medications such as Becotide or Flixotide inhalers. The American Academy of Allergy, Asthma and Immunology urges people with asthma to take all prescribed medications during the summer, even if there are no symptoms. This is the best way to avoid a flare up. The only exception may be children under the age of five years. Parents of these children should talk to their paediatrician before stopping any asthma medications. Studies in North America and Europe have proved that taking a break from the control medications, which, by the way, used to be recommended, leads to a spike in hospital visits to emergency and admissions to hospital for asthma in the second or third week of the new school term in September.

Continue medication The control medications are safe and they may take weeks to be really effective –– it is far better to continue taking them and enjoy an asthma-free summer. Then, you can look forward to a healthy transition back to school in September with no asthma flare-ups. Many children will be lucky enough to be going to summer camps where there will be outdoor activities such as swimming, sailing, tennis and cricket; however, many children will be staying at home. These children may spend


FRESH AIR: If children are staying at home for the summer try, to get them outside every day, find some open space and throw or kick a ball, play Frisbee or just go for a walk or a run. hours watching television and playing computer games to fill the days until school starts again in September. Watching television or playing video games for two hours or more a day is now considered a risk factor for childhood asthma. Children of all ages should be encouraged to be out in the fresh air every day, and swimming is the very best exercise for children with asthma. In fact, many Olympic swimmers started swimming because they had asthma as a child. Swimming will help the small airways in the lungs to develop. We are lucky living in Bermuda, so there is no excuse. Our beaches are the

best in the world –– get your children down to the beach whenever you can –– don’t wait for Cup Match! If children are staying at home for the summer, try to get them outside every day, find some open space and throw or kick a ball, play Frisbee or just go for a walk or a run.

Summer and asthma The indoor environment is a huge problem in Bermuda for people with asthma; the temperatures are high in the summer and so is the humidity. Nowadays we have to close our windows and lock our doors while we are away from home, and this is an ideal environment for mould, dust-mites and cock-

roaches to multiply. These are all asthma triggers. As soon as you get home from work, please open windows in every room, use fans to help ventilation. If you use dual unit air conditioners, please make sure you still open windows in every room for at least 20 minutes every day. These units do not bring any fresh air into your home but simply circulate and cool the air. Remember, it’s summertime and the living is easy –– get outside in the fresh air and let’s breathe freely, Bermuda! n

FOR MORE information visit or call Open Airways 232-0264.



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How is asthma different from allergies? BY TRACY NASH, RN Director of Asthma Education, Open Airways

While both conditions may often occur together, there are also differences between allergies and asthma. An allergic reaction is caused by the body’s immune system overreacting to harmless foreign substances. These substances, which can trigger allergic reactions, are known as allergens. Some of the most common allergens are pollens from grass, trees and weeds, mould spores, animal danders from cats, dogs and horses, dust mites, insects, certain foods, in particular eggs, peanuts and shellfish, and some drugs such as penicillin. In an allergic person, the body reacts to these substances and starts to fight them as if they were invaders by producing histamine, a chemical that causes redness, itching and swelling. Depending on the body part affected, the release of histamine can trigger the allergic symptoms we are familiar with. Allergy of the nose, otherwise known as rhinitis or “hay fever”, produces sneezing, congestion and an itchy, runny nose. Allergy of the lungs affects the small airways and causes asthma with coughing, wheezing, shortness of breath and difficulty breathing. Allergies affecting the skin can cause hives, a rash with raised red areas or eczema –– an itchy, red and scaly skin. Allergy of the eyes produces itchy, red and watery eyes. Allergy in the digestive tract can cause nausea and vomiting, colic, diarrhoea, and itching or swelling of the tongue, lips or mouth. Some allergic responses can trigger a reaction throughout the whole body known as an anaphylactic reaction. This is a lifethreatening reaction that


HOUSE DUST MITES live in mattresses, pillows, carpets and soft furnishings. needs immediate treatment. An asthma attack occurs when the airways come into contact with something you are allergic to or something that irritates your airways, known as a trigger. The most common triggers are viral infections, allergens such as pollen, house dust mites, moulds and cockroaches. Approximately 80 per cent of asthmatics have allergies and also suffer from rhinitis, but asthma can also be non-allergenic.

Chronic inflammation However, unlike nasal allergies, the symptoms of asthma are due less to the release of histamine but more to the consequences of chronic inflammation caused by the allergic reaction. The chronic inflammation causes the small airways affected to become hyperresponsive or “twitchy”. These hyper-responsive airways can then react to other irritants such as cold air, inhaled chemicals, perfumes or cigarette smoke, causing asthma symptoms. Allergy to dust mites is

caused by an allergen in the mites’ droppings. House dust mites are invisible to the human eye and live in mattresses, pillows, carpets and soft furnishings. These minute particles are breathed into the nose and lungs causing rhinitis and asthma. If you wake up each morning with sneezing and a stuffy nose, chances are that you are allergic to dust mites However, diagnosis can be performed by skin prick tests or blood tests. Skin prick testing can be used to diagnose allergies. A small drop of many different common allergens is pricked into the skin; within 15 minutes a reaction to a specific allergen will show up as a red wheal, confirming allergy to that allergen. A blood test can also be performed to test for specific IgE allergies. Treatment for allergies and asthma depends on the severity and organ affected. Step one: avoidance of allergen where possible. For dust mite allergy, tackle the bedroom first. Buy a new pillow each year;

consider allergy impermeable covers for the mattress and, where possible, remove carpeting or vacuum regularly with a vacuum fitted with a hepa filter, and limit soft furnishings and cuddly toys. If you are sensitive to animal danders, remove the pet from the house or, failing that, at least from the bedroom. Step two: medical treatments. For nasal allergies, an anti-histamine or decongestant may be used. If symptoms are persistent, a prescription inhaled nasal spray may be needed. For asthma, the cornerstone of treatment is preventative. A controller inhaler may be prescribed to be taken daily. A quickrelief inhaler will also be needed to relieve asthma symptoms of tight chest, cough and wheeze. Please see your doctor for treatment advice on medications and avoidance. n

CONTACT OPEN Airways for more information 232 0264 or visit our website

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READY FOR ACTION: Team Hope on the Move and Team To Inspired to be Tired pose for a team picture before the start of the Relay for Life event held at National Stadium in May.

Relay for Life: The burden of cancer BY ROBYN BARDGETT

As the morning of May 31 loomed closer, I started to doubt how much fun walking a full two hours around a track would be. But I snapped out of it quickly when I reminded myself this wasn’t about fun. This was about showing support for those that have battled cancer, those that are battling cancer and those that have lost their brave fight. Unfortunately, I have known too many. While those who I have known that have lost their battle with cancer weighed heavily on my mind, my team was in honour of my cousin Alicia Cotti who is currently fighting her own cancer fight. My team: Team Hope on the Move, along with Team Too Inspired to Be Tired, were filled with family members and friends all determined to try and understand the burden that both survivors and their caregivers face every day by taking turns walking throughout the day and

‘Watching her take her survivors lap to big cheers from the crowd was very emotional for all of us.’ night at the National Sports Centre.

Bermuda first Across the world each year, millions of people take part in the American Cancer Society’s Relay for Life events. This year’s 24-hour charity walk, hosted by the Bermuda Cancer and Health Centre, was the first time the event had been held in Bermuda. For its first time hosting, the people of Bermuda came together and raised over $300,000; most of that money will stay in Bermuda to support the Bermuda Cancer and Health Centre. Over 100 teams signed up to form relay teams to walk around the outer track at the National Stadium’s North Field. Teams were

encouraged to decorate their tents, which were lined up around the track. There was music, entertainment and activities throughout the 24-hour event, most notably marked by the Luminaria Ceremony on the Friday evening, in which candle-filled tribute bags decorated with personal messages for those who have lost their lives to cancer lined the track.

Showing support For those on Alicia’s teams, it was a time for us to come together to show our support for a person we all deeply care about and who has touched our lives in many different ways. Watching her take her survivors lap to big cheers from the crowd was very

emotional for all of us. As all of the teams took to the track with a marching band leading the way to kick off the event, the joyous nature of the occasion was really brought home. It was an upbeat atmosphere that put cancer in the back seat for 24 hours. After the event, Alicia said to us: “Relay For Life not only brought a big smile to my face but I can honestly say it is the first time in three-and-a-half years I felt I didn’t have cancer; I felt normal” She added: “I felt loved, special and happiness all wrapped up in one. I don’t think I smiled so much in my life! “When I was doing the survivor lap, I was fighting back the tears, but when I saw all of your faces, it just brought a big smile to my face and I couldn’t help but wave just like Johnny Barnes.” We might not have cured cancer that day, but I think it was one of the most beautiful sights seeing so many people come together for one cause. n



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Recognise anxiety as a human experience excessive worry and associated agitation. n PTSD is the least common and perhaps most complicated. It is associated with the experience of a significant trauma such as war, rape or any situation where one’s life feels threatened. In the past, this was referred to as shell shock or battle fatigue. Although anxiety disorders may look very different in their presentation, treatments for these conditions are typically the same. Your doctor or psychiatrist may prescribe an anti-anxiety medication or a psychoactive drug such as Valium. However, it is important to only take these in the short-term, as they can be very addictive and can worsen anxiety in the long term.

BY DR SHAWNÉE BASDEN Clinical psychologist, Bermuda Hospitals Board

We’ve all experienced it –– a sudden feeling that your heart is pounding so much it might leap out of your chest, along with feeling hot, dizzy and nauseous. You may write it off as being stressed, as something you ate, or feeling nervous about a presentation or social event, but when this happens more than once, most people start to worry there might be something wrong –– that you may be experiencing a heart attack or having a nervous breakdown. Many people will present to the emergency room when experiencing these symptoms. Doctors will determine if you are having a heart attack. If this is ruled out, then they may determine you have experienced a panic attack.


Panic attacks Panic attacks often occur in the context of many anxiety disorders and may occur randomly, without an obvious trigger. In fact, one out of 10 people will experience a panic attack in their lifetime, and panic attacks account for more emergency room visits than any other psychiatric illness. Despite this, few people will go on to develop an actual anxiety disorder. When experiencing anxiety for the first time, it is important to assess if there may be any obvious causes, such as medications or a medical condition. For instance, caffeine found in tea or coffee, as well as some tobacco products, can cause anxiety symptoms. Additionally, some prescription and non-prescription drugs, including steroids, asthma medications and some cough/cold remedies, can cause anxiety symptoms. Anxiety may also be associated with medical conditions such as having an


ON THE EDGE: One out of 10 people will experience a panic attack in their lifetime and panic attacks account for more emergency room visits than any other psychiatric illness. overactive thyroid (hyperthyroidism) or hormonal changes associated with menopause. As a result, it is always important when you are experiencing anxiety to speak with your doctor about your concerns. A complete and full assessment will rule out any medical or medication causes of anxiety. Anxiety disorders are the most commonly occurring psychiatric conditions and include panic disorder, social phobia, generalized anxiety disorder, posttraumatic stress disorder (PTSD) and specific phobias. n Panic disorder is char-

acterized by having panic attacks that can be triggered by situations or sensations that may occur out of the blue. As a result of these attacks, an individual may learn to avoid certain situations, such as crowds, to prevent an attack from occurring.

Phobias Specific phobias involve anxiety related to triggers, such as flying, spiders or enclosed spaces. n Social phobia is characterized by feeling fearful and sometimes avoiding social situations. n Generalized anxiety disorder is characterized by

The best medications for anxiety are the same that a doctor would give for depression: a class of medications called SSRIs such as Prozac. These are taken daily and after a two-week period and can lessen the experience of anxiety considerably. Psychotherapies, especially cognitive-behavioural therapy, have been shown to be the most effective longterm treatments for anxiety disorders. This treatment often involves facing anxiety-provoking situations and altering thoughts that might act to increase feelings of anxiety. It is important to note that not all anxiety is bad for us. We’ve all experienced anxiety and in some ways it can help us to achieve more. Anxiety can save you from a speeding car by helping you to get out of the way quicker, and can help you at work by encouraging you to make the extra effort. In the end, anxiety is a human experience. It is when it becomes persistent or begins to impact your life in a significant way that it is best to seek professional help. n


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Fundraiser at Horseshoe Bay sure to draw a crowd


oppertone created an annual event hosted by the Bermuda Volleyball Association to create awareness about proper sun protection against damaging UV rays. The fundraising event sees all proceeds go towards the Bermuda Cancer and Health Centre. This year’s event will take place on Saturday, July 5, from 9am to 3pm at Horseshoe Bay. n

FUN IN THE SUN: Take a look at some of the pictures from last year’s inaugural event. n PHOTOS SUPPLIED




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What you can do to keep your mouth healthy BY ROBYN BARDGETT

You know the drill. You brush twice a day, floss (when you can remember) and rinse your mouth out. You try to do as much as you can for a healthy mouth, but here are some oral care tips from Listerine to help get a healthier mouth.

Replace your toothbrush every three or four months As soon as the bristles are frayed, is a good time to replace but every three to four months is a good guide. A worn toothbrush won’t do as good a job of cleaning your teeth.

Visit your dentist twice a year Make sure to keep up with professional cleanings and oral exams. The more you go, the healthier your mouth will be — and those visits will seem less daunting.

Rinse your mouth twice a day Rinsing your mouth on a regular basis has shown to help reduce 52 per cent more plaque and 21 per cent more gingivitis than brushing and flossing alone.

Limit between-meal snacks If you indulge, chew sugarless gum afterward. It increases saliva flow and helps wash out food and acid that causes tooth decay.


ORAL HYGIENE: Make it a goal to brush and rinse twice daily, and floss once. That extra 30 seconds of swishing will make your mouth feel clean.

Exercise regularly In addition to maintaining a healthy oral care routine, it’s important to fit in workouts and keep your body fit, as well.

Maintain a healthy oral care routine Make it a goal this week to brush and rinse twice daily, and floss once. That

extra 30 seconds of swishing will make your mouth feel clean.

Limit foods that are high in sugar If you do give in to your sweet tooth, eat sugary foods with meals. Your mouth produces more saliva during meals, which helps neutralize acid production and rinses food

particles from your mouth.

Eat a balanced diet Eat fruits, vegetables and protein and avoid sugary foods that are neither good for your teeth nor your health. n

FOR MORE information about oral care, visit www.

Good oral care necessary to avoid gum disease Gingivitis Gingivitis is a lot more common than you may think. About 50 per cent of US adults have some form of gingivitis. Gingivitis, while common, may progress to a more serious condition called periodontitis if left untreated. Periodontitis Periodontitis is a serious gum infection that can occur if gingivitis is allowed to progress. Scientific evidence suggests

that periodontitis weakens your teeth’s support system, which, in turn, can cause tooth loss. Smoking Everyone knows that smoking can cause serious health problems. Did you know that smoking is one of the leading risk factors of gum disease? That’s why your dentist and physician strongly agree with the US Surgeon General: quitting is the best thing you

can do for your mouth and your body. Diabetes Diabetes increases your chance of problems associated with gum disease. For this reason, physicians and dentists say that a good oral care routine is important for diabetics. Tell your dentist, hygienist, or physician if you have diabetes, or if you’ve been told you are at risk for diabetes. n




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