Healthier You Fall 2015

Healthier You Fall

managing chronic pain

the falls guru 6 handy numbers for seniors

2015

health apps Page 25

The childhood

obesity epidemic Why it matters

and how to prevent it Is your child overweight?

A young woman tells her story of childhood obesity Interview

Provincial Health Officer Dr. Perry Kendall on flu shots – p. 6

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Volume 1, Issue 3

coverstory

The Childhood Obesity Epidemic

Fall

2015

Obesity is likely to overtake smoking as the number one preventable public health concern. Experts say the solution lies with treating, and preventing, the condition in childhood.

12

By Jake Adrian

other stories

p.

‘Look at Me Now’ My journey from unhealthy obesity to good health and happiness.

By Sierra, as told to Jake Adrian

inside Flu shot, yes or no? �������������������������������� Page 6 Provincial Health Officer Dr. Perry Kendall talks about what went wrong with last year’s flu vaccine, challenges with landing the perfect vaccine – and why the flu shot is still your best bet.

By Shannon Henderson

Who ya gonna call? �������������������������������� Page 9 6 must-have numbers every senior needs on their fridge

By Bonnie Irving

Hannah’s Challenge ������������������������������ Page 20 How one 11-year-old Surrey student challenged Surrey Memorial Hospital staff members to commit to one positive change for health as part of Change Day BC coming October 15

By Diane Wild

• Why obesity matters • Is your child overweight?

• Prevention is the key

My Health Coach Sleep your way to a healthy weight

By Cathryn Smith

p.35

DYI Health ����������������������������������������������� Page 25 Apps to help you manage some of your chronic health concerns Compiled by Lisa Thibault The Falls Guru �������������������������������������� Page 26 Want fresh ideas about reducing injuries from falls among seniors? Ask Fraser Health’s Fabio Feldman.

By Tasleem Juma No Magic Pill ����������������������������������������� Page 30 Imagine what your life would be like if you were in pain 24 hours a day, seven days a week. One man shares his personal story of chronic pain, the effect it’s had on his life and how he’s learned to take his life back.

By Wendy Young

fall 2015

Healthier You

3

CEOmessage

Good Health, Long Lives

Healthier You Volume 1, Issue 3 – Fall 2015

This is our third issue of Healthier You. And from all reports you are finding the articles engaging and useful.

published by:

Our goal with this magazine is ‘simple’ – to promote healthy living. While our hospitals may be the first thing you think of when you hear the words ‘Fraser Health’, our role extends far beyond illness and the hospital.

By Michael Marchbank, President and CEO Fraser Health

Where can you find Healthier You?

“In doctors’ offices, walk-in clinics, pharmacies and other community settings, we will be waiting there too – keeping you company, and sharing stories and insight into health-related issues that matter to you.”

One of the biggest challenges our health care system faces is how to encourage the behaviours we know can prevent chronic disease – particularly cancer, diabetes, heart disease, chronic obstructive pulmonary disorder (COPD) and depression. One in three of us lives with one or more of these five diseases. If we could prevent them from starting in the first place, or prevent them from worsening for those already affected, we could eliminate much needless suffering. We could also save BC taxpayers many billions of dollars a year.

Fraser Health wants to promote the kind of healthy living that will reduce the incidence of these diseases. Scientists can tell us what factors contribute to the onset of these diseases – lifestyle (no exercise, alcohol use); smoking; obesity; genetics; and poor nutrition – but it will take more than just naming them to get us to change.

We use a variety of methods to talk prevention. This magazine is one of them as are our activities on Facebook and Twitter. We have built formal and informal partnerships with municipal councils, nonprofit community organizations and groups of family doctors to support and promote activities that support healthy living in our communities.

Prevention, of course, really needs to start with our children. When we reach out to moms, dads and grandparents, we hope we are encouraging them not only to modify their own behaviours, but also to set their children on the path to good health and long lives.

As always, please let our editorial team know what you liked about this issue, and what you would like to see in coming issues at feedback@fraserhealth.ca.

Connect with us: www.fraserhealth.ca

4 Healthier You

fall 2015

www.glaciermedia.ca

PUBLISHED BY FRASER HEALTH & GLACIER MEDIA

Copyright ©2015. All rights reserved. Reproduction of articles permitted with credit.

Fraser Health

Editors / Bonnie Irving, Tasleem Juma Content Advisor / Samantha Tong–Population and Public Health

Contributors / Jake Adrian, Shannon Henderson, Hannah, Cathie Heritage, Tasleem Juma, Sierra, Cathryn Smith, Lisa Thibault, Diane Wild, Wendy Young.

Glacier Media Group

Sales & Marketing Kevin Dergez Director of Special Projects kdergez@glaciermedia.ca Ellyn Schriber Newsmedia Features Manager BC eschriber@glaciermedia.ca Keshav Sharma Manager Specialty Publications ksharma@glaciermedia.ca

Creative Director / Eric Pinfold Advertisements in this magazine are coordinated by Glacier Media.

Fraser Health does not endorse products or services. Any errors, omissions or opinions found in this magazine should not be attributed to the publisher. The authors, the publisher and the collaborating organizations will not assume any responsibility for commercial loss due to business decisions made based on the information contained in this magazine. Speak with your doctor before acting on any health information contained in this magazine. No part of this publication may be reproduced or transmitted without crediting Fraser Health and Glacier Media. Printed in Canada. Please recycle.

FSC

Flu shot,

yes or no?

Provincial Health Officer Dr. Perry Kendall talks about what went wrong with last year’s flu vaccine, challenges with landing the perfect vaccine – and why the flu shot is still your best bet.

By Shannon Henderson

Finding your perfect match isn’t easy, especially if you’re a flu vaccine.

While last year’s flu vaccine was effective in protecting us against two types of flu viruses, it was rejected by the circulating H3N2 virus – the one virus that was giving us the most trouble.

In Fraser Health alone, there were nearly 60 flu outbreaks in long-term care facilities – the most since tracking began in 2007. While some of this increase was likely due to better reporting, it is also an 6 Healthier You

fall 2015

indicator that the reduced protection resulted in more at-risk people, like seniors, becoming ill with the flu.

This mismatch, along with studies that questioned the impact of getting vaccinated every year, has led some people to question the value of getting the flu shot.

As the provincial health care system gears up for the 2015-2016 flu season this fall, Healthier You connected with Provincial Health Officer Dr. Perry Kendall to get his take on what all this means to you.

Last year we kept hearing about what a bad match the vaccine was to the circulating strain of flu. How bad was the match, really?

“Flu vaccines used in BC contain three flu strains, or types – two flu A strains and one flu B strain. Last year, one of the A strains (H1N1), as well as the B strain, were a good match to circulating viruses. But the second flu A (H3N2) was not. In fact, it had the lowest vaccine effectiveness in Canada since we started measuring in 2005. While the H3N2 mismatch led to a significant number of illnesses in older people, the H1N1 and B components provided very good protection.

This year’s vaccine has been changed to match the H3N2 strain that is predicted to circulate later this year.”

How are flu vaccines determined each year? Are there opportunities to adjust the vaccine mid-season if there are indications you haven’t got a good match?

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“The most common way flu vaccines are made is by using a chicken egg-based manufacturing process. Eggs are injected with the types of flu viruses scientists at the World Health Organization (WHO) predict will be the most prevalent in the upcoming year. The eggs are incubated for several days to allow the viruses to reproduce. The virus-containing fluid is harvested from the eggs. For flu shots, the flu viruses for the vaccine are then ‘inactivated’ (killed), and the virus antigen is purified and tested. For the nasal spray vaccine, the viruses are weakened rather than killed and go through a slightly different production process.

We can help!

When given to a person, the killed or weakened viruses will stimulate an immune response without actually causing the flu. That resulting immunity is our protection from the live viruses we will encounter.

We offer a wide variety of flavours and dosage forms.

The manufacturing process takes about six months if all goes well.

Therefore, it’s not possible to adjust the vaccine in mid-season if the best guesses from WHO scientists are wrong. Additionally, flu viruses change form constantly and rapidly. Because of these factors, there is always the possibility of a poor match between the vaccine and the types of viruses that are circulating that year.”

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So, if the scientists guess wrong about which strain of H3N2 to include in this year’s vaccine, there’s nothing that can be done?

“That’s correct. The lengthy time it takes to develop a vaccine means that we cannot develop a new vaccine in that flu season. However, staying healthy, practicing hand and respiratory hygiene and staying home when ill are additional measures to help protect oneself and others against a range of viruses, including flu.”

How bad is it if you get the flu, really?

“It can be deadly for older people and can send others with underlying illnesses, like asthma, to hospital. For otherwise healthy people, it can be a miserable illness marked by severe muscle and joint aches, headaches, fatigue and a cough that can last for up to two weeks. It also forces you to miss out on winter fun like that sunny beach vacation you booked, parties, family get-togethers and the ski season.”

Have you seen an increase in the past five to 10 years in the number of people who get their flu shot? If so, what do you think is generating the increase?

“Fortunately, we have. Over the years, people have seen how serious and even deadly the flu can be, especially for older people.

Increasingly, people are more conscious of the role they play in not only protecting themselves, but also others who are vulnerable to illness.”

fall 2015

Healthier You

7

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What are the common misunderstandings that prevent people from getting the flu vaccine?

攀砀挀攀瀀琀椀漀渀愀氀 昀漀漀琀眀攀愀爀 昀漀爀 挀漀洀昀漀爀琀Ⰰ 眀愀氀欀椀渀最Ⰰ 戀甀猀椀渀攀猀猀 愀渀搀 搀爀攀猀猀⸀ 瀀爀漀昀攀猀猀椀漀渀愀氀 猀栀漀攀ⴀǻ琀琀椀渀最 挀甀猀琀漀洀 漀爀琀栀漀琀椀挀猀 漀爀琀栀漀瀀愀攀搀椀挀 昀漀漀琀眀攀愀爀 昀漀爀 搀椀愀戀攀琀攀猀Ⰰ 愀爀琀栀爀椀琀椀猀Ⰰ 戀甀渀椀漀渀猀Ⰰ 搀椀愀戀攀 愀渀搀 猀眀攀氀氀椀渀最 漀爀琀栀漀瀀愀攀搀椀挀 洀漀搀椀ǻ挀愀琀椀漀渀猀

“There are so many reasons people will give for not getting the flu shot. They range from ‘I’m healthy and don’t need it’ to ‘the flu shot will give me the flu’. The reality is that between 10-20% of the population does get the flu every year, healthy people included. As to whether the flu shot actually gives you the flu, the vaccine contains either killed virus or weakened virus. These are like paper targets your body can practice shooting at. To say that you can get the flu from the flu shot is like saying paper targets can shoot back at you. That’s impossible. Yes, your body’s practice reaction can make your arm sore for a day or two, and sometimes even cause a fever, but it’s not the flu.

Trust me, when you get the flu, you’ll know it.

Some people report that they received their flu shot and still got the flu, and there are a few reasons for this: one is that the overall vaccine effectiveness is about 60% on average, which is still very good in terms of population protection; two, is that they may have been incubating the flu at the time they got their flu shot; and three, that it wasn’t the flu they got but another respiratory bug, instead.”

Public health officials talk about how at-risk populations, like seniors or pregnant women, should get the flu shot. Do you think that gives the rest of the population that doesn’t identify itself as ‘at risk’ an excuse not to get vaccinated?

倀甀琀 礀漀甀爀 昀攀攀琀 椀渀 漀甀爀 栀愀渀搀猀⸀ ⌀㄀ 㤀ⴀ㄀㘀㔀㘀 䴀愀爀琀椀渀 䐀爀⸀Ⰰ 匀漀甀琀栀 匀甀爀爀攀礀 㘀 㐀⸀㔀㌀㠀⸀㠀㈀㜀㘀 簀 猀琀爀椀搀攀猀⸀挀愀

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“I don’t believe focusing on those most at risk has discouraged people from getting vaccinated. Rather the reverse as they get vaccinated to protect those at risk and provide what we call ‘herd’ or ‘community’ immunity. It’s that herd immunity that is so important in protecting the population as a whole from potential widespread disease.”

Recent studies from the BC Centre for Disease Control show that people who receive flu vaccines year after year can sometimes show reduced protection.

Researchers in several countries have shown similar puzzling results. What do you make of these findings?

“These studies have provided important insights into the factors influencing flu vaccine protection. To date, these studies overall have shown that people who receive the flu vaccine are better protected against seasonal flu than those who are not vaccinated. But among those who are vaccinated each year, the amount of protection may be reduced over time. The reasons for this require better understanding.

None of the effectiveness studies to date have shown that receiving the flu vaccine increases the risk of serious flu illness. Since these studies show that vaccinated people are better off than unvaccinated people, it is important that people continue to get their annual flu vaccine.”

Is there a better solution on the horizon as to how flu vaccines are determined?

“Research is ongoing for a better, longer-lasting, flu vaccine. A vaccine that covers off all flu strains would be good, so then we wouldn’t be worried about changes in the viruses and matching vaccine to circulating strains.”

Given everything we know about flu and vaccines, what’s your best advice for people?

“Exercise, eat healthy, don’t smoke, get enough sleep, wash your hands frequently, stay home if you are sick and GET YOUR FLU SHOT.” o find out where you can get your flu T shot, visit fraserhealth.ca/flushot

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8 Healthier You

fall 2015

Who ya gonna call?

6 must-have numbers every senior needs on their fridge

By Bonnie Irving

Last September 80-year-old Marjorie had a stroke, which left her with some speech impairment as well as partial paralysis of her left leg and numbness in her left arm.

Her daughter Sara wondered if Marjorie would need to move to a nursing home where she could get ‘round-the-clock nursing care. But Marjorie insisted she wanted to go home to her cat, Molly, and their Langley home. Her care team knew she would need a lot of help but they believed Marjorie would be okay as long as she could access the services she needed in the community while she recovered.

They figured Marjorie would be fine on her own with just these six numbers:

health information

8-1-1

1

#

HealthLink BC – healthlinkbc.ca Call if you’re feeling unwell or have a minor injury and are unsure about what to do. Or if you just have a health question or need advice about a health issue. Here’s what you get with this free service any time of the day or night: • Health advice from a nurse • Nutrition information from a dietitian • Advice about drugs and pills from a pharmacist • Where to find health services in your community • Translation services

Personal health

2

#

04-xxxx YOUR DOCTOR 6 r if you have him or he health expert. Call Your doctor is your seen to soon. If be to u think needs yo n n er nc co nt ge an ur ay be a good optio , a walk-in clinic m e. you don’t have a GP st on handy for the close so have a number

home health

1-855-412-2121

3

#

Fraser Health’s Home Health Service Line Call this number to find out whether you qualify for home support for personal care, home care nursing, palliative care, day programs for adults or respite services for caregivers.

• Trained phone staff will identify your needs and refer you to the services you need • Open 7 days/week, 8:30-4:30 • Confidential, translation services • Seniors will pay a fee for some services, based on their income. Services of health care professionals are free.

fall 2015

Healthier You

9

Who ya gonna call?

Community Services

2-1-1

5

#

bc211.ca

home help

604-268-1312

Call this number if you need a service and aren’t sure what it’s called or where to find it.

Here’s what you get with this free service: • One call connects you to an information and referral specialist with numbers for all community, social and government services including Fraser Health’s Public Health offices • Available 24 hours/day, 7 days/week • Confidential, multilingual • Services for Fraser Valley, Metro Vancouver and Squamish-Lillooet Regional Districts, Sunshine Coast

4

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Better at Home – betterathome.ca

Call this number to get help with home tasks like housekeeping and transportation to appointments.

Here’s what you might get with this service: • Friendly visiting, Transportation to appointments, Light yard work, Minor home repairs, Snow shoveling, Light housekeeping, Grocery shopping (Services vary by community) • Seniors pay a fee for some services, based on their income. Some services may be free.

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fall 2015

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O be The Childhood

sity Epidemic

By Jake Adrian

12 Healthier You

fall 2015

specialfeature

Obesity is likely to overtake smoking as the number one preventable public health concern.

Experts say the solution lies with treating, and preventing, the condition in childhood.

Canada, like many nations, is in the midst of an epidemic of obesity and excess weight. And according to the Childhood Obesity Foundation in Vancouver, children’s eating and exercise habits are a big part of the problem.

According to the 2009-2011 Canadian Health Measures Survey, close to one-third (31.5) of children between five and 17, an estimated 1.6 million, were overweight or obese. Only a few years earlier, a similar survey showed that ‘only’ about one-quarter of children between two and 17 were overweight or obese. The upward trend is worrisome.

Why does it matter?

Because being overweight or obese is dangerous for a child’s health.

Recent societal trends have encouraged unhealthy eating and inactive lifestyles which result in excess fat accumulation.

Obese children are more likely to develop a range of health problems, including Type 2 Diabetes, heart disease, liver disease, bone and joint problems to name only a few of the potential physical problems. As well, emotional problems include low self-esteem and negative body image, depression and the emotional fallout from feeling judged and being teased and bullied.

Most adolescents do not outgrow this problem and, in fact, many continue to gain excess weight. As a result of obesity, says the foundation, it is possible that for the first time in history our children may have a shorter lifespan than their parents.

In addition to the toll being overweight and obese can take on an individual – including dying up to three to seven years earlier than counterparts with a healthy weight – there are also financial costs to society. In 2013, the total in health care costs caused by obesity to Canadians was $23 billion.

This is 25% higher than costs caused by tobacco smoking ($23.3 vs. $18.7 billion). From 1998 to 2008 the costs associated with smoking decreased while the costs of excess weight increased. According to the Canadian Journal of Public Health, the economic burden attributable to smoking decreased to $18.4 billion from $21.3 billion (-13.4%). On the other hand, the economic burden attributable to excess weight and physical inactivity increased to $21.3 billion from $19 billion (11.7%) and to $10.6 billion from $10 billion (6.3%) respectively.

Obesity is difficult to reverse. But it can be done. Healthier You asked one young woman to share her journey from obesity to health.

Continued on next page >

fall 2015

Healthier You

13

Look at me

Now! My journey from unhealthy obesity to good health and happiness

By Sierra as told to Jake Adrian Photos Jerald Walliser

My name is Sierra and I’m 15 years old.

I’ve been overweight for most of my life.

I can’t remember not being overweight. I was chubby as a child and just gained more and more weight as I got older. Because of my weight, I was always being bullied and made fun of at school. This started when I was in kindergarten and went on all through elementary school. In the younger grades kids would say things like ‘You’re fat’ or ‘People fat like you are dumb.’ They drew pictures of me as a large round circle with

14 Healthier You

fall 2015

I would tell other kids who are struggling with weight issues, ‘You aren’t alone. There are people and places you can go to for help. And it’s okay to ask for help.’

a tiny head. Kids pushed me down in the playground and laughed at me. I also have dyslexia, a learning disability, so kids teased me about that too. These were kids in my class and I thought they were my friends.

Then my mom would tell me ‘No, they’re not your friends – they’re treating you badly. You just haven’t realized it.’ I guess the teasing had become normal to me. I grew up with it and didn’t know any different, but I didn’t like it at all.

When I got older, kids were less physical, but bugged me more with name calling and swearing. My parents talked to my teachers several times. They didn’t see the bullying though and didn’t seem to know anything about it. They would often write it off saying ‘Kids will be kids.’ Some teachers were helpful and tried moving me away from the problem kids. That just made them pick on me more. Kids would go out of their way to tease me.

Just going to school made me feel sick to my stomach. Every day I felt like throwing up because of how nervous I was. I didn’t feel safe at school at all. I’d come home and cry. It made me really sad so I’d just stay in my room eating and watching television to feel better.

To try to help, my parents had me change schools.

One school had a special education program I was asked to participate in, but that just led to more teasing. It’s like when someone has a flaw or is obviously different in some way we’re automatically picked on and laughed at. After two years, I changed schools again. I went to three different schools in six years, never lasting more than two years at one school because the name calling followed me and happened again and again at the different schools. But every day I showed up and faked a smile pretending that everything was A-okay.

My eating habits were terrible. I only wanted to eat lasagna, chips and iced cappuccinos. These were foods that made me feel good. I didn’t like vegetables or anything green. My parents tried to get me to eat better, but I didn’t want to listen to them. I was picky and moody.

By the time I was 12, I was really large – way over the 97th percentile for my age, weight and height. I was gaining more and more weight and just couldn’t stop eating. I didn’t like the way I looked at all. I wished I

fall 2015

Healthier You

15

could just cut off my stomach to make it flat. I wanted to get rid of the weight so bad I started skipping meals. Then I’d be so hungry I’d break down and eat a bag of chips.

After a checkup at my pediatrician’s office she told me my cholesterol and fasting insulin levels were really high, which could lead to heart disease and Type 2 Diabetes, and recommended I enter the Shapedown BC Program at Langley Memorial Hospital.

“When I see a picture of myself from before, I’m glad I got help and am not like that anymore.

I wasn’t happy. I want to be healthy and stay this way.”

At first I didn’t want to go. I thought it was going to be a lot of work like school and didn’t want that. The hardest part was admitting to myself that I needed it – that I needed help. My parents didn’t give me a choice.

They said I needed to give it a try.

Why obesity matters Obese children are more likely to develop a range of health problems, including: Physical: • Type 2 Diabetes • high blood pressure and elevated blood cholesterol • heart disease • liver disease • bone and joint problems • respiratory problems and sleep disorders such as difficulty breathing while asleep (sleep apnea) • earlier than normal puberty or menstruation • eating disorders such as anorexia or bulimia • skin infections due to moisture from sweat being trapped in skin folds • fatigue Emotional: • low self-esteem and negative body image • depression • feeling judged • being teased or bullied • bullying others • being more socially isolated • poorer social skills • high stress and anxiety • behaviour and/or learning problems as a result of psychological difficulties related to childhood obesity

16 Healthier You

fall 2015

“I didn’t feel safe at school at all. I’d come home and cry. It made me really sad so I’d just stay in my room eating and watching television to feel better.”

– Sierra

The first few times were really hard. Then I got to know other kids like me struggling with their weight and I started to feel more comfortable. My parents and I attended group twice weekly. We went once a week together for classes and then once on the weekend for family fitness. During the week, they would be with the other parents learning things like how to plan healthy meals, how to read food labelling and trying different healthy recipes like quinoa salads.

I went with the other kids and learned things like how much food is in a single serving or that a meat serving should be the size of your palm. I didn’t need to eat everything on my plate if I was full. I learned to tell the difference between ‘heart hunger’ – eating when you’re sad – and ‘stomach hunger’ – when you’re actually physically hungry.

Now when I eat I chew slowly and take breaks in between bites of food. When I get hungry I can check in with myself and ask if I am really hungry. I’ll wait and see if my stomach is growling, then I’ll know I am.

I want to keep my weight off so I’ve learned to like fruits and vegetables and eat them a lot more.

Continued on page 18 >

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“The best thing of all is that now when I smile – it isn’t faked anymore.”

Continued from page 16 >

We got a six-month membership to the Tong Louie YMCA as part of the program. On Saturdays we’d meet with the other kids and a fitness coach and go swim, play soccer or other games where we were exercising, but it was made fun. I was too young at first to use the weight machines – the stationary bikes, weights and elliptical machines – but learned to use them later once I was old enough.

I also learned to set realistic exercise goals. The first time I set an exercise goal it was to take four long walks in a week. I walked so much that I got really tired and didn’t want to do it anymore. Now I know how to be realistic. I watch TV less and spend more time taking my dogs for walks or even going walking with my friends. I work out twice a week and do sit-ups, pushups and the plank.

Another thing that really helped me was in one of the classes they showed us how women in magazine pictures are made to look perfect; how they’ve had so much editing and airbrushing done to make them look that way.

Learning these things helped me to start feeling better about myself. I was starting to lose weight and because I saw a result my confidence grew too. I thought, ‘This program isn’t so bad – I can lose more weight.’

When I finished the program I was invited to come back. Because I was losing weight, I wanted to continue and ended up taking the program three times. Now I’m at a healthy weight. The bullying has stopped. I have more friends and I feel a lot better about myself.

My family used to eat a lot of packaged food or takeout because we were so busy and we thought it was quick and easy. Now we make our own pizzas rather than takeout and we eat a lot more salads.

I’d like to tell people who used to tease me – look at me now. Bullying people because they may be overweight really hurts, even if you’re just joking – it doesn’t feel that way. I would tell other kids who are struggling with weight issues, ‘You aren’t alone. There are people and places you can go to for help. And it’s okay to ask for help.’

When I see a picture of myself from before, I’m glad I got help and am not like that anymore. I wasn’t happy. I want to be healthy and stay this way.

The best thing of all is that now when I smile – it isn’t faked anymore.”

Is your child overweight?

The Childhood Obesity Foundation defines a healthy weight as a body composition that positively contributes to an individual’s overall health, well-being and quality of life over their lifespan. Healthy weights in children vary by age, sex and height. It is important to remember that weight is only one marker of health and a healthy weight is different for each individual child.

The Body Mass Index (BMI) is one tool doctors use to assess if a child is overweight. It is defined as a person’s weight in kilograms divided by the square of his height in metres. According to the World Health Organization (WHO) after BMI is calculated for children and teens, it is expressed as a percentile which can be obtained from either a graph or a percentile calculator at the link here: dietitians.ca/your-health/assess-yourself/assessyour-bmi/bmi-children.aspx Overweight: 85th to less than the 97th percentile Obese: Equal to or greater than the 97th percentile If you are concerned that your child is above a healthy weight, visit your family doctor for an assessment.

18 Healthier You

fall 2015

Prevention is the key Maintaining good health throughout one’s life begins in childhood. Learning proper eating and exercise habits needs to start early to prevent unhealthy weight gain or disease.

Canada’s Food Guide suggests eating well and being active every day. Help your child develop healthy eating and exercise habits with: • Plenty of vegetables, fruits and whole-grain products • Low-fat or non-fat milk or dairy products • Lean meats, poultry, fish, lentils and beans for protein • Reasonably-sized portions • Lots of water • Less sugar and saturated fat • Brisk walking • Playing tag • Jumping rope • Riding a bike • Playing soccer • Swimming • Dancing Source: cdc.gov/healthyweight/children/

Live 5210 – live5210.ca Maintaining good health throughout one’s life begins in childhood. A great rule of thumb is the 5-2-1-0 rule:

5 or more veggies and fruit per day 2 no more than two hours of screen time a day

1 hour of physical activity or more per day

0 no sugar drinks Source: Childhood Obesity Foundation childhoodobesityfoundation.ca/scope/

For more info on tips for healthy eating and exercise: • dietitians.ca • healthyfamiliesbc.ca • participaction.com • physicalactivityline.com • healthycanadians.gc.ca/eating-nutrition • healthlinkbc.ca/healthyeating • Shapedown BC childhoodobesityfoundation.ca

fall 2015

Healthier You

19

Hannah’s

Challenge

By Diane Wild

When Fraser Health’s quality improvement consultant Catherine O’Donnell came home from work last May, she told her daughter Hannah about a new project she’d taken on: encouraging Fraser Health employees to commit to a positive change for health, for October’s Change Day BC. She knew where she’d like to start and was excited to share her enthusiasm.

Turns out, she got off to a massive start through that chat with Hannah.

“I decided right away I wanted to pledge to promote the day and get 100 pledges,” says the 11-year-old Surrey student.

Inspired by a movement that started in England, Change Day BC encourages people who work in health or social care to commit to an act of change that will improve care for patients or the system they work in. It also encourages members of the community to commit to a change that would improve their health.

How one 11-yearold challenged Surrey Memorial Hospital staff members to commit to one positive change for health as part of Change Day BC 20 Healthier You

fall 2015

Hannah’s first convert on the way to blowing that goal out of the water was her friend Christina, who pledged to talk to her grandparents in Chinese about pledging to make a change for better health. Both girls walked around their cul de sac to get more pledges, and Hannah made posters for her neighbourhood. She also met with her principal and vice principal at Woodland Park Elementary, both of whom embraced the idea.

The two friends’ goal was to get everyone in their school to make pledges related to healthy living. But Hannah didn’t stop there. After an email exchange with Surrey Memorial Hospital’s executive director Cathie Heritage, she challenged the hospital to match her school’s pledges. above

Three change-makers: Pals Chanteya and Hannah team up with Fraser Health’s Catherine O’Donnell.

I pledge to.

Hannah: I would be more than happy to challenge your staff to try and get more pledges than me. The thing is they’re going to have to keep up – I’m on a roll! If your staff have more pledges than me, I’ll hand out a $25 gift voucher from my birthday money (which is a lot of money for a fifth grader), and I’ve convinced my mom to give a $50 gift voucher as well. She says that’s a lot of money for a Scottish person.

Cathie: I accept your challenge on behalf of Surrey Memorial Hospital. If you win I will personally contribute $250 to your school for a healthy living project. What do you think? I would also be happy to speak to your principal if you want. Maybe I could come to your school and meet with you both. I think it might be exciting to bring you and a few of your classmates on a tour of Surrey Memorial Hospital. We could take some pictures and you could take them back to a school assembly.

I think it is really important that the community understands how important healthy living is. We need your help to keep our community fit, healthy and happy!

Hannah: I love your offer and I bet my school will too. Now we are extra motivated to make this pledge happen. I just feel sad about taking that $250 away from you.

With a goal of 5,000 pledges across the province, Hannah and Cathie teamed up to rally their entire community to commit to a change. The challenge went beyond the school and hospital as Hannah and one of her classmates, Chanteya, presented their plan to the senior leadership of Fraser Health to spur each community in the region to try to get more pledges than Surrey.

I pledge to.

Hannah alone racked up over 300 pledges from her circles within a month of starting her efforts, making her one of the top 10 contributors to Change Day BC amid a field that includes large health care organizations.

Cathie: We want this challenge to extend beyond our hospital’s doors because we recognize the importance of prevention, and staying healthy.

Much of Fraser Health’s work is about trying to keep people out of the hospital and getting the support they need in their communities instead.

Hannah:

I pledge to... ... s mile at everyone I passing in hallways

meet

30 minutes ... r un twice a week for s and donate ... c lean out my closet to those in need

alk on my lunch break ... w live in the e more like my pup: ... b nt mome ..

I pledgehto. good and ... c atc people doing mediately m acknowledge the im

Surrey Memorial Hospital pledges

It’s everyone’s chance to fix something in their lives and in the health care system. For example, like wearing a helmet, making healthy food choices and exercising daily. I want people’s health to be better. You can’t stop accidents, but you can prevent lots of them.

Cathie: Just start doing it! It doesn’t need to be complicated, and it shouldn’t be. It can be something simple about your own health.

Sometimes we create unrealistic expectations of ourselves. Even small changes can make a huge difference. Maybe it’s packing your lunch, or taking 15 minutes a day to just rest and relax.

Hannah: People can make changes for themselves or for a better

I pledge to...

system.

... w ear my helmet when riding my bike ... walk to school or ride my bike ... w alk 3 times a w eek for 20-30 minutes ... recycle to save the environment ... eat more fruits and veggies u

se int er ne I pl... t edge to... only when my parents can mon itor

Woodland Park Elementary pled ge

s

Cathie: I was a nurse but it has been a long time since I cared directly for patients. About eight months ago, I spent an entire day on a hospital ward to better understand the challenges our frontline staff, like nurses and doctors, face today, especially at the patient’s bedside. It was really a positive learning experience for me.

Cathie calls Hannah an “amazing young woman,” saying she and her mother Catherine are equally inspiring.

Change Day BC is October 15, too late for the results of the Hannah-Cathie competition to be reported in this issue of the magazine. But we’re betting that win or lose both competitors will feel like winners.

Says Cathie Heritage: “Any opportunity for Surrey Memorial Hospital to engage with our community is great. Children have so much influence with mom and dad and the choices the family makes.

It’s very powerful to have kids involved, making active choices about their own health.”

Hannah herself makes the inspiring – and challenging -- case for change: “If you make a pledge for healthier living, you can make the world a better place. More importantly, you don’t want to be beaten by an 11-year-old.”

“Any opportunity for Surrey Memorial Hospital to engage with our community is great... It’s very powerful to have kids involved, making active choices about their own health.”

– Cathie Heritage, Executive Director fall 2015

Healthier You

21

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Good for your brain.

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• Salmon is high in Omega-3s, which helps prevent heart disease and stroke – two of the leading causes of death in Canada.

• 80% of premature heart disease and stroke is preventable.

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Creating Healthy Delicious Dishes

Salmon is one of nature’s superfoods Maple Chipotle Salmon Recipe (Yield: 4 servings) As the Chef for the B.C. Agriculture in the Classroom Foundation and the Chef Instructor at Maple Ridge Secondary School, I am committed to creating delicious, healthy dishes that not only celebrate B.C.’s agriculture, but are also very easy to prepare. The Cedar Planked Maple-Chipotle Salmon is no exception. By rounding off the sweetness and the heat with a splash of fresh lime juice, this twist on a B.C. classic is sure to be a hit at your next dinner party or weekday family dinner. When choosing to cook with B.C. products, you are setting your meal up for success – not only will those fresh ingredients make the dish come alive, but you are also supporting local farmers at the same time. Give this a try and let us know how you enjoyed Taking a Bite of B.C. Take a Bite of BC was developed by BC Agriculture in the Classroom Foundation in partnership with the BC Culinary Arts Association, BC agricultural commodity groups and BC producers. The program started in 2009 with 14 schools participating. Take a Bite of BC is now in 30 schools in the Fraser Valley and Okanagan. For more information on AITC, their programs and recipes, please visit www.aitc.ca/bc.

Culinary creation by Chef Trevor Randle.

For the brine: • 2 L Cold Water • 125 ml Kosher Salt • 125 ml Brown Sugar • 4 – 8 oz Salmon Filets or 1 – 32oz Salmon Side

For the glaze: • 15 ml Chopped Chipotle in Adobe Sauce • 30 ml Fresh Lime Juice • 45 ml Maple Syrup • Salt and Pepper to taste • 4 Small or 1 Large Cedar Plank

Directions 1) Combine brine ingredients in a casserole dish.

2) Submerge salmon in the brine and refrigerate 30 – 45 minutes.

3) While salmon is soaking, combine all glaze ingredients.

4) Just before you are ready to start cooking, place cedar planks over direct heat to heat them up.

5) Remove salmon from the brine, pat dry and place on heated cedar planks.

6) Place salmon on the grill using indirect heat.

7) Glaze with half of the chipotle maple mixture, close lid and cook at 400F for 5 minutes.

8) Open the lid, glaze again and cook another 5 minutes.

Continue to cook until desired oneness is reached.

9) Serve with our Brussel sprout and cranberry slaw and roasted B.C. Potatoes.

Note: Brining your salmon will not only help it taste better, but it will also assist with avoiding the unattractive, white albumin from seeping out.

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DYIhealth BC Health Service Locator App

Apps to help you manage some of your chronic health concerns

healthlinkbc.ca If, despite your best efforts to keep healthy, you need medical help, here’s a good local app. It helps you find walk-in clinics, hospitals, emergency rooms, immunization locations, afterhours pharmacies, and laboratory services near you. You can search for health services by city or keyword. You can also call 8-1-1 and view the latest health alerts.

Compiled by Lisa Thibault

WebMD Pain Coach

WebMD Allergy

Pain Coach™ tracks symptoms and goals in order to help you better manage your chronic pain condition. This highly personalized app allows you to select the symptoms, treatments and goals you wish to track for your particular experience with chronic pain. Over time you will be able to review patterns that help you understand your pain triggers and set goals and lifestyle choices you can share with your family doctor.

After you enter the allergies you have, the WebMD Allergy app for iPhone and Android will help you manage each day with a personalized allergy and weather forecast for your location. The app also includes a library of tips that can be customized for your allergy. You can track how you feel each day, your symptoms, and treatments to track your allergies and any potential triggers – info you can share with your doctor.

The app includes:

The app includes:

• A journal to easily record how you feel each day, your pain experience, symptoms, triggers, treatments and notes

• Allergy forecast with up-to-date allergen levels based on your location. You can also look up data for other communities if you are travelling

• Tool to help you select goals from five categories related to your pain conditions

• Seasonal allergy map

• Library and tips to help you manage your chronic pain

• Symptom tracker

MyMedRec Developed with input from several Canadian health care associations, this is a fantastic little app that lets you track your health care record so you can share it with your health care provider, pharmacist or family whenever you need to.

The app lets you track medications, allergies, blood pressure, immunizations and other information for you and members of your family.

Track the following in MyMedRec: • Medications and natural products, immunizations, blood pressure, cholesterol, allergies, health care providers, notes Other features: • Dose reminders for medications. Multiple profiles to keep track of family members. Add entries to your calendar for medication refills, appointments and immunizations. Email parts of your record to your health provider.

• Library and tips to help you manage your allergies

The Canadian Red Cross First Aid App

The Canadian Red Cross First Aid app provides lifesaving first aid information in the palm of your hand. It includes information on preparing for emergency situations and quizzes to test your knowledge. Great resource if you’ve ever wondered what to do when faced with a medical emergency.

fall 2015

Healthier You

25

The Falls

Guru Want fresh ideas about reducing injuries from falls among seniors? Ask Fraser Health’s Fabio Feldman.

By Tasleem Juma

Fabio Feldman, manager of Fraser Health’s seniors’ falls and injury prevention program, never thought he would turn out to be so passionate about falls. But his love for translating research into practical applications naturally led him into a field in which he was eventually able to turn all conventional wisdom about seniors’ falls on its head.

Falls among seniors over 65 are, unfortunately, common, with one in three falling at least once a year. This rate goes up to one in two for those over 80.

Falls cost the Canadian health care system over $1 billion a year – money that could be diverted to other pressing needs.

When Feldman first got involved in the field of injury prevention, it was ripe for change and ready for people like him who were hungry to ask their own questions and find their own answers. After arriving in Canada from Brazil, where he was a professional football player, in 1996 Feldman attended Simon Fraser University (SFU) to study kinesiology, eventually completing his master’s and a PhD. As a young researcher at SFU, Feldman was part of a team that challenged and ultimately dislodged much of the accepted wisdom about falls and injury prevention. He has been putting that research into action over the last 10 years, ultimately improving the quality of life of seniors and saving millions in our health care system.

For Feldman, it means constantly questioning the validity of other people’s work and putting their conclusions to the test. He worked closely in those early days with his revered mentor and PhD supervisor, Dr. Stephen Robinovitch, then the Canada Research Chair in Injury Prevention and Mobility Biomechanics. After Feldman was hired by Fraser Health, the two developed a strong partnership that has greatly improved Fraser Health and SFU’s research

26 Healthier You

fall 2015

capacity, netting them both over $5 million in grants from the Canadian Institute for Health Research and other agencies.

“What really attracted me to seniors and falls and injury prevention is that it’s such a big problem – it’s costly and there are personal issues, pain and suffering, and there’s so much being done, yet we know so little about the problem,” says Feldman.

Why they fall Major predictors of falls injuries: dizziness, hypotension, balance, gait disturbances, syncope, confusion, frequent urination, use of assistive devices, dementia or cognitive impairment, increased gait and mobility impairment, staffing and environmental issues.

From the beginning of his graduate studies, Feldman focused his work on injury prevention as opposed to falls prevention. His collaboration with fellow researchers has led him to pursue several theories aimed at reducing injuries, including stickon hip protectors and bouncy floors.

while providing equal, if not better, protection than traditional hip protectors that are currently available.

Prototypes have been developed for a clinical trial, beginning with a pilot project at Surrey Memorial Hospital, to make sure people are comfortable using the stick-ons, that the tape is effective, and that it is resistant to wear and tear.

As an adjunct professor in the department of biomedical physiology and kinesiology at SFU and the manager of injury prevention at Fraser Health, Feldman is ideally positioned to combine research with cuttingedge technology.

For the bounce of it Feldman and his team at SFU have also discovered a unique energy-absorbing floor produced by Satech Inc. in Washington state. The flooring cushions falls and prevents injuries when installed in indoor areas.

Stick it to it!

Feldman has come to see the many benefits of hip protectors through his research over the past seven years. But he has also seen how the design of today’s hip protectors presents a real barrier to their use by some.

Photo: Jerald Walliser

“What attracted me to seniors and falls and injury prevention

Testing revealed that the ‘bouncy’ floor could reduce 40% of the impact force to the hip and 70% to the head – enough to dramatically reduce injuries due to falls.

Feldman has been known to demonstrate the floor’s injury-prevention qualities by repeatedly dropping an egg on it

Traditional hip is that it’s such a big problem – it’s costly and there are protectors are special personal issues, pain and suffering, yet we know so little garments (underwear, about the problem.” – Fabio Feldman shorts or pants) containing soft pads inserted into pockets without breaking it. covering the hip area. The underwear-style model poses The special flooring is currently being evaluated in a many challenges in hospitals: it needs to be laundered large clinical trial led by Feldman and Dawn Mackey, an often to reduce the spread of germs; many different sizes assistant professor at SFU. The researchers hypothesized are necessary; and they are difficult to use on seniors that the flooring should reduce fractures and head with mobility issues, especially when they need to use the injuries by at least 50%. Results from the trial, expected washroom. in 2017, may change the way residential care facilities are Through collaboration with colleagues from SFU, designed to prevent injuries due to falls.

Feldman has developed a disposable stick-on hip Taking the show on the road protector that capitalizes on a special tape developed by 3M that can be reused several times. Unlike its garment Feldman has also led the establishment of Fraser Health’s counterpart, once it’s placed directly on the skin covering falls prevention mobile clinic. The clinic’s model was the hip, the stick-on pad doesn’t move until removed. And developed to improve access to risk screening, assessment it can be reused over and over again – cutting down costs tools and interventions for seniors by bringing experts

fall 2015

Healthier You

27

from various fields together to help prevent falls and fall-related injuries. This is the first of its kind in the world.

The most unique feature of this clinic is that it goes to seniors rather than vice versa. It takes falls assessment and interventions to community locations where seniors typically meet, like recreation centres and seniors’ centres. It also operates at a relatively low cost due to contributions from community, government and private partners. Each session of the clinic provides services to a large number of seniors and can be adapted to different ethnic groups.

Similar clinics are now being offered across Canada.

Staying Upright 4 key things that can prevent falls: • Have a doctor or pharmacist review your medications • Make your home safer • Start a regular exercise program to improve balance and strength • Have your vision checked at least once a year

The clinics have proven to be so successful that the BC Ministry of Health recently awarded Feldman and his team $400,000 through the Centre for Hip Health and Mobility to increase the availability of Fraser Health’s falls clinics and to support other BC health authorities to implement the same model in their regions.

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New Directions Feldman’s research success has led to new opportunities to improve seniors’ health. He has started to focus on dementia and delirium in seniors and is leading a research project at Royal Columbian Hospital to examine whether exposure to a digital skylight above a patient’s bed in the emergency room reduces the incidence of severe confusion or delirium.

He and his team have also developed the Safety Superheroes Program (safetysuperheroes.com) that promotes an intergenerational approach to fall prevention. Launched in 2010, the program includes a picture book, Safety Superheroes: Preventing Grandparents from Falling and related print activities to help children ages five to 10 and their families learn ways to prevent falls at home. This is the first and only children’s book in the world to address this issue and it is now being utilized in over 30 communities across North America.

In spite of all the attention and focus Feldman receives, he is quick to stress the cooperative nature of his work and credits his team for their support. The quintessential team player, Feldman will continue to lead Fraser Health in new, innovative directions in the pursuit of preventing falls and injuries for some of the most vulnerable members of our communities.

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28 Healthier You

“The beauty of these clinics is that they are a cost-effective way to provide falls and injury prevention to the community through partnerships with community organizations and other health care professionals. The model can even be used to address chronic diseases,” says Feldman.

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no magic

Pill

Imagine what your life would be like if you were in pain 24 hours a day, seven days a week. One man shares his personal story of chronic pain, the effect it’s had on his life and how he’s learned to take his life back.

By Wendy Young

With his skates, pads and large sports bag over his shoulder, 13-year-old Justin rushed out of the house, slamming the door behind him. His mother was waiting in the car to take him to his weekly early-morning hockey practice.

Justin had been playing hockey since he was five and was the goaltender on his AAA rep-level team. He had hopes of playing for a college league and eventually maybe even the NHL.

column are fused together. The most common signs are a short neck and restricted mobility of the upper spine.

Countless questions and concerns raced through Justin’s mother’s mind. ‘What does this mean? How will this impact his life?’ A very uncommon condition, the doctor didn’t have a lot of information to offer except that it was a degenerative condition with no cure. Justin and his mother left with more questions than answers.

That dream was shattered one day during a physical education class at school when he suffered a minor neck injury, which led to the discovery of a very rare disorder that forced him to stop playing all sports, including his beloved hockey.

Shortly after his return home in 2006, Justin’s neck pain got progressively worse and the medications were losing their effectiveness. Then one day, after a long day at work managing a hydroponic store, he suffered extreme neck pain to the point where he could no longer move. An MRI and CT scan both confirmed that his condition was deteriorating.

The diagnosis: Klippel-Feil syndrome – a congenital deformity – in which two or more bones of the spinal

30 Healthier You

fall 2015

Over the years, Justin managed the resulting headaches and stiff necks with Tylenol #3® and ibuprofen. He enrolled in horticulture science at Kwantlen Polytechnic University while managing a garden supply store. Then, while developing his green thumb, Justin developed cabin fever and cured it with a bite from the travel bug. Over the next three years, he took breaks in between his studies to travel to Australia and Asia.

The long slide into despair His doctor advised him to stop all physical activity, including his work. That day, when he was only 26 years old, marked the start of a downward spiral of suffering that would eventually rob Justin of his work, school, friends, independence and enjoyment of life.

Despite the lack of activity and the stronger prescription pain medication, every day was a gamble. Justin would not know whether he would make it through the day or if his pain would return and derail his plans. Ultimately, he had to drop out of university due to the pain and the medication which affected his memory and left his mind in a constant fog.

Justin’s pain had overwhelmed him. Isolated in his room and confined to his bed, he spent his days mindlessly watching television programs and movies, and playing video games. He was forced to stop driving because he would lose sensation in his hands and legs. And he was unable to participate in regular social activities. Justin developed severe chronic depression, relying on prescribed narcotics and medical marijuana to numb the pain and escape the reality of his life. It seemed pointless. “I’d often cross the street and not bother to look for oncoming traffic,” he admits.

But there was hope.

In 2008, Justin’s mom who was a former nurse introduced him to Ruth Ringland, a nurse practitioner at Surrey Memorial Hospital with advanced education in pain management.

Ringland could see that pain had become part of every aspect of Justin’s life. He had lost his job, had no income and was socially isolated. The resulting emotional roller coaster made his underlying problem worse. Justin had become another patient struggling to deal with chronic pain which was devastating his life.

What is chronic pain?

Persistent chronic pain is not a symptom, but rather a disease that is quite different from acute pain, for example after surgery or as a result of an accident. But left untreated, the neurological processes that transmit acute pain messages to the brain create ingrained pathways and actually result in physiological changes to cells. Like a scratched music CD gets stuck playing the same few sounds over and over again, nerve endings fire the pain message endlessly. Ruth Ringland gives the insidious example of phantom limb pain, where pain seems to emanate from an appendage that no longer exists.

Medication and interventions can help some people but they are usually not the only answer to managing pain.

Medications are often initially effective but the effectiveness often wears off over time, especially with opioids such as morphine.

There are a host of factors that are interacting in patients with chronic pain. It’s not just about skin, bones and tissues.

Anxiety, depression, neurotransmitters and the immune system all affect the way nerve signals are transmitted, and it’s a very individual thing.

The goal of chronic pain management is not to cure it; it’s about improving the person’s quality of life. How much an individual suffers from their pain is not always related to

how severe the pain is. It’s not that severe pain does not cause suffering. It does. But an individual may be suffering because the pain has affected all aspects of their life – psychological, physical, social, financial and spiritual. Managing pain is about shifting the mind to re-define those aspects and find options to cope with the change.

Pain experts say that there are skills and behaviours that can help chronic pain sufferers live well with their condition.

They refer to this ability to influence their pain as ‘selfmanagement’. It doesn’t replace physical therapies, medication and psychological support, but it’s a big part of feeling better. To start controlling the effect of the pain first requires acceptance from the sufferer that they have the power to effect a change.

When nurse practitioner Ruth Ringland met Justin, she Justin and the team who helped him get herself had his life back: (l to r) Dr. David Twist, wanted to better Ruth Ringland, Julie Carlson. understand how to help patients like him manage their own pain when other avenues failed. She enrolled in a self-management pain workshop with Justin and five other patients. They attended the weekly workshops to learn practical skills and behavioural approaches to better manage their symptoms and day-to-day life. Topics included dealing with stress and depression, appropriate exercise, relationships, nutrition and pacing daily activities.

Despite learning some self-management techniques, Justin continued to struggle with his pain and its crushing impact.

It was another three years before Justin and Ringland would meet again.

An intervention offers hope By 2011, Fraser Health had opened a specialized pain clinic at the Jim Pattison Outpatient Care and Surgery Centre in Surrey. The Pain Clinic provided access to advanced techniques and specialized equipment to treat pain. Ringland and pain specialist Dr. David Twist identified Justin as a possible candidate for the Radio Frequency Lesioning (RFL) treatment. RFL treats certain types of chronic pain by interrupting or blocking nerve signals on a semi-permanent basis, usually for six to nine months.

There was only one problem: Justin’s needle phobia. In fact, the sight of needles scared him so much that his heart rate and blood pressure would suddenly drop and he would faint.

Julie Carlson, the social worker at the Pain Clinic, worked

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Healthier You

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7 principles of self-management • Use knowledge about chronic pain to validate your experience, understand treatment options and empower you to be your own best advocate.

• Optimize your sleep – it may improve energy levels, pain coping and mood.

• Lifestyle changes. Eat well, quit smoking and use appropriate alternative and complementary medicine.

• Cognitive-based psychotherapy cannot alter pain but many people find it dramatically alters how much they suffer from their pain. Get help with anxiety, depression, anger and fear.

• Getting the right kind of support from your spouse and from others who have chronic pain can reduce the burden of chronic pain and offer alternative perspectives. Look into community resources, subsidies and help with employment and disability.

• Use gentle exercise and progressively increase activity to optimize weight, reduce stress and to improve tolerance, fatigue and sleep.

• Mindfulness, yoga, and breathing exercises will reduce your pain, calm your nervous system, reduce stress and improve your sleep.

Source: Pain BC Pain Toolbox

with Justin over several counselling sessions using a variety of therapeutic approaches to help him overcome his phobia as well as find coping strategies to live with his pain.

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“Patients with needle phobias often have an overwhelmed nervous system including thought patterns that increase their anxiety before they even enter the treatment room,” explains Carlson. “I focus on self-regulation strategies and mindfulness techniques to help patients calm the mind and body before and during the medical procedure.”

Mindfulness meditation trains the mind to focus on the present without any judgment. The goal is to not get lost in the past or worry about the future; it’s just to be curious and open to the present experience. For Justin, practicing the strategies he had learned encouraged him to respond to his daily pain in a positive manner.

● Housekeeping every week. ● 24-hour on-site emergency call system.

Following Carlson’s counselling, Justin was determined to go through with the RFL treatment and overcome his fear. With the guidance of Ringland and Carlson he developed a ‘system’ that helped him to remain calm. He’d plug in his headphones, close his eyes and let the streams of classical music calm his mind. He’d picture roots from his feet grounding him into the floor and rub a smooth rock in the palm of his hand while concentrating on his slow, rhythmic breathing just as he had practiced.

● Vacation and respite stays. ● Pets allowed

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Carlson emphasizes mind-body strategies to manage stress and anxiety. These therapies and practices balance self-regulation strategies and mindfulness meditation with using one’s mind (thoughts, feelings, beliefs and attitudes) to positively affect one’s physical health.

His first treatment was a success, and he suffered only a minor anxiety attack – fostering positive results. “It was like night and day,” describes Justin. The RFL treatments were effectively minimizing his pain. Justin returned every six months for the procedure, and each time it would get a little easier.

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32 Healthier You

fall 2015

More info:

The glass is half full The tides were slowly turning as Justin chose to see life more positively. “I was miserable before, very negative. But now I try to avoid the negativity because it only makes the pain worse,” he says.

He also quit smoking medical marijuana as it created more health issues, namely chronic obstructive pulmonary disease (COPD), rather than providing any real relief. Justin joined a yoga class offered at the Pain Clinic designed for those living with chronic pain, which taught them to understand their own bodies’ limits and boundaries.

It offered relaxation, safe stretches and a positive connection with the body for a change.

With the coupled success of the RFL treatments and mind-body strategies, Justin, now 35, has gained the confidence and strength necessary to take back his life. He renewed his driver’s license and started connecting with friends again. He made travel plans for Mexico, Las Vegas and Arizona. He also went back to part-time work as an actor in background roles in films and television. Earlier this year, Justin was on set with David Duchovny for the filming of The X-Files revival series premiering in January 2016.

“There is no cure, surgery or magic pill that will take away my pain forever,” says Justin. “I could keep taking drugs and more drugs until I was a vegetable in a wheelchair but I didn’t want that.” He has learned to manage his condition by pacing his activities. Whether it is doing the laundry or emptying the dishwasher, he takes his time and doesn’t push himself too hard. “It’s not worth it. If I go too hard, the pain can set me back for weeks.”

“Without his willingness, tenacity and enthusiasm, he wouldn’t be where he is today,” says Ringland. The road to get there wasn’t easy but Justin’s journey offers hope to other chronic pain sufferers that they too can take back their lives.

RETIREMENT. LIVING!

• Fraser Health: fraserhealth.ca/pain • Pain BC: painbc.ca • Canadian Pain Coalition: prc.canadianpaincoalition.ca • Self-Management BC – free pain workshops: selfmanagementbc.ca • Yoga: yogadirectorycanada.com (check your local community recreation centres for restorative yoga classes) • The Mindfulness App by MindApps • Catch My Pain app (pain diary and community) • YouTube - Understanding Pain: What to do about it in less than five minutes www.youtube.com/ watch?v=RWMKucuejIs

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MyHealthCoach

Sleep your way to a healthy weight

By Cathryn Smith

A

re you still fighting the battle of the abdominal bulge despite being active and eating healthily? Ongoing research suggests that, besides exercise and diet, two other factors may also play a large role in how many pounds you carry and where you carry them: sleep and stress. So let’s look at how these two factors play a role.

More than 35% of Canadians have trouble sleeping or staying asleep, about 10% get less than six hours of sleep regularly and 30% don’t feel refreshed after sleep, according to Dr. Cameron Mustard, a scientist and president at the Institute for Work & Health (IWH). Missing out on both the quantity and the quality of sleep sets biological and behavioural processes in motion that lead to increased food intake, fat storage and physical inactivity. Dr. JeanPhilippe Chaput, assistant professor of pediatrics at the University of Ottawa, states that sleep deprivation affects hormones, increasing ghrelin, which tells you when to eat, and decreasing leptin, which tells you when to stop. More ghrelin and less leptin equals weight gain.

“Lack of sleep is a stressor,” says Chaput, “which leads to elevated [levels of the hormone] cortisol – short sleepers have higher levels of cortisol at the end of the day.” You can blame that cortisol for depositing fat in your abdomen and increasing your risk for Type 2 Diabetes. Inadequate sleep also leads to feeling fatigued, making you less likely to be active, decreases the immune response, increases the risk of injury and interferes with mood, memory and clarity of thought.

“If you sleep less than five hours a night, you have a 50% likelihood of being obese.”

sleep and/or excess stress can cause weight gain. Excess weight is one of the risk factors for obstructive sleep apnea, which interrupts your sleep, which leads to more stress… you get the picture. It’s a bit of a vicious cycle, for sure.

How to Break the Cycle Pay attention to patterns eep a daily journal for a week or two. Track how you feel when K you wake up, your activity level, your energy level, your nutrition and fluids for the day, how you are feeling emotionally. Note whether there is anything in your life causing an increase in stress and how you respond. This can help you become aware of any areas in your life where you may need to make some changes and perhaps seek out some assistance from a health care professional.

Slow things down ry to cut back 10%. Walk 10% more slowly, drive 10% more T slowly, talk 10% more slowly, decrease your commitments by 10%.

Don’t over-exercise ith exercise, you can get too much of a good thing, especially W if you are feeling chronically stressed or sleep deprived. Research published in the journal Hormone Research found that long distance running – like that done by endurance runners – causes a sustained increase in cortisol which can make weight loss more difficult. In other words, overtraining when you are already tired or feeling stressed can have the exact opposite effect that you are looking for. Try something gentle like a walk outside or a yoga class until your energy level improves. It’s about finding the right balance for your body.

Here are a few more tips to help improve the quality of your sleep.

– Russell Foster, neuroscientist

Improve your sleep • Have a consistent, fixed wake-up time every day as this is one of the most important factors in building a consistent sleep pattern

Each time you’re stressed, whether the stress is something like not sleeping eight hours a night or being stuck in traffic, your adrenal glands release the stress hormones cortisol, adrenaline and noradrenalin. Regardless of what the stress is, these hormones help you either to fight the stress or to run from it – the so-called ‘fightor-flight’ response. They increase heart rate and blood pressure, divert blood and nerve supply from the gut to the limbs, heighten the immune response, slow down weight loss and metabolism and inhibit any form of relaxation and deep sleep.

So let’s get this straight: stress can cause lack of sleep, and not getting adequate sleep is a stressor. A shift in hormones due to poor

• Avoid caffeine after noon or so. Caffeine has a half-life of five hours. If you drink a cup of coffee at noon, at 5 pm only half of the caffeine will be out of your system • Remember that alcohol – even one drink – can interfere with the quality of sleep • Keep the bedroom dark and cool and have a routine that helps you unwind before sleep • If you are a shift worker, it is important to decrease light when the shift is complete (using blackout blinds and/or an eye mask ) and increase light when it is time to go to work (opening blinds and using a light box may help).

More info: Ted Talk by circadian neuroscientist Russell Foster ted.com/talks/russell_foster_why_do_we_sleep?language=en

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Healthier You

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