April 2012 Magazine

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Dr. Hister On

Stress And Your Heart The Power Of Probiotics Diabetes Complications Company’s Coming Recipe

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Dr. Hister on the reasons why stressing out is not healthy for your heart.

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Helping People Live Better Lives

Dr. Hister

Managing Stress And Your Menopause Heart One of the greatest and seemingly unavoidable stresses in my life these days is that I am constantly getting questioned (or worse, challenged and even worse, sometimes condemned and vilified) about many of the things I say aloud, and no, that’s not just because I’m a husband, although on the positive side, I must say that being a husband for over 4 decades (and yes, amazingly still to the first one) has been a terrific form of training to confront this other source of constant questioning in my life, which is a direct result from being on TV. You see, no matter how innocuous a medical news report may have seemed to me before I chose to highlight the findings on TV, someone (and often more than one person, alas) is going to send me a nearly instant email questioning the opinion I had offered about that news, a message that will sometimes hit my in-box even before I have come home from the studio 10 minutes after having been on air, and oh, how this so often makes me wish that people who have something critical to say to someone else had to go back to sending letters via Canada Post, which would at least make them stop and think for a few seconds before sharing their contrary views.

I must add quickly that most email critics are polite, thank God, but a few are not, and a very few, for some reason that in disagreeing with what I said, they

have to start with a pejorative or nasty (or sometimes even way worse) comment (“And you call yourself a doctor” is one of the more frequent and least offensive of such comments), and needless to add, I suppose, expecting to get those nasty emails has become a great source of stress for me, although it wouldn’t, of course, be equally stressful to everyone doing my job.

In fact, I once worked with a good friend in the media who absolutely relished getting an angry or a nasty letter directed towards him because it gave him a chance to be even nastier in his response than the writer had been to him.

But that’s the odd but distinctly important thing about stress, namely that “stress” to one person – a visit from the in-laws, having to deliver a public talk, getting stuck for an hour on an elevator with Deepak Chopra, waiting in an 8-item express line behind someone who deposits 9 items on the counter and who then has to search the many pockets in their safari jacket for the exact 94 cents change – can often be a source of pleasure or even mirth (and certainly not a stressful occurrence) to another person.

So in today’s column about the effect that stress may have on your heart, I must stress (a poor bit of stress-related humour) right off the top that the nature of stress is exceedingly variable in that it depends so much on one’s perspective, one’s Continued On Page 11

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Ian Lloyd

Pharmacist, Peoples Pharmacy

Diabetes Complications It is thought that over 2.4 million Canadians have diabetes and these numbers continue to rise. This disease costs the Canadian healthcare system an estimated 13.2 billion every year. Diabetes can cause many health complications. It greatly increases one’s risk of heart disease, stokes, blindness and kidney failure. Diabetes complications are lumped into three major categories: macrovascular, microvascular and nerve damage. In other words, it affects big blood vessels, little blood vessels and your nerves.

One way to help prevent these complications is to learn about them. The more you know about your health, the better you can take care of yourself.

But first, what is diabetes? The condition called diabetes occurs when the body does not produce, or is unable to properly use, insulin. Insulin is needed by all cells to use glucose, which is the body’s primary source of energy. One analogy is that insulin is the “key” to open your cells “door” to let glucose in. There are many symptoms that can indicate if you have diabetes: unusual thirst, frequent urination, weight change (gain or lose), unusual fatigue, or blurred vision.

If you, or someone you know, has diabetes tell them to look down every once and a while. Why down? Because that is where your feet are. People with diabetes are at greater risk of developing foot problems. Sometimes these problems are mild, like a cut that won’t heal, or in some extreme instances a foot may have to be amputated. These foot issues occur due to the complication of diabetes called 6 People First peoplesdrugmart.com

peripheral neuropathy. This refers to the nerve damage which occurs in the extremities, like hands and feet. The feet generally develop more problems because we use them quite a bit and we don’t often look closely at them. When was the last time you looked in between your toes? A person with diabetes may develop nerve damage in their feet and therefore may not be able to feel the pain of a wound that is not healing. This is why it is so important for people with diabetes to take care of their feet.

I mention foot care first because it is a complication that people can care for themselves. There are excellent resources on the internet about foot care for people with diabetes. Visit the Canadian Diabetes Association website (www.diabetes.ca) and search for the topic 'foot care.' Or better yet, ask to see a foot care Nurse. Yes there are nurses that specialize in foot care; that is how important this complication is.

People with diabetes are at a higher risk of developing heart disease and/or having a stroke. These are macrovascular complications. Also, people with diabetes may develop heart disease 10 to 12 years earlier than those without diabetes. It is thought that 80% of people with diabetes will die as a result of a heart attack or stroke. The best way to prevent these complications is to be good to your heart.

Monitor your blood pressure regularly. Most Peoples Pharmacists have a blood pressure machine in their store which you can use, free of charge. Visit Continued On Page 8

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your Doctor to have your cholesterol checked. High cholesterol is another risk factor for cardiovascular disease. If you still smoke, quit. Smoking is bad for you in more ways than you can imagine. Talk to your Peoples Pharmacist; they might have a way to help you stop smoking for free Don't forget to exercise. Regular, aerobic exercise has been shown to help diabetes, reduce blood pressure, reduce risk of heart disease, help with weight loss, improve mood....need I go on? It only takes about 20 minutes of walking most days of the week.

Perhaps we should mention some of the microvascular complications of diabetes.

The most worrisome to people is diabetic retinopathy. Diabetes is the single largest cause of blindness in Canada. The back of your eye is full of tiny blood vessels that transport blood and nutrients. Over time, high blood sugar can cause these blood vessels to weaken, leak or become blocked. This is why peo-

ple with diabetes should visit their eye doctor regularly and report any vision problems promptly. You might also want to consider taking the supplement lutein. Lutein is a natural antioxidant that is found in dark green leafy vegetables, egg yolks and various fruits. Lutein has been shown to reduce the risk of developing macular degeneration (another eye disease associated with diabetes). Don't forget to wear your sunglasses and hat. Prolonged bright sunlight exposure to your eyes increases one's risk of developing cataracts (clouding of the eye's lens). People with diabetes are at risk of developing cataracts earlier than most people. Be kind to your eyes, you will 'clearly see' the benefits.

Another microvascular complication of diabetes is kidney disease. Again, the ravages of prolonged high blood sugar can damage the tiny vessels that help the kidneys filter your Continued On Page 10

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pharmacist recommended Health & Wellness Information From Your Peoples Pharmacist

Seasonal Allergies Allergies occur when your body has an unusual immune response to a common substance like pollen, dust, or mold. When these substances cause your immune system to overreact, they are called allergens. Allergens don’t directly create the symptoms you experience but they latch on to cells in your body, triggering them to release histamine and other “chemical mediators.” The allergy symptoms you feel are a result of your body’s reaction to these chemical mediators. The most common type of allergy is called allergic rhinitis. This happens when the allergens are inhaled through the nose, where they trigger the allergic reaction. Allergic rhinitis caused by pollens that are only present in a specific season is called hayfever.

Signs and Symptoms of Allergic Rhinitis: Common nasal symptoms of allergic rhinitis include itchiness, sneezing, a dripping/runny nose, and stuffiness. Some people also get symptoms in their eyes. They get watery/teary eyes that are red, itchy, and swollen. Other general symptoms that may be present are ear pain or itch, sore & itchy throat, sinus congestion, headache, and postnasal drip. Postnasal drip is the name for when a runny nose drips “backwards” into the throat, this can cause a mild cough and contribute to the “itchy throat” feeling.

Managing Allergic Rhinitis Three things to be considered when developing an allergy management strategy are awareness, prevention, and treatment. You must educate yourself about your allergies and what causes them, learn to minimize exposure to your triggers, and discover how and when to treat your symptoms.

Awareness: The first thing to do in establishing your allergy awareness is to learn what causes your reactions. Is it pollen, animal dander, dust or something else?

You might wish to consult an allergist if you are having trouble pinning down the source of your allergies. If you have seasonal allergies, get to understand what pollen is and learn about your local pollen seasons. Pollen from non-flowering plants is very small and easily airborne. This type of pollen is likely to be an allergen whereas pollen from flowers is more likely to be an irritant. An irritant can worsen your allergy symptoms if the nasal tissues are already inflamed, but will not trigger an allergic reaction on its own.

Prevention: Managing allergies is the same as managing any other condition. It is important to treat cause as well as the symptoms.

Once you discover what it is that you are allergic to, you can decrease your symptoms by reducing and/or avoiding situations in which you are exposed to your allergens. Here are some tips to help you prevent your hayfever: • Shut windows and doors to keep airborne allergens out of your house.

• Plan outdoor activities for later in the day because most plants pollinate in the morning.

• Avoid outdoor activities on warm, windy days but enjoy them after a rainfall washes the pollens away.

• Keep your distance from pollen producing trees.

Most pollen stays within 10 meters of the tree.

• Avoid pets, even if you are not allergic to them.

Animals can bring pollen and dust inside on their fur.

Treatment: Knowing what your allergens are and trying to avoid them will certainly help to improve your allergy symptoms, but are not likely to eliminate them. The last step in managing allergic rhinitis is to learn how and when to treat your symptoms. It is important for you to consult your doctor and pharmacist in this step. There are many allergy medications available, some are prescription-only and others are over-the-counter. Most cases of allergic rhinitis can be effectively managed with overthe-counter medications called antihistamines that your Peoples Pharmacist can help you select.

Tell your doctor and Peoples Pharmacist about ALL of the medications you are taking (prescription & over-the-counter). Some drugs, antibiotics and heart medications especially, can interact with antihistamines and cause serious and dangerous drug interactions. Take the antihistamine before you will be exposed to an allergen to prevent or reduce the severity of your symptoms. If you have hayfever, begin taking your antihistamine just prior to the start of pollen season and continue taking it regularly during pollen season. Prevent your symptoms from ever becoming severe by anticipating them and treating them accordingly. peoplesdrugmart.com People First 9

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blood. Diabetes can also damage the nerves that tell you when your bladder is full. This can lead to increased bladder pressure and further kidney damage. If you have diabetes, your doctor should be sending you to the lab for testing to determine the health of your kidneys.

Depression is a complication of diabetes that is often overlooked. The reasons why people with diabetes are more likely to suffer from depression are not clear. It might be due to the emotional stress of living with a long-term chronic medical condition or blood sugar issues in the brain. Symptoms of depression include: too much or too little sleep, inability to concentrate, feelings of hopelessness, loss of appetite or being more irritable than the usual. Depression can also affect your diabetes as it can lead to decreased self care, poor meal planning and not following medication instructions. Symptoms of depression should not be ignored; they are not 'just'

in your head and may not spontaneously resolve.

Perhaps the best option for depression is 'talk therapy.' Seek out counseling or a support group through your local diabetes association. Discussing your health concerns can be very reassuring. It can also comfort you to know that you are not alone.

If you do have diabetes, learn all that you can about this condition. There are many things that you can do to improve your health and reduce the risks of developing complications. High blood sugar should not be ignored. Over time, this strain can lead to complications such as: kidney and nerve damage, vision problems and sexual dysfunction.

With better control of your blood glucose, you can reduce your risk, or delay the development, of these complications. So talk to your doctor or Peoples Pharmacist if you are concerned about diabetes.

The more you know, the healthier you will be.

Written By Ian Lloyd, Pharmacist & Chartered Herbalist, Peoples Pharmacy

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Dr. Hister...Continued From Page 4

circumstances, and one’s nature and personality (one man’s meat is another man’s poison, one man’s floor is another man’s ceiling, one man’s marauding tiger is another man’s kitty-cat, and so on).

So rather than starting with a definition of stress (which wouldn’t, I know, satisfy a lot of you and which might in turn result in a few emails that I don’t really want to get), I’ll instead simply say that for most of us, stress is best seen through the same lens that a US Supreme Court judge once famously used to give his views about what constitutes pornography: it’s very hard to define, he said, but you know it when you see it.

It’s the same for stress: “stress” is not the same for everyone, but we nearly always know stress when we see it in our own lives, and most of us, alas, also see far too much of it these days, which in turn has potential major negative effects on our hearts and cardiovascular systems, negative effects both from the cumulative injuries of chronic stress (everyone seems to know about those) but also from acutely stressful events in our lives (that’s less well appreciated, I think).

Thus, everyone likely knows that suffering from a load of excess stress on a chronic basis (“Yah, Jim, just another shoot-out loss by the Canucks tonight.

Same old Canucks, eh?”) has been linked in numerous studies to a significantly higher risk of many negative cardiovascular consequences such as a raised risk of suffering a heart attack or a stroke, developing high blood pressure (which in turn also raises the risk of suffering a stroke and/or heart attack), ending up with chronic heart failure, and on and on.

In other words, chronic stress can wear down your heart and eventually result in something “bad” happening to your heart.

What is less well appreciated or at least less acknowledged by most people, it seems to me, is that acute stress (“Yikes, Jim, the Canucks are going to play him in goal again tonight. Oh, I’m not sure if

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Are your medications working effectively for you?

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Dr. Hister...Continued From Page 11

my heart can stand it”) also has huge negative consequences on the heart and cardiovascular system, consequences that are, of course, immediate – not eventually, but today or tomorrow - in their effects.

Two recent – and somewhat different - studies are excellent indications of the potential negative effects on the heart of acute stress.

In the first study, researchers found that following intercourse, as one would expect, a male has a raised risk of suffering a heart attack, which is not surprising, of course, because, well, even for the least engaged guy, participating in sexual relations requires at least a tiny bit of physical effort and any physical effort at all slightly raises the risk of a heart attack.

But – and here’s the part about stress that’s interesting in this study - the risk of suffering a post-coital heart attack is way higher for a man who is participating in such activities during an affair than for a man who’s merely (I’m not sure that’s the best word to use here but it’s the only one I could think of; don’t send me emails, please) having relations with his spouse.

In the second study, researchers found that following the death of a spouse, a bereaved surviving partner was found to be at an amazing 21 times higher risk of suffering a heart attack for the 7 days following the death of a loved one, and he or she remains at up to 6 times higher risk of ending up with a heart attack for the next 6 months.

It’s true, in other words: you can die of a broken heart. And it’s a pretty immediate effect.

Anyway, the bottom line is easy to discern: to spare your heart and cardiovascular system, you have to try to lower both your acute and chronic stress levels.

How you do that is a whole other story, of course.

But that story has to be saved for another column, I’m afraid, because I’m really too stressed by the looming deadline for this one to try to write any more now.

Dr. Art Hister can be heard on CKNW and other Corus Radio Network stations on House Calls on Saturdays at 10 AM, as well as seen on Global TV news on Saturday mornings at 9:20.

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Probiotics for Health We often associate bacteria with illness or something that will harm us but not all bacteria are to be feared; vast colonies of bacteria live on and within our bodies and play an important role in our health and well being. One area in which bacteria are extremely important is in our digestive system. It could be said that we are only as healthy as our digestive tract and our digestive tract is only as healthy as the balance of beneficial bacteria that inhabit it. Probiotics belong to a family of beneficial bacteria that play a key role in helping to fortify and maintain healthy intestinal flora. They aid in supporting optimal digestion and assimilation of nutrients; they also help support our immune system and defend us against unbeneficial microorganisms that can make us sick.

Basically our intestines are a breeding ground for over 3 pounds of microorganisms; these bacteria are a mix of beneficial and not so beneficial bugs. The good guys are essential to a strong immune response and problem free digestion. The right balance of beneficial organisms can also help to hinder proliferation of harmful microorganisms. Problems arise when there are not enough of the good guys to keep the bad guys in check. Antibiotic use is perhaps the number one enemy to a healthy gut ecosystem, as it does not discriminate between the bacteria that are making us sick and the ones that are keeping us healthy. Thus they basically throw the baby out with the bathwater. This can leave us more susceptible to a host of other threats unless we correct the imbalance with probiotic therapy. Healthy gut balance can also be thrown off by diets high in sugars and processed food, chlorinated drinking water, drugs, alcohol, stress and environmental toxins.

One of the more traditional ways to get probiotics into our system is by supplementing our meals with fermented foods like pickles, kombucha tea, tempeh, yoghurt, kefir, cultured buttermilk, cheese, sauerkraut, kimchi, natto and miso. The key to these foods is that the bacteria are active and alive; this means that they have not gone through the process of pasteurization. Pasteurization effectively destroys all pathogenic organisms while at the same time killing off all the beneficial enzymes and bacteria. Sterile food does not lend itself to promoting a healthy digestive tract. There is a renewed interest in

14 People First peoplesdrugmart.com

the art of fermentation and many people enjoy the benefits of foods they ferment at home.

But fermentation is not for everyone. Another way to get probiotics into the system is through supplementation. When choosing a probiotic supplement you want to find one that has a broad range of viable strains from three main categories: 1. Lactobacillus acidophilus is perhaps one of the most well known friendly inhabitants of the small intestine and can be a beneficial ally in gastrointestinal disorders. It is also effective in promoting health of the urinary tract and vaginal tract.

2. Bifidobacterium bifidum is a champion for maintaining a healthy colon and can support liver health. Bifidobacterium infantis is a specific strain that is important to infant health.

3. Lactobacillus bulgaricus lends support to lactobacillus acidophilus and bifidobacterium bifidum. It also aids in digestion and assimilation of carbohydrates and proteins.

Probiotic supplements come in many forms; depending on your need, you can choose from capsule, powder, wafer, gum or fresh whole food forms. Potencies range from the millions to billions and speak to how potent the product will be by the time it reaches the expiry date if kept in an optimal environment. Many need to be refrigerated to remain viable, but others are formulated to be shelf stable and are ideal for those who wish to support their immune and digestive system while travelling. The wide variety of available products can seem overwhelming to the first time shopper; it is best to consult with your local Peoples Pharmacist to find a product to suit your individual needs.

Prebiotics are another piece of the healthy digestive ecosystem; they are non-digestible soluble fibres that intestinal bacteria can feed upon to proliferate. The two main prebiotics on the market are FOS (fructo-oligosaccharides) and inulin typically derived from jerusalem artichokes and chicory. When adding a prebiotic to your diet you want to start slow and build up gradually as too much too fast can cause gas and abdominal discomfort. Always remember when it comes to our health, more is not always better but balance is essential.

Good Health to You

bo Soupthat Wild Gulom vely earthy flavour

Wild rice has a e t soup apart from th sets this thick low-fa ce d also helps to redu traditional gumbo-an arly half. overall calories by ne

1 tbsp. 15 mL Canola oil 11⁄2 cups 375 mL Chopped celery 11⁄2 cups 375 mL er Chopped green pepp 11⁄2 cups 375 mL Chopped onion 2 2 Garlic cloves, minced er) wd (or 1/2 tsp., 2 mL po 5 mL 1 tsp.

Dried oregano 5 mL tsp.

1 1 Dried thyme ⁄2 tsp. 2 mL 1 Dry mustard ⁄4 tsp. 1 mL Pepper cups 1.5 L 6 h ot Prepared vegetable br d) okra, 2 cups 500 mL Sliced fresh (or frozen, thawe 1 3 ⁄2 inch (12 mm) thick 175 mL ⁄4 cup Diced kielbasa n sausage)2 (or other spiced cooked lea 150 mL ⁄3 cup Wild rice 2 2 Bay leaves 500 mL ps cu 2 breast Chopped cooked chicken to 250 mL p cu 1 Chopped seeded toma 15 mL . sp 1 tb Hot pepper sauce

t 8 ingredients. n on medium-high. Add nex Heat canola oil in Dutch ove ing occasionally, until onion is softened. s, stirr t to medium-low.

Cook for about 8 minute Bring to a boil. Reduce hea Add next 5 ingredients. 40 minutes until rice is tender. Remove and ut Simmer, covered, for abo about 5 minutes discard bay leaves. s. Stir. Cook, covered, for Add remaining 3 ingredient about 10 cups (2.5 L). kes until heated through. Ma ver Results Healthy Recipe Makeo 281 Calories; 13.6 g Total Fat (1.1 g Sat); ): mL 0 (25 cup 1 E: OR BEF 677 g Sodium Fat (2.0 g Mono, ): 150 Calories; 4 g Total Carbohydrate; g AFTER: 1 cup (250 mL 15 ol; ster ole 35 mg Ch 1.0 g Poly, 1.0 g Sat); ium Sod mg 458 ; tein Pro 3 g Fibre; 14 g

Recipes For Good Health

Wild Gumbo Soup Healthy Recipe Makeovers Cookbooks are available at participating

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SALMO • 107 - 4th St. 357-9444 NELSON • 405 Hendryx St. 352-3121 SPARWOOD • 107 Centennial Square 425-2015 NAKUSP • 88 Broadway St. 265-2228 CRANBROOK • East Kootenay Hospital 13 -24th Ave. North 420-4133

PEACE RIVER CHETWYND • 4733 - 51 Street 788-3393 st

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*Points awarded on net pre-tax purchases.

Certain restrictions apply (check with your local Peoples Drug Mart or Peoples Pharmacy for a complete list of non-eligible medications, services & products).

Some stores may use a manual system with a different reward level.

The articles published in People First are for the general information of the reader. While effort is made to reflect accepted medical practice and knowledge, articles should not be relied upon for the treatment or management of any specific medical concern or problem and People First accepts no liability for reliance on the articles. For proper diagnosis and medical care, you should always consult your family physician promptly. Opinions expressed in sponsored articles by, Dr. Art Hister, Ian Lloyd, and Darlene Booth are paid editorials and are not necessarily shared by Peoples Drug Mart stores or Peoples Drug Mart (B.C.) Ltd. Some advertised products are not available in all stores. We reserve the right to substitute products or limit quantities. Prices effective while quantities last. Sale in retail quantities only.

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