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People First contents

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Shingles Dr. Art Hister looks at shingles, a reactivation of an old chicken pox infection, a health concern for adults 50 plus.

5

Trusted Health Products Wide selection of items to help you live a better life.

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Baby Care Peoples Pharmacist Ian Lloyd provides tips on keeping your baby happy and healthy.

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Baby Health Selection of health products to help keep your baby happy.

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Pharmacist Recommended Helpful tips on water safety for children. Health news on B vitamins and how they may fend off Alzheimer’s.

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SHINGLES Like Perry Como (remember him? Great sweaters, eh? And what a lovely soothing smooth voice – no one croons like that any longer, alas), I get letters, I get letters, I get lots and lots of letters.

Actually, no one gets lots of letters any more, not even a health columnist like me, but I do get lots and lots of emails, and most of them, of course, detail some very frustrating situation that the email writer has witnessed or endured, and unfortunately, some emailers tell me stories about what an objective reader could only describe as horrible or even tragic medical problems.

In other words, I am used to reading about misery.

So you really have to trust me when I tell you that I’ve learned over the years that high on the list of the most frustrating and debilitating medical problems that can befall an aging individual is to end up with enduring pain from a case of shingles, what doctors refer to as post-herpetic neuralgia or PHN. So what is shingles? And why does PHN happen to some and not to others?

Well, the first question is easy to answer.

Shingles (AKA a herpes zoster infection) is nothing more than the reactivation of an old chicken pox infection, and those of you who can still remember Perry Como will also easily remember that back in our day, nearly every kid you knew got the telltale outbreak of a chicken pox infection sometime during early childhood, although quite happily chicken

Dr. Art Hister

pox has now become much more rare as a result a few years ago of the introduction of an effective chicken pox vaccine (but please note that this chicken pox vaccine is not the same thing as the shingles vaccine that I will discuss later on).

(As an important aside about chicken pox, however, I must note that since chicken pox was so prevalent once, that there were even some parents out there who used to organize “chicken pox parties” during which an infected child would pass this highly contagious virus to other pre-school kids in the neighbourhood who had not yet been infected but who would now get that infection out of the way before they started school, a practice that is fairly risky, however, since the usually benign chicken pox infection can occasionally result in significant, even life-threatening complications. In fact, as I am writing this, there is a story on one of the wire services about a 15-year-old girl from Ohio who has just died as a consequence of chicken pox).

But back to shingles, and the connection here between chicken pox and shingles is this: like kids who never again move out of the basement suite in mom and dad’s house once they’ve managed to re-establish their residence down there, the chicken pox virus also never leaves once it’s lodged in your system because what that virus does after entering your body is to burrow into your nerve tissue and to remain there forever.

And unfortunately, under certain circumstances which we still don’t fully understand (although it Continued On Page 11

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BABY CARE

Despite being smelly, loud and disruptive to one's sleep, babies are wonderful. They really don't need much in the way of special care. Just add good food, love, lots of sleep and they thrive. Often the parents need more care. Sometimes little ones need special attention. They get colds, skin rashes, bumps and bruises. This month we shall take a condensed look at baby care.

Jokes about missing instruction manuals aside, babies need a lot of attention. Lets start our discussion about baby care needs from the top. Cradle cap (seborrheic dermatitis) is usually the first medical condition parents encounter. While potentially unsightly, this is a harmless condition. It is caused by an overproduction of skin oil on the scalp. This dried oil looks like dandruff with yellow/brown scales or crusty patches. Cradle cap will often resolve on its own. Parents often feel the need to do something; treatments for cradle cap are simple.

You can massage the scalp or use a soft brush to remove the scales. Shampooing the scalp, only once a day, will aid in the clearing the scalp. For more troublesome cases, try massaging a small amount of olive oil into the scalp about one-half hour before shampooing. Bring this condition to the attention of your doctor if the scales spread beyond the scalp or if there is any bleeding.

Next we arrive at the eyes. Little ones are prone to getting conjunctivitis (inflammation around the eye). This should be brought to the attention of your physician quickly, to ensure there are no other issues. Usually, it is a minor viral or bacterial infection which is easily resolved with treatment. Parents 6 People First Join us on

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Ian Lloyd Peoples Pharmacist

can remove any yellow discharge around the eye with a lukewarm, damp cloth.

Teething can be the most troublesome condition new parents will face. With good reason, if sharp bones started to poke through my gums, I would start yelling too. Symptoms of teething are unmistakable: drooling, facial rash, red cheeks, unusual irritability, sleep problems and loose stools.

The best treatments involve providing cool, hard things to gnaw on. Our favourite was a damp face cloth and a refrigerated soother. For more persistent symptoms, I recommend homeopathic teething remedies. These remedies are very safe and can be quite effective. You can also apply a very small amount of topical anesthetic teething gel. At night time, I recommend giving a dose of acetaminophen if teething disturbs sleep. Check with your Peoples Pharmacist for the proper dose. Parents are reluctant to give their little ones medication. However, a good night’s sleep is very important; both for parents and baby .

There is no bigger parental concern than infants with cold and flu symptoms. In most cases, no medications are needed. In fact it is not recommended that you use any over the counter cough and cold products for children under six years old.

It is also not recommended that you use topical menthol and camphor rubs on children under two years old. For nasal congestion, the best treatments are saline nasal drops, a humidifier and lots of fluids. If congestion is affecting sleep, try placing them in their car seat to sleep. When a child coughs in the night, the only ones who lose sleep are their Continued On Page 8

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Ian Lloyd...Coontinued From Page 6

parents. A great home remedy for coughing is a teaspoonful of honey. This is great for anyone over the age of one years old. Just use pasteurized honey and don't forget to brush their teeth afterwards. The only product I sometimes recommend for coughing, after everything else has not worked and people are desperate for sleep, is diphenhydramine. While normally used to treat allergies, it also has mild anti-coughing activity and can help with sleeping. There are so many simple, home remedies to help treat the symptoms of a little one's cold and flu. Ask your Peoples Pharmacist for any ideas they might have. There are many good ideas in the BC Health Guide, as well as warning signs you should watch out for. You can pick up a BC Health Guide at any pharmacy, doctors office or health unit.

Rashes, rashes, rashes. It seems that infants always have problems with their skin. This is normal. Their n e w s k i n i s v e r y se n s i t i v e a n d t h e y a r e e xp o s e d t o new things everyy day. In most cases, all that is required to heal their skin is a little cleaning and mois-

turizing. Bring any skin rash to the attention of a physician if it covers a significant amount of the body (more than 50%), has lasted longer than two days or is accompanied by a high fever. The most common r a s h n e w p a re n t s h a v e t o d e a l w i t h i s d i a p e r r a s h .

There are enough diaper rash remedies to fill a book.

We had a multi-stage approach to treating diaper rash. For minor symptoms, we were diligent about keeping the diaper dry and allowing naked bottom time. Diaper rashes are generally caused by wetness and irritation from urine or stools. If things got worse, we used a barrier cream containing zinc and kept a closer eye on the “bottom� line. Barrier creams protect the skin from irritants and zinc seems to help every skin condition. If the bottom got bad, we mixed equal parts anti-fungal, cortisone and zinc cream and used this at every diaper change. Worsening of symptoms may be caused by yeast, hence the anti-fungal cream. The cortisone brings down swelling and redness. If this did not work, we would have brought our daughter into see the doctor. LuckContinued On Page 10

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pharmacist recommended Health & Wellness Information From Your Peoples Pharmacist

Water And Swimming Pool Safety Tips You might be surprised to learn that the second leading cause of death in children aged one to four is drowning. Here are some tips on how to help keep your kids safe when playing near water — whether a swimming pool, river or lake.

• Make sure young children are always wearing a lifejacket or personal flotation device (PFD) when playing in, on or around water.

Keep young children within arm's reach at all times.

• Choose a safe place to swim, such as a supervised waterfront or beach. Check for hazards before wading in — including any posted information about water pollution.

• Enroll your child in a water safety and swimming program — and sign yourself up to learn basic lifesaving skills.

• An adult should actively watch children at all times while they are in a pool. For toddlers, an adult should be in the water and within arm’s reach, providing “touch supervision.”

• For older children that know how to swim, an adult should be paying constant attention and be free from distractions, like talking on the phone, socializing, tending household chores, or drinking alcohol. The supervising adult must know how to swim.

Swimming Pool Rules If you have a pool, insist that the following rules are followed: • Keep toys away from the pool when the pool is not in use.

• Empty blow-up pools after each use.

• No tricycles or other riding toys at poolside.

• No electrical appliances near the pool.

• No diving in a pool that is not deep enough.

• No running on the pool deck.

Swimming Pool Fences Children can climb out a window, though a pet door, or sneak out a door to get to the back yard and the pool. To prevent small children from entering the pool area on their own, there should be a fence that completely surrounds the pool or spa. Combined with the watchful eyes of an adult, a fence is the best way to protect your child and other children who may visit or live nearby.

Be safe this summer!

The information contained in this article should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

health news B Vitamins May Slow The Advance Of Alzheimer’s Elderly people could fend off Alzheimer’s disease by taking supplements of B vitamins as B vitamins were found to reduce the brain shrinkage associated with the disease by up to 90%, reports an Oxford University study.

Vitamins B6, B12 and folic acid can lower levels of homocysteine, an amino acid linked to shrinkage of the brain in conditions such as Alzheimer’s disease. Previous studies had shown that patients with mild cognitive impairment suffered 50% less brain shrinkage overall if

they took B vitamins.

However, the study of 156 patients by researchers at Oxford University, found that shrinkage was reduced by 90% in areas of the brain most vulnerable in Alzheimer’s patients.

Experts cautioned against drawing any firm conclusions from the “early” results and said a balanced diet and exercise “can help to keep our brains healthy as we get older.”

peoplesdrugmart.com People First 9

Ian Lloyd...Continued From Page 8

ily, it never got that far. I'm certain my - now - young lady is terribly embarrassed that I have discussed her bottom issues with a large segment of the population of British Columbia.

Stomach issues and colic are troubles that always seem to appear at bedtime. Not sure why, I guess parents are always lucky. Babies with healthy lungs cry. The term 'colicky' is applied to any baby that cries for longer than two hours without stopping.

Many times, parents associate this with a baby's possible stomach pain. It might not be the case, but it gives parents a place to start. The most common culprit for digestive and skin issues is intake of milk products. Other foods that may cause problems for breastfed infants are peppers, cucumbers and cruciferous vegetables. We always kept a food diary to try and identify food intolerances. The omission of certain foods can improves a baby’s health. A newly emerging thought is that little ones can benefit by giving them health stomach bacteria. There are now

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probiotic formulations specifically designed for infants. Ask your Peoples Pharmacist if they stock these preparations, they are often stored in a fridge. We had great success with chiropractic care for our little one's colic issues; the results were rapidly noticeable.

Caring for a little one is tough. There is no instruction manual and they are not good at communicating their needs. Luckily that little smile is all that is needed to make it rewarding. When you need help there are lots of places to turn. Your family doctor and Peoples Pharmacist are great sources for information on baby care. You can also look in the BC Health Guide and a great website is BabyCenter.ca. It is OK to ask for a break. Even having someone watch the little one for an hour, while you go for a walk or have a bath, can do wonders for your constitution. It will get better, I promise.

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Dr. Hister...Continued From Page 4

largely has to do with increasing age – doesn’t everything? - and/or with an impaired immune system such as for example, in someone who has an HIV infection or is undergoing cancer therapy) that hidden lurking chicken pox virus springs back as shingles producing a pretty classical-looking rash, which is usually a one-sided “stripe” or a “band” (a band that corresponds to the nerve supply the virus is affecting), and which is accompanied by pain of varying intensity.

Although this shingles rash occurs most often as a band on the torso, it can in fact appear anywhere including the face, where it can be a really troublesome infection if it threatens the eyes.

Once the rash of shingles appears, it’s usually fairly easy to make the right diagnosis, but often, alas, the rash is preceded by intense pain for a few days without any other obvious signs, and that’s when the diagnosis of shingles is much more difficult to make because there’s nothing to see yet.

If the diagnosis is made quickly, the current theory is that anti-viral medications can result in the outbreak dying down more quickly than it might do if left untreated (anywhere from 2-4 weeks) although unfortunately, early treatment with antiviral drugs does not seem to lower the risk of PHN. So the key thing to stress in this article (and the main message I’ve gathered from those many frustrated emailers I mentioned earlier) is that you really want to avoid getting shingles in the first place, and happily, there is a way for many of us to substantially lower our risk of both shingles and (especially perhaps) PHN, and that’s via a shingles vaccine that’s been available in Canada for the last few years and which the experts currently recommend for anyone over the age of 60, and not leave it to the usual standard age for being considered a senior, namely age 65.

(Which brings me to this aside: that so many undoubtedly young - experts keep reducing the age at which they want us to consider ourselves “seniors” so much so, in fact, that if this downward definition trend continues, pretty soon some experts will argue that a senior is anyone just out of

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Dr. Hister...Continued on Page 13

peoplesdrugmart.com People First 11

Shingles Vaccinations The shingles vaccine protects against herpes zoster, more commonly referred to as shingles. Shingles are caused by the varicella zoster virus, which also causes chickenpox. The vaccine is approved by Health Canada. The shingles vaccine is the best way to protect you from getting shingles. The vaccine has been shown to reduce the risk of getting shingles by 50%. For those who still get shingles after being immunized, the vaccine can reduce pain, including the type of pain that lingers after shingles.

Talk to your doctor or Peoples Pharmacist today to find out how to help protect yourself against shingles and if the shingles vaccination is right for you.

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Dr. Hister...Continued From Page 11

their teens, although when you think about it, that’s pretty much what all teenagers think is true anyway).

Anyway, the good news is that the shingles vaccine is pretty effective.

Thus, according to a recent review of over 700,000 patients that was recently published in PLOS Medicine and which looked at the way the shingles vaccine works in the real world (as opposed to how it was said to work in studies that were used to test it, the kind of studies that often significantly over-estimate the effectiveness of anything the researchers are looking at) concluded that overall, the shingles vaccine is about 50 % effective in reducing the risk of getting shingles and about 60 % effective at reducing the risk of ending up with PHN, although it’s also important to note that the researchers in this study did not have enough data to evaluate the effectiveness of the vaccine in “really old” seniors, and previous studies have indicated that the vaccine becomes less effective the older we are when we get immunized.

Anyway, here’s the bottom line the way I see it: even though the shingles vaccine is not completely effective, and even though that effectiveness may drop off in older individuals, and even though it costs around $200, aside from the cost, there really doesn’t seem to me to be much of a downside, so at the very least, if you’re an oldie but goodie and you fit the bill for whom the vaccine is recommended, you should, I think, seriously consider getting this vaccine because you really want to do all you can to avoid becoming one of those people who email asking me if there’s anything that I can recommend for this persistent pain you now have from a bout of PHN. 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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TIPS FOR HEALTHY DINING OUT

ar e e Boot

It is easy to eat healthy when you are in control of the kitchen, but dining out can often be a troublesome and tricky venture for a health conscious connoisseur. Restaurants want to sell food that will keep you coming back and this typically means comfort food; they are going to tantalize your taste buds with salt, sugar, refined carbohydrates and plenty of fat for good measure. But eating out does not have to sabotage your health; you can learn to make healthier choices and still revel in the fact that you don’t have to do the dishes afterwards.

If your first standard for what constitutes a good restaurant are the humongous portion sizes, then we have a lot of work to do here. The only thing I recommend to super size in a restaurant is the water. Portion distortion has become a Western dietary nightmare. Even if you take a pass on the complimentary breadbasket, your meal is likely going to be much larger than you actually need. Before you start eating the meal, ask for a take out box and put half of the food in there; out of sight out of mind lessens temptation and you already have your lunch made for tomorrow. If there is a choice between a large or small portion, order the small. I often find the appetizers are a perfectly adequate meal size.

If you are afraid it won’t be enough, then order a small salad – dressing on the side please. That way you can control how much you need.

Scout out your local restaurants beforehand so you can familiarize yourself with their menu and know if the food is going to suit your dietary needs. You can often find menus online and some of the major chains will have nutritional information as well. I have been avoiding gluten and dairy products for a couple years so consequently Italian restaurants are not my first choice anymore. Still, if I find myself with no other option, it is usually possible to find something that works as long as my server is willing to work with me.

Asking questions about the food on the menu is always a good idea. Don’t be afraid to ask them to prepare it to suit your needs. If you are on the road and not familiar with the

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R.H.N

local eateries, stay away from fast food outlets and all you can eat buffets; while they sometimes offer healthy choices, temptation to overeat may win over your resolve.

Restaurant menus do not list nutrition facts, which makes it all too easy to impulse eat. You might have had the best of intentions to just have a salad for lunch but then decide the linguini would not be such a bad choice. A lunchtime serving of linguini Alfredo could add 600 - 00 empty calories to your daily total; most of the calories come from carbohydrates and fat. This is not a good bang for your nutritional buck. If you decide that you absolutely must have pasta, a small serving with tomato sauce is going to be the better choice.

Substitute healthier choices for low nutritional density, calorie-laden food; the next time you are out for breakfast, try passing on the hash browns and bacon; ask for fruit instead. A baked potato is going to be healthier than french fries but be mindful that the butter and sour cream will not.

Order a side of steamed vegetables, brown rice or quinoa if they are available; if you are going to eat bread, opt for fibre rich whole grain varieties over white. Key healthy words to look for on a menu are broiled, baked, boiled, grilled, steamed and poached; stay away from anything fried, breaded, battered, creamed or smothered. When it comes to starters, soup broths are a good bet as they give a sated feeling without tons of calories.

So you have chosen the broth and pared your meal choice down to a manageable and healthy size. We all know what happens next right? Along comes your server with that all knowing grin asking if you would care to see the dessert menu. If you can’t just shake your head and say, “check please,” then your next best strategy is to order the least damaging sweet on the menu and share it between your fellow diners. Accompany that with a non-fat decaf latte or chai and you will not feel deprived. If you do feel deprived, then treat yourself and follow that with a long walk. Balance is always the key. Good Health to You!

Grilled Crandrizzle Salmon

Grilled Crandrizzle Salmon

A moist salmon fillet topped with a crunchy berry salsa. A tasty way to get a healthy dose of essential fatty acids and antioxidants.

2 lbs (900 g) fresh salmon fillets, skin removed 1 Tbsp (15 mL) prepared mustard 2 Tbsp (30 mL) brown sugar 1 ⁄4 tsp (1 mL) salt 1 ⁄4 tsp (1 mL) pepper 1 ⁄4 tsp (1 mL) diced fresh rosemary 1 ⁄4 cup (60 mL) cranberry juice 1 ⁄4 cup (60 mL) + 1 Tbsp (15 mL) softened butter, divided 2 Tbsp (30 mL) raspberry vinegar 1 ⁄2 cup (125 mL) boiling water 1 ⁄2 cup (125 mL) dried cranberries 1 ⁄2 cup (125 mL) chopped almonds 1 tsp (5 mL) chopped fresh thyme 2 Tbsp (30 mL) maple syrup 1 tsp (5 mL) poppy seeds Cut salmon fillet into 5 equal pieces according to weight. In a small bowl combine mustard, brown sugar, salt, pepper, rosemary and cranberry juice. Smooth mixture over salmon and allow to marinate for 30 minutes.

In a heavy bottomed pot, bring water and vinegar to a boil. Stir in cranberries and remove from heat. Cover with plastic wrap and allow to steep for 20 minutes.

Preheat a grill or broiler. Remove salmon fillets from marinade, and set remaining marinade aside. Brush a small section of hot grill with soft butter and gently place a fillet of salmon over top. Repeat with remaining fillets and adjust heat to medium-high. Cook for 2 minutes, then rotate salmon 90 degrees to acquire cross pattern grill marks. Cook for another 2 minutes, then flip salmon over and cook until it is firm with a moist centre, about 3 to 5 minutes. Remove from heat and keep warm.

Melt 1 Tbsp (15 mL) butter in a medium sized heavy bottomed sauce pan over medium-high heat. Add almonds and allow to slightly brown. Add 2 Tbsp (30 mL) marinade. Lower heat and add rehydrated cranberries, thyme, maple syrup and poppy seeds. Generously spoon mixture over each fillet and serve.

Tip: Grilling salmon is a delicate process. Be sure to brush the grill and the fish with butter continually during the cooking process to prevent the salmon from sticking to the grill.

1 serving: 490 Calories; 30 g Total Fat (13 g Mono, 3 g Poly, 11 g Sat); 95 mg Cholesterol; 27 g Carbohydrate; 2 g Fibre; 30 g Protein; 740 mg Sodium

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PEOPLES DRUG MART & PEOPLES PHARMACY Reprinted from Healthy Family Recipes © Company's Coming Publishing Limited

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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.

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