Healthier You Spring
SHRINKING GEOGRAPHY Health care programs that overcome
our vast northern landscape
NH CONNECTIONS: TAKING THE WORRY OUT OF HEALTH CARE TRAVEL TELEHEALTH IN NORTHERN B.C. HELP WITH ALLERGIES OVER THE PHONE
Volume 6, Issue 1
NORTHERN HEALTH CONNECTIONS: CELEBRATING TEN YEARS OF SERVICE
Ten years later, the Northern Health Connections bus service continues to provide affordable, worry-free health care travel to keep residents of northern B.C in their home communities.
MEDICAL SPECIALISTS LAND ON THE SHORES OF STUART LAKE�������������������������������������������������PAGE 8 Telehealth is win-win-win in Fort St. James!
A NORTHERN PROGRAM FOR NORTHERN PEOPLE������������������������������������������������������������������� PAGE 12 Specialized support for HIV and hepatitis C care available in-person, via telehealth, and over the phone.
HELPING SENIORS AGE AT HOME Specialists travel the north with the Geriatric Outreach Service.
A LIFESAVING PROGRAM, NO TRAVEL REQUIRED������������������������������������������������������������� PAGE 18 A unique way to deliver addictions treatment takes root and changes lives in Terrace.
FOOD ALLERGIES? HELP IS JUST A PHONE CALL AWAY!��������������������������������������������������������� PAGE 20 Learn about the services provided by HealthLinkBC’s allergy dietitian.
DONATING MOTHER’S MILK����������������������� PAGE 14 Northern moms connect to a lifesaving donation system.
8-1-1 AND PHYSICAL ACTIVITY��������������������� PAGE 16 Exercise professionals join the suite of services available via HealthLinkBC.
A vast geography full of opportunities
Healthier You Volume 6, Issue 1 – Spring 2017
600,000 square kilometres. An area the size of France. Two-thirds of the province. No matter how you describe it, the area served by Northern Health is vast.
Cathy Ulrich President and Chief Executive Officer, Northern Health
While our expansive geography provides healthy opportunities for recreation and access to nature, it can also create challenges.
In this issue of Healthier You, we look at how these challenges have created a unique space for northern innovation, technology, and ideas.
Where can you find Healthier You?
Did you know, for example, that the Northern Health Connections bus service is celebrating 10 years of providing affordable health care travel for northerners? We were delighted to read the testimonials of past riders (page 6) and we look forward to welcoming even more travellers on board in 2017. NH Connections is a wonderful example of a northern idea that has contributed to helping people access the health care they need while living in their chosen home community.
• Doctors’ offices • Walk-in clinics • Pharmacies • Other community settings
Technology has also played a big role in making services more accessible in northern B.C. Telehealth is linking specialists and patients (page 8, 12, and 18) and qualified exercise professionals are now just a phone call away (page 16). It will be exciting to see which innovations are coming next. As you read this issue, I hope that you enjoy learning about some of the services that are defying geography in northern B.C. and how they might make a difference in your life and in the lives of your loved ones. As always, please contact our health promotions team at firstname.lastname@example.org if you have any feedback or questions about Healthier You or the stories in this issue. Thank you for reading.
the northern way of caring
PUBLISHED BY NORTHERN HEALTH & THE PRINCE GEORGE CITIZEN
Copyright ©2017. All rights reserved. Reproduction of articles permitted with credit. Northern Health
Contributors / Healthier You is produced by the Northern Health health promotions team with contributions from Northern Health staff and partner organizations, in partnership with The Prince George Citizen.
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Advertisements in this magazine are coordinated by The Prince George Citizen. Northern 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 Northern Health and The Prince George Citizen. Printed in Canada. Please recycle.
health care travel
NORTHERN HEALTH CONNECTIONS: CELEBRATING TEN YEARS OF SERVICE A HEALTH CARE TRANSPORTATION SOLUTION IN THE NORTH Haylee Seiter, Health Promotions, and Maureen Haley, Patient Transportation, Northern Health
Imagine living in your beautiful rural community in northern B.C. and receiving medical news that you must travel to a bigger centre for treatment or require access to health care services not available in your community. Geographically, the nearest community with accessible health care services is hours away and your urgent search for airfare reveals a price tag upwards of $600 per person round trip. The high cost of the trip brings added stress and, on the other hand, just thinking
about driving such a long distance makes you worried and anxious. For years, this scenario was familiar to residents seeking health care outside of their communities in northern B.C. That is, until a health care transportation solution in the north was born. Recognizing a need During Northern Healthâ€™s community consultation in 2004, participants overwhelmingly expressed that safe, affordable access to health care via transportation was one of the greatest barriers to health care in the north. From this feedback, Northern Health Connections travel service was created in partnership with Diversified Transportation Ltd. The program began in late 2006 with the objective of keeping people in their home communities while still having accessible health care. The first phase of the program included only long distance service with four routes that started from communities such as Fort Nelson and Prince Rupert. The short distance, same-day services started later in 2007. By creating a scheduled transportation service throughout the north that linked communities to services, the goal was to improve health outcomes for northerners. Ten years of service In 2017, Northern Health Connections is celebrating ten years of continued scheduled health care transportation service in the north.
Richard Banks, Connections driver since June 2006: “What makes me proud about the service is that it is always greatly appreciated and required by so many clients, along with the gratitude shown to me by the clients. We must continue to go the extra mile to provide a first class service.” Thanks to a team of dedicated staff, the service has provided exceptional transportation options for health care patients – and continues to do so – with affordable fares ranging from $20-40 return trip between northern communities and $40 return trip from Prince George to Vancouver. Today, the comfortable and reliable Connections fleet consists of five coaches and six mini coaches, each equipped with wheelchair spaces, wheelchair lifts, washrooms, DVD players, and many other great amenities. Connections buses are driven by a team of skilled and compassionate drivers who ensure each and every rider receives the compassion they need when travelling to their health care appointments. Striving for excellence As part of the contract with Diversified Transportation, new buses are added to the fleet each year to continually improve safety and reliability while travelling northern highways. Throughout the last ten years, many improvements have been made in response to feedback from surveys and comments from Connections riders. Some of these new additions to the fleet amenities have included adding washrooms on the mini coaches, as well as adding Automated External Defibrillator (AED) units to the entire fleet in order to improve safety for passengers. When the AEDs were added, drivers attended an orientation session including AED and CPR training in order to be prepared in the event of a cardiac situation on the bus. Juli Hornland: “My daughter and I have travelled to and from Prince George on the Northern Health bus on many occasions. What a wonderful service! We in the north are so fortunate to have this option available to us. The drivers are so courteous and helpful, they repeatedly ask if you are warm and comfortable or need pillows or blankets. They assist you on and off the bus if needed; they even carry your bags if you are unable to do so. I cannot say enough about this wonderful service; my only wish is that it was utilized more.” The website and branding was updated to streamline information and create an online reservation system. The new system allows anyone who needs to travel for health care appointments to check the bus schedule online and book their seat. One-way travel is still booked through the call centre.
Connections continued The employees of Diversified Transportation, from the drivers to the call centre staff, all believe in the service and know the difference this transportation option has made to the lives of many. After 10 years of serving the north, there are still people who are unaware of the program or think they must be sick to use the bus. Northern Health Connections operates to ensure northerners can remain in their beautiful home communities and still be able to access the health care they need to stay healthy and active. Help us to continue to spread the word about the Northern Health Connections service by recommending and sharing the service with others. Ron Krell, Connections driver since July 2006: “What makes me proud is being able to help our clients in their time of need and seeing how much the service impacts their lives.” Do you have a Connections story or a suggestion about the service you would like to share? We would love to hear from you! Please contact email@example.com.
MORE INFORMATION Who can use Northern Health Connections? • Any northern residents who must travel outside their home community for non-emergency health care are eligible to use the service along with a companion, if needed. • Find eligibility criteria and travel information at nhconnections.ca
Book your trip today! •
Reservations and inquiries: Our team is at your service Monday - Friday, 8 a.m. to 5 p.m. to help with your booking or answer any related questions. Call 1-888-647-4997.
Self-service: Book a trip using our online reservation system at nhconnections.ca/bookatrip
Please note: We do not accept reservations or cancellations by email.
Dr. Brent Ohata on the monitor, ready to start the first virtual patient visit from his office in Burnaby.
MEDICAL SPECIALISTS LAND ON THE SHORES
OF STUART LAKE IMPROVING CARE, SUPPORTING PHYSICIANS, AND ENGAGING SPECIALISTS: TELEHEALTH IS WIN-WIN-WIN IN FORT ST. JAMES! Kris Nielsen, Practice Support Program Coach, Northern Health
November 14, 2016, was an exciting day for residents and health care providers in Fort St. James. Although the Fort St. James Medical Clinic, its physicians and staff, and the patients in the clinic that day all looked the same as they might have on any other day, what happened that fall morning marked a significant change to health care in this community. November 14, 2016, was the first day that the medical clinic piloted secure, in-clinic telehealth. This is a great step in supporting patients to stay in their home community for more of their health care needs.
On the 14th, patients with joint and muscle concerns came to the Fort St. James Medical Clinic as they have many times before. They checked in for their appointment and were escorted to the exam room. That’s when things started to get a little different and a little exciting! Within minutes, the patient and their family doctor were talking with a rheumatology specialist in Vancouver via a computer monitor. Computer technology is creating opportunities for a different type of “face-toface” between the specialist, the patient, and his or her family physician. If this was a typical face-to-face visit, a rural patient could be one of many patients waiting six months or longer to see this specialist. This appointment with a unique specialist would normally require travel, time off work, hotel stays, and more. What are patients saying about telehealth in Fort St. James? After their consultations with the rheumatology specialist, patients were very pleased with the service. “This program can benefit so many people in small communities,” said one patient. “The wait time is so short compared to if I had to travel. It was easy to talk to [the specialist] on the computer monitor and I have my family physician available to support me at any time during the consult.” Another patient commented, “I really appreciate this new way of seeing a specialist and I don’t have to leave my community. I don’t have to worry about travelling on winter roads or the expense of going to Vancouver to see this specialist.” What about the doctors?
Dr. Anthon Meyer and patient Kay Hall. 8
For Fort St. James Medical Clinic director Dr. Anthon Meyer, who attended the telehealth appointments, realtime access to specialists like this for his rural patients makes a world of difference. “This is truly patientcentred care,” said Dr. Meyer. “It provides access to specialist services when the patient requires the service and where the patient requires the service, in real time.
This is exactly the kind of access that we have been talking about for years in support of our patients and in support of isolated rural communities and physicians. I want to thank our clinic staff, my colleagues, Northern Health, Dr. Brent Ohata, and Dr. John Pawlovich for their unconditional support to assist us in making this program a reality. Isn’t this true collaboration?” More than just technology: bringing specialists to Fort St. James The telehealth care that started in Fort St. James this fall is just the latest addition to the Fort St. James Medical Clinic’s work to increase access to specialists in their community. Specialist outreach has occurred here since 2010. Specialists who have visited the community in person include: • Dr. Drummer (geriatric specialist) • Dr. Smith (respiratory specialist) • Dr. Leccese (pediatric specialist) • Dr. Lowry (nephrology specialist) • Dr. Vallentyne (physical medicine & rehabilitation specialist) • Dr. Kitson (dermatology specialist)
There is now a schedule of visits to the clinic four times a year by four of these specialists to see new and existing patients. Patients have responded very well to outreach visits by specialists. “I don’t have to take time off work to see the specialist,” shared one patient. “I don’t have to take a specific trip out of town. Seeing a specialist at home saved me the expense of travel. I would come to another appointment like this – I feel better equipped to deal with my health issues.” Specialist visits benefit more than just the patients, though, as local physicians benefit from face-to-face discussion about a patient’s health issues and hands-on medical education while the specialist is in the clinic. Why share this story? For Dr. Meyer, specialist outreach and telehealth in Fort St. James represent a model for others to learn from. “It is our sincere hope that this innovative and collaborative community-driven initiative might assist other communities to develop similar programs where we will be able to change waiting times and access, support rural and isolated physicians, and ultimately improve patient care in a meaningful manner.”
GERIATRIC OUTREACH SERVICE: HELPING SENIORS AGE AT HOME GERIATRIC SPECIALISTS TRAVEL THE NORTH Shell Lau, Geriatric Outreach Services, Northern Health
In 2013, when Northern Health asked community members about healthy aging, one theme that kept coming up was that older adults and seniors want to stay in their homes as long as possible. In fact, the aim of Northern Health’s Healthy Aging in the North action plan (http://bit.ly/nh-healthyaging) is “to assist seniors to live well, retain their independence, and where possible, to avoid or minimize the duration of hospital stays. Ultimately, the goal is to support seniors to continue to be active and vibrant in their communities and to age healthily and gracefully at home.” While there are many things that older adults can do to stay healthy and retain their independence, in every northern community there are also seniors who are at higher risk of losing their independence. How can we support these high-risk seniors to live as healthfully and independently as possible? What can be done to keep even frail and ill seniors with complex conditions in their community – where we know they want to be (and where research shows they do best)?
This is where the Geriatric Outreach Service comes in! The Geriatric Outreach Service supports general practitioners in their care of high-risk seniors (65 years old and above, with some case-by-case exceptions) across northern B.C. Through the program, geriatric specialists see seniors with complex medical and psychiatric illnesses that are affecting their physical, cognitive, social, or functional status. The geriatric specialists travel to 14 different northern B.C. communities up to four times each year. For two additional communities, McBride and Mackenzie, specialist visits are done via telehealth. The purpose of the service is to support local doctors and nurse practitioners with their more complex senior patients. When they visit, geriatric specialists bring expertise in various areas affecting northern seniors, including: • Falls • Declining mobility and movement disorders • Osteoporosis • Cognitive disorders and delirium • Mental health concerns • Functional decline and increased dependence For the geriatric specialists involved in the program, the chance to work with different teams in different communities is a welcome opportunity. Geriatrician Dr. Martha Spencer shared her thoughts about outreach and reflected on a unique experience in Terrace: “I thoroughly enjoy my outreach trips to northern B.C. communities. Patients and their families are always appreciative of our care and the allied health staff is very accommodating and hospitable. I also enjoy the opportunity to work in a variety of settings from outpatient to inpatient, and long term care to home visits. While in Terrace last summer, one of
the nurses from clinic picked me up at the crack of dawn before clinic to climb Terrace Mountain, which was such a treat! The natural beauty of the communities I visit is unparalleled and I cannot wait for my next adventure!” While the Geriatric Outreach Service continues to bring valuable experts and expertise into northern communities, preventing the complex conditions that require specialist visits is even more important. According to Dr. Spencer, “The most important thing that people of any age can do for their health is exercise. Exercise is especially important as we age. Gait speed is increasingly becoming a vital sign in its own right, with slow gait speeds predicting a range of adverse outcomes such as falls, hospitalization, and death. Additionally, there is evidence that exercise benefits the brain, both in those who are cognitively intact and those with dementia. Some degree of exercise is possible for everyone, irrespective of one’s cognitive, motor, or functional abilities and should be recommended for all. It is better than any pill out there!”
MORE INFORMATION All referrals to the Geriatric Outreach Service come from a physician or nurse practitioner. If you or a loved one would like more information about this program, contact Shell Lau, regional coordinator for geriatric outreach services, at 250-645-6297.
DID YOU KNOW? There are physical activity guidelines tailored for those aged 65 and over. According to the Canadian Physical Activity Guidelines for Older Adults (csep.ca), “to achieve health benefits, and improve functional abilities, adults aged 65 years and older should accumulate at least 150 minutes of moderate- to vigorous-intensity aerobic physical activity per week, in bouts of 10 minutes or more. It is also beneficial to add muscle and bone strengthening activities using major muscle groups at least 2 days per week.” Learn more at csep.ca. SPRING 2017
hiv / hepatitis C
“A NORTHERN PROGRAM FOR NORTHERN PEOPLE” HAVE QUESTIONS ABOUT HIV OR HEPATITIS C? THE SPECIALIZED SUPPORT TEAM HAS YOU COVERED. Vince Terstappen, Health Promotions, Northern Health
Because of advances in treatment and new research into the prevention of HIV and hepatitis C, HIV screening is now recommended for everyone as part of their routine health care. Despite these advances – which have also meant that those diagnosed early and following a prescribed treatment plan can live nearly as long as those without HIV or hepatitis C – there’s no doubt that a positive test can be a scary and confusing result. For individuals across northern B.C., however, there is now a specialized team available in-person, via telehealth video link, and over the phone to help navigate this tumultuous time. No matter where you live, the team can help you with any questions that you might have. I had the chance to sit down with specialized support team members Brenda MacDougald (social worker) and Jennifer Hawkes (pharmacist) to learn more about the way that they deliver care across the north. What is the specialized support team? The specialized support team is a team of professionals who work together to complement the care being provided by an individual’s family doctor or nurse practitioner. Our team includes a social worker, pharmacist, dietitian, and a consulting nurse practitioner. We were created in March 2016 and provide information specific to HIV and hepatitis C to 12
patients and their care team. We support both patients and care providers. What type of support do you provide? We provide specific, tailored information for patients and care providers about what community resources are available, how to access medications, considerations for starting a family, how to navigate the health care system with regards to HIV and hepatitis C, and more. We are also committed to helping those without a primary care provider to find one, because that’s the person they’re going to be seeing most regularly. In other words, we help individuals and their families navigate through getting their condition managed and their questions answered. We’re centered around the patient and their families. We want to help people meet their own goals. We are all about providing people with the information they want, when they want it. Some people want all of the answers right away. Other people don’t want any information for years. People’s questions also aren’t answered in one visit or interaction. Things come up as time goes on. We’re committed to connecting regularly, whenever the person has a question. How does your team address the challenge of providing HIV and hepatitis C care in rural and remote communities across northern B.C.? We consider ourselves a northern program for
MORE INFORMATION Brenda MacDougald, social worker, specialized support team
Contact the specialized support team at 1-888-645-6495 or visit hiv101.ca/ContactUs.aspx.
Why is testing for HIV important? Testing for HIV used to be a risk-based test. Now, it is a routine test for everyone, even individuals without symptions. Why is this?
Jennifer Hawkes, pharmacist, specialized support team
northern people. We help everyone access the kind of specialized services they might get in large, urban centres. We offer services to all northerners, including First Nations communities, who we serve in partnership with the First Nations Health Authority. We offer telehealth services, phone support, support by mail – we just want to make sure that people are linked to whatever resources are available. We also ensure that everyone working with the patient knows about HIV and hepatitis C. We work with care providers on appropriate language and best practice. We provide educational support to build on the capacity that already exists within care teams. How have HIV and hepatitis C changed over the years? There has been a shift in how we think about HIV and hepatitis C. People are living with these conditions for their entire lifespan. This is not like the 80s or 90s and, frankly, we need to be re-learning what we thought we knew! We are now looking at them more as chronic diseases, which means looking beyond just prevention and infection and addressing the entire lifecourse. Recent scientific breakthroughs have also resulted in a movement towards ‘treatment as prevention.’ By testing everyone, we ensure that we don’t miss any diagnoses and get the benefits of early detection and treatment. Research has found that treatment of HIV-positive individuals can prevent the spread and
• Early diagnosis is key to successful treatment. • Many people can have no symptoms for many years. • Testing prevents late-stage diagnosis. • Because HIV is spread through unprotected sex or blood contact, all adults are considered to be at risk. • Current guidelines advise that everyone be screened every 5 years. Depending on the presence of certain risk factors, others may be screened more often. progression of HIV. What has changed the most is treatment and medication. Medications are becoming as simple as one pill, once a day in many cases. Medications have fewer side effects. Hepatitis C is considered curable and HIV is manageable. People used to think that you couldn’t have these conditions and have a loving partner or a family – that is simply not true anymore. How can individuals diagnosed or living with hepatitis C or HIV access the specialized support team? Just give us a call! People can be referred by community groups, their care team, even themselves (self-referrals are welcome). When we get the call, we’re very flexible with the support we provide. If people want just one question answered, that’s fine. If they are interested in ongoing support, that’s fine, too! The support that we provide is individualized and we will help people as long as they need it. Can you take us through a typical journey in this program? There are really just two ‘typical’ things: we provide access to information – both general and personal – and we provide access to medications. How we do that is dependent on the person – where they are at and their preference for how and when to communicate.
MOMS CAN HELP SAVE
LIVES BY DONATING
MOTHER’S MILK A NEW MILK DEPOT IN PRINCE GEORGE HELPS NORTHERN MOMS CONTRIBUTE TO A LIFESAVING DONATION SYSTEM. Holly Tran, BC Women’s Hospital + Health Centre
Carol Ng was excited to be carrying twins. But with multiple births, there’s an increased likelihood of giving birth prematurely. On December 14, 2016, the Ngs welcomed two baby girls: Charlotte and Ariel. Charlotte and Ariel were born premature at 34 weeks and three days, weighing in at 4.4 lbs and 3.9 lbs respectively. When the babies were born, hospital staff asked Carol whether she would prefer human milk or formula for the babies. Without a question, Carol opted for donor human milk. As a new mom, Carol hadn’t yet produced enough milk, which is very common for moms who deliver prematurely. Carol was thankful to have the option of feeding her babies with donor milk. “Human milk has more nutrition and antibodies than formula,” said Carol. “The simple sugars are easy for babies to break down and this is especially important for premature babies.” Currently, the Ng babies are doing well and slowly gaining in size. Premature babies are at a high risk of developing necrotizing enterocolitis (NEC), a life-threatening disease that affects the intestine. Research has shown that breast milk can prevent NEC in premature babies. When moms are unable to breastfeed, donor milk is the next best option. Due to the fragile health of premature babies, access to mother’s milk can be life-saving. BC Women’s Provincial Milk Bank is always in need of milk donations. The Milk Bank provides donor human milk to all B.C. neonatal intensive care units (NICUs), where the sickest babies are treated. With increased demand, the Milk Bank relies on a steady supply of donations. The Milk Bank collects donations from milk depots located throughout B.C. Once screened and pasteurized, the milk is bottled and stored to be distributed to various NICUs. When supply is high enough, milk is also available with a prescription for discharged babies who still require donated milk. Baby Ariel with Uncle Alex. 14
If you’re a healthy breastfeeding mom who has extra milk, please consider giving this special gift to families in need.
Donating is easy! Just follow these steps: • Donation starts with donor screening that can be done over the phone with a nurse to answer some general questions. • Moms complete a set of short forms (including a medical history sheet) and fax them to BC Women’s Hospital. • Once reviewed, a request for information and blood work is sent to the prospective donor’s doctor. • When the blood results come in and there are no issues, the donor is contacted about getting her milk donations to the Milk Bank.
Charlotte being treated for jaundice in incubator.
• Donated milk can either be personally delivered or couriered to BC Women’s Hospital or dropped off at one of the milk depots in B.C. The hospital in Prince George recently opened a drop-off depot in July 2016. BC Women’s Provincial Milk Bank is a non-profit providing mother’s milk to babies in need free of charge. For more information on how you can donate and a stepby-step guide with videos on how to store and collect milk, please visit bcwomens.ca and search: milk bank.
8-1-1 & PAL: PHYSICAL ACTIVITY IN THE NORTH – THE OPPORTUNITIES ARE ENDLESS! EXERCISE PROFESSIONALS JOIN THE SUITE OF SERVICES AVAILABLE VIA HEALTHLINKBC.
Gloria Fox, Regional Physical Activity Lead, Northern Health
No matter where you live in northern B.C., if you’re looking to make a lifestyle change this year but you’re not sure where to start, HealthLinkBC can help! HealthLinkBC is a completely free resource that provides access to invaluable health information and advice 24 hours a day, 7 days a week, either online, via mobile app, or by simply dialing 8-1-1 from your phone. Until recently, the health professionals available to the public via HealthLinkBC included health services navigators, nurses, dietitians, and pharmacists. However, aligning with the Ministry of Health’s commitment to support British Columbians in pursuing and achieving healthier, more active lifestyles, the HealthLink team has now expanded to include exercise professionals from the Physical Activity Line. Before the addition of exercise professionals to the team, the professionals on the phone lines at HealthLinkBC were fielding approximately 1,200 calls per day, with the website receiving approximately 10,000 visits per day! I think it’s safe to say these numbers are only going to increase with the addition of physical activity resources.
What to expect When you dial 8-1-1, you’ll be greeted by a health services navigator who will provide you with general health information and advice and/or connect you with the appropriate health care professional to address your concern. You have the option of either 16
MORE INFORMATION Who is available when? • Health services navigators & nurses: 24 hours/day, 7 days/week, 365 days/year • Dietitians & exercise professionals: MondayFriday, 9 a.m. – 5 p.m. • Pharmacists: 7 days/week, 5 p.m. – 9 a.m. (when a community pharmacist is unavailable) Website: healthlinkbc.ca Mobile App: BC Health Service Locator creating a profile or remaining anonymous during your conversation, so it’s a very “low risk” conversation. If you are phoning for physical activity advice, the exercise professionals are a great resource for evidence-based information for all ages and abilities. They are equipped to provide general physical activity screening; information on healthy living; advice on how to get and stay active; individualized physical activity prescriptions; and referrals to physical activity programs available in your local area. I wasn’t sure that this would be the case for residents of smaller communities in northern B.C., but the nice gentleman I spoke to assured me that if there are resources and programs available, they will locate them for any area of B.C.
For example, if you’re calling from Vanderhoof, they may inform you about the accessible paths with nearby playground at Riverside Park, the cross-country ski trails at the Nechako Valley Sporting Association grounds, or the drop-in badminton club that meets at the local high school. The exercise professionals will also provide comprehensive assistance with facilitating and supporting behaviour change, including advice on overcoming barriers, setting realistic goals, and even coming up with a backup plan to prevent or correct a relapse into unhealthy habits. The Physical Activity Line’s move to HealthLinkBC became official via the telephone lines on November 24th, and the website move is still in progress. Considering the number and the remoteness of communities in northern B.C., it’s pretty amazing that today’s technology makes the region and its opportunities and services so much smaller and easier to navigate. With translation services in more than 130 languages as well as services for those who are hearing impaired by dialling 7-1-1, this is a truly accessible health service – now complete with physical activity information – for all British Columbians.
mental health & addictions
A LIFESAVING PROGRAM,
NO TRAVEL REQUIRED A UNIQUE WAY TO DELIVER ADDICTIONS TREATMENT TAKES ROOT AND CHANGES LIVES IN TERRACE. Vince Terstappen, Health Promotions, Northern Health
“Addictions can be like a spring,” said Rai Read, integrated professional team lead, as we sat down to talk about a unique program in Terrace. “Opioids are a weight pressing down on that spring. When someone wants to stop using, it’s often not safe to just stop – that’s a lot of pressure to release all at once. What opioid substitution like methadone or suboxone does is safely release this pressure, little by little, under the supervision of health care professionals.” “And what’s more,” added Anita Ziegler, clinician and program coordinator, “while the pressure on this spring is being reduced, we can provide supports like counselling, mental wellness support, and life skills development.”
MORE INFORMATION If you or a loved one are experiencing difficulties with substance use, find information about services available in your community at: https://northernhealth.ca/YourHealth/ MentalHealthAddictions.aspx. This type of addictions treatment work, especially given its strict monitoring guidelines, can be difficult to deliver in northern communities. Through an innovative partnership, technology, and a caring team of health care providers, however, opioid substitution has come to Terrace, Prince Rupert, and, soon, Kitimat. “In Terrace, the opioid substitution team includes two doctors specializing in addictions from the Alliance Clinic in Surrey and a program coordinator and administrative support person in Terrace,” said Read. “We’re hoping to add a life skills worker soon.” The specialist doctors travel to Terrace once a month for face-to-face visits with clients and to conduct intake assessments for new clients wanting to stop using opioids. Follow up visits are done via video conference and telehealth. “Having it so that clients don’t have to travel is incredibly important,” said Read. “Getting a methadone licence is a major undertaking for physicians and may not be feasible for local doctors. Because of this, people previously looking for this program were braving winter roads and service might have been inconsistent.” “Consistency is key for opioid substitution,” said Read. With the new program model in Terrace, individuals wanting support to end their opioid addiction have timely, consistent access to the same doctor. They also get full support from Ziegler to develop healthy relationships, strengthen their mental wellness and coping skills, build relapse plans, and navigate the sometimes complicated regulations of opioid substitution therapy. These regulations are one reason why Read and Ziegler say it’s important for this type of program to be available in communities like Terrace. When individuals first start opioid substitution treatment work, for
MORE INFORMATION Another important role of the opioid substitution program in Terrace has been to promote the use of take-home naloxone kits. Naloxone is a medication that reverses the effects of an opioid overdose. If you would like more information about take-home naloxone, visit TowardTheHeart.com/naloxone. 18
Members of the Terrace opioid substitution treatment team. From left to right: Celeste Presby (administrative support), Dr. John Koehn (Alliance Clinic), Anita Ziegler (clinician), and Rai Read (team lead).
example, their doses need to be witnessed, which requires daily visits to the pharmacy. This can be a lot to manage, which is why Ziegler’s local, personalized support is integral to the program’s success. “Individuals make a life here,” said Read. “When they are working to manage an addiction, they need to have skills that work in the local community. If you’re getting care out-of-town, you may encounter triggers when you return home or have new skills that don’t translate. Delivering care here means working within that local context, with triggers and appropriate coping skills in mind.”
MORE INFORMATION Read more about the Terrace opioid substitution program at: http://bit.ly/terrace-ost.
Clients have been very appreciative of this local access, too. “There was some initial hesitation to videoconferencing, but they are now very comfortable with that service,” said Read. “It makes a difference that the intake is done face-to-face,” added Ziegler. “The doctors are great at developing a relationship in the first visit that carries over to the videoconference visits.” Programs like this that deliver care across our vast geography are having positive impacts at many levels, with local physicians learning from visiting specialists, for example. For Ziegler, though, it’s all about the clients’ successes: “We’re seeing people getting back to work, getting all of their functional skills back, strengthening relationships, improving their physical health, getting their kids and families back,” said Ziegler. “That’s the true impact of what’s happening here. Without a program like this, that same person may have died. The progress is incredible to see. It’s amazingly rewarding.” SPRING 2017
HELP IS JUST A PHONE CALL AWAY! HEALTHLINKBC’S ALLERGY DIETITIAN GUIDES INDIVIDUALS AND FAMILIES AS THEY NAVIGATE THE DIETARY CHANGES RELATED TO FOOD ALLERGIES. Dietitian and Physical Activity Services, HealthLinkBC
Food allergy can develop to a single food such as egg or peanut, or to multiple foods. The most common food allergens among Canadians are milk, egg, peanut, tree nuts, soy, seafood (fish, shellfish, crustaceans), wheat, and sesame seeds. Common in childhood, food allergy affects about 5-8% of young children. While a food allergy can continue into adulthood, some children will outgrow one or all of their food allergies. Once a person has developed a food allergy, an allergic reaction will happen every time the food is eaten. For many people, finding support from a health care provider to manage their food allergy can be a challenge. Geography and limited access to specialized health services in northern B.C. can make it hard to know and understand what foods to eat, what foods to avoid, and how to feel confident about nourishing a child with food allergy. This is where the Allergy Nutrition Service with
Dietitian and Physical Activity Services at HealthLinkBC (HealthLinkBC.ca) can help. Linda, HealthLinkBC’s allergy dietitian, provides specialized nutrition information, education, and counselling support to individuals and families with a range of questions and concerns: from how to prevent food allergy to managing suspected and diagnosed food allergy. She is available to speak with anyone from anywhere in the province with or without a referral from a physician or nurse practitioner. Just call 8-1-1 and ask for Dietitian Services. Lots of parents of infants and young children call in to the service. They reach out to Linda concerned about their child’s nutrition, especially after a suspected allergic reaction or a newly diagnosed food allergy. Linda stated: “Our clients’ concerns are understandable. They worry about whether their child will get the nutrients they need to grow well while avoiding the foods that cause allergic reactions. As milk and egg are common ingredients in a range of family food choices, these foods become inappropriate for their child with milk and egg allergy.” Linda acts as a guide for parents as they navigate the dietary changes required for their children. She listens to their concerns, answers questions, and helps families come up with meal and snack ideas that work. She helps to increase their confidence and to feel that despite the food allergy, their child will thrive. If a food has already been removed from the child’s diet, Linda helps them choose nutritious, family-friendly, and personally acceptable alternatives. Food allergy too often leaves a child feeling left out at meal and snack
times, especially during social occasions. This doesn’t have to happen. Part of the support Linda offers is to help all family members and to bring some joy back to meal and snack times. A recent client of the Allergy Nutrition Service stated: “I felt more confident after speaking with Linda. I ended the call knowing exactly how we as a family can help my son meet his protein, fat, calcium, and vitamin D needs. She made me feel more confident that my son’s milk allergy wouldn’t put him at a disadvantage or take the fun away from our family meal time together.” Linda also helps parents and caregivers find information on a variety of topics such as preparing a preschooler with food allergy for enrolment in a child care centre, giving epinephrine (the lifesaving medication for an accidental exposure to a food allergen) to someone with severe food allergy, and accessing a pediatric allergist. Whatever the need, Linda is here to help her clients.
MORE INFORMATION If you would like to speak with Linda about food allergy, call 8-1-1 and ask for Dietitian Services. You can also call 8-1-1 for help with other food, nutrition, or physical activity questions. Registered dietitians and qualified exercise professionals are available to speak with you Monday to Friday, 9:00 a.m. to 5:00 p.m. Translation services are available in over 130 languages. For more information about HealthLinkBC, visit healthlinkbc.ca.
FEATURED INDIGENOUS LANGUAGE CULTURAL WELL-BEING IS FOUNDATIONAL TO HEALTHY WELL-BEING. DID YOU KNOW... • Aboriginal peoples include three distinct populations: First Nations, Métis, and Inuit. • 30 per cent of the Aboriginal people in B.C. live within the Northern Health region. • Of the 300,000 people served by Northern Health, over 17 per cent are Aboriginal. • In the northwest, over 30 per cent of the population is Aboriginal. Celebrating culture, language, and traditional activities are key to healthy communities. Incorporating culture and language into activities and relationships leads to healthier, more resilient communities. In northern B.C., there are many diverse Aboriginal peoples, territories, languages, and cultures. This issue, we’re highlighting Sm’algyax, spoken on the north coast of B.C., in the Skeena River drainage. Sm’algyax is part of the Tsimshianic language family. Learn more at web.unbc.ca/~smalgyax
To learn more about Indigenous languages and to hear recordings of words, phrases, stories, and songs, visit: • FirstVoices.com • First Peoples’ Language Map of B.C. maps.fphlcc.ca • LearnMichif.com • Inuktitut Tusaalanga tusaalanga.ca/aboutinuktitut
SM’ALGYAX (COAST TSIMSHIAN) ‘Niit, nda wila waan.
Hello, how are you doing?
Aam, dis ‘nüün?
Fine, and you?
Naayu di waan?
What is your name?
_______ di waayu.
My name is ________.
ü Walks every day ü Eats his greens ü Wears his head gear