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SUMMER 2014

New Treatments for Patients with Brain Injuries LAWSON TAKES HEALTHESTEPS TO FIGHT DIABETES

St. Joseph’s Experts, Donors Drive Innovations in Urology

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CALL

CHANTAL KREVIAZUK INSPIRES AT BREAKFAST OF CHAMPIONS PAGE 53

After a movie script opened his eyes to bipolar disorder, BRADLEY COOPER started speaking out

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Because of Lorraine and John... St. Joseph’s tradition of compassionate care continues.

We want to help ensure others experience the same high-level of care that we received. ST. JOSEPH’S BREAST CARE CENTRE provided compassionate care and support to Lorraine Yeoman when she was diagnosed with breast cancer three years ago. Both Lorraine and her husband John were so grateful for the level of care she received they decided to name St. Joseph’s Health Care as a beneficiary in their will. Visit our website to learn more about how you too can leave a legacy of care.

Renowned for compassionate care, St. Joseph’s is one of the best academic health care organizations in Canada dedicated to helping people live to their fullest by minimizing the effects of injury, disease and disability through excellence in care, teaching and research.

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St. JoSeph’S Notebook

High-energy success A focus on fundraising and innovation

Bringing their own energy to help make Bust a Move for Breast Health London a success were, from left, Frank Longo, chair of the event, Michelle Campbell, president and CEO, St. Joseph’s Health Care Foundation, Carolee Coulter, Shoppers Drug Mart pharmacist/owner, and Sally Aarssen, event vice-chair.

st. JosepH’s Hospital Goes sMoke free

Movin’ and Groovin’ for Breast HealtH Hundreds of participants took part in six hours of fun, heartpumping exercise March 29 in support of St. Joseph’s Breast Care Program at the second annual Bust a Move for Breast Health™ London event. The day was filled with high-energy music and funky fitness routines, and capped off by a special aerobic session with Canadian fitness expert Tommy Europe. Watch for plenty of photos and an update on total funds raised in the next issue of Vim & Vigour.

AL DESrOCHErS, SnApD LOnDOn

top 10 rankinG For 2013, Lawson Health Research Institute ranked ninth among Canada’s top 40 research hospitals—the same ranking as the previous two years—with just more than $103 million in research income in 2012. That figure includes all funds to support research costs received from all sources to the organization. Each year, Research Infosource Inc. publishes Canada’s Innovation Leaders, which shines a spotlight on the country’s most innovative universities, corporations, hospitals and colleges. Much of Lawson’s continued success is due to ongoing local support for health research innovation.

On Dec. 2, 2013, St. Joseph’s Hospital went smoke free. This means there is no longer a designated smoking area on-site and smoking will no longer be permitted on hospital property, which includes the parking garages. This step was taken to better support patients and promote a healthy community. By winter 2014–15, all St. Joseph’s sites will be smoke free, including Mount Hope Centre for Long Term Care, Parkwood Hospital and the new London mental health facility opening later this year. The Southwest Centre for Forensic Mental Health Care in Central Elgin has been smoke free since it opened in June 2013.

season Continues to sHine BriGHt Community compassion was felt throughout St. Joseph’s Health Care London thanks to donors who helped raise $450,000 from Nov. 15 to Dec. 31, 2013, for St. Joseph’s Health Care Foundation’s 24th annual Season of Celebration campaign. Funds raised were directed toward patient and resident care and comfort items like blanket warmers, touchscreen technology, rehabilitative equipment, and a patient and resident transfer bus. The spirit of Season of Celebration is felt not only at Christmas, but all year long at St. Joseph’s.

Best in patient satisfaCtion Once again, patient satisfaction results for overall care in the inpatient unit at St. Joseph’s Hospital in London have been ranked the highest among Ontario’s teaching hospitals. This is the second year for these outstanding results, which were released by NRC Picker Canada in its second annual report Patient Ratings of Overall Satisfaction and Likelihood to Recommend for Ontario Hospitals. SUM MER 2014

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ConneCting With our Community

Enjoying the Warmth of Community Spirit

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s warmer months round the corner for summer, we at St. Joseph’s are enjoying the warmth of tremendous community spirit and generosity experienced once again at the Bust a Move for Breast Health™ London event hosted in March by St. Joseph’s Health Care Foundation and presented by Shoppers Drug Mart. This was the second year for the event in London and it was inspiring to see the momentum from last year’s successful inaugural event propel the energy to even greater heights this year. We thank all participants, volunteers and sponsors for their supDr. Gillian Kernaghan, left, and Michelle Campbell port and dedication to excellence in breast care in London. Watch for the next issue of Vim & Vigour for full coverage of Bust a Move. The community also came together in support of mental health care with the sold-out Breakfast of Champions in April featuring keynote speaker Chantal Kreviazuk. With candor, the singer-songwriter shared her family’s experience with mental illness, the lessons she has learned and the need to do better for those suffering. Read her story in this issue. We simply could not do what we do across St. Joseph’s without the enduring support of the community and the dedication of our staff, physicians and volunteers. In this issue of Vim & Vigour we highlight several areas of excellence making important inroads in the care of patients and residents. From major advances in rehabilitation for people with brain injury and stroke, to the success of the recovery model of care for those with mental illness, to world-class urological care made possible by donor dollars, to research that puts valuable tools in the hands of those with diabetes—St. Joseph’s is indeed making a difference in the quest to live fully. This mission and the St. Joseph’s values remain, as always, in the forefront as we adapt to changing provincial funding models while facing rising costs, the challenge of balancing each year’s budget and the need to make difficult decisions. In June, we invite you to visit us at sjhc.london.on.ca and sjhcfoundation.org for a year in review. Through our annual reports we are offering opportunities for questions and feedback. We look forward to hearing from you as we forge ahead to ensure the best possible care for our patients and residents.

ST. JOSEPH’S HEALTH CARE FOUNDATION 2013–2014 Board of Directors Peter Mastorakos, Chair Tim Brown Michelle Campbell, President Lesley Cornelius Michael Dale Ian Dantzer Dr. Tim Doherty Samira El-Hindi Dianne Evans Mark Farrow Murray Faulkner Stacey Graham

John Haasen Dr. Gillian Kernaghan Dr. Roman Kozak Frank Longo Ron Martindale Jr. Margaret McLaughlin Theresa Mikula Rick Spencer Tania Testa Brian Waltham Paul Way

ST. JOSEPH’S HEALTH CARE LONDON 2013–2014 Board of Directors Margaret McLaughlin, Chair Brad Beattie John Callaghan Kimberley Chesney Dr. Robert DiCecco Murray Faulkner Marcella Grail Phil Griffin Darcy Harris Dr. Sarah Jarmain Margaret Kellow Dr. Gillian Kernaghan, President

Paul Kiteley Gaétan Labbé Ron LeClair Rev. Terrence McNamara Dr. Mohan Merchea Karen Perkin Scott Player Pat Pocock Bruce Smith Dr. Michael Strong David Van Trigt

Contributing Writers Kelsi Break, Emily Bullas, Sonya Gilpin, Amanda Jackman, Laura Janecka, Anne Kay, Dahlia Reich, Renee Sweeney

Editors in Chief Kathy Burrill and Michelle Campbell

Editor Dahlia Reich

Production McMurry/TMG, LLC

801 Commissioners Road East London, ON N6C 5J1 519 646-6085 sjhcfoundation.org If you prefer not to receive Vim & Vigour from St. Joseph’s Health Care Foundation, please call 519 646-6085. TM

Vim & Vigour, Summer 2014, Volume 30, Number 2, is published quarterly by McMurry/TMG, LLC, 1-888-626-8779. Vim & Vigour is published for the purpose of disseminating health-related information for the well-being of the general public and its subscribers. The information contained in Vim & Vigour is not intended for the purpose of diagnosing or prescribing. Please consult your physician before undertaking any form of medical treatment and/or adopting any exercise program or dietary guidelines. TM

TM

TM

Dr. Gillian Kernaghan President and CEO St. Joseph’s Health Care London

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Michelle Campbell President and CEO St. Joseph’s Health Care Foundation

Publications Mail Agreement #41661016. Return undeliverable Canadian addresses to: 801 Commissioners Road East, London, ON N6C 5J1.

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CONTENTS

SPECIAL A Day in the Life A young man’s rehabilitation journey back from serious injury and his family’s enduring support.

50 DEPARTMENTS 1

Notebook Bust a Move for Breast Health London is a success.

2 Connecting with Our Community The impact of community spirit. 8 Faces of St. Joseph’s Leadership awards recognize a dedication to excellence. 46 Virtual Health The gluten-free gourmet, finding Dr. Right, cool health trackers, and more.

COVER PHOTO BY FRED THORNHILL/REUTERS/CORBIS

55 In Your Own Words Grateful patients share their St. Joseph’s experiences. 56 Inspired to Give Armatec supports groundbreaking research.

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FEATURES 24 28

Bringing Breakthroughs to Life Thanks to generous gifts, St. Joseph’s Urology Centre is advancing care worldwide. Recovery in Sight A Canadian first at St. Joseph’s Parkwood Hospital is helping those with acquired brain injury. Lost and Found A special vest treats a lost-in-space sensation that comes with brain injury. Stress SOS What’s the best way to lower your anxiety level? Yoga or an hour of TV? You might be surprised. Plus, how to prevent the summertime blues. The Truth About Sunscreen See how much you really know about that lifesaver in your beach bag. The Transformers Tiny tools and minimal incisions are giving the operating room an extreme makeover.

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Get Your Head in the Game Concussions don’t just happen to the pros. Here’s what to know before your tykes head for the ice. The Journey Continues Pack your bags and your meds—a chronic condition doesn’t mean your travel days are over. The Foot Follies On the journey through life, your feet are two of your best friends. It’s time to treat them that way. Friendly Fat Bring it, swimsuit season! These recipes feature delicious ingredients that may help flatten your tummy. Research Takes HealtheSteps Forward Lawson Health Research Institute tackles diabetes prevention. The Best Day of the Week A passion for cooking helps in the recovery from mental illness. A Girl Surrounded Chantal Kreviazuk shares her personal experiences with mental illness. The Art of Empowerment St. Joseph’s breast care patients find inspiration in artwork.

32 ON THE COVER Bipolar disorder wasn’t even on his radar screen when Bradley Cooper started filming Silver Linings Playbook. Now he’s an outspoken advocate for mental health.

SUM MER 2014

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Bringing

Breakthroughs Gifts to St. Joseph’s Urology Centre are impacting care worldwide

By Kelsi Break and Laura Janecka

to

T

Life

hrough surgical innovation, research excellence and teaching, the Urology Centre at St. Joseph’s Hospital in London has become world renowned for treating patients with diseases and conditions such as prostate and kidney cancers, kidney stones, urinary incontinence (the involuntary leakage of urine) and erectile dysfunction. This level of expertise takes gifted surgeons, nurses and staff, and cutting-edge technology supported by generous community donors. These include some of London’s most spirited philanthropists and community-minded companies wanting to make a difference. Over the years, St. Joseph’s Health Care Foundation has been able to allocate millions to advance urological care at St. Joseph’s. Here are just some of the individuals who have helped make that happen:

All ‘Fore’ Better Patient Care For the past 10 years, Trudell Medical Urology Golf Tournament has been teeing off and raising funds for urological care, bringing in more than $600,000 in donations. The golf tournament is run by enthusiastic volunteers, including 10-year chair Erin Rankin Nash, a lawyer with McKenzie Lake, and the tournament’s title sponsor, Trudell Medical Marketing Limited. Proceeds from the tournaments have helped fund such innovations as the digital C-arm fluoroscope imaging unit, which identifies kidney stones and defects and obstructions in the urinary tract through noninvasive imaging, providing quicker and more accurate results. “We are strong believers in St. Joseph’s urology program,” says Rankin Nash. “The team does such great work that we want to honour, celebrate and support them.”

Igniting Innovation Funding for the revolutionary da Vinci Surgical System wouldn’t have been possible without donor support from people like Mitch Baran,

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CEO and founder of Trudell Medical, who is driven to enhance care and ignite new innovations. “I am committed to supporting medical researchers and innovators quietly working away at the next breakthrough,” says Baran. “I am very excited to see what’s next for the world class St. Joseph’s urology team.”

Supporting Care Close to Home Generous donors in the community like Michael Howe of Norquay Developments Limited have supported London’s only lithotripter, located at St. Joseph’s Hospital. “By supporting innovative technology like the lithotripter, I know that I’m helping bring the best in care closer to home,” says Howe.

Championing Leadership The Miriam Burnett Chair in Urological Sciences, which provides scientific leadership at Lawson Health Research Institute and St. Joseph’s, was established thanks to The W. Garfield Weston Foundation’s $2.5 million donation to focus on probiotics and prostate and other urological cancers. 

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A History of Surgical Innovation Surgeons at St. Joseph’s are pioneers in urological surgery, including minimally invasive robotic surgery, performing more than 100 robotic assisted procedures each year and achieving many Ontario, Canadian and world firsts. Over the years, the team has enhanced surgical treatments using the revolutionary

da Vinci Surgical System. Most recently, in a trial believed to be the first of its kind in Canada, renowned urologist Dr. Stephen Pautler successfully reduced the length of stay for prostate cancer patients undergoing a robot assisted radical prostatectomy from the current standard of three days to 23 hours.

St. Joseph’s urologist Dr. Stephen Pautler sits at the da Vinci Surgical System’s master control station where, during surgery, he manipulates the surgical tools attached to the robotic arms.

Leading in the Treatment of Kidney Stones At some point in their life one in 10 Canadians will have a kidney stone, which causes excruciating pain. St. Joseph’s Urology Centre is the first in Canada to establish a onestop kidney stone prevention clinic housing a team of experts, including a nephrologist, a urologist and a

nutritionist, to provide assessment and education. In 1990, St. Joseph’s became the second hospital in Ontario to offer lithotripsy, a noninvasive way to break up kidney stones. By 2002, the service was the busiest in the world and today treats more than 1,300 patients a year.

A patient undergoes non-invasive treatment for kidney stones in the state-of-the-art lithotripsy suite at St. Joseph’s Hospital.

Sharing Knowledge Around the Globe Through a series of broadcast surgeries and in-person lectures, St. Joseph’s urology experts are teaching surgeons around the globe new and innovative treatments. Several live surgeries, including treatments for kidney stones and kidney cancer, have been broadcast to audiences in China, Vancouver, Rio de Janeiro and Las Vegas with plans for further teaching sessions

to Colombia and Mexico. The broadcasts are possible through technology that allows for a unique, interactive audio-video experience. St. Joseph’s is also sharing expertise internationally through an Endourology Fellowship Program that has attracted trainees from across Canada, Israel, Australia, New Zealand, Mexico, Belgium, Saudi Arabia and Bahrain.

In the operating room at St. Joseph’s Hospital in London, Dr. John Denstedt, chair/chief of surgery, connects with surgeons in China during a broadcast of a urological surgical procedure.

Taking Research to the Next Level

The tumour bio-bank located at St. Joseph’s Hospital is a liquid nitrogen freezer that can store up to 48,000 patient samples at -200 degrees Celsius to keep them perfectly pristine.

One in seven Canadian men will develop prostate cancer in their lifetime, making it the most common cancer in men. With early detection the key to survival, Lawson Health Research Institute has created a prostate tumour bio-bank to collect and store samples for research. Patients at St. Joseph’s Hospital undergoing testing to detect prostate cancer are asked to participate by giving tissue, urine and blood samples. “While there are other

prostate bio-banks in North America we are the only ones collecting samples from the same patients over a long period of time,” says Lawson scientist Nicholas Power. “This will help us identify changes in the bio-markers and tissue of patients throughout the treatment process with the goal of improving on PSA detection and initial diagnosis, monitoring responses to therapy and providing information on overall patient outcomes.” SUM MER 2014

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Recovery in Sight St. Joseph’s Parkwood Hospital is the first Canadian hospital using a new tool to improve vision in those with acquired brain injury

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BY ANNE KAY

Occupational therapist Nicole McLean observes William Lunn’s progress as he practices vision exercises by staring at the white dot in the centre of the Vision Coach screen while trying to touch red dots that appear randomly in his peripheral vision field.

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ASCAR drivers use it. So do police tactical units. Now St. Joseph’s Parkwood Hospital does too, becoming the first hospital in Canada to take this step. It’s called Vision Coach—a novel piece of equipment that can sharpen visual skills. At Parkwood, it’s the latest tool used by therapists working with patients recovering from brain injury and stroke. Vision Coach is a state-of-the-art interactive light board that helps patients practice eye movements and hand/eye coordination. The height of the board, visual stimulus and complexity of tasks are tailored to meet each patient’s needs. The system is designed to enhance visual function, muscular coordination and neuromotor abilities. William Lunn, 27, finds Vision Coach is improving his peripheral vision. In 2011 he suddenly passed out at work. After other nearcollapses and a battery of tests, he learned he had hit the tipping point from the many concussions he sustained through years playing contact sports like hockey and football. “I can’t walk well and have headaches, but one of my most unusual symptoms is that everything I look at is shaking,” he says.

Vision problems for those with neurological injuries go beyond the ability to see clearly because meaning is derived through vision. For many patients, improving visual function substantially enhances quality of life. To help with his vision Lunn trains regularly on the Vision Coach. Occupational therapist Nicole McLean programs the equipment specifically for him. “Vision Coach collects data on patients so we can accurately track their visual progress and help them set goals,” McLean explains. At the same time, she adds, patients have fun using this new technology, which replaces less sophisticated exercises.

A Key Grant Patients in the BrainEx 90 therapy group are among those benefiting from the Vision Coach equipment. With growing demand for mild traumatic brain injury rehabilitation at Parkwood Hospital, a group treatment approach was developed to improve access to care. A grant from the St. Joseph’s Health Care Foundation was key to this model. The grant supported the purchase of mobile computers (tablets) for staff and a tool to efficiently assess patients, called BrainFx. BrainFx enables patients to complete a Web-based questionnaire prior to their first appointment, which helps the therapy team pinpoint areas to work on during the treatment sessions.

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LOST & FOUND

At St. Joseph’s Parkwood Hospital, a special vest is dispelling a lost-in-space sensation for patients with brain injury

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t’s an unsettling feeling of being lost in space. And with that sensation often comes the inability to judge distances, along with much anxiety. For those with mild traumatic brain injury (mTBI), it can be a crippling problem complicating the road to recovery. “We think this is because some patients have difficulty sensing where their body is in space and they have to work hard to negotiate their environment,” explains physiotherapist Shannon McGuire from the Acquired Brain injury (ABI) Rehabilitation Program at St. Joseph’s Parkwood Hospital. “They become overwhelmed and anxious because their brain is having trouble processing sensory information.”

DeGroot was suddenly very dependent on others. After considering various treatments for DeGroot, McGuire and her colleagues came up with the idea of using a compression vest. “The vest fits snugly to the body—it feels like it’s giving you a big hug,” explains McGuire. “We believe the weight combined with compression helps patients feel more grounded.”

SIMILAR RESULTS At first, DeGroot wore the vest whenever she left the house, but she has progressed so well that now she only wears it when in situations with a lot of new stimuli. After seeing her success with the compression vest, the ABI outpatient team began introducing it to other patients with similar results. In collaboration with physiotherapy students at Western University, McGuire conducted a pilot study on the clinical impact of the compression vests for patients with an mTBI and is now extending that research to gauge the impact of adding weight to the vest. —Article adapted by Anne Kay

Wearing a weighted compression vest, Linda DeGroot, right, practices her balance with the help of Parkwood Hospital physiotherapist Shannon McGuire.

AN IMMEDIATE TRANSFORMATION At Parkwood, therapists are trying something new. A specially designed vest that combines weights and compression is helping patients with an mTBI know where their body is in space and find balance. It is also easing anxiety, reducing fatigue, improving attention and concentration, and diminishing overstimulation in busy environments. Not only are Parkwood therapists forerunners in exploring the effectiveness of these vests, they have also enhanced the vests currently on the market by improving the fit and adding weights. Linda DeGroot, a patient with mTBI, felt an immediate transformation when she put on the vest. “It was the first time I’d felt secure since sustaining the mTBI,” says DeGroot, a teacher who suffered a concussion when she hit her head on the ice while playing hockey. When DeGroot first came to Parkwood, she was experiencing tremendous levels of anxiety. As a result of her concussion she couldn’t drive, go to work, attend church or do many of the things she loved. For a woman used to being independent, SUM MER 2014

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FACES OF ST. JOSEPH’S

Leading with Passion Two awards highlight a dedication to excellence BY ANNE KAY

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Dr. Gillian Kernaghan, left, president and CEO of St. Joseph’s Health Care London, presents the Aspiring Leader award to Parkwood Hospital nurse Colleen Hardy.

Dr. Mohan Merchea is presented with the Leadership in Mission Award from Karen Perkin, left, vice president, acute and ambulatory, professional practice and chief nurse executive, and Michelle Mahood, director, Ambulatory Surgery Services.

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very year, St. Joseph’s Health Care London presents the President’s Awards for Leadership to individuals who have made extraordinary efforts to advance the mission, culture and performance of the organization. Here, St. Joseph’s celebrates the exceptional dedication of the 2013 recipients: The Aspiring Leader Award recognizes an individual who has shown significant skill development, has recently risen to the challenges of a leadership role or activity, and has demonstrated outstanding leadership qualities and contributions to the organization. The 2013 recipient is Colleen Hardy, a nurse in the Veterans Care Program at Parkwood Hospital. Respected by colleagues, patients and families alike, Hardy’s broad skill set makes a real difference to patient care. An infection safety champion, she has been instrumental in significant gains by her team in various practices. She is also an effective coach for fellow nurses, promoting best practice guidelines and new approaches to care that improve the resident experience and overall well-being. This dedicated nurse leads by example, say colleagues. Her positive attitude, humour, resilience, flexibility, and respect for the contributions and expertise of team members make her a standout. At the same time, families and residents appreciate Hardy’s calm approach and how she puts them at ease. She takes the time to learn about their interests and ensures their wishes are known and honoured. The Leadership in Mission Award recognizes a St. Joseph’s leader who has made extraordinary efforts to exemplify and advance St. Joseph’s roles and values as a Catholic, academic and community-oriented

health care provider. The 2013 recipient is Dr. Mohan Merchea, medical director and surgeon in the Cataract Suite at the Ivey Eye Institute, and a member of St. Joseph’s Board of Directors. Dr. Merchea is known for his compassion, honesty and positive attitude in good times and in challenging times. He was instrumental in leading a team of dedicated ophthalmologists and staff during a time of

The President’s Awards for Leadership go to individuals who make extraordinary efforts to advance the mission, culture and performance of St. Joseph’s Health Care London. significant change in health system funding. Cataract surgery was one of the first procedures impacted by the province’s new “quality-based funding” approach. While maintaining a commitment to safety and excellence, Dr. Merchea worked with the cataract team to analyze data and compare surgical practices to find efficiencies. Through this work, instrumentation, supplies and pharmaceuticals used in cataract surgery were standardized, which led to achieving the cost-per-cataract-case target. Always going above and beyond, Dr. Merchea’s professionalism, passion and respectful, collegial approach contribute to an environment where physicians and staff feel empowered and hopeful as they work together to meet the changes and complexities of the health care system, say colleagues. He models what it takes to continue to grow and improve as health care evolves.

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Because everyone has the right to dignity... we are bringing mental illness out of the shadows. Brett’s recovery began at St. Joseph’s. FIRST HOSPITALIZED AT AGE 15, Brett’s story describes the dramatic impact of serious mental illness that, for this survivor, would include jail time and years of care with St. Joseph’s Forensic Psychiatry Program. Today, Brett is a successful business owner living well in the community. Taking what he has learned from managing his illness, he is helping others see the same is possible for them. Visit our website to learn more about St. Joseph’s Forensic Psychiatry Program and services. CARING FOR THE BODY, MIND & SPIRIT SINCE 1869

Renowned for compassionate care, St. Joseph’s is one of the best academic health care organizations in Canada dedicated to helping people live to their fullest by minimizing the effects of injury, disease and disability through excellence in care, teaching and research.

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STR ESS

SOS Feeling frazzled?

4 stress-busting strategies that work

PHOTO BY GETTY/MEDIAPHOTOS

A project deadline. Kids arguing about their chores. An epic traffic jam. An unexpected car repair. A sick dog. Your list of stressors is endless—and seems to be getting longer. You have company: In 2012, almost 23 per cent of Canadians surveyed said they found most days “quite a bit or extremely stressful.”

BY JODI HELMER

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SUM MER 2014

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MASSAGE

How it works: You already know that massage eases tense muscles, relieves headaches and reduces joint pain. But it has also proved effective for combating stress by increasing the feel-good hormones serotonin and dopamine. In one study, heart rate slowed and the relaxation response kicked in after five minutes of massage. “If stress makes you feel constantly tense, it can cause you actual physical pain,” Mayer says. “A massage helps relieve that tension and helps alleviate other physical symptoms of stress.” You don’t have to spend big bucks at a spa to get the stress-busting benefits of massage. Ask a friend to rub your shoulders or give yourself a foot or hand massage to ease stress. When to use it: When you can take a short time out. Massage proves that you don’t have to work too hard to relieve stress. Once the appointment is made, all you have to do is choose a scented oil, listen to the nature soundtrack and enjoy the feeling of a skilled therapist working out the kinks. If you’re uncomfortable with a stranger seeing you unclothed (for some, it adds anxiety), try Thai massage. You’ll wear loose-fitting clothing while the therapist presses rhythmically and moves your body into positions that ease tension.

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STRESS BUSTER:

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hile some stressors are fleeting—like the butterfl ies you feel before a nurse draws blood—a constant barrage of them can cause serious health issues. Stress has been linked to headaches, fatigue, depression and heart disease. “A little stress here and there keeps us on our toes. But constantly fighting little fires can become a way of life that damages the body and exhausts your mind and depletes the spirit,” says Kate Hanley, a yoga teacher and the author of The Anywhere, Anytime Chill Guide. The possible health implications of stress have led to countless newspaper headlines, best-selling books, TV shows and radio segments urging you to calm down. The avalanche of advice can actually add to your anxiety. When you feel the familiar symptoms of stress— chest pain, insomnia, upset stomach, sweating, a lack of concentration—should you veg in front of your favourite sitcom? Tuck into a child’s pose? Make an appointment for a neck massage? Go for a brisk walk? It depends. “The best way to relieve stress is to find an action plan or stress management method that works for you,” says Matthew Mayer, a senior specialist of mission information for Canada’s Heart and Stroke Foundation. The techniques that are effective for combating stress depend on the situation. Want to know which proven stress-busting strategies work in different situations? Keep reading—and try to relax.


Tech Stress Busters

STRESS BUSTER:

DEEP BREATHING

PHOTO BY CORBIS/SUPERSTOCK

QUIZ

How it works: During stressful times, your breathing becomes shallow, making you feel short of breath and anxious. You can combat the stress response and feel more relaxed by taking several deep breaths. Deep breathing expands the diaphragm, lowers levels of the stress hormone cortisol, slows the heartbeat and lowers blood pressure. For the best results, Hanley suggests inhaling deeply through your nose for a count of four, exhaling slowly through your mouth for a count of four, and repeating the sequence at least six times. “A deep breath is the quickest way to short-circuit the stress response,” Hanley says. When to use it: Anytime, anyplace. The best thing about deep breathing exercises—aside from their effectiveness—is that it’s possible to use them in a range of situations. Stuck in traffic? Turn off the radio and tune in to your breathing. Pressured at work? You can take deep breaths while prepping a client report or taking notes in the morning meeting.

Assess Your Stress

Go to cmha.ca/mental_ health/whats-your-stressindex and take the Canadian Mental Health Association’s “What’s Your Stress Index?” quiz to rate your stress levels.

STRESS BUSTER:

WATCHING TV

How it works: Your favourite shows can reduce the physical effects of stress, including fatigue. But skip the true-crime dramas and opt for sitcoms instead. “Laughing triggers the release of feel-good hormones. It also encourages deeper breathing, which is simultaneously relaxing and energizing,” Hanley says. Watching a rerun may be particularly helpful in recovering from a stressful experience, according to a new study. Researchers believe that knowing the outcome of a previously viewed TV show alleviates any pressure to pay close attention to the plot. Just the anticipation of laughing at the characters can release endorphins and reduce stress. When to use it: When you don’t have the energy to engage in active stress relief. Stress can sap your energy. Zoning out in front of the television might be the perfect antidote to a stressful day at work. While it’s OK to watch an hour or two of television in an evening, avoid too much screen time, which can lead to weight gain, increasing— you guessed it—stress.

St. Joseph’s Regional Mental Health Care London is taking a technological approach to reducing patient stress levels. DVD players and iPods, with content focused on mindfulness and relaxation, are helping patients manage and cope with stress and anxiety, explains nurse Cheryl Riley. The iPod contains educational programs related to stress management, memory improvement, meditation and breathing techniques paired with soothing music or nature-related sounds and photos. The DVDs contain various techniques to engage the senses and ease the patient into a state of self-actualization and mindfulness. Younger patients who are more tech savvy tend to gravitate towards the iPods, while the DVD players are better suited to the elderly population, says Riley. “Patients can request specific types of music, sounds and photos to add to the already vast collection, giving them a truly personalized experience.” Techniques learned, adds Riley, can help patients to cope even after discharge. SUM MER 2014

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8 CURES FOR

EXERCISE

How it works: Physical exercise produces moodelevating endorphins and reduces stress hormones like cortisol and adrenaline. Focusing on the moves in a Zumba class, your pace on the treadmill or a yoga pose helps take your mind off of a stressful situation. Getting your heart pumping doesn’t just release stress in the moment. Research shows that the beneficial effects continue after your workout ends, helping you feel calm when faced with future stressors. “Exercise helps release some of the energy that stress creates,” Mayer says. “It also helps get you out of your head and into your body, helping you relax.” When to use it: Anytime you can get physically active, for 15 minutes to an hour. When it comes to stress busters, exercise is a strategy that works for everyone. Lacing up your sneakers for a long-distance run is just as effective for relieving stress as taking a deep-stretch class. And a brisk walk around the block has the same stress-busting effect as a 60-minute spin class. “As long as you’re moving your body, you’ll experience the benefits,” Mayer says.

The BENEFITS of Stress Feeling a little frazzled can be a good thing. In addition to protecting against danger, the “fight or flight” response has been shown to enhance learning, stimulate immune cells and boost performance. “Stress itself is not the problem. Never counteracting stress by spending time doing things that are actively relaxing leads to never-ending stress, which is a major problem for your health, your relationships and your overall happiness,” says Kate Hanley, author of The Anywhere, Anytime Chill Guide. Don’t stress about feeling stressed out. Just be sure to use effective stress-busting strategies to keep minor stressors from becoming overwhelming.

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SUMME R BLUES BY STEPHANIE R. CONNER

Simple tricks that will help manage your mood

T

he sun is out. The birds are chirping. Flowers are in bloom. It’s summertime, and the living is easy. Right? Not so fast. For some people, long, sunny days and lazy afternoons can trigger depression. According to Dr. Friedemann Schaub, the author of The Fear & Anxiety Solution, the possible reasons are varied. “It can be issues about the disruption of the routine,” he adds. “Kids are out of school, and you have to drive them from one [activity] to the next.” It’s also an expensive season. When you’re paying for camps, baby sitters or vacations, summer can lead to financial stress. And depending on where you live, he notes, heat can play a role. For some people, extreme heat affects sleep patterns, and dehydration contributes to lower energy levels—another depression trigger. Dr. Schaub notes that for people unsatisfied with their appearance, even wearing fewer clothes can trigger summertime anxiety. Regardless of the cause, here are eight ways to manage your mood and take control of those summer blues. PHOTO BY THINKSTOCK

STRESS BUSTER:

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or the

Growing Seeds of PromiSe

e rtime “It’s unbelievable how many people who are depressed have no breakfast,” Dr. Schaub says. After you’ve fasted all night, blood sugar levels are low, and your body and your brain need food to function. Physiologically, he says, eating breakfast helps to maintain your blood sugar levels. Blood sugar levels that spike and crash can wreak havoc on your mood.

2

sEt a routinE.

Going on vacation, having the kids at home and changing your work schedule throw off your routine. For some people, that means feeling a loss of control, spurring depressive symptoms. Fight back by establishing a new routine. The kids can sleep in, but you can still set bedtimes.

3

takE CarE of YoursELf.

“Having a self-care routine is very important, especially when you’re anxious or depressed,” Dr. Schaub says. “When you feel like everything is about taking care of the kids, it’s important to bring your focus back to yourself.”

4

run awaY from dEprEssion.

photo by thinkstock

Exercise can be like a drug—reducing levels of the stress hormone cortisol and releasing mood-elevating endorphins. Doctors are even prescribing exercise as a treatment for depression. Start your day with a morning jog, take a walk during your lunch break or do yoga on your patio.

5

LEan on Your friEnds.

“The greatest buffer against depression is your social support network,” says Shawn Achor, a co-founder of the Institute for Applied Positive Research and the author of Before Happiness. “The depth

and breadth of your relationships is the greatest buffer against depression.”

6

fEnd off faCEbook.

A study published in the Public Library of Science in 2013 suggested that heavy Facebook users were more likely to be unsatisfied with life. If you find yourself struggling with all those photos of happy people or feeling disappointed when you compare your achievements with those of others, Dr. Schaub says, close down Facebook.

7

GEt Your ZZZ s .

The relationship between sleep and insomnia is bidirectional, according to the Canadian Sleep Society. In other words, sleep problems can lead to depression, and depression can lead to sleep problems. If you’re feeling rundown, examine your sleep schedule and consider changing your bedtime or installing new shades to keep the light out.

8

foCus on thE positivE.

It’s important to focus on the good, Achor says. Make a list of things in your life that you feel fortunate about: success at work, people you love. “You have a lot to be grateful for,” he says.

TOOL

1

Eat brEakfast.

Health and wellness are blossoming at St. Joseph’s Mount Hope Centre for Long Term Care as residents nurture their souls with nature. Horticultural therapy at Mount Hope is a holistic program tailored to meet the needs and ambitions of each resident. From growing vegetables to designing flower arrangements to breeding monarch butterflies—there is a variety of projects residents can take part in, explains horticultural therapist Jennifer Grant. “Activities are focused on cognitive, physical and mental well-being by establishing a relaxing, natural environment for each participant. No matter how small or fragile, every plant helps residents reconnect with life.”

Optimal Optimism

Part of managing depression and other mental health conditions is understanding your individual health. Check out Optimism, a free app that helps you chart your mood so you can detect patterns and develop coping strategies. Visit findingoptimism.com to learn more.

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The About Sunscreen 16

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BY ELLEN RANTA OLSON

Is SPF 45 any better than SPF 15?

Which are the harmful rays,

UVA or UVB?

See how much you know about the lifesaver in your beach bag I’ve come a long way since my teenage days of slather-

n

ing up with coconut-scented oil and roasting by the pool. But I have a confession to make: I still don’t practice safe sunning. Sure, I’ll apply a low-grade SPF for a day at the beach, but everyday wear? Not for me. Staying out of the sun between 10 a.m. and 2 p.m.? No way. Reapplying sunscreen every hour or so? Can’t be bothered. As I approach a milestone birthday this year, I’m resolving to take better care of my skin. And as I recently learned, my new approach to sun safety can’t come a day too soon. If, like me, you need a good dose of reality to help you change your risky ways, read on. >

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TRUE OR FALSE:

Any SPF (sun protection factor) higher than 30 is a bunch of hooey.

FALSE I hate to be a party pooper, but that SPF

4 tanning oil isn’t helping your skin. Turns out, a higher number really is better. An SPF of 15 filters out about 93 per cent of all incoming UVB rays, while SPF 30 blocks 97 per cent, and SPF 50 keeps out 98 per cent. The differences may seem negligible, but if you are light-sensitive or have a history of skin cancer, they can make an impact. Plus, over a lifetime, a few more percentage points can add up to a lot less sun damage. “Everybody should use a sunscreen, every day,” says Dr. Barry Lycka, founder of the Canadian Skin Cancer Foundation. “I recommend a minimum SPF of 30 overall, but you should use 45 for the face. If you have really sensitive skin, always opt for a higher number.”

TRUE OR FALSE:

The sun’s rays are all dangerous, so you have to block them all.

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TRUE OR FALSE:

Wearing sunscreen can be bad for you.

FALSE OK, this one was easy. But some people shy away from sunscreen, believing it poses a health risk. Consider those myths officially debunked. “Modern sunscreens are highly engineered these days and are not shown to be dangerous to humans,” Dr. Lycka says. “It is definitely safer to wear a sunscreen than to not wear one.” Another common misconception is that wearing sunscreen will limit your ability to get enough vitamin D. While it’s true that the sun’s rays are a source of this nutrient, they aren’t the only one. “It is certainly a better option to obtain your vitamin D from food and supplement sources, as opposed to relying on the sun,” Dr. Lycka says.

TRUE OR FALSE:

Even under total cloud cover, sunscreen is essential.

TRUE Sunscreen should be a part of your daily

routine, not just something you throw in your beach bag. Even on an overcast day, up to 40 per cent of the sun’s ultraviolet radiation reaches Earth. This can lead to serious sunburn, because when you don’t feel the sun’s rays, you may be inclined to spend hours outdoors without protection.

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PHOTO BY BLEND IMAGES/SUPERSTOCK; PRODUCT PHOTOS FROM COMPANIES

TRUE UVA? UVB? UB40? OK, so the 1980s band behind the song “Red, Red Wine” has nothing to do with sun protection, but it’s easy to get confused with all these abbreviations floating around. When shopping for a sunblock, not only are you deciding which SPF to get, but you also have to look for a product that protects against both types of damaging rays. Ultraviolet B rays are the chief culprits behind sunburns. They play a large role in the development of skin cancer, and their intensity varies with the season, location and time of day. It was once thought that UVB rays were the only worrisome ones, but we now know that UVA does damage, too. Ultraviolet A rays penetrate the skin more deeply than UVB and play a major role in aging and wrinkling. Until recently, scientists believed that UVA’s damage was superficial, but new studies show that UVA rays do in fact contribute to skin cancer. So what does it all mean as you navigate the sunscreen aisle? “Purchase a sunscreen that’s labelled broad-spectrum,” Dr. Lycka says. “If you’re confused, ask your doctor or dermatologist for a recommendation. Products can vary by region, so it helps to have a local opinion.”


TRUE OR FALSE:

If I put on sunscreen, I can safely veg on this lounge chair all day.

FALSE Sorry, sun worshippers, but SPF is only

one aspect of complete sun protection. Dr. Lycka recommends practicing sun avoidance, especially between 11 a.m. and 3 p.m. during daylight saving, and 10 a.m. to 2 p.m. during the rest of the year, when the sun is at its strongest. If you are outside, wear protective clothing and hats and seek shade when possible. And to get the full benefits of sunscreen, make sure you slather it on right: Apply 30 millilitres (about a shot glass full) every two hours. During a long day at the beach, one person should go through about half of a 240-millilitre bottle.

Sunscreenings Not sure which sunblock is right for you? Here are some of our recommendations: For Kids Alba Botanica Very Emollient Sunscreen Kids Mineral Protection Go natural with this paraben-free, waterresistant sunscreen. Minerals provide strong protection for days spent playing in the sun.

For Runners Neutrogena Wet Skin Sunscreen We tested the sweatproof claims during a run on a hot summer day—it held up its end of the bargain.

Protecting your eyes from UV and blue-violet sunlight is as important to overall health as sunscreen. “The sun emits harmful rays year-round, rain or shine, contributing to eye diseases such as age-related macular degeneration and cataracts,” says optometrist Dr. Alex Mao of the Ivey Eye Institute at St. Joseph’s Hospital. Blue-violet light is also found indoors projected from LED and fluorescent lights, computer monitors, tablets and smartphones. Special filters applied as a coating to sunglasses and clear lenses protect the eyes from bad light while allowing “good light” to pass through. A new SPF index termed E-SPF measures the UV protection of a glass lens, front and back. An effective filter should have an E-SPF of 25 or higher.

online

PHOTO BY BLEND IMAGES/SUPERSTOCK; PRODUCT PHOTOS FROM COMPANIES

For Recovering Tanoholics Jergens Natural Glow + Protect All hail the gradual self-tanner. Get a sun-kissed look while protecting your skin.

Your Mother Was Right— Don’t Stare at the Sun

For Busy Women Clarins UV Plus HP This formula protects and enhances skin tone, so you can skip the foundation.

For Your Kisser Aquaphor Lip Repair + Protect Now with broadspectrum SPF, this pout protector covers all the bases.

Access Our Expertise

For information on the wide range of world-class care available at St. Joseph’s Ivey Eye Institute, visit sjhc. london.on.ca/ivey.

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illustration by aaron meshon

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Tiny tools and minimal incisions are giving the operating room an extreme makeover by jo ostgarden

A

ppendectomies in the 19th century were the type of operation that would make a grown man faint: a large incision, exposed muscles and tissue, blood-staunching nurses. Post-op wasn’t much better, as a patient would spend weeks in recovery, fighting infection. Today, if you develop appendicitis, and a laparoscopic appendectomy is the appropriate surgical option, the doctor will make a few 2.5-centimetre abdominal incisions and use a tiny camera and miniature tools to remove the rupture. You’ll likely be walking hospital corridors in hours and heading home the next day.

illuSTrATion By AAron mEShon

Great Strides in Surgery

Rapidly evolving advances in biotechnology, diagnostic methods and specialized instruments have helped speed this astounding medical transformation. Surgeons can repair and remove everything from an inflamed appendix to a tumour using minimally invasive surgery (MIS). Not everyone is a candidate for MIS, explains Dr. Togas Tulandi, a spokesman for AAGL, an international minimally invasive gynecologic surgery association. But when it does replace conventional surgery, as MIS often does for hysterectomies in Canada, the benefits are many. Here’s an overview of MIS today. >

12000 B.C. The earliest known surgery is performed. Skulls from the Stone Age, discovered by archaeologists, offer evidence of trepanation, in which a hole is drilled to relieve pressure; the earliest known surgery.

3600 B.C. Talk like an Egyptian: A tracheotomy is portrayed on two ancient stone tablets; the procedure is also noted on the Ebers Papyrus, a medical papyrus from 1550 B.C.

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what’s in a name?

MIS is also known as endoscopic surgery, keyhole surgery and less-invasive surgery. You may have heard the term laparoscopic surgery. Laparoscopy is the most common type of MIS, in which surgeons examine and repair organs in the abdominal or pelvic cavities.

how do they do that?

Lights, camera … surgery!

For two centuries, doctors have inserted endoscopes into human bodies to diagnose ailments. Today’s scopes, thin tubes equipped with lights, cameras and surgical tools, allow surgeons to also make repairs. Utilizing an incision or a natural body opening, the doctor guides the endoscope as live imaging appears on a video screen, allowing him to clearly see the surgical site. Other small incisions are used as entry and exit points for surgical instruments.

the bot and the body

During robotic-assisted MIS, a physician sits at a console and manoeuvres “arms” that replicate hand movements to manipulate miniature instruments. A high-definition camera that has been inserted

600 B.C. The first rhinoplasty (nose job) is recorded in India.

22

through a small incision streams 3-D images to a monitor. The robot’s riveted arms and tiny assisting surgical tools provide greater flexibility in approaching repairs. Robotics also reduce the surgeon’s natural movements, like hand tremors, for more precision.

From the top down

MIS can be performed almost anywhere in the body, from the brain to the foot. According to Dr. Tulandi, “in Canada, when you include all specialties, ovarian cystectomies [cyst removal] and gallbladder removals are the two most common procedures.” Prostate and uterus removal are other operations in which MIS is frequently used. Heat can be delivered to destroy or shrink tumours. Heart valves can be repaired. Hernias, diverticulitis, uterine fibroids, joint problems, obstructions and herniated disks are just some of the conditions for which MIS may be suitable.

1842

1911

The first documented successful operation using ether as an anesthetic is performed in Georgia in the U.S. Two neck tumours are removed and the patient pays $2.

Laparoscopic surgery, dubbed “minimal access surgery” or “organoscopy,” is performed for the first time in the U.S.

1958 In Sweden, the first cardiac pacemaker is implanted and functions for three hours.

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ILLUSTraTIonS by aaron meShon

The beauty of minimally invasive surgery is, of course, the small incisions, or maybe no incision at all, if the surgeon is able to manoeuvre a scope and work through a body’s natural opening. Usually, incisions will be less than a 1.25 centimetres. Space is tight in there! In some abdominal cases of MIS, carbon dioxide gas is pumped into the cavity around an organ to create better working space.


What’s to like

things to think about

There are a few downsides to consider. Procedures can sometimes take longer because of the skill required, so a patient may be under anesthesia longer. Surgeons can’t touch organs and feel around to look for other problems. People who are obese or who have scar tissue from previous surgeries may not be candidates. Robotic surgical equipment is pricey, and compared with laparoscopy, such operations typically cost the hospital more per patient and require more operating time.

What’s neW in a hot field

Improving the Patient Experience St. Joseph’s Hospital in London is a Canadian leader in minimally invasive surgery. The hospital’s experts in urology have been able to safely move some procedures from the operating room to smaller clinic rooms thanks to surgical innovation. “This has streamlined our process and reduced wait times for patients needing complex surgery,” says Anne Marie McIlmoyl, director of Perioperative Services. Patients having simple procedures are treated by a team of surgeons, anesthesiologists, and nursing and support staff and usually go home the same day as their operation.

iLLuSTrATionS By AAron meShon

Single-incision laparoscopic surgery, also known as single-port surgery, is a newer form of MIS. The physician uses a soft and flexible instrument equipped with three distinct openings that allow for the simultaneous use of three surgical devices—all accessed through one small incision, usually in the navel. It’s increasingly being used for gallbladder, urologic and gynecologic procedures. Another new frontier is known as “scarless surgery,” or NOTES, for natural orifice translumenal endoscopic surgery, which uses the body’s existing openings, such as the mouth and the vagina, to access organs with an endoscope and surgical tools. Modern medicine may not be magic, but it’s coming awfully close.

video

You may be able to go home the day of MIS or the next day. In general, Dr. Tulandi says, “it’s an overnight stay for most MIS procedures, including hysterectomies, but it does depend on [the body location] where you have the surgery.” Overall, MIS means shorter stays, smaller scars, less pain, less medication and fewer complications. And because of the smaller incisions, recovery is faster and infection risk is lower.

Wonders for Women

If you’re thinking about MIS for a gynecologic issue, explore the wealth of information on AAGL’s “MIS for Women” website at misforwomen.com.

1960

1985

2001

2012

The first hip replacement is performed. The procedure becomes one of the most successful types of surgery performed.

A robot called the Puma 560 places a needle for a brain biopsy using CT guidance.

The first bariatric surgical device, commonly called a Lap-Band, is approved to treat obesity.

Doctors in Sweden perform the world’s first motherto-daughter uterus transplant.

2008 French neurosurgeons use a tiny fibre-optic laser to destroy cancerous brain cells.

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HEAD GET YOUR IN THE GAME BY STEPHANIE R. CONNER

PHOTO BY THOMAS BARWICK /GETTY

Know the signs of a concussion and how to prevent long-term damage You’re on your feet, screaming for the home team. You know you’ll have a sore throat tomorrow from the cheering, but your kid is playing like a champion, and this is one exciting game. Then, suddenly, the crowd falls silent. The athletes stop playing. The coach and trainer race to help your child off the ice. Your heart stops. When your child suffers a head injury, what do you do? Injuries, including concussions, are part of sports at every level of play. But to prevent long-term damage, it’s important to know the signs of a concussion and what steps to take next. >

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COMMON CAUSES OF

CONCUSSION

A concussion is a type of traumatic brain injury often caused by a blow to the head. Typically, accidents or sports are to blame. A 2013 study in the journal PLoS ONE found that for kids ages 5 to 19, ice hockey is the most common sports-related cause of concussion, followed by soccer, American football, and rugby. As parents research athletic activities for their child, it’s important to consider the risks and each child’s particular interests, says Dr. Michael Cusimano, a neurosurgeon and professor at the University of Toronto. “If a child had a prior brain injury, it might make more sense to focus on non-contact sports than to go for high-impact sports like football or ice hockey,” he notes. “Parents need to make that exploration if a child is going to start a sport.”

Concussion and the Classroom

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WHAT TO LOOK FOR During a concussion, the brain is violently rattled against the inside of the skull. So it’s no wonder that headaches are a common symptom of a concussion. And while many people associate concussions with loss of consciousness, that doesn’t happen in most sports concussions. Look for the following types of symptoms: • Cognitive. Children might be confused or disoriented or have amnesia. • Behavioural. They may feel as if they’re in a fog, or may be more emotional than usual. • Physical. Kids can experience headaches, dizziness or nausea, or have difficulty with balance or coordination. It’s essential for coaches and trainers to recognize these symptoms because what happens next is critical to a child’s health. “This is a very important point,” says Dr. Stanley Herring, a member of the National Football League’s (NFL) Head, Neck and Spine Committee in the U.S. “If there’s a suspected concussion, they’re out for the day.” Next, it’s important to make an appointment with your child’s doctor. “The brain is vulnerable until the concussion heals,” he adds. A second blow to the head before a concussion heals can

PHOTO BY THOMAS BARWICK /GETTY

A recent report in the journal Pediatrics warns doctors, parents and school officials of potential cognitive damage resulting from a concussion. While concussion victims are already cautioned to avoid activities such as texting, playing video games, reading, and watching TV, the new study indicates that normal schoolwork may need to be adjusted for up to several weeks after the trauma. Be sure to discuss the issue with your child’s doctor.

Then, he suggests, parents should educate themselves about concussions and talk to team coaches. “They should get to know the coach’s philosophy around winning and injury and whether coaching staff or the league provides coaches and trainers with education around concussion,” advises Dr. Cusimano, who is also one of the authors of the PLoS ONE study.

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WHAT TO DO While there is no legislation in Canada governing the post-concussion return to sports for young athletes, there are generally agreed-upon guidelines that leagues at all levels should follow, Dr. Cusimano says. “Any child who gets suspected of concussion must be removed from play and must be cleared before they return,” he says. How long that takes depends on the individual child and injury. In about 80 to 90 per cent of kids, symptoms will resolve in seven to 10 days, he says. Once the symptoms have gone away, the athlete can begin to slowly return to activity, he adds. That means progressively increasing activity to make sure symptoms don’t reappear. Young athletes should return to competition only when they are asymptomatic at rest and on assertion— and are not on any medications for the symptoms. It’s important, Dr. Herring adds, for coaches, trainers and parents to be educated about concussions and to take advantage of free resources. “In youth sports, there aren’t always trained medical professionals on the field,” he says. “I don’t expect (coaches and parents) to make a diagnosis, but look at a checklist.” What makes this crucial is knowing that young athletes may not always be honest about their symptoms. In addition, Dr. Herring says, coaches should adopt a team concussion policy. “Athletes sometimes listen to their parents, but they always listen to their coach,” says Dr. Herring, an advocate for head trauma legislation to protect youth athletes. “Everyone’s tough, but no one has a tough brain. … Reward robust reporting. Make it part of the team culture.” While brain injuries are scary, it’s important for parents to not overreact, he adds. With the rise of childhood obesity, Dr. Herring says, sports can be incredibly healthy for kids.

Brain Injury Education Weighing about three pounds, the human brain perches precariously atop an intricate wiring system. In this vulnerable position the brain is subjected to many bumps in a lifetime, but significant bumps can injure its delicate wiring resulting in an acquired brain injury (ABI). About 15 per cent of people who sustain relatively minor head injuries also end up with a lasting brain injury. To help those with an ABI learn skills to manage the injury’s impact, St. Joseph’s Parkwood Hospital offers an eight-week video conference series each spring throughout Southwestern Ontario called the Brain Injury Survivor and Family Education Series. During this series, rehabilitation therapists share their expertise and brain injury survivors, like Sherry Zettler, share their journey to recovery. “I want them to know they are not alone, and that they’ll be OK,” she says.

CLASSES

cause serious and lasting damage or even death. And the incident you’re watching for doesn’t even necessarily have to be a blow to the head, Dr. Cusimano says. A blow elsewhere to the body can be transmitted to the head, he notes. “If there’s an interruption to the child’s flow, that should be enough to take the child out of play,” he says, offering words of caution. “If in doubt, they should sit out.”

Tune In

Parkwood Hospital’s Brain Injury Survivor and Family Education Series is for people with an acquired brain injury and their family, friends and caregivers. For information on the wide range of topics covered and how to tune in by video conference or attend in person, call 1-866-484-0445.

“There are consequences to not letting kids play sports,” he notes. “Youth sports are an important part of physical and social development. And injury is an inevitable part of an active lifestyle. … It’s how you manage the first concussion and treat the athlete that will make a difference.” SUM MER 2014

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Pack your bags and your meds—a chronic condition doesn’t have to mean your travel days are over BY BOB PAYNE

THE JOURNEY

CONTINUES

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or anyone who enjoys travelling, learning that you have a chronic medical condition comes with the apprehension that the adventures you’ve enjoyed throughout your life will become a thing of the past—that you’ll have to tuck away your passport and put your suitcases in the attic. But retired business executive Mike Eicher says it doesn’t have to be that way. Eicher has undergone heart and lung surgery. He’s experienced a stroke, and he suffers from diabetes, all combining to limit his stamina and mobility. Yet he remains a world traveller, and believes that others with chronic health conditions can travel safely, too. “As long as you take precautions, health issues shouldn’t keep you at home,” says Eicher, author of Travel for Seniors Made Easy: Staying Alive @ 65.

Cardiologist Dr. Chi-Ming Chow, a spokesman for the Heart and Stroke Foundation of Ontario, agrees, adding that the precautions should include talking to your doctor in order to understand your ability to travel, carrying a copy of your medical records with you and understanding your medical coverage.

6 RULES OF THE ROAD

Every chronic condition creates its own demands and limitations for travellers. The best way to learn about specifics is from organizations such as the Kidney Foundation of Canada (kidney.ca), the Canadian Diabetes Association (diabetes. ca) and the Heart and Stroke Foundation of Canada (heartandstroke.com). But you’ll discover there’s a core of precautions common to all:

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Your list of medications should include generic names and be written in the local language if possible. Also consider a medical alert ID, in the form of a bracelet or necklace, that contains your basic medical information or a USB drive with your medical history.

3 4 5

TELL SOMEONE travelling with you where your medicines are packed, where you keep your medical records, and about your medical needs.

1

HAVE YOUR DOCTOR EVALUATE your ability to undertake the journey. That could mean a medical exam, an assessment of potential risks, and research into the care available at your destination. For kidney patients travelling in Canada, for example, there is an online directory of dialysis centres accepting visitors. Go to the website of the Canadian Institute for Health Information at cihi.ca and search for “e-directory of dialysis centres.”

2

CARRY RECORDS that can help a doctor quickly assess your condition. The records should include prescriptions for the medicines you are taking and a letter from your doctor at home, detailing your condition and what you need to do for it, the medicines and medical supplies, such as syringes, you require, food or medicine allergies, and emergency contacts.

CARRY ENOUGH MEDICINE and supplies to last for the trip, plus a few days extra in case of spills or travel delays. Keep them in your carry-on, along with written prescriptions for emergency replacements. DETERMINE what your insurance will cover and, if necessary, supplement it with short-term travel, health, and medical evacuation insurance. Be aware that in the U.S. many dialysis units charge considerably more than what provincial health plans will pay. Carry your insurance card with you.

6

WHEN BOOKING, let airlines know if you need special assistance or special meals, let hotels know if you have problems with stairs or distance, and, if you use a travel agent, tell him or her about your special needs, too.

DON’T LEAVE HOME WITHOUT THEM

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• Family member or close contact remaining at home • Health care providers at home • Lodging at your destination • Hospitals or clinics at your destination, including emergency services • Canadian embassy or consulate in your destination country

PHOTO BY EXACTOSTOCK/SUPERSTOCK

Travellers with health conditions venturing out of the country need to bring extra paperwork. In addition to the list of medications you are taking and a letter from your doctor detailing your medical condition, it is widely suggested that you carry a card containing contact information for the following:

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To safely treat you as a transient patient, most dialysis units will ask for the following information, usually mailed or faxed six to eight weeks in advance, with another copy hand-carried by you: • The dates you need dialysis treatment • Your name, address, phone number • Medical history and recent physical exam reports • Recent lab results • Recent EKG • Recent chest X-ray • Your dialysis prescription and three to five recent treatment records • Dialysis access type • Special needs or dialysis requirements • Information about your general health • Insurance information • Where you will be staying in the area • A list of the medications you take during treatment and at home

IF YOU HAVE DIABETES The biggest challenge for travellers with diabetes can be the clock: On a long journey east or west an air traveller may rapidly cross several time zones. That can make keeping track of insulin and meal schedules confusing, as they must be done based on time intervals and not the time of day at your current location. According to the Canadian Diabetes Association, you should keep these points in mind. • When travelling east, your travel day will be shorter. If you lose more than two hours, you may need to take fewer units of intermediate or long-acting insulin. • When travelling west, your travel day will be longer. If you gain more than two hours, you may need to take extra units of shortacting insulin and more food. You can change the time of injections and • meals by up to two hours in a day without adjusting your dose or your meal plan.

• Follow

your usual meal plan as closely as possible. • If you are crossing more than two time zones, you will need to prepare a meal and insulin schedule with your doctor or diabetes educator.

IF YOU HAVE A HEART CONDITION Deep vein thrombosis (DVT) is a condition in which blood clots form in a deep vein, usually in the legs. It is serious, because if a clot breaks off it can travel through the bloodstream to the lungs, blocking blood flow, which is known as a pulmonary embolism. Sometimes called “economy class syndrome,” because it is associated with the restriction of mobility on long flights, DVT can happen to any air traveller. But if someone has had vascular disease or a history of heart failure, the risk increases. Here are the generally accepted guidelines for minimizing that risk: • Drink adequate fluids but avoid alcohol and caffeine. • Get up and walk around the cabin, when you can. If that’s not possible, frequently exercise your lower legs and ankles. On • the advice of your doctor, wear compression stockings, which can reduce the chances of blood pooling and clotting. • Your doctor may also prescribe bloodthinning medications. For more specifics, Dr. Chow and colleagues have developed an app, Drive+Fly Guidelines, for the Canadian Cardiovascular Society. Available for Apple and Android devices, it covers all aspects of drive and air travel for heart and stroke patients, including a section on DVT.

online

IF YOU HAVE KIDNEY PROBLEMS

Travelling wiTh DiabeTes The Diabetes education Centre at St. Joseph’s Hospital provides patients with a packing list for travelling. Below are essential carry-on items for those with diabetes: • Double the supply of insulin or pills for diabetes. • Double the amount of syringes and needles, plus an extra insulin pen if needed. • Blood glucose testing kit and record book. • Fast-acting insulin for high blood glucose and ketones. • Fast-acting sugar for low blood glucose. • extra food to cover delayed meals. • Ketone-testing strips. • Glucagon kit if you have one. • Medication list and phone numbers of your doctor and diabetes educator. • identification card/medic alert bracelet.

Education Resources

The Diabetes Education Centre of St. Joseph’s Health Care London has many helpful handouts available on a variety of topics. Visit sjhc.london.on.ca/diabeteseducation for printable versions of the information.

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Brain Man BY ALISSA M. EDWARDS

How a movie role compelled BRADLEY COOPER to become an advocate for mental health

W

hen Bradley Cooper took on the role of a man with bipolar disorder, he probably never imagined it would change his worldview. Portraying Pat Solatano in Silver Linings Playbook, the 39-year-old actor and executive producer earned Academy, Golden Globe and Screen Actors Guild award nominations. The film also catapulted him into a role as a high-profile advocate for mental health issues.

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BRADLEY COOPER PHOTOS BY JEFF VESPA/CONTRIBUTOR; CATHERINE ZETA-JONES BY GETTY/WIREIMAGE; JEAN-CLAUDE VAN DAMME BY GETTY IMAGES FOR EXTRA; CARRIE FISHER BY GETTY; LINDA HAMILTON BY FILMMAGIC

You Don’t Know Brad Think you’ve got Bradley Cooper all figured out? Here are seven things you probably didn’t know about this charming and versatile actor.

1

CALL HIM “COOP.” His closest friends do.

2

HE LOVES HIS DOGS. “They are both rescue dogs and they are the best,” Cooper told People magazine. “They’re my kids.”

3

HE’S QUITE A COOK. “My grandmother was an amazing cook. I used to make homemade pasta,” he told People. “I love the idea of making whatever is in the fridge into something.”

4

HE’S ON FIRE. The actor reportedly earned $15 million for reprising his role of Phil in The Hangover Part III.

5

HE HASN’T HAD A HANGOVER FOR A WHILE. He quit drinking at age 29 after a rough night of partying sent him to the ER. “I realized I wasn’t going to live up to my potential, and that scared ... me,” he told US Weekly.

6

HE LOVES HIS VESPA, which was given to the cast of The Hangover Part II as a gift by producer Todd Phillips after they wrapped.

7

HE HAS A BROMANCE. He’s best friends with Dax Shepard, of Punk’d and Parenthood fame.

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bradley cooper photos by Jeff Vespa/contributor; catherine zeta-Jones by getty/Wireimage; Jean-claude Van damme by getty images for extra; carrie fisher by getty; linda hamilton by filmmagic

A Fresh PersPective Before researching the Silver Linings role, the star of The Hangover trilogy admits to being relatively ignorant to the plight of those with bipolar disorder. “It’s not that I didn’t know about mental illness. … I just didn’t see it as a part of my own life; I didn’t really think that it affected me,” Cooper said during a speech at the U.S. National Conference on Mental Health in June 2013. But filming the movie changed his perspective. “I realized that people that I knew, people that I loved and cared about, they were coping with this in silence and … I really had no idea.” The truth is that most of us don’t. And although bipolar disorder is more common than we might realize, affecting anywhere from 2.2 to 6 per cent of Canadians in their lifetime, misconceptions abound. We have answers to six common questions.

Q

What is biPolar disorder and What are the symPtoms?

Q

hoW does biPolar disorder affect a Person’s life?

Bipolar disorder is a mental health disorder that causes dramatic, sudden shifts in mood, energy, sleep and activity levels. Though researchers aren’t sure exactly what causes it, “genetics clearly play a role and environmental factors like significant life events also appear to trigger episodes,” says David Miklowitz, PhD, a psychologist and the author of The Bipolar Disorder Survival Guide: What You and Your Family Need to Know. “Some neuroimaging studies have also found differences in the brains of bipolar individuals.” In Silver Linings Playbook, the character’s illness manifests itself in obsessive behaviour, delusions, rapid speech, sleeplessness, manic and depressive episodes, and temper flare-ups, “with mood swings and weird thinking brought on by severe stress,” the Solatano character explains to his therapist.

For Solatano, bipolar disorder is a contributing factor in both the end of his marriage and the loss of his job as a substitute teacher. People with bipolar disorder face similar challenges in real life. “It’s common to experience problems in work, social and family relationships due to extreme mood states,” says Ryan Niemiec, PsyD, a psychologist and

Celebs

Speak Out

bipolar disorder can affect anyone, including your favourite celebrities. “there’s evidence that people with this illness have high levels of creativity,” says david miklowitz, Phd, a psychologist and the author of The Bipolar Disorder Survival Guide: What You and Your Family Need to Know. “it seems to go along with the artistic temperament.” here, hollywood’s finest share their experiences. Catherine Zeta-Jones, on going public. “i hope i can help remove any stigma attached to it,” she told People magazine, “and that those who didn’t have it under control will seek help.” Jean-Claude Van Damme, on medication. “in one week, i felt [the medication] kick in,” he told E! Online. “all the commotion around me, all the water around me ... became like a lake.” Carrie Fisher, on being bipolar. “i thought if i could ever get [bipolar disorder] to be funny, it would be brilliant,” she told BP Magazine. “but it took a really long time ... dealing with the bipolar situation was far from funny.” Linda Hamilton, on treatment. “every year is just richer ... because i’m really returning to who i was meant to be,” she said on Larry King Live.

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A ChAnging Diagnosis

Q

How is it diagnosed?

Q

How is it treated?

In Silver Linings Playbook, Solatano’s diagnosis comes after a particularly violent altercation during which he nearly beats someone to death. His diagnosis lets him skip jail time but puts him in a mental health care facility for eight months. For most people, however, it’s not a single event that precedes a diagnosis. “Most people seek the help of a mental health professional after experiencing symptoms for an average of 10 years before getting a [correct] diagnosis,” Dr. Miklowitz explains. To be diagnosed with bipolar disorder, individuals may undergo a physical examination and blood tests to rule out other problems that could be causing symptoms. Next, a psychological evaluation is performed, usually along with charting moods and sleep patterns, to determine whether the person meets the criteria for a diagnosis.

A comprehensive treatment plan, as explored in the film, should include counselling, medication, a healthy lifestyle and a strong support network, Dr. Niemiec says. A plan typically entails: Mood-stabilizing medication. Though it might be the most important piece of the treatment puzzle,

QUIZ

For women with depression, having a baby could result in more life changes than they were expecting. Dr. Verinder Sharma, a psychiatrist at St. Joseph’s Regional Mental Health Care, recently published new research findings on bipolar disorder in postpartum women that is receiving national attention. His study of nearly 150 women living with depressive disorder found that within a year after having a child, some women had a diagnostic change to bipolar II disorder. “These findings are very important as it would change clinical treatment, including possible alterations to medications,” says Dr. Sharma. With depression, individuals experience a somber mood, which impacts all aspects of life. With bipolar II, there are highs and lows. The highs might include racing thoughts, irritability, risky behaviour and less need for sleep, while the lows could include decreased energy, isolation from others and thoughts of suicide. The study, to be published in Bipolar Disorders Journal, is the first to look at the role of childbirth and the conversion of depression to bipolar disorder.

the co-author of Movies and Mental Illness: Using Films to Understand Psychopathology. “To complicate things further, the moods of people with bipolar disorder are negatively affected by stress in their relationships.” Though treatments can help minimize these problems, they don’t erase them. Bipolar individuals, along with their employers, co-workers and the people who care about them, should educate themselves and make adjustments accordingly. Changes could include, for example, a more flexible work schedule to allow for adequate sleep and counselling sessions.

Worried About You or a Loved One?

If you think you or someone you love may be bipolar, PsychCentral offers a screening quiz that can help you determine whether you should see a mental health professional. To take the quiz, visit psychcentral.com/quizzes/ bipolarquiz.

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photo provided by the weinstein co.

by the end of Silver Linings Playbook, therapy, family and ballroom dancing have helped cooper’s character begin to manage his illness.

many patients have an on-again, off-again relationship with medications because of side effects like memory and concentration problems, nausea and drowsiness. Though the process can involve trial and error, Dr. Miklowitz says the right medication or combination of medications can “make a world of difference.” Counselling. When combined with medication, research shows that therapy can help those with bipolar disorder recover faster from episodes and better control their moods. Diet and exercise. A healthy, balanced diet that includes plenty of omega-3s (found in foods such as fish, eggs, soy, seeds and nuts) may help lessen symptoms and prevent weight gain associated with medications, while exercise can decrease mood swings and reduce the stress of manic episodes. “You see Cooper’s character doing this with running and eventually dancing in the film,” Dr. Niemiec says. Structured sleep. A regular and consistent sleep schedule is critical. Insufficient sleep is considered a trigger for manic episodes—as when Solatano bursts into his parents’ bedroom at 4 a.m. after spending the night reading Ernest Hemingway’s A Farewell to Arms. Support. Attending a support group and having a network of friends and family can help bipolar individuals stay on course with treatments and better cope with the day-to-day ups and downs of their diagnosis.

Q

What are barriers to treatment?

Despite the variety of treatment options available, many people with bipolar disorder “white

knuckle it,” as Solatano tells his psychologist he did before his diagnosis. They go without medications or therapy. Dr. Miklowitz says this is due in part to the stigma surrounding mental illness. “Many people still think that mental health issues aren’t as legitimate as physical problems,” he explains. “Even though there’s medical evidence that they affect the brain and can be inherited, people still blame the victim.” Another challenge is adhering to medication regimens, Dr. Niemiec says. “Like Solatano, many individuals don’t like the way the medicines make them feel, so they quit on their own—a very dangerous thing to do.”

Q

hoW can i help?

Watching Silver Linings Playbook will open your eyes to the plight of individuals dealing with bipolar disorder. Educate yourself about bipolar disorder, share what you learn and practice compassion toward those experiencing mental illness. “People need to know that bipolar disorder is a biologically based, genetically acquired illness,” Dr. Miklowitz says. “We need to stop blaming people for their behaviour and show them the same sympathy and encouragement that we show people who have physical illnesses.” Cooper agrees. “It’s less about the people who are dealing with this illness and more about the people who aren’t,” he said in his closing remarks at the National Conference on Mental Health. “I think it is up to all of us to help, and I want to help. … I want to be a part of the solution.” Now you can, too. SUM MER 2014

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THE FOLLIES BY JO OSTGARDEN

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On the journey through life, your feet are two of your best friends. It’s time to treat them that way

Q

uick! Name the woman whose stiletto obsession led to a rush on $400 shoes designed by Jimmy Choo and Manolo Blahnik. It’s Carrie Bradshaw, of course, the Sex and the City heroine portrayed by actress Sarah Jessica Parker—who confessed that the steep heels she wore while filming left her with permanently damaged tootsies. Alas, human feet are, well … complicated. Composed of 26 bones, 33 joints and more than 100 muscles, ligaments and tendons, feet are essentially the body’s foundation. Instead of torturing them, why not try a little podiatric pampering? You might just kick up your heels. >

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THE FIX: “You can try [unmedicated] U-shaped pads for corns and bunions, but if you continue to wear high heels, the bunions and hammertoes may require surgery,” Dr. Stern says. “If you want height and better cushion, go for wedges or chunky high heels. Save your fancy high heels for special events or parties.”

CULPRIT 2

TIGHT SHOES CULPRIT 1

HIGH HEELS

“Heels higher than 1.5 to 2 inches [3.8 to 5 centimetres] significantly change the slope of the foot,” says Dr. Joseph Stern, president of the Canadian Podiatric Medical Association. “This increases the pressure and force directed on to the forefoot and toes.” It also creates a forceful stride that presses feet into a perpetually flexed, toes-pointed position. Nerves become inflamed and problems like hammertoes (a contraction deformity) are exacerbated. It’s not just the front of your foot that suffers. “When your heel comes down on a [tiny] tapered point, it becomes a balancing act,” Dr. Stern says. “Your ankle inevitably wobbles, stressing calve muscles that are shortened from wearing a heel that’s significantly higher than the toe. If you don’t strain your Achilles, you [may] sprain or fracture your ankle.”

The majority of today’s high-fashion footwear is designed with a narrow, pointed profile that doesn’t resemble the feet most of us were born with. Stuffing your feet into cramped contours can make toes curl and cause “pump bumps,” knotty bone protrusions on the side of the heel. The repeated friction or pressure of ill-fitting shoes also can lead to corns (raised hard skin), calluses (diffuse patches of hardened skin) and bony enlargements (bunions) on the side of the big toe. THE FIX: “Wear shoes with low heels and a roomy toe box,” Dr. Stern says. “Flat feet require stiff soles. High arches need flexible soles. Cobblers can stretch narrow fashion shoes to make for a roomier toe box or to accommodate a bunion.” Feet hurt badly? Get a foot specialist (a podiatrist, a pedorthist or an orthopedic physician) to evaluate them.

CULPRIT 3

HEALTH CONDITIONS

The inflammation of osteoarthritis and gout can cause foot swelling and pain. Being overweight stresses foot muscles and joints, which leads to

TOES AND NOSE

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PHOTOS BY THINKSTOCK

Each pair of human feet contains about a half-million sweat glands, so if you lace them up all day in a pair of non-breathable shoes, they’re likely to get sweaty. Sweat causes the bacteria count inside of your shoes to increase, leading to stinky feet. The solution: Wash and dry your feet thoroughly every day; wear socks made of wool or synthetic fibres designed to wick moisture; and rotate your shoes daily. Besides creating an odour, sweat can also lead to athlete’s foot (tinea pedis), a fungus that loves dank places like shoes and locker room shower stalls. It can make your feet itch like crazy. This problem doesn’t go away on its own; treat it with an anti-fungal balm or straight tea tree oil.

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structural instability and even foot ulcers. Diabetes also increases the risk of foot ulcers and nerve damage. Toenail fungus can be a problem for people with diabetes and rheumatoid arthritis and other immune deficiencies. If you’re pregnant, swelling in your feet is usually normal but can be a sign of preeclampsia (pregnancyrelated high blood pressure). Some medications, especially those used to treat high blood pressure, can also cause swollen feet. The Fix: “Buy your shoes after 4 p.m. when feet are at their widest,” Dr. Stern says. The same shoe buying tips apply to people with chronic health conditions, he says: “The right fit is a thumbs-width between the top of the shoe and your toe.” Diabetics should inspect their feet daily and keep blood sugar levels under control to prevent foot ulcers. See a doctor if you notice open wounds or toenail problems. Untreated ulcers can lead to serious infections and even amputation. If you experience numbness or a prickly pain in your feet, get them checked for nerve damage. Your doctor may recommend padded socks and specialized footwear to reduce pressure and speed healing. If you’re pregnant, pack away your pumps. Look for shoes with a wide forefoot and adjustable straps that accommodate the intermittent swelling that can occur any given day during pregnancy.

Culprit 4

HigH-impact ExErcisE

photos by thinkstock

VIDEO

Distance runners, race-walkers, and serious hikers and backpackers are prone to a long list of foot woes, including corns, calluses, blisters, athlete’s foot, fungal infections, plantar fasciitis, Achilles tendinitis and metatarsalgia. Most problems are a result of

Keeping Your Feet To prevent amputations due to diabetes, wound care specialist Kyle Goettl at St. Joseph’s Parkwood Hospital is supplying patients with a foot care kit of lotions and products, including a telescopic mirror to help check feet and amputation sites for wounds. “By checking their feet at least once a day, people living with diabetes can notice skin problems early, take the appropriate action and reduce the odds of requiring an amputation,” says Goettl. “For those who have already lost a lower limb, the goal is to prevent a second amputation.”

high-mileage training or excursions, and ill-fitting or worn-out footwear. The Fix: While some athletes have gone barefoot based on the belief that running shoeless improves foot strength and proprioception (the sense of how the body is positioned in space), Dr. Stern says the trend is fizzling. Another segment has moved to hybrid shoes with minimal padding and enhancements, but with some protection from the elements. Whatever type of footwear you choose, Dr. Stern says the benefits remain user-dependent. “It’s important to remember,” he says, “that everyone’s feet, needs, idea of comfort, and running or walking style is different.” A bigger issue is wearing worn-out shoes. He recommends replacing “running shoes every 300 to 500 miles, and walking shoes every 400 to 600 miles.” Don’t be surprised if the soles look fine, he says. “It’s the midsole that breaks down the fastest. If the mid-sole looks a little wrinkled or cracked, they’re worn out.”

Learn More

Nurse clinician Kyle Goettl at St. Joseph’s Parkwood Hospital has produced a video on caring for feet if you are a diabetic. To view the video, visit sjhc.london.on.ca/ amputee-rehabilitation-program/ educational-videos. To purchase, call 519 685-4000, ext. 42542.

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BY JODI HELMER

Friendly FAT Bring it, swimsuit season! These delicious ingredients will help you welcome summer with open arms (and maybe a flatter tummy)

A

s temperatures rise, the idea of foods to avoid,” Sass says. “This has brought confronting the dressing room ‘superfoods’ [like MUFAs] into the limelight.” mirror in a strapless one-piece Dietitians of Canada recommends a diet with can fill you with dread. But 25 to 35 per cent of calories from fat, with 20 per instead of skipping meals to slim cent of those calories coming from monounsatudown or spending the summer hiding under a rated fats. In other words, if you’re following a cover-up, a few delicious diet changes can help 1,600-calorie diet, you should aim to consume trim belly fat so you can brave swimsuit season 35 grams of MUFAs per day. with confidence. Because monounsaturated fats Monounsaturated fatty acids, aren’t listed on nutrition labels, it’s or MUFAs, are one weapon in the hard to track your consumption of If you’re following a battle of the bulge. Research shows the good fats. Kate Comeau, a registhat MUFA-rich foods like almonds, tered dietitian and a spokeswoman avocado, peanut butter, dark chocofor Dietitians of Canada, recomcalorie diet, late and olive oil can reduce belly fat. mends eating MUFAs at every meal you should aim to These “good” fats also are thought to to ensure you’re consuming enough consume help increase HDL (“good”) cholesof the healthy fats. terol, reduce the risk of diabetes and Incorporating MUFAs into your breast cancer, and protect against diet is as simple as sprinkling flaxof MUFAs per day. cardiovascular disease. seeds on your morning bowl of oatWhile it’s unclear how the healthy meal, adding avocado to a turkey fats help you slim down, Cynthia Sass, a regissandwich, keeping a stash of almonds in your tered dietitian and the co-author of the Flat Belly desk drawer for snacking or using a splash of Diet, believes consuming more MUFAs may help extra-virgin olive oil to broil veggies at dinner. prevent the accumulation of visceral belly fat or “Eating MUFA-rich foods will help keep you boost metabolism, or do both. feeling full for longer,” Comeau says. “The foods “We’ve known about the health benefits of that contain these healthy fats are really deliMUFAs for years, but recently nutrition educacious, so it feels like a treat to eat them.” tion has strongly shifted towards focusing about These MUFA-rich recipes prove that even a which foods to eat for health rather than which “diet” dish can be filled with delicious fats.

1,600-

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PHOTOGRAPHY BY SUPERSTOCK; GETTY IMAGES; THINKSTOCK

35 GRAMS

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Garbanzo NUTS

PHOTOGRAPHY BY SUPERSTOCK; GETTY IMAGES; THINKSTOCK

Makes six 79 ml servings 160 calories per serving INGREDIENTS 2 398 ml cans garbanzo beans, rinsed and patted dry 15 ml olive oil dash of chipotle pepper powder dash of salt (optional)

DIRECTIONS 1. Heat oven to 180 degrees Celsius. 2. Line a jelly roll pan (cookie sheet with a rim) with aluminum foil or parchment paper. 3. Place garbanzo beans in a medium-sized bowl. Add olive oil and chipotle pepper or other herbs and combine well. 4. Place on baking pan and bake for two hours (monitor so they don’t start to burn). 5. Turn off the heat and leave the garbanzo beans in the oven as they cool and become a crunchy “nut.” (This usually takes a few hours. For best results, let them cool overnight.) Store in an airtight container.

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Cherry Almond Ginger SMOOTHIE Makes 1 serving, 416 calories

INGREDIENTS 1 single-serve container (142 grams) of non-fat plain Greek yogurt 60 ml water 225 ml frozen pitted cherries 30 ml almond butter 60 ml dry old-fashioned rolled oats 1.23 ml fresh grated ginger DIRECTIONS 1. In a blender, combine all ingredients and process to desired consistency. 2. Pour into a glass and serve.

Peanut Butter GRANOLA BA RS M akes 48 se rvings , 120

calorie s pe r se rv

ing D RY IN G RED IE NTS 675 m l raw oats 22 5 m l fl ax seed m eal 4.75 gram s baki ng soda 22 5 m l pe an ut s, chopped 11 8 m l sunf low er seed s 11 8 m l dried ch er ries of cran be rrie s, chopped 2. 38 gram s salt (optional) 11 8 m l dark choc ol ate ch ips WET IN G RED IE NTS 22 5 m l pe an ut butter 22 5 m l favourit e je lly such as st rawbe rr y or ra sp be rr y 44 m l saff lower oi l or ot he r high -o le ic oi l such as pe an ut or ha ze ln ut 4.75 gram s vani lla ex trac t

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D IREC TIO N S 1. H eat oven to 180 degree s Cel siu s. 2. Line a 22 x33 cm baking dish w ith parchment paper. 3. Combine first seven dr y ingred ient s and mix well. Keep choc olate chips sepa ra te . 4 . Combine all wet ingredient s in a large pot. Cook over low he at until well co m bi ned, st irring frequent ly. Rem ove from he at . 5. Pour dr y ingr edient s into the pot and mix wel A llow mix ture to l. cool for about 15 minutes . 6 . Add chocolat e chips and mix well. 7. Pour mix ture into the baking di sh and pres s fir mly. (Keep m ix ture from st ic king to hand s by pres sing with a piece of parchm ent paper.) 8 . Bake at 180 de gree s for about 20 minutes . 9. Cool slightly before cutt ing in to 48 medium sized bars .

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Ode to Olive Oil

Makes 2 servings 291 calories per serving

INGREDIENTS Salad 1 ear corn 1.23 ml cayenne pepper 1 pint baby romaine leaves 1 /2 pint canned, no-salt-added black beans, drained, rinsed 1 /2 ripe Hass avocado, sliced

DIRECTIONS 1. Sprinkle corn with cayenne pepper and roast in oven at 180 degrees Celsius until kernels are slightly golden. 2. To create the pico de gallo, combine tomatoes, bell pepper, onion, cilantro, jalapeño and lime juice. Toss together and allow to sit while the corn is roasting. 3. Slice kernels off corncob. 4. Toss greens with pico de gallo and transfer to a plate. 5. Top with beans, corn and avocado and serve.

SMOOTHIE PHOTO BY ALEXANDRA GRABLEWSKI; CUTTING BOARD AND SALAD BY THINKSTOCK

Pico de Gallo 1 /2 pint grape tomatoes, quartered 120 ml yellow bell pepper, minced 120 ml white onion, minced 28.3 grams fresh cilantro, minced 9.5 grams fresh jalapeño, minced Juice from a fresh lime

ONLINE

Sassy Fiesta SALAD

Which oil is good oil if you have heart disease? At the Cardiac Rehabilitation and Secondary Prevention Program at St. Joseph’s Hospital, dietitian Carol Mason-Taylor is a proponent of the Mediterranean diet, which has long been associated with lower incidence of cardiovascular disease and cancer. The Mediterranean diet is rich in fish, whole grains, fruit, vegetables and olive oil, which may be the secret ingredient, says MasonTaylor. “The most recent research has shown that a Mediterranean diet, supplemented with extra-virgin olive oil or nuts, resulted in substantial reduction in the risk of major cardiovascular events among high-risk individuals.” Olive oil is low in saturated fat, which makes it a healthy alternative to other oils. MasonTaylor also suggests her patients choose the extra or standard virgin variety rather than “pure” olive oil. Extra and standard virgin olive oil is extracted directly from the olive fruit and produced naturally rather than from chemical treatments, making it a higher quality. As for all the hype about coconut oil, Mason-Taylor suggests doing some reading before switching to this popular tropical fat. There’s no scientific evidence it’s the superpower some are claiming it to be, she says.

Helpful Advice

At the Cardiac Rehabilitation and Secondary Prevention Program of St. Joseph’s Health Care London, patients follow an individualized program to overcome some of the physical complications of heart disease, limit the risk of developing more heart trouble, and return to an active life. To learn more, visit sjhc.london.on.ca/ cardiacrehabilitation.

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Virtual HealtH By AlissA M. EdwArds

All It’s Missing Is FarmVille

Crafting a healthy menu that your family will actually enjoy is a challenge to begin with. But it reaches a whole new level of difficulty when someone in your house has a gluten sensitivity or celiac disease. “When I was diagnosed with an autoimmune condition, I decided to try going gluten-free and I felt so much better,” says E.A. Stewart, a

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registered dietitian also known as the Spicy RD. She chronicles her challenges, and ultimate success, on her blog, eastewart.com, a collection of healthy and 100 per cent gluten-free recipes. From her “amazingly addictive” artichoke squares to pumpkin pesto bruschetta to blueberry streusel muffins, they’re as unusual as they are delicious. “Although no one diet fits all, everyone can benefit from more fruits and veggies,” Stewart says. “All my recipes feature lots of seasonal produce to make them both healthy and delicious.”

photography by fitbit inc.; thinkstock

Fab

photography by thinkstock

GlutenFree

What if learning about your health—and then making positive changes—could be as fun as Facebook? Everyday Health (everydayhealth.com) helps you create your own profile page, then customizes your news feed with relevant information on the topics and conditions that matter to you most (like parenting or diabetes). Everyday Health is also home to a wealth of social forums, where you can chat with others who have similar conditions (Crohn’s disease) or goals (losing 10 pounds). It regularly hosts live Twitter chats with national health experts. The site also features online tools including a pollen counter, a weekly meal planner and a body fat calculator, and offers a food and fitness journal, a weight and measurement tracker and a calories-burnedduring-exercise calculator to boot. Best of all, it’s free.

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You have to be active. And you have to sleep. But chances are, if you’re addicted to your smartphone, tablet or Facebook account, the digital world is robbing you of these two health necessities. The Canadian Society for Exercise Physiology recommends at least 150 minutes of moderate to vigorous physical activity each week, and the Canadian Sleep Society says adults’ internal clocks call

for six to nine hours of sleep each night. Are you getting enough of both? The FitBit One ($100) can help you find out. About the size of a money clip, this gadget tracks physical activity, calories burned and sleep quality, then outputs the data into charts, graphs and tools on fitbit.com. Unlike some activity-tracking gizmos, the FitBit One clips unobtrusively on to clothing during the day (no “dork alert!” armband) and syncs wirelessly with your computer or smartphone without a USB cord. Transfer it to a wristband at night to monitor sleep duration and quality. It even wakes you with a gentle vibration.

PHOTOGRAPHY BY FITBIT INC.; THINKSTOCK

LOOKING FOR DR. RIGHT?

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ou know the benefits of maintaining an ongoing relationship with a primary care physician— from continuity of care to disease prevention. Finding one you like and trust is the first step. RateMDs.com takes the guesswork out of finding a doctor or a dentist. The online tool lets you search for practitioners by specialty, province or gender and then tells you about their educational backgrounds, board certifications and types of insurance accepted. You can also read anonymous reviews from patients and schedule an appointment.

Speech language pathologists (SLPs) at St. Joseph’s Parkwood Hospital are using tablets to revolutionize the way they help patients communicate. “The marvellous thing about tablets is we can now provide supported conversation in more situations, to more patients, in more ways,” explains Margo Clinker, SLP with the Neurotrauma Rehab and Assistive Technology Enabling Possibilities programs. “Tablets foster a better learning environment because they’re fun, interactive and engaging,” says Crystal Branco, SLP with the Community Stroke Rehabilitation Team. For patients with aphasia who have difficulty speaking, understanding others, reading and writing, the tablet’s multimedia options ease their frustration by encouraging two-way conversation.

tools

Clip-on Health

Engineering Rehabilitation

Strange Symptoms?

Though you should always have your doctor evaluate anything out of the ordinary, everydayhealth.com/ symptom-checker can give you an idea of where to start when something seems a little wonky.

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Step by Step Walking for 30 minutes a day can help reduce your risk

for heart disease and diabetes. What are you waiting for?

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ReSeaRch TakeS

HealtheSteps

FoRwaRd

A new Lawson Health Research Institute project tackling diabetes prevention has received more than $2.7 million in funding

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By Sonya Gilpin

esearch promoting exercise as medicine and mobile technology to prevent chronic disease has received more than $2.7 million in federal and industry funding. A new project led by Lawson Health Research Institute will focus on healthy living to reduce type 2 diabetes in rural communities and has the potential to reduce the rate of disease across the country. Diabetes contributes to about one in 10 deaths in Canada. Fortunately, many of the factors that put people at risk are preventable, explains Dr. Rob Petrella, project lead and director of Lawson’s Aging, Rehabilitation & Geriatric Care Research Centre located at St. Joseph’s Parkwood Hospital. Unhealthy diet, physical inactivity and tobacco use can all be managed—if the right support is available.

At-risk AreAs In rural communities, the risk of developing diabetes and other chronic diseases is particularly high. Many residents lack easy access to health care providers and health information. Dr. Petrella’s team at Lawson is hoping to change that. “Our goal is to put information about chronic disease prevention into the hands of rural Canadians, give them incentives to adopt healthier and more active lifestyles, and then evaluate the results and benefits,” says Dr. Petrella.

The study will target rural and remote residents in Ontario, Quebec, British Columbia and the Northwest Territories. Each participant will receive a lifestyle prescription called “HealtheSteps,” which combines exercise programs and healthy eating. Trained coaches will provide support in person, over the phone, and online. Half of the participants will also have access to two smartphone applications: “HealtheSteps” and “eaTracker.” Each app will be designed to provide customized, individual support to help keep participants on track. John Dyson, a 54-year-old London resident, participated in a similar study with Dr. Petrella last year, an experience he describes as “life changing.” “One of the biggest challenges with my diabetes is that I feel alone,” he says. “Diabetes is invisible—you can’t see it. I have spent most of my life battling depression. It’s hard to want to take a needle every day.” After enrolling in the program, Dyson noticed a dramatic difference. “It made me feel like someone was listening. I was always getting feedback so that I could make improvements. When there were blips I could tell right away. It made all the difference.”

Dr. Rob Petrella, director of Lawson Health Research Institute’s Aging, Rehabilitation & Geriatric Care Research Centre located at St. Joseph’s Parkwood Hospital, describes the landmark HealtheSteps project during the funding announcement for the research.

oNliNe

Next Step Please visit healthesteps. igloo communities. com for more information about the HealtheSteps project.

NAtioNAl impAct Dr. Petrella and his team hope to see similar outcomes with this project. Providing personal support resources, they believe, could have a major impact on health behaviours and help to reduce the rate of diabetes across the country. Federal funding for the project is provided by the Public Health Agency of Canada’s Canadian Diabetes Strategy. Other partners include Dietitians of Canada, Dairy Farmers of Canada, Sykes Assistance Services, Sanofi Canada, and 10 academic partners from across the country. SUM MER 2014

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A DAY IN THE LIFE OF ST. JOSEPH’S

Kyle’s Journey, a Family’s Gratitude

A young man comes back from a serious injury with the help of loved ones and a dedicated rehabilitation team

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BY LAURA JANECKA AND ANNE KAY yle Ford is all smiles as he makes his way around Parkwood Hospital’s Fitness Centre with walking poles that help keep his posture aligned for a better workout. His positive attitude has remained steadfast throughout his journey to recovery from a car accident in 2007 that left him in a coma for months and waking up to life with a serious brain injury. Initially the young man’s outcome looked grim, but at Parkwood Hospital’s Acquired Brain Injury (ABI) Rehabilitation Program his family began to see signs of hope. Inspired by Ford’s courage and grateful for the care he has received, his family is paying it forward, dedicated to making a difference for others. The Ridgetown family hosts annual fundraisers to benefit patients and residents

at Parkwood. From 50/50 draws, to wine and jazz events, to golf tournaments and more, the Fords and their enthusiastic community have raised more than $45,000 over the past six years for rehabilitative equipment in Parkwood’s Fitness Centre and the enhancement of a patient/ resident lounge. This year’s event, an evening of blues with Chuck Jackson and the All-Stars, was held in March at University of Guelph’s Ridgetown Campus. On these pages is a glimpse of Ford’s remarkable journey and the all-encompassing support of a giving and devoted family.

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In 2007 Kyle Ford and a group of friends were out for a night of fun when a tire blew on their car, causing it to spin out of control. Ford was ejected from the vehicle and found by firefighters in a ditch and unresponsive. When he awoke from a coma after 3 1/2 months the Fords captured the happy moment. Remarkably, Ford was able to recognize everyone, including his mom, Vicky, far right, sister Kristen and niece Lidiah.

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Encouraged to talk to Ford while he was in a coma, his parents promised him a puppy when he awoke. When he did, fourlegged Brody (seen here) was brought into the family. Ford, now 29, and Brody have been inseparable ever since.

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Ford’s dedicated family has hosted six fundraisers since he was admitted into the Acquired Brain Injury Rehabilitation Program at Parkwood Hospital. Here, Ford and his parents, Vicky and John, enjoy one of their wine and jazz events. Proceeds are donated to St. Joseph’s Health Care Foundation to benefit patients and residents at Parkwood Hospital in a variety of ways.

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These days, Ford comes to Parkwood Hospital three times a week to work with physiotherapy assistant Barry Lynam and physiotherapist Janelle Wittig on strength, balance and walking.

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With the help of Wittig, Ford uses walking poles, which keep him more upright than a walker. In his daily life he uses a scooter or four-point walker to get around.

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Ford’s rehabilitation is a family affair. Each week his grandfather accompanies him on the hour-long drive from Ridgetown to Parkwood Hospital for therapy. During the holidays, mom Vicky was able to be with him.

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When not out and about in Ridgetown on his scooter, Ford is working on a special project—his autobiography. He has been documenting his life after the accident—typing with one finger—to share in his experiences in the hopes of inspiring others.

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The Ford Family Golf Play Day is just one of the family’s popular fundraisers for Parkwood Hospital. Here, Ford takes command of the golf cart with his soonto-be brother-in-law, Chad Bourgeois, as his passenger.

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Kyle and his grandfather, Bill, enjoy a moment in the patient lounge on 4AE at Parkwood Hospital, where the Ford family spent a lot of time. The patient lounge was renovated and refurbished thanks to the Ford family’s fundraisers. SUM MER 2014

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Best Day

Week

of the

For Cory, cooking has been an important part of his recovery from mental illness

By Renee Sweeney

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delicious aroma is filling the house on Steele Street, drawing its occupants into the newly renovated kitchen where Cory, who has recently discovered his passion for cooking and baking, is preparing a meal, excited to serve up the latest recipe to his house mates. It’s Monday at St. Joseph’s Steele Street Rehabilitation Residence in St. Thomas, where Cory is one of nine people living and receiving mental health rehabilitation therapy. And it’s his night to cook dinner. “Monday is my favourite day,” he says with a grin. “I like cooking and baking for my house mates—it puts a smile on people’s faces. Before I came to Steele Street, I didn’t even realize I was good at it. It has really helped me to build self-esteem and confidence.”

Tools and skills

others and collaborating on new recipes to try. He’s found a special talent.”

Time wiTh Family Cory stresses that there are many important factors to recovery, including support systems, the proper medication and asking questions. “If you don’t ask questions, you won’t get the answers. You’ve got to want to know your sickness. If you don’t know what you’re suffering from, then how can you recover?” One thing he looks forward to most is using the many skills and tools learned at Steele Street to build on relationships with his family members—sharing a meal, sharing conversation, sharing support. “I’ve made it my goal, when I have my own place, to have my grandmother over and my dad, my sister, my mom, put on a good meal for them and talk and say, ‘Listen, this is how I’m doing.’ ”

One of nine residents at St. Joseph’s Steele Street Rehabilitation Residence, Cory is learning about himself, his talents and abilities on his road to recovery— including some impressive skills in the kitchen.

Cory, 26, has been in and out of hospital since age 21, struggling with the difficulties of managing both a mental illness and an addiction to alcohol. The seven months he has spent at the group home, however, have already made a huge difference in his rehabilitation and recovery. Through the Illness Management Recovery Program at the residence, Cory is learning tools and building skills he’ll need when he gets back out on his own and living independently in the community. “It’s not just the cooking abilities that I’m discovering,” says Cory. “I’m finding myself here. I’m learning communication skills I didn’t have—how to be social, how to feel civilized. I couldn’t even speak at family functions before, not unless it was a one-onone conversation.” Now he’s a full and willing participant in the daily and weekly activities at the group home. “Cory has made leaps and bounds in his journey here,” says occupational therapist Jackie McAdams. “I love to watch him in the kitchen, giving cooking tips to the

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A Girl Surrounded Through words and song, Chantal Kreviazuk moved a sold-out audience at Breakfast of Champions

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BY LAURA JANECKA

n the surface, Winnipeg-born Chantal Kreviazuk’s life is a charmed one. She is a Juno-award winning singer and songwriter, and mom to three boys with wellknown musician Raine Maida. Together, they divide their time between homes in Toronto and California. But for most of her life Kreviazuk has been surrounded by mental illness, growing up with a sibling who has bipolar disorder and as a close friend to someone she watched lose their battle to schizophrenia. These experiences have been cathartic inspiration for many of the singer’s songs and the 2006 short film Pretty Broken, which she wrote, co-produced and starred in. On April 29, Kreviazuk was the featured guest at Breakfast of Champions presented by St. Joseph’s Health Care Foundation and the Canadian Mental Health Association to raise awareness of and funds for mental health programs in London. In words and song the artist revealed why she’s an “expert witness” to mental health and the insight it has given her over the years. Here she shares what mental illness has taught her and what she wants others to know:

Q: What is your message to others when it comes to mental illness? A: There have been times I have caught people saying something about my family member. It was tough and painful to hear. It would be great if we could lower our need to judge others. Sometimes our fears or lack of understanding is what causes us to be judgmental. We can’t understand so we do all of this projecting based on our own capacity and our own insights about our life. But you’re applying your capacity to somebody that doesn’t have that capacity.

Q: What inspired the song ‘Surrounded’? A: “Surrounded” was about a friend who had a very quick turnaround with his schizophrenia. My friend, who I loved a lot, took his life. Because it was a hard thing for me to get over, I wrote “Surrounded” as part of my own healing process. When I perform it, it’s like my friend is with me and I feel like I’m honouring him.

Q: Why did you produce the film Pretty Broken, in which you portray a woman with a mental illness struggling through various treatments?

ONLINE

Read More

For the full interview with Chantal Kreviazuk, visit sjhcfoundation. org/stories/girlsurrounded.

A: In a family with a mental health patient everyone is, or ends up being, affected. But it can also become an opportunity for growth. Sometimes in your growth—at least for me—you’re like ‘I’m over it, I don’t want to listen anymore.’ ... What I needed to do was go inside the patient I love and I needed to go to their darkest place.

Q: How have your life experiences shaped who you are today? A: Mental illness, in all its forms, is something that I am really passionate about because it has defined me in a pretty substantial way. But it’s also not all of me. These things don’t define us, they happen to us. … Over the years I’ve learned that whoever is around you will really impact you … but the thing is how we respond to it. SUM MER 2014

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Empowerment

THE ART St. Joseph’s breast care patients find OF inspiration in the artwork of four women touched by cancer

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The comforting and inspiring artwork of Sheryl McTavish, left, Carolyn Hill, Alison Brown and Lin-Pei De Souza (kneeling) now hangs in the Norton and Lucille Wolf Breast Care Centre at St. Joseph’s Hospital in London. The four artists are participants in the art therapy program of Wellspring London and Region.

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he imagery and messages are powerful, and even more compelling when you know the artists. They are cancer survivors, a caregiver and someone living with cancer, and they are reaching out through art to those just starting out on the cancer journey. The art hangs in a waiting room of the Norton and Lucille Wolf Breast Care Centre at St. Joseph’s Hospital. Empowering patients with messages of courage, strength, peace and hope, the artwork appears like stained glass where patients wait for their tests. The artists are participants in the art therapy program of Wellspring London and Region, which partnered with St. Joseph’s to create the set of four panels. “Each panel is like a visual sound clip of who they are and what they hope for everyone else who is going through this journey,” explains Wellspring art therapist Wanda Sawicki of the four artists.

For Alison Brown, a throat cancer survivor, art therapy helped her uncover “hope and joy that hadn’t been touched by the cancer.” “I know what it’s like to be waiting for tests, waiting for results, the anxiety you feel,” says Brown. The art is meant to be “a moment of beauty, a moment of hope, a moment of inspiration.” Brown’s best friend and caregiver, Carolyn Hill, is also among the four artists. “I am so pleased that the paintings may offer some distraction or some opportunity for curiosity, and some evidence of the touch of the human hand and heart.” For Sheryl McTavish, the gift of art is a way of giving back for the support she has received through Wellspring while undergoing treatment for cervical cancer. “I was so excited to be doing this for the Breast Care Centre. My mom had breast cancer, and I have the BRCA2 gene [mutation],” explains McTavish, who had a double mastectomy and her ovaries removed five years ago as a preventive measure. Her cervical cancer was discovered last year when she decided to also have a preventive hysterectomy. Lin-Pei De Souza also has a special connection to the hospital. While pregnant and due to deliver at St. Joseph’s she was diagnosed with a brain tumour. She needed immediate surgery at University Hospital in London. She also needed to deliver her baby. A perinatal team from St. Joseph’s travelled to University Hospital and delivered the infant by Caesarean section in the operating room, which was immediately followed by brain surgery. De Souza’s little girl is now three years old. Wellspring, which offers a wide range of cancer support programs, and St. Joseph’s have enjoyed a long-time partnership to meet the needs of people facing cancer, explains Gillian Milcz, a nurse navigator with St. Joseph’s Breast Care Program. “We continually explore ways we can work together.”

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In Your own words have been back to St. Joseph’s twice, first, for a stent to be removed, and, second, for an ultrasound scan; and I felt as though I was returning, if not home, at least to welcoming friends. Sincerely, David Cobain Hamilton, Ontario

Among the care providers for surgery patients at St. Joseph’s are, from left, Wilma Bartlett, surgical inpatient unit nurse; Wilma Rosehart, administrative assistant to urologist Dr. John Denstedt; Mary Agnes Hall, Urology Centre nurse; Mary Anne Sunderland, Urology Centre nurse; and Nancy Roberts, surgical inpatient unit nurse.

‘Professionalism and Personal Warmth’ admired Some weeks ago, I underwent a surgical operation in your hospital at the hands (and certainly under the direction) of Dr. John Denstedt, and I wish the staff to know of my deep appreciation and admiration of the skill, dedication and kindness lavished on me. As I remarked to Dr. Denstedt when I took my leave of him after a final check: ‘It was almost a pleasure.’ That was, of course, a cheerfully sardonic nod to the discomfort associated with such procedures and their aftermath. But, that aside, the remark was wholly intentional. Dr. Urologist Dr. John Denstedt Denstedt and his surgical associates, Wilma and the other ladies in the urology clinic, aided and abetted by the nurses on the 6th floor (particularly, Donna, Marlene, Theresa and Nancy), were all tirelessly efficient and captivatingly charming. Indeed, professionalism and personal warmth were almost unfailingly evident throughout my stay, from the receptionists in radiology as I entered, to the ward from whence I departed. Since the operation, I

a fantastic team I have been a patient at the Urgent Care Centre at St. Joseph’s Hospital. I wish to compliment and pat the staff on the back for their awesome, kind care given to me. I arrived at Urgent Care with severe lower back pain and was taken care of immediately by very caring, kind staff, who had me in a bed and hooked up to IV and liquid painkiller in a very short time, with guiding advice and help from Dr. B. Hassani. They were all fantastic and worked well as a team. They all need to be praised for being such wonderful, caring and knowledgeable people. Compliments and thank you are very scarce in the medical field, so I wanted to inform you how great the care was that I received. Thanks to all,

Every day, St. Joseph’s Health Care London receives words of appreciation and praise from grateful patients and their families. St. Joseph’s prides itself on serving with respect, excellence and compassion, which shows on our patient satisfaction scores—among the highest in the province. But don’t take our word for it …

Betty Wallis London, Ontario

email

‘an incredible nurse’ I had surgery for my broken jaw and on the last day of my care and discharge, I was cared for by Wilma Bartlett [seen in photo above]. I was so impressed by the level of care she provided I wanted to commend her thoroughly for her amazing services. She was a wonderful person with a great sense of humour and provided constant, timely, professional care. For my discharge she went through every line of the instructions left by the surgeon. She is an incredible nurse and everyone should know about it! Thanks, Wilma!

Your story

If you would like to comment on the care you received at St. Joseph’s Health Care London, please email Dahlia Reich at dahlia.reich@ sjhc.london. on.ca.

Laurence Daw London, Ontario SUM MER 2014

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InspIred to Give

promising possibilities Transformative technology inspires Armatec to support groundbreaking research at St. Joseph’s

Armatec President and CEO Karl Pfister is up for the challenge of experiencing transcranial magnetic stimulation (TMS) first-hand. Dr. Alexandre Legros, principal investigator with the Human Threshold Research Group at Lawson Health Research Institute, operates the TMS equipment, a noninvasive way to increase or decrease brain activity that can be applied to a wide variety of psychiatric and neurological conditions.

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arl Pfister sits in a white armchair with a black strap around his forehead, and his fingers are twitching. A device on a stand hovers over his head and an image of his brain is on the computer screen. Dr. Alexandre Legros, principal investigator with the Human Threshold Research Group at Lawson Health Research Institute, operates the equipment, known as transcranial magnetic stimulation (TMS), which is literally stimulating Pfister’s brain and causing his fingers to jerk. The president and CEO of Armatec Composites and Armatec Survivability is in awe, even with his extensive background in engineering, manufacturing and machinery.

Far reaching impact What Pfister was experiencing was a non-invasive way to simulate regions of the brain to increase or decrease activity, which can be applied to a wide variety of psychiatric and neurological conditions. Research shows that TMS can help treat Alzheimer’s disease, drug-resistant depression, obsessive-compulsive disorder, chronic pain and migraines. It also has a role in research,

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particularly unlocking the mystery of what happens when an abnormal signal from the brain causes abnormal movement in a limb, as with Parkinson’s disease. The promising possibilities are alluring to the world-renowned Armatec, which is in the business of changing and saving lives itself. The London company transfers technology from the aerospace industry to military vehicles, engineering systems that improve crew protection and vehicle survivability. The company also conducts research and development that includes battlefield intelligence and modern testing techniques. It’s only fitting that Armatec is supporting some of the most cutting-edge technology at St. Joseph’s Health Care London and Lawson. It was Pfister’s curiosity and enthusiasm for transformative technology that inspired him to help move the TMS program forward. “We have a long-standing tradition here at Armatec to contribute to innovation that leads to new things, things that haven’t been sought before that will have a big impact and make a difference to people’s lives.”

Opening a WindOW Armatec’s gifts over the years have benefited St. Joseph’s in various ways, having contributed to the purchase of a PET/CT machine and TMS research, says Dr. Frank Prato, Lawson’s assistant scientific director and Imaging Program lead. “Armatec’s support has helped open a window,” says Dr. Prato. “It will allow this group to continue building. TMS will make a difference with respect to recovery—and how fast people can recover. It will impact our research program, which ultimately will impact the well-being of our patients here in London and throughout Southwestern Ontario.”

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Benefitting St. Joseph’s Breast Care Program

Proudly presented by:

THANK YOU FOR YOUR SUPPORT!

Thanks to the generosity of participants, volunteers and sponsors, London’s 2nd annual Bust a Move for Breast Health event on March 29 was a tremendous success! THANKS TO OUR GENEROUS SPONSORS:

Special thanks to: Hendrix Restaurant Equipment & Supplies Medbuy Corporation

Renowned for compassionate care, St. Joseph’s is one of the best academic health care organizations in Canada dedicated to helping people live to their fullest by minimizing the effects of injury, disease and disability through excellence in care, teaching and research. Charitable Registration Number: BN 11918 3390 RR0001

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sjhcfoundation.org

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St. Joseph’s Health Care Foundation 268 Grosvenor Street London, ON N6A 4V2 Please return Canadian Addresses to above address

||||||||||||||||||||||||||||||||||||||||||

ST. JOSEPH’S TRIBUTE DINNER SEPTEMBER 18, 2014 LONDON CONVENTION CENTRE

RESERVE TICKETS NOW

$195 PER PERSON

sjhcfoundation.org 519 646-6085

Early Bird Tickets

$ 175

EARLY BIRD DEADLINE IS JUNE 27

With st special gue

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Vim & Vigour Summer 2014  

Vim & Vigour Magazine, St. Joseph's flagship health information resource featuring stories about the breakthrough healthcare and healthy liv...

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