Page 1

winter 2020

Cut carbs with ‘chaffles’ page 16

VGH: leader in life support

photo: dan toulgoet

page 18

Hospital parking fees under review page 6

also available online at vancourier.com



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LIGHTEN UP Vitamin D from the sun

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EAT WELL Sometimes comfort foods

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contents on the cover

Hospital parking rates under review in B.C. Photo: dan toulgoet



Michelle Bhatti editor

Sandra Thomas sthomas@vancourier.com contributing writers

Jeremy Hainsworth Cindy E. Harnett Tyler Orton Elisia Seeber creative director

Marina Rockey

For advertising inquiries, contact Michelle Bhatti at mbhatti@vancourier.com

winter 2020

6 12 14 15 16 18

Hospital parking fees add to stress Parking fees are under review by health minister Cindy E. Harnett

B.C. kidney disease treatment lands $65 million investment Vancouver company using precision medicine to fight ‘underserved’ disease Tyler Orton

student mental health B.C. government rolls out more funding for student mental health programs Elisia Seeber

B.C. medical premiums ended Dec. 31 Transition to Employer Health Tax could mean lower wage increases, higher prices Jeremy Hainsworth

cut carbs in 2020 with ’chaffles‘ This combination of cheese and eggs is replacing bread and sweets at meals sandra thomas

Vancouver General Hospital: leader in advanced life support VGH is the first Canadian hospital to achieve gold level status from the Extracorporeal Life Support Organization Courier staff

volume 6, number 1, Winter 2020 Published by glacier media. Copyright ©2020. All rights reserved. Reproduction of articles permitted with credit. Advertisements in this magazine are coordinated by Glacier Media. Glacier Media does not endorse products or services. Any errors, omissions or opinions found in this magazine should not be attributed to the publisher. The authors, the publisher and the collaborating organizations will not assume any responsibility for commercial loss due to business decisions made based on the information contained in this magazine. Speak with your doctor before acting on any health information contained in this magazine. No part of this publication may be reproduced or transmitted without crediting Glacier Media. Printed in Canada. Please recycle.

winter 2020


SANDRA THOMAS Editor, Healthier You photo Chung Chow

where can you find healthier you? It's in doctors' offices, walk-in clinics, pharmacies and other community settings — keeping you company by offering stories and insights into health-related issues that matter.

Here’s to a happy and healthy 2020 As we head into the next decade, I was recently reflecting on 2019 — and what a year it was.

park. That’s why I decided to make hospital parking fees the lead story of this edition of Healthier You.

Some days I had to give myself permission to not read the news, especially some of what’s happening south of the border. As a journalist, ignoring the news — even if for one day — is not acceptable, but for the sake of my mental health there were times I could not handle reading about one more mass shooting or another piece of fake news going viral.

More good news for 2020 is the fact that B.C. residents no longer have to pay MSP premiums, which will hopefully leave more money in the pockets of working individuals and families. You can read about the pros and cons of this new program on page 15.

But one piece of good news I was happy to read about last year, is the fact B.C. Premier John Horgan and Health Minister Adrian Dix are reviewing the cost of hospital parking. My husband had knee-replacement surgery this past April and, yowza, I thought I was going to have to get a payday loan to keep up with my hospital parking costs. The year before, I ended up in the emergency department at a Vancouver hospital one day and paid $30 to sit and wait for a doctor to see me. Going to the hospital as a patient or visitor is stressful enough — without worrying about the exorbitant price we pay to


winter 2020

Also, with a new year often come health and fitness goals. Mine are pretty basic, cut out some carbs and move more. It was while researching low-carb recipes that I discovered “chaffles,” a mixture of egg and cheese cooked in a waffle maker. I even joined a couple of Facebook groups dedicated to these cheesy waffles, which

can replace bread, pizza dough and regular waffles, but with a fraction of the carbs. And now I’m a chaffle convert and spend at least an hour on Sundays cooking different variations in preparation for the week. You can learn how to make the perfect chaffle on page 16.

Health is where we live, learn, work and play.

Moving into the new year, I wanted to make this edition of Healthier You both informative and entertaining and I hope I've accomplished that. All the very best for 2020! Sandra Thomas editor, healthier you

Healthier You is an innovative health and wellness magazine, published by Glacier Media Group, one of the largest publishers of specialty publications in Canada. Healthier You offers readers in depth features on health professionals, events and issues that have an impact on B.C. Communities, as well as informed articles designed to help the people of B.C. live healthier lives. Healthier You offers a targeted and qualified readership in the Vancouver Coastal region. Join the growing network of businesses and organizations supporting health improvement and benefit from the valuable exposure of Healthier You publications. To be part of our next edition, please contact Anthony Pan at 604-562-3354 or apan@glaciermedia.ca.

exTendinG your reACh wiTh


Parking at VGH runs between $3 and $3.75 per half hour. Photo: Dan Toulgoet


winter 2020

Hospital parking fees add to stress Parking fees are under review by health minister Cindy E. Harnett | Contributing writer

B.C. Health Minister Adrian Dix says the elimination of hospital parking fees is a complicated issue that he is reviewing with Premier John Horgan. But he’s not promising any action.

and families. They asked that this be done in an evidence-based way to prevent abuse by those who are not patients or family members, such as people working or visiting other locations near hospitals.

“There’s very few issues that people feel more strongly about in the health-care system than the paid-parking question,” Dix said at a news conference in Victoria in November. Hospital parking fees bring in about $40 million in gross revenue each year across the province, up from $15 million in 2003, Dix said.

A resolution passed by delegates called hospital parking fees “a hardship during some of the most stressful moments in a family’s life.” It also said they “give private companies the chance to profit from parking ...the elimination violations incurred of hospital by sick or grieving parking fees is people using a publicly run a complicated service.” issue...

During the NDP’s recent convention in Victoria, delegates called on the province to eliminate parking fees for patients

Pay parking at hospitals is not consistent on Vancouver Island. People visiting patients at Victoria General, Royal Jubilee and Saanich

Peninsula hospitals pay parking fees. At the Campbell River and Comox Valley North Island hospitals, parking is free. “It’s a challenging and it’s a complicated issue that the premier has directed me to look at,” Dix said. “And so we’re doing that right now — and so the resolution at the party convention will inform that process as well.” On the mainland, during the fiscal year ending March 31, 2018, Fraser Health received nearly $15 million in parking revenue and Coastal Health garnered about $5.5 million. The budget of each health authority is roughly $3.5 billion per year. Much of the revenue from parking fees goes to hospital foundations and to support health-care services. In cases where there is a need or continued on page 8

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continued from page 7

people are in hospital for a long time, health authorities frequently waive the parking fees, Dix said. Almost all of the parking management at B.C. hospitals is contracted out. It’s challenging in some communities to offer and police low-cost parking, he said. “It’s a significant concern people have. I hear about it all the time,” Dix said. Health authorities are involved in his review, Dix said. The cost of all options will be considered. Some health authorities encourage staff to take transit

to work and some have set up shuttle bus services, he said. “It’s a significant review we’re taking. I’ve been taking the issue very seriously.”

HospitalPayParking.ca, an online site aimed at ending “the obligatory pay parking trap and [advocating a] transition to something better that works for everyone,” applauded the unanimous passing of the NDP convention resolution. “Perhaps our droning on about hospital pay parking in B.C. needing

vancouver coastal health facility

lot location

Almost all of the parking management in B.C. at hospitals is contracted out.

reform has finally sunk in.”

Opposition health critic Norm Letnick said he raised the issue of pay parking in May and Dix said he was reviewing it then. “The review is taking a long time,” Letnick said. The province has a responsibility “to answer the question on what it wants to do on the pay parking issue,” he said, adding that he would be happy to work across party lines on a solution. With files from Sandra Thomas

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PainPro Clinics RMTs, Physiotherapists, Chiropractors and Kinesiologists dedicated to providing easy access to effective treatments Pain is a demanding taskmaster. It has little patience and won’t go away no matter how much you try to ignore it. That’s why painPRO Clinics is committed to its promise of “same day or next day” appointments when someone calls one of the six clinics in the Lower Mainland. “When you wake up with a sore neck because you slept badly or you slipped and fell, an appointment two weeks away won’t help you,” says Ryan Desrochers, who owns painPRO with his father Michael, who founded the company in 2004. “We understand the importance of providing easy access to effective treatments when people need them most.” This approach is particularly beneficial for people who have been injured in motor vehicle accidents. painPRO will help coordinate care with ICBC by working with the patient’s adjustor to get the approvals needed for the most effective treatment plan and treatment type. “The quicker we can address issues, depending on the severity of your injuries, the better the long-term outcome,” Ryan says. Not only do the professionals at painPRO want to immediately start alleviating a patient’s pain or discomfort, they also want to ensure they’re back doing the things they love as soon as possible. painPRO facilitates communication and information-sharing between its team of more than 70 Registered Massage Therapists, Physiotherapists, Chiropractors and Kinesiologists. Patients might start with a massage therapist who will assess their issues. If the massage therapist believes a chiropractor or physiotherapist can speed up recovery, then the patient will be referred to the appropriate team member. painPRO therapists focus on evidence informed approaches to healthcare. One very important area of research is the integration of active rehabilitation through movement. After undergoing treatment with a Registered Massage Therapist, Physiotherapist, or Chiropractor, many patients are referred to a Kinesiologist. They are specially trained in understanding the mechanics of human movement and will customize an exercise program that can be done at home to help reduce healing time.

Shockwave therapy, which helps break down scar tissue and improve the healing cycle, is included with no extra charge when needed. “We’re all about reducing the treatment cycle and saving patients money,” Ryan says. Sometimes pain prevention is equally important. A grandparent who wants to be able to pick up their grandchild with ease or someone who sits at a desk all day long will benefit from a specialized preventative maintenance program and active rehabilitation. painPRO is one of the few clinics with programs specially designed for the challenges dancers face. It has developed close ties with Arts Umbrella through team member Dr. Tony McDougall, a chiropractor who understands that dancing can be an extreme sport.

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“Dancing is really hard on your body,” says Ryan. “We have therapists who are trained and focused on specific treatments and exercise programs to support dancers on a preventative maintenance cycle as well as a rehabilitation cycle. We help them achieve their highest levels of excellence.” This team-based, collaborative approach is deeply embedded in painPRO’s culture. It has created the Institute of Clinical Excellence, which is headed by the former research chair of the Registered Massage Therapists Association of B.C. to develop and deliver educational seminars to painPRO’s staff and healthcare team. Veteran practitioners share their expertise with young graduates who get to further learn advanced methods. A video conferencing room facilitates discussions about best care options for patients with complex needs. “We’re in service to the patients from a health-care perspective and we’re in service to practitioners,” says Ryan, who adds the company is also dedicated to paying staff a living wage. “There’s a large team that has made painPRO what it is. We don’t have a top-down approach; it’s left-right. It’s a culture — we’re a healthcare community and we really do care about the people who are within it. It’s not just about the patients; we empower the practitioners and the employees with the knowledge to support patients at an extremely high level.”

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B.C. kidney disease treatment lands $65 million investment Vancouver company using precision medicine to fight ‘underserved’ disease Tyler Orton | Contributing writer

Treating kidney disease compared with other diseases in 2019 may evoke thoughts of the Dark Ages for some patients and doctors, according to Tom Frohlich. That is to say, it feels like an eternity ago. “It’s a lot like where cancer treatment was 30 years ago,” said the chief business officer at Chinook Therapeutics Inc., adding that most treatments are focused on addressing high blood pressure or controlling patients’ diabetes rather than the disease directly. “It’s an area of medicine that’s largely being underserved.” The Vancouver-based pharmaceuticals company aims to take a leap forward after raising $65 million in capital in August to get clinical trials underway by 2021 for treatments for kidney disease. Patients with end-stage renal disease — the last stage of chronic kidney disease — make up one per cent of Medicare patients in the U.S., but account for seven per cent of costs, according to University of California San Francisco research. The research pegged those costs to the American Medicare program at US$35 billion in 2016. 12

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“Despite that fact, very few drugs exist to slow the progression of kidney disease once you’re diagnosed,” Frohlich said. “We see a real opportunity to go after progressive kidney diseases.” Historically, big pharmaceutical companies tried developing treatments for broad groups of people — generally those whose kidney disease was caused by high blood pressure or diabetes. “There’s different causes of kidney disease in those patient types,” Frohlich said, “so going after them with one mechanism didn’t really do very much.” Instead, Chinook has been tapping into advances in precision medicine — tailored treatments based on genetic profiles — and identifying specific subsets of patients that have either a genetic predisposition or a key chemical pathway that’s driving the kidney disease. Versant Ventures managing director Jerel Davis, whose firm led Chinook’s $65 million funding round, said in an email that his company’s investment comes from a conviction that kidney disease is poised for “novel new treatments” owing to advances in precision medicine.

Larger drug companies, such as Johnson & Johnson Inc. in Boston and Novartis International AG in Switzerland, have also been setting up kidney-focused teams as precision medicine opens up the doors to new markets. Frohlich acknowledged the arena will be getting increasingly competitive, but the company’s relatively small size will keep it nimble as it moves into clinical trials. It’s launched partnerships with the Mayo Clinic in Minnesota and Washington University in St. Louis since launching about a year ago with a team of 25, many of whom had been reconstituted from a Merck KGaA division that was formerly in Vancouver. “The money is going to follow the innovation,” said Wendy Hurlburt, CEO of the LifeSciences B.C. industry association. She praised the advances being made by Chinook, adding that she’s hopeful breakthroughs from other B.C.-based companies will draw not only more capital but also more talent to the province’s life sciences sector. In November, LifeSciences B.C.’s annual investors summit drew a record 200 attendees (mostly investors from the U.S., Europe and Asia looking to sink cash into

Researchers at Chinook Therapeutics specialize in developing treatments for kidney diseases. The Vancouver-based company raised $65 million in capital in August to expand its research and commercialize. Photo: submitted

early-stage B.C. companies) and 85 applications from companies looking to present to investors. “We definitely have better momentum than we’ve had historically,” Hurlburt said, citing data from her organization that concluded there were more than 1,300 clinical trials currently underway in B.C., 59 per cent of which are industry funded.


mental health B.C. government rolls out more funding for student mental health programs Elisia Seeber | CONTRIBUTING WRITER

More funding has been provided to B.C. schools for student mental health programs to ensure youth across the province have the right support when they need it. The B.C. Government announced the $2-million province-wide grant in November, highlighting it will help make sure kids feel safe and connected at school. All 60 school districts will receive a portion of the funds to support new, and enhance existing, school-based mental health programs focused on prevention, wellness promotion and early intervention. About one in seven young people in B.C. — or 14 per cent — will experience a mental illness at some point, according to the Canadian Mental Health Association, B.C. division.

Education Minister Rob Fleming said the goal is to ensure that no matter where students live, they have access to effective and community-based preventative programming that will set them on positive paths to mental health and wellness. Each school district will be able to choose how the grants are spent based on their individual needs. Minister of Mental Health and Addictions Judy Darcy said the funding will allow school districts to make sure more students, teachers and caregivers have the tools they need to support physical, mental, emotional and social well-being during a critical time in a student’s life. “Every young person deserves the best possible start in life,” she said. “That’s why these grants are so important.” This is the second round of student mental healthfocused school capacity building grants. The funding is part of $8.87 million being invested over the next three years.

The B.C. government is offering up $8.87 million to school districts and independent schools for mental health and wellness programs.

“Many mental illnesses — between 50 and about 70 per cent — show up before the age of 18, so they can have a huge impact on a child’s development,” the association said.

In B.C., about six per cent of kids Photo: Dan Touloget experience an anxiety disorder and 3.5 per cent of young people will experience depression, most often in their teen years. 14

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The previous $2 million went towards a variety of programs across school districts. Schools in the Cowichan Valley created “calm kits” to help students manage stress and achieve emotional well-being throughout the day. While schools in Chilliwack organized a school-based mental health strategy retreat involving 120 educators, and the Peace River district produced a number of recommended social and emotional learning programs. Chris van der Mark, president, B.C. School Superintendents Association, said positive mental health is foundational for student success. “Many initiatives are already underway in all of our school districts, and this funding will allow us to continue to collaborate with our partners and rights holders to expand the scope and impact for all members of the school community.”

B.C. medical premiums ended Dec. 31 Transition to Employer Health Tax could mean lower wage increases, higher prices Jeremy Hainsworth | CONTRIBUTING WRITER

The elimination of premiums means a net tax cut of $800 million, the government said. Individuals will save up to $900 per year, while families will see up to $1,800 per year staying in their wallets.

Jock Finlayson. The new Employers Health Tax (EHT) kicked in at the start of 2019, while MSP premiums continued to be collected from both individuals and companies providing health benefits to employees. Those premiums, however, were cut by 50 per cent that year, dropping government revenue from that source from $2.6 billion in 2018 to $1.2 billion in 2019, Health Minister Adrian Dix said.

The other side of the coin, however, is an increased cost to employers for labour, which could be passed on to employees or consumers, said Business Council of B.C. (BCBC) chief policy officer

The government said provincial administrative savings from eliminating premiums would amount to more than $50 million annually. Horgan said the reason the lowered premiums were kept while the

As of Jan. 1, British Columbians no longer have to pay medical premiums, as that tax burden shifts to employers, Premier John Horgan said Dec. 5.

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EHT was collected was to allow for a transition between the two. The cutting of the premium rate while instituting the tax, he said, was to give companies funds for administrative changes through the halved premiums savings. The BCBC in August identified the EHT as the second biggest tax increase of the year under the NDP government. The council said the tax could have an impact on businesses of up to $1 billion. Finlayson said not all people were covered under the old system — including some employees, students and retirees who paid their own premiums. He said those people accounted for about half of premiums collected. Now, he explained, businesses with payroll costs above $500,000 a year will be taxed 1.95 per cent on those costs.


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cut carbs in 2020 with

This combination of cheese and eggs is replacing bread and sweets at meals sandra thomas | editor

Earlier this fall, I started experimenting with what’s known as a “lazy” or “dirty” keto diet. It’s basically a way of eating that keeps carbs under 20 grams a day, which pretty much cuts out all cereal, pasta, rice, sugar, potatoes, pizza dough, baked goods and, most importantly, all things bread. And because keeping carbs to a minimum can be a struggle —

think bun-less burgers and eggs with no toast — some genius created the chaffle, a mixture of eggs and cheese cooked in a waffle maker until crisp. Today, there are so many variations of the chaffle I struggled

to find its origins to include in this column. Perform one online search for “chaffle” and “Pinterest” together and you’ll see what I’m talking about. I even joined a couple of Facebook groups dedicated to this low-carb option to bread and let me tell you, the members there have many, many opinions when it comes to making chaffles. Chaffles are becoming so mainstream, there are even stock photos available online. Photos: iStock


winter 2020

Tips If your plan for 2020 is to cut out some carbs, chaffles are a great alternative and when it comes to variations, you’re only limited by your imagination. Flavour combinations to consider include, sugar-free chocolate chips; jalapeno, cheddar and bacon; sugar-free peanut butter; zucchini; cauliflower; cinnamon; or use as a base for pizza.

“Wonder Bread” Chaffle

Here are some tips and recipes to ensure your first attempt at chaffles makes you a fan, too.

1 tsp. water

Basic Chaffle

(three net carbs)

This is a good recipe to use for sandwiches. ingredients 1 large egg beaten 1 tbsp. almond flour 1 tbsp. mayonnaise 1/8 tsp. baking powder Method Preheat your waffle iron. Mix ingredients together.

(two net carbs)

Pour into waffle maker.

ingredients 1 large egg beaten ½ cup of shredded mozzarella

Cook until it stops steaming.

Method Preheat your waffle iron — it has to be hot. Mix ingredients together. Once your waffle iron is ready, sprinkle some grated cheese right onto the hot griddle before pouring in the batter. Sprinkle a handful of grated cheese on top of the batter and close the lid. Because I have a larger machine, I cook mine for six to eight minutes — until it stops steaming.

Sweet Chocolate Chaffle (two net carbs)

ingredients 1 egg beaten 2 oz. cream cheese softened or melted on low in the microwave. 2 tsp. unsweetened cocoa powder 1.5 tbsp. sweetener or to taste 1 tsp. vanilla 1 tbsp. coconut flour ½ tsp. baking soda Serve with butter or sugar-free syrup or jam. Method Preheat your waffle iron. Mix ingredients together. Pour into waffle maker. Cook until it stops steaming.

 I make chaffles with all kinds of pre-shredded cheese and so far they’ve all been great. Some true Keto followers insist you have to grate your own cheese due to the products used to keep the cheese from clumping, but for lazy keto I buy it by the bag and it’s been a lifesaver when I’m busy.  A lot of chaffle lovers purchase mini waffle makers, but I own a large one, which allows me to make four at a time.  Your waffle iron has to be really hot.  To spray or not to spray, depends on you. I never spray my waffle maker and have had no problems with sticking.  Let your eggs get to room temperature or place your eggs in a bowl of warm water to take the chill off.  Place your waffle maker on a cookie sheet to catch the drips.  Cooking times can vary, depending on your waffler maker, but if you cook your chaffle until it stops steaming, you should be good.  If you start to open your waffle maker and your chaffle is sticking, close the lid and give it another minute or two.  Once your chaffles have cooled, you can store them in your fridge or freezer.  Reheat chaffles in a toaster, a frying pan or in your oven. winter 2020


Vancouver General Hospital

leader in advanced life support VGH has is the first Canadian hospital to achieve gold level status from the Extracorporeal Life Support Organization Courier staff | Contributing writer

Nick Kanaan knows the medical system better than most people. He lost two siblings to cystic fibrosis at a young age and the disease nearly cost him his life. But thanks to innovative technology and a team of health care professionals at Vancouver General Hospital, Kanaan is breathing easier these days and chasing his young daughter around the playground. “If it wasn’t for the team at VGH who stood by me in my darkest hour, I wouldn’t be here today,” Kanaan said. “They placed me on ECMO, which was my bridge to a lung transplant.” Extracorporeal membrane oxygenation (ECMO) is an advanced form of life support that pumps and oxygenates blood outside the body so a patient’s heart and lungs can rest. VGH is the first Canadian hospital to achieve gold level status from 18

winter 2020

the Extracorporeal Life Support Organization (ELSO) for its ECMO program. The hospital received the award at the ESLO’s annual meeting in Austin, Texas. “This recognition is a testament to the excellent health care professionals at Vancouver General Hospital who bring teamwork and technology together to care for the most critically ill people in our province,” said Health Minister Adrian Dix. “As we can see with survivor Nick Kanaan, this technology is a lifeline for those with serious, lifealtering conditions.” The hospital has nine ECMO machines. There are two types of ECMO — one is connected to a vein and an artery for patients with heart and lung problems, while the other is connected to one or more veins, usually near the heart, for patients with lung problems.

Nick Kanaan The ECMO team (centre) is flanked includes doctors, by Vancouver nurses, perfusionists, General Hospital respiratory therapists, physiotherapist physiotherapists, Rys Chapple (left) and Dr. Hussein Kanji. pharmacists, an Photo: Vancouver extracorporeal life Coastal Health support specialist and dietitians. To date, more than 130 patients at Vancouver General Hospital have benefitted from ECMO. Many of them, like Kanaan, needed the machine to survive until suitable organs become available.

“ECMO is game-changing,” said Dr. Hussein Kanji, intensivist and co-director of the ECMO program at VGH. “But it’s the expertise of our entire team that enables us to provide this gold standard of care. Ten years ago, we couldn’t keep people alive long enough to receive a transplant; now patients like Nick are on ECMO for extended periods, increasing their chances of survival.”

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