Your Health Fall 2008

Won’t Back Down: An Edmonton woman fights for what’s right

AHS-Capital Health’s magazine for living well

Fall 2008 FREE

Fit to Be

Tried

How to get in shape the Zen way

The Power of Resistance Lifting weights will lift your spirits

Goodbye, Couch Potato

A reader relates her recipe for success

Final Issue

The Gift of Giving

How and where to volunteer

Return undeliverable mail to: Circulation Department, 10259-105 Street, Edmonton, AB T5J 1E3. Publications Mail Agreement #40020055

Contents

37

Fall 2008

Features

Departments

20 Take the Wheel

New licensing laws keep young drivers safer than ever

By PhOEbe Dey

22 Goodbye, Couch Potato

A slimmed-down reader stands in one leg of her old pants

By Sharon Gafka

23 Get off the Gravy Bloat

24

ON THE COVER Writer Jeff Gonek and his grandfather John Heck photograph by curtis trent

A few holiday eating tips so you don’t tip the scale by 2009

By Sally Johnston

24 Cover Story: Fit to Be Tried

4 Capital Comments 6 Health First

Peanut problems; Smoking and teeth; Listless with listeria; Fish oil formula; Yoga at your desk; HPV quiz; Events calendar

9 Pound by Pound

Tracy reflects on 12 months of challenging herself to be better

10 The Fitness Edge

Strength training will test your mettle

12 Ask the Experts

Who has a hernia?; My elderly dad can’t pee; Little pitchers’ big ears; Got macular?

14 A Day in the Life

A grandfather and grandson team up to get fit without getting hurt

By Jeff Gonek

28 Won’t Back Down

A male nurse already stands out in a crowd; Lloyd Tapper wants to do more

17 Foundation Series

The Black Gold Health Foundation digs deep

42 Frontiers of Medicine

A profile of a champion of AHS-Capital Health’s new Spina Bifida Clinic

The Comprehensive Tissue Centre’s scope gets bigger

By malcolm azania

46 By the Numbers

30 Flowers for Vera

A Stony Plain couple embodies the best of the volunteer spirit

By cait wills

37 Sweet Nothings

How to protect your kids from candy overload this Halloween

By Jim Veenbaas

30 Your Health – AHS-Capital Health’s magazine for living well

20 www.capitalhealth.ca

Fall 2008

Fall 2008 • Volume 6, No.4

In With the

New

Alberta Health Services’ mission is to build the best health care delivery system in the world

A

utumn feels like a time of new begin-

nings for many of us, but this year is especially important. Recently, the province’s regional boards and boards for cancer, addictions and mental health were replaced with a single governance board that is responsible for overseeing the entire health system in Alberta.

Alberta Health Services, as it is now known, is on a mission to provide a patient-focused health system that is accessible and sustainable for all Albertans. Every citizen of this province deserves equal access to health care services – from acute care, to wellness services, to preventative health initiatives. Whether they live in the far north or south, in an urban or rural setting, every man, woman and child must be able to get the care they need when they need it. We act in trust on your behalf, and every decision made going forward must place your interests first and foremost.

Since May, we have established a new health leadership team, drawn from expertise across the province, to help guide this new structure. This team will build on the excellence in health care that already exists in Alberta. It will create the connections and relationships vital to an integrated, co-ordinated system that will provide fast and consistent access to services for all Albertans.

Unfortunately, this will be the last issue of Your Health magazine in 2008, but we have big ideas for the future, which will be an integral part of our provincial approach to promoting wellness.

In conjunction with the Minister of Health, we have begun to fill the remaining board positions. We have a chief executive officer and a provincial management team which is structured around four portfolios: Continuum of Care, Planning and Programs, Corporate Services and Financial Services. The key priority for all of these groups is to think provincially while providing effective services locally. The sharing of

Fall 2008

publisher Ruth Kelly rkelly@venturepublishing.ca

associate publisher Daska Davis Executive Editor Ronna Bremer ronna.bremer@capitalhealth.ca

KEN HUGHES Interim chair of the Alberta Health Services Board

information, innovation and expertise are no longer going to be constrained by imaginary lines on the map. An example of how this can work: three years ago, a new pilot project testing a new care path for patients needing hip and knee care began in three health regions in our province. A team of health professionals guided patients from the assessment and pre-surgery stage through to recovery and rehabilitation much faster. The results, as measured in wait times, were fantastic: conventionally, it took 145 days to get from a referral to the first orthopaedic consult. Those wait times were cut by 85%, or down to 21 days. Similarly, it took 290 working days to proceed from the first orthopaedic consult to the operating room. The new project cut that wait time by 87%, or down to 37 days.

We want these kinds of improvements to be the standard of care for all Albertans in many different specialties. It is a model that makes sense; providing support for the physicians and simplifying care for patients and providers alike. This initiative will have clear benefits all across the province. We will build our system on the foundations in place today, and work together to shorten wait times, to improve access to primary care, mental health resources, wellness and preventative health initiatives.

We will build on the momentum of research and leadership cultivated here. We will attract world-class researchers to augment the delivery of health care, for the benefit of all. We will build a health-care system that is efficient, effective and financially sustainable. I invite you to stay informed and involved as Alberta Health Services evolves and to use the contact form on our website (www.albertahealthservices.ca) to provide us with feedback. Your perspectives are critical and I hope you will share them. Our goal is straightforward: to build the best health-care system in the world. It’s as simple as that.

Capital Comments is written by Alberta Health Services - Capital Health. www.capitalhealth.ca

Managing Editor Noémi LoPinto nlopinto@venturepublishing.ca

Copy CHief Kim Tannas ktannas@venturepublishing.ca

editorial advisors Mark Dixon, Sandra Huculak Dr. Gerry Predy, Marianne Stewart Art Director Charles Burke cburke@venturepublishing.ca

graphic designer Rodrigo López Orozco Production technicians Betty-Lou Smith and Geoff Cwiklewich Circulation coordinator Amanda Dammann Advertising Representative Alicia Kuzio akuzio@venturepublishing.ca

Contributing writers Phoebe Dey, Cynthia Dusseault, Malcolm Faust, Katherine Fawcett, Sharon Gafka, Jeff Gonek, Greg Hudson, Sally Johnston, Lindsey Norris, Lisa Ricciotti, Jacqueline Schimpf, Jim Veenbaas, Cait Wills Contributing Photographers and Illustrators 3Ten, Bluefish Studios/Christy, Lance Burns, Daniel Chen, Dustin Delfs, Caroline Hamel, Rodrigo López Orozco, Kelly Redinger, Amy Senecal, Curtis Trent

Your Health is published by Venture Publishing Inc. for AHS-Capital Health.

10259-105 Street Edmonton, AB T5J 1E3 Tel: 780-990-0839 • Fax: 780-425-4921 Toll-free: 1-866-227-4276 One year subscription: $12.00 (plus GST) Two year subscription: $24.00 (plus GST) E-mail subscription requests and address changes to yhcirculation@venturepublishing.ca Call toll-free 1-866-227-4276 ext. 237 The information in this publication is not meant to be a substitute for professional medical advice. Always seek advice from your physician or other qualified health provider regarding any medical condition or treatment.

Printed in Canada by Transcontinental LGM Graphics Publications Agreement #40020055 Contents copyright 2008 by AHS-Capital Health.

Content may not be reprinted or reproduced without permission from AHS-Capital Health.

AHS-Capital Health’s Your Health magazine

UR O 9 Results Matter

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Tips to manage a food allergy • Don’t eat unlabelled food.

• Read all ingredient statements. Different brands of the same food can have differ ent ingredients. The same brand may be safe to consume for one product size but not another.

A Tempest in a Peanut The article “Edible Enemies” in our summer 2008 issue resulted in an unusual volume of letters. In the article, pediatric allergist Dr. Stuart Carr was asked if schools should ban peanuts. “Absolutely not,” he said. “The smell doesn’t carry any protein to trigger an allergic reaction. Food allergies need to be respected, but you’re not a time bomb.”

Our readers responded passionately. One mom with peanut/tree nut allergies (and a son with the same) said the allergist didn’t understand the school environment. “Many children have no forethought to the effects of their behaviour when they’re eating, causing cross contamination of utensils, desks, platters,” she wrote. A Leduc writer said her daughter nearly died of anaphylactic shock in school two decades ago when her class was making peanut butter. “Most people will not have an allergic reaction unless peanut products are consumed,” she wrote, “but there’s no way of knowing, before an incident, who will have a severe reaction.”

Dr. Carr responds: “Please do not misunderstand me. It is critical to treat food allergies with the respect they deserve.

But it is equally critical not to add to our affected children and their families’ burdens with unproven fears. Avoiding accidental ingestion of food allergens remains the best management strategy for patients with a food allergy. The next critical issue is the prompt recognition of the symptoms of anaphylaxis and administration of epinephrine in suspected cases. A recent European study established the risk for a fatal reaction to be approximately one in a million. My patients take a greater risk driving to my clinic on our over-crowded roads.”

Still another writer challenged that food labels, contrary to what we printed, are confusing, and invited us to come to the grocery store with her as she shopped for her

Fall 2008

multiple-food-allergy family. We consulted with AHS Nutrition Service Manager Kim Brunet about labelling.

“Health Canada and the Canadian Food Inspection Agency have jointly identified 10 food products that are primarily responsible for 90 per cent of the adverse food reactions in the Canadian population,” she said. “In Canada, manufacturers must label priority allergens, which includes peanuts, tree nuts, sesame, milk, eggs, fish, crustaceans and shellfish, soy, sulfites and wheat.” Products that contain these allergens are declared on the label when sold separately. However, when that food is added as an ingredient of another food, components do not have to be declared. “For example,” Bunet said, “bread may also contain milk and egg. If bread crumbs are added to a product, these components don’t have to be declared.” The absence of a warning is not a guarantee.

Manufacturers currently list ingredients on the labels, but these may be reported by a scientific name, such as albumin or lysozyme for egg. Voluntary statements (“Made in a facility that processes nuts,” for example) are often included on labels. But the language isn’t standard, so statements lack clarity.

Planned changes to Canada’s labelling law would ensure that food manufacturers use plain language. Instead of listing lactoglobulin, for example, a label would simply say “milk.” But the fish, shellfish and crustaceans would still be listed by their common – but not well known – names, such as escolar and barramundi.

Health Canada published proposed amendments in Canada Gazette, in July, 2008 to allow for public comment and will take into consideration any comments received for three months. Manufacturers will have one year after the final regulations are published in January 2010 to comply. www.capitalhealth.ca

• Don’t rely on common sense to determine if foods are safe. Surprise ingredients are everywhere, such as wheat in soy sauce.

• Take precautionary warnings seriously, but know they don’t appear on every food.

• Beware of hidden allergens. Potent allergens such as sesame and milk can hide behind the words “natural flavours” or “spices.” Become familiar with names of hidden ingredients, such as “casein” (milk) or “albumin” (egg).

• Know where the food is made. Seek out products that say they are made in a “dedicated peanut-free, nut-free, soy-free or allergy-free facility,” depending on your diet restriction.

Just Say AAAAA

Doctors aren’t the only ones pressuring smokers to give up their nasty habit. Albertan dentists are also stepping up efforts to get their patients to butt out. The Alberta Dental Association and College (ADA+C, not to be confused with AADAC, who incidentally also want people to stop smoking) are not only concerned with tooth discoloration, bad breath, and gum disease, but a more serious illness: cancer. Dentists are being encouraged by the College to follow the five As, as in: 1. ASK if patients smoke or chew tobacco.

2. ADVISE them about the harmful effects to oral health.

3. ASSESS their willingness to quit.

4. ASSIST those wanting to quit by referring them to resources and programs.

5. ARRANGE for followup phone calls and support as they attempt to quit.

No matter what you do for a living, it looks like a pretty good method for supporting a smoker who is ready to quit. For more information on that, go to www.albertaquits.ca AHS-Capital Health’s Your Health magazine

Stretch Your Limits Release tension in your hard-working calf muscles with this easy stretch.

Stand facing a wall. Place your palms at shoulder height flat on the wall.

Pap quiz

Step one foot behind the other, keeping your heel flat on the floor. (If this feels uncomfortable, shorten the distance between your front and rear legs.)

Bend your front leg until you feel the stretch in your calf.

Hold the stretch for 30 seconds and release.

Repeat on the opposite side.

Answers on page 8

Capital Health is taking steps to protect young women from the consequences of contracting Human Papillomavirus, or HPV. The publicly funded Alberta HPV Immunization Program is for girls in Grade 5 and 9. The vaccine is licensed for girls and women from nine to 26 years of age. But before you decide whether or not you want it, do you know enough about HPV to answer these questions?

1. HPV is a concern because it can lead to: a) Penile cancer b) Genital warts c) Cervical cancer d) All of the above 2. What are the chances of contracting HPV? a) Negligible b) You probably already have it c) About one in 10 d) About one in 1,000

3. If you or your daughters don’t get HPV vaccine: a) Genital warts are inevitable b) Cancer is inevitable c) HPV will continue to spread d) None of the above 4. If you provide the HPV vaccine to girls early, they will: a) Begin experimenting with sex right away b) Stop using condoms c) Develop autism

Always check with your doctor before starting a new exercise program.

d) None of the above

A Very Bene-fish-oil Study Fish are already remarkable creatures. They’re

November, indicates that giving babies a fat emulsion

quiet, make a good first pet, and can breathe under-

IV containing fish oil before and after surgery reduces

water for remarkable periods of time. Fish oil is also

swelling, fever and infection. This is especially good

beneficial for human heart and cholesterol

for critically ill infants, who benefit from its anti-

levels. And, according to research led by Bodil

inflammatory effects. Currently, the standard

Larsen, an advanced practice dietitian with

practice is to use soy bean oil, but Larsen hopes fish

AHS-Capital Health’s Regional Nutrition & Food

oil will become the new status quo within the next

Services, fish oil might also help save your child’s

two to three years. This is good for parents and their

life. Her research, which won’t be completed until

sick children, but not so much for the fish.

AHS-Capital Health’s Your Health magazine

www.capitalhealth.ca

Fall 2008

Desk Strain What are you doing for your coffee break? Instead of downing another cuppa, the Alberta Centre for Active Living wants you to get moving. To help, it has launched a new website that guides viewers through a few exercises to counter the harmful effects of a desk job. The first video, the Stretching atYour Desk series, is designed to help counter some of the pun-

Mark Your Calendar

ishing effects of computer work, such as wrist strain.

Or try Yoga atYour Desk for an eight-minute break of serenity in the hectic pace of your day. Each video is less than 10 minutes long. Everything shown is lowimpact, so there’s no warm-up required. Do follow the site’s guidelines before starting the exercises.

Visit www.centre4activeliving.ca

Answers to the HPV Quiz 1.d. All of the above; although the real proven link is to cervical cancer.

There are hundreds of types of HPV. The vaccine is effective at stopping the two types of the virus responsible for 70% of all cervical cancer and 90% of genital warts cases.

2.b. About 70% per cent of women will come into contact with HPV during their lifetime. The virus can stay dormant in the body for up to two years, and sometimes more, before becoming symptomatic.

3.d. By taking the vaccine, you are protected from the most dangerous form of HPV, and by practicing safe sex your risk of infecting others diminishes even further.

4.d. Research has shown that fear of getting a sexually transmitted infection does not affect a young person’s decisions to have sex for the first time. However, being immunized for HPV may oblige an open familial discussion about sex, STIs and unwanted pregnancy.

Fall 2008

AHS-Capital Health offers a variety of workshops and programs to help you improve your health.

Here is what’s on the agenda this fall. For more information, visit www.capitalhealth.ca.

Success Over Stress This three-week stress management course is provided by AHS-Capital Health occupational therapists from the Community Rehabilitation Program. This course is practical, interactive and fun. Classes are free and held once a week for three weeks. Call 780-413-5779 for information on locations or visit www.capital health.ca for a schedule and registration.

Boosting Your Memory This memory enhancement program is for adults, age 50 and over, who are interested in addressing concerns around memory in relation to normal aging. Classes are held once a week for six weeks. There is a registration fee of $15 per person. For more information, call 780-735-3490.

Weight Wise Adult Education Learn how to make healthier choices by attending a Weight Wise session. AHS-Capital Health offers two, two-and-a-half-hour workshops to help you create your own plan or support your family in weight management.

Register by calling 780-401-BOOK (2665).

Child Safety Seat Inspection Clinics A guide to choosing and correctly installing a child safety seat. Clinics take place in Spruce Grove, Edmonton, St. Albert, Beaumont, Sherwood Park and Leduc. Call your local fire hall or Health Centre for an up-to-date schedule of clinics in Edmonton and area.

www.capitalhealth.ca

Live Better Every Day Workshops A six-week workshop series, to help people learn how to take care of chronic health problems, carry out normal activities and manage their emotional changes.

For more information or to register, phone 780-401-BOOK (2665).

Steady As You Go This program is intended to prevent falls among older adults who are at risk. Two sessions are offered. For more information, visit www.capitalhealth.ca. To register, call 780-401-2665.

Diabetes Health Radio Shows Diabetes Compass Radio interviews diabetes health experts and people with diabetes.

Listen at 9 a.m. each Saturday morning on AM930 CJCA Radio or visit www.diabetes compass.com. For more information, call 780-970-0060.

12 Weeks to Weight Loss and Wellness 12 Weeks to Weight Loss and Wellness is a non-diet, balanced approach to weight loss. Weekly group sessions facilitated by a certified coach, facilitate self-awareness and change. This program is run by Wholly Hannah! Coaching & Training, a member of AHS-Capital Health’s Weight Wise Community Network. www.weightandwellnesscoach.ca or call Claudette Pelletier-Hannah at 780-481-0313.

AHS-Capital Health’s Your Health magazine

Pound by Pound

The New Me

By Tracy Hyatt Photograph by Bluefish/Christy Dean

Tracy’s transformation turned out to be from the inside out, rather than the outside in

Tracy’s Stats Height: 5 feet 4 inches Starting weight: 186 pounds (Nov. 2007) Present weight: 171 pounds Pounds lost: 15 Goal: To keep going AHS-Capital Health’s Your Health magazine

T

his is my summer in a nutshell: Mon-

days I go for a gruelling one-hour bike ride through the river valley. The next day I wake up feeling sore in unmentionable places. Most Wednesdays, I hit the treadmill for a 30-minute run.

At about the 12-minute mark, my hand is hovering over the red stop button, but I elect to spend the next 18 minutes listening to the voices in my head that tell me to keep on running.

Saturday is my “I’m-having-so-much-fun-thisdoesn’t-feel-like-exercise” day. Recently, I went for my first dip in a swimming pool since Grade 10 PE class. I got a stinging sensation up my nose every time I dove into the deep end. Not to mention, I scratched my skin raw later after reacting to the chlorinated water.

There are many days when I question why I am going through with all of this. Being skinny is so overrated, and there are better things I could be obsessing about. Such as how to attract and keep a man, or how to make the maintenance light go off in my Honda. Fortunately, there are more days when I wake up and ask myself why I didn’t start doing this a long time ago. To answer the latter question, I turn to Joanne McLeod of those annoying Body Break episodes I used to catch on TV: “Exercise helps me to feel good about myself while doing something good for my body,” she said. This is what regular exercise has done to me. Quoting Joanne McLeod. But it’s true.

I didn’t even come close to dropping 40 pounds but I’m confident that I’ll get there. I no longer roll my eyes when someone suggests we spend the evening playing baseball or tennis. “Count me in” is my usual reply to my new friends, a more active and energetic set than the bunch I usually hang out with. Instead of filling my closet with sandals and sundresses this summer, I bought a new pair of Nikes, a baseball glove and a new tennis racket. I even bought a mountain bike online from a lady who said she’d only used it twice. “I just never have the time to go for a ride,” she wrote in an e-mail when I asked why she was getting rid of it. Her loss, my gain.

One of the spinoffs that I never expected is my improved mental health. Despite all the physical aches and pains, I’ve got more energy throughout the day. I can concentrate and focus www.capitalhealth.ca

better at work. My exercise time has become “me” time. On my bike or in the gym, I’m not stressing about deadlines or worrying about that maintenance light in my car. Instead I’m taking in all of my surroundings and concentrating on my breathing. Exercise has renewed my sprit and boosted my self-esteem.

The new me shops for groceries with pride, filling my biodegradable shopping bag with seasonal fruits and vegetables, a complete change from the processed foods that stocked my fridge and cupboards a year ago. It’s never just a quick jaunt to the grocery store anymore. A typical trip lasts an hour because I spend most of the time reading food labels. I’m shocked at what food manufacturers try to pass off as healthy. A word from the newly wise: stay away from the inside aisles. That’s where the big stores stock all the processed foods. Circle the perimeter for the fresh goodies and then get out of there.

That being said, there are some things that will never change. As I’m writing this column, I’m munching away on a bag of zesty tortilla chips.

It’s a small bag, though, and today is Wednesday. I’ll be hitting the gym after work.

Tracy’s Top Five Weight Loss Tips • Some diet programs lump all carbohydrate foods together and give them a bad name.

But grains, beans, potatoes, rice and pasta give you a lot of nutrients and can help pre- vent disease. Don’t ban carbs as a rule; a balanced diet is key to weight loss • Think of pop, iced tea, fruit beverages, sports drinks and slurpees as “liquid candy.” High in sugar and low in nutrients, limit these drinks to only one cup (250 mL) every once in a while.

• Don’t skip breakfast; meal skippers often overeat later, which may lead weight gain.

Start and finish your day off right.

• Eating on smaller plates can help you avoid taking large portions just to fill up space, and also makes smaller portions look bigger, so you don’t feel restricted.

• When you’re eating out, ask your server to wrap up half of your meal right away. Not only will you be watching your portions, you won’t have to make tomorrow’s lunch!

Fall 2008

The Power of Resistance You don’t have to be an aspiring Mr. Universe to lift weights, but it might help to be willing to reach for the stars

By Cynthia Dusseault | Photograph by Lance Burns

STRONG ON FITNESS: Trainer Susan Agrios (right) gives tips to a willing client

10

Fall 2008

www.capitalhealth.ca

AHS-Capital Health’s Your Health magazine

Y

ou can do it with free weights, resist-

ance bands or exercise machines; you can even do it with nothing at all.

“You can do some pretty incredible things with just your own body weight,” says Susan Agrios, an Edmonton-based fitness trainer and yoga instructor.

Also called weightlifting, strength training is all about using increasing amounts of resistance to build muscle strength. It is ideal for people who can’t attend a regular fitness class, homebodies who keep odd hours or people who prefer an activity they can do on their own, anywhere.

However, technique is very important, especially when you’re first starting out. Get some expert advice, and a training program that works for you based on your body shape, strengths and weaknesses. Using trial and error can result in a serious injury. “One of the biggest mistakes I’ve seen in the gym is people lifting heavy weights with improper technique,” says Agrios. “Strength training is all about getting that muscle memory and that pattern ingrained correctly.”

When developing routines for her clients, Agrios considers their ages, goals, fitness backgrounds, medical conditions, past and present injuries and strength levels. If someone does a great deal of travelling, she develops a program that’s portable. If someone wants to work out at home, she helps them set up a home gym. People with obesity and related illnesses such as diabetes, heart conditions or high blood pressure should focus on weight loss before they try to buff up. “There’s a difference between discomfort and pain. I am not of the mindset ‘no pain, no gain.’ If there is pain, you stop.”

Free weights are ideal because machines tend to restrict your movements, and many don’t fit different people properly. With free weights you can work with your own range of movement and patterns. We don’t move our muscles in isolation in our regular daily activities, so instead of leg extensions, for instance, which only work the quadriceps, she recommends clients do back squats, which engage a host of muscles in the legs, but also the abdominals, back and pelvis. You want a whole body workout, designed to help you do whatever it is that you do, better.

Agrios is quite passionate about the importance of getting expert advice until you’re motivated and knowledgeable enough to keep working out AHS-Capital Health’s Your Health magazine

www.capitalhealth.ca

on your own. No doubt, having an appointment with a buff athlete who can bench-press 300 pounds can be a great motivator.

“Ultimately it’s about setting a goal and working towards it until you see a result,” says Agrios.

“That’s very empowering, especially for the people who started out feeling very nervous.”

Top Three Weightlifting Myths 1. You’ll look like the Governator. “The amount of work that goes into that is absolutely incredible,” says Agrios. Professional bodybuilders also work at it full time, so stop worrying.

2. More is better. Train smarter, not harder.

Slowly increase your weights, always allowing your body time to rest and recover. Workouts of 30 to 60 minutes per session, three times a week on non-consecutive days, are all you need to see results.

3. Stretching is for cats. As you build muscle, your body starts to lose some flexibility, so stretching before and after a workout is extremely important.

Calling the Kettlebells Black Cast iron kettlebells represent a very old form of resistance training that is once again becoming popular in North America. They originated in Russia as counterweights for balance scales in the marketplace. Vendors used them to impress each other with their strength. In the late 19th century, kettlebells became the conditioning tools of choice for “strongmen” doing the travelling circuit and in the 1900s, they became the main training tools of the Russian military, a tradition that continues to this day.

Kettlebells are unique because they’re asymmetrical, which makes them unpredictable, much like human movement. This explains their popularity with martial artists and boxers, who are training to react quickly to the unpredictable. But because they’re like nothing you’ve ever worked out with before, if you want to give them a go, work with a certified kettlebell trainer. Otherwise, far from looking like a strongman, you may end up being carried out of the gym by one.

Fall 2008

11

Q&A Dr. Brad Hinz

Staff Ophthalmologist, Regional Eye Centre AHS-Capital Health

Ask the Experts Macular degeneration; Hernia; Pee problems; Infant hearing photography by Dustin Delfs

Question: My mother has macular degeneration. What are my chances of getting it too?

Dr. Brad Hinz, staff ophthalmologist with AHS-Capital Health’s Regional Eye Centre and assistant clinical professor in the Department of Ophthalmology at the University of Alberta, replies:

Age-related macular degeneration (AMD) is a painless disease that blurs the sharp, central vision that is needed for “straight-ahead” activities such as reading and driving. It affects the macula, the central part of the retina that allows you to see fine detail. It doesn’t usually affect peripheral vision.

Sometimes, AMD advances so slowly that people may not notice the gradual vision change. Other times, the disease progresses faster and may lead to a loss of vision in both eyes. AMD is a leading cause of vision loss in patients over 60 years and comes in two forms: wet and dry.

If you have vision loss from dry AMD in one eye only, you may not notice any changes in your overall vision. You may notice changes in your vision only if AMD affects both eyes. So-called dry AMD can damage vision slowly. Wet AMD can damage vision quickly.

More than 85% of people with AMD have the dry form. It tends to run in families. Although genetics plays a role, we don’t fully understand how. If there’s a gene that determines AMD and multiple family members have it, why don’t they all get the eye disease? A lot of research is focused on figuring out why some people get it and others don’t.

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Fall 2008

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Other factors that appear to contribute are: diet, smoking, high blood pressure and exposure to ultraviolet light. We do know that if you have a particular gene (complement factor H) and you smoke, your risk of getting AMD is almost nine times greater than for a non-smoker who has the gene. You are stuck with your genes, but smoking, a major factor in AMD, is within your control.

Question: I have a lump in my lower abdomen. Could it be a hernia?

Dr. Ernst Schuster, family physician and medical director of primary care for AHS-Capital Health, replies:

A hernia is a weakness or disruption of fibromuscular tissues in the abdominal wall through which other structures, such as a part of the bowel or abdominal fat, can protrude. In most cases, it’s not painful; it just presents itself as a lump. But it can be serious, because if you can’t get the bowel to go back into the abdominal cavity, it can become trapped in there, a condition called an incarcerated hernia. This can lead to bowel obstruction, requiring immediate surgery.

In most cases, there’s no particular event causing hernia. Most are congenital; people are born with them even if they are not evident until later.

Men are nine times likelier to develop a hernia than women. There are several different types.

An inguinal hernia is the most common in males, usually felt as a lump above the groin. A femoral hernia is more common in females and shows as a lump in the groin or crotch. (Such a AHS-Capital Health’s Your Health magazine

Dr. Howard Evans

Urologist Royal Alexandra Hospital

Dr. Ernst Schuster

Kathy Packford

Medical Director, Primary Care AHS-Capital Health

lump could also be caused by other things such as an infection, a tumour or a swollen lymph node.)

If a lump is painful and raised, you can’t push it back, or it made a sudden appearance, seek immediate medical attention. If it’s not painful and there are no other symptoms, make an appointment with your family physician.

Question: My 65-year-old father is having trouble peeing. What could be the matter?

Dr. Howard Evans, a urologist at the Royal Alexandra Hospital, replies: There are a handful of possible causes behind difficulty peeing, also called urination. These problems can have their root in the prostate, the urethra, the bladder or the nervous system.

The most likely reason for a man of his age would be benign enlargement of the prostrate.

This means his prostate, the cherry-sized gland that surrounds his urethra, is bigger than normal and is obstructing the urethra, which is the tube through which urine leaves his body. The condition makes it harder to urinate or means he has to urinate more often. We’d typically prescribe medicine to relax the prostate. If that doesn’t help, we might try surgery to ease the blockage.

But we also look for other causes. These might include cancer of the prostate, which has a variety of treatments that might include surgery, radiation and chemotherapy, depending on the stage of the cancer.

Another cause could be small scars inside the urethra, which might be the result of past AHS-Capital Health’s Your Health magazine

Audiologist Glenrose Rehabilitation Hospital

infection or past catheterization (tube inserted through the penis to drain the bladder during surgery). Treatment includes dilation (gentle expanding) of the urethra or surgery to correct the problem.

Your father’s condition could be due to the bladder itself. An overactive bladder, one that clenches and gives the sudden, frequent urge to pee, can be treated with medicines. But we rule out more serious causes, such as bladder cancer, first. Finally, problems with urination may also have neurological causes, stemming from such diseases as diabetes, Parkinson’s disease or multiple sclerosis. Treatment of the underlying disease may improve the condition.

Question: How can I tell if my infant is hearing properly? Is there a test?

Kathy Packford, audiologist at the Glenrose Rehabilitation Hospital, replies: Infants respond differently to sounds at different ages. Although there’s individual variation among kids, there are some general guidelines.

A baby up to three months of age will startle when she hears a loud, sudden sound or may awaken to loud sounds, such as a door slamming. A healthy six-month-old will smile when he hears a familiar voice, music or other sounds and babies will usually begin imitating sounds and babbling by 12 months. Older infants begin to develop single words between 12 and 18 months and they understand simple phrases.

Children with hearing loss aren’t able to learn language by listening, so early lanwww.capitalhealth.ca

guage skills may be slower to develop. Some signs that may indicate hearing loss include: • Failure to startle to loud sounds • Lack of response to his/her own name or familiar voices by six months • Babbling changes into high-pitched scream ing or fails to develop into recognizable sounds of speech like “ ba-ba, ma-ma” by six to eight months • Inability to locate where a particular sound is coming from • Failure to respond to simple commands, such as “get the ball,” by 12 to 18 months If you suspect a hearing problem, trust your intuition. Contact your doctor or an audiologist.

Damage to any part of the hearing pathway can cause a reduction in hearing.

The audiologist has a number of tools to evaluate hearing. Hearing tests may be completed in a soundproof booth where an audiologist will observe the child’s reaction to different sounds.

Other objective measures used to determine whether an infant is able to hear are: auditory brainstem response (ABR) audiometry and otoacoustic emissions (OAEs). Based on testing, an audiologist can help the family plan treatment.

No child is too young to be tested.

Ask the Experts is a regular section in which medical and other health professionals answer questions on a variety of health-related topics. For general health advice or specific concerns,­ please call Health Link Alberta at 780-408-LINK (780-408-5465). Outside the local calling area, phone 1-866-408-LINK.

Fall 2008

13

The Man in

White

By Lisa Ricciotti |

Photography by AMY SENECAL

Alberta’s only emergency nurse practitioner stands out wherever he goes

14

Fall 2008

“H

e’s the guy in the white shirt,”

says the receptionist, pointing to the emergency area at Edmonton’s Northeast Community Health Centre. That’s all the direction needed to find Lloyd Tapper among the bustle of staff moving purposefully around the ER nursing station.

For one thing, he’s not in a brightly coloured top like the other nurses, and he’s not in scrubs and a mask like the doctors. In his crisp white dress shirt and black dress pants, Tapper stands out.

He also stands out as the province’s only nurse practitioner working in an urban emergency department. It’s a position that the 38-year-old has held for nearly four years, and from day one he’s worked to define his role, beginning with a departure from standard medical garb.

“Initially when I introduced the role, I wanted to make sure I had an opportunity to develop it, but not based on any traditional nursing or medical models,” says Tapper, “so that the added value of the role could be identified as different, but working in complete collaboration with the entire health-care team.”

Nurse practitioners, or NPs, are still relatively new. There are only a few hundred in the entire province, men and women who are stepping beyond the scope of the traditional nursing practice and into areas usually limited to doctors.

Tapper is authorized by the College and Association of Registered Nurses of Alberta through the Health Professions Act to assess, diagnose, treat

and refer patients. Nurses work under the act as well, but are not authorized to diagnose, prescribe or refer patients to medical personnel. “If I am a registered nurse, I cannot call a cardiologist and say: I want to refer this patient to your clinic.

With my licence, I can pick up a phone and refer that patient to be seen by that service.”

For cases beyond his expertise, he consults with, or defers to, attending ER physicians or the appropriate referral service. “If you go to your family doctor and your problem is beyond him, he’ll refer you to a specialist or possibly an emergency physician. If it’s outside the emergency physician’s area, he may also consult with a specialist. At a time when access to health-care services is limited, the focus is on matching the client’s concern with the appropriate health-care provider. That’s what makes me different,” says Tapper.

It’s 7:30 on a Monday morning. Tapper starts the day with a review of charts left by ER physicians over the weekend. As he briefs himself, he outlines his career path for me. (The man’s a born multi-tasker.) Originally from Newfoundland, a fact no longer detectable in his speech, Tapper trained to be an aircraft mechanic, but he couldn’t find a job in his field. In the mid- to late-’90s, he noticed men were finding more and more employment in non-traditional careers, and, following the trend, he decided to enrol in nursing at St. Clare’s School of Nursing in St. John’s.

The seemingly radical career shift had its roots in an earlier self-discovery. “In the time I was

working on airplanes, I realized that I liked people more than parts. I went to air cadets and started teaching kids principles of flight and leadership.

By the time I finished, I really didn’t want to be an aircraft mechanic.”

He graduated from St. Clare’s in 1997. He worked as an emergency and general surgery nurse in Kitimat, B.C., then as an emergency room nurse at the University of Alberta Hospital in 1999. Somehow he found time to finish a certification program in emergency nursing at Mount Royal College in Calgary and earn his master’s degree in nursing at the U of A, while working full time. When Tapper joined the Northeast Community Health Centre’s emergency department in 2004, he had seven years of emergency nursing experience and training to draw from.

It’s now 8 a.m. – time for the IV therapy clinic, a service Tapper adopted as part of his scope of practice. He personally follows every patient in the clinic to make sure their care is continuous, stable and streamlined. Every Monday he follows up with the patients who have been receiving intravenous antibiotic treatments over the weekend. Depending on the results of their blood work and his hands-on medical examination, Tapper determines whether they can be prescribed oral medication.

Since these patients have had to come to the ward three times a day, all weekend for IV antibiotics, the change is a welcome relief. So is having a scheduled appointment, instead of

Fall 2008

15

waiting to see an ER doctor who is rushing between critical cases.

Today Tapper has three patients to check up on. Blair Hault, 53, came to the emergency room after his leg swelled to three times its normal size and Mike McMullan, 44, a paraplegic athlete, is suffering from an infection caused by pressure on his legs from his wheelchair. Tapper sees them individually, greeting each with, “Hi, I’m Lloyd.

It’s very nice to meet you.” He discusses their symptoms thoroughly, gives advice, suggesting an update on tetanus shots for Hault and advising McMullan to try padding his wheelchair and avoid contact sports in the short term. Both are now well enough for antibiotic pills, but before passing out prescriptions, Tapper discusses their costs and possible side-effects. “My job is about the little things,” he says.

Next in line is Brad Brommeland, 42, who is concerned about numbness in his foot after twisting his ankle. Tapper determines that nothing is broken, recommends ice and ibuprophen and asks whether Brommeland needs a note to excuse him from work while he rests. Then Tapper leans over and plucks a package of cigarettes from

Brommeland’s shirt pocket, which was exposed as he bent to put on his shoes. “Have you thought about quitting or cutting back?” he asks. “Because if you want to, we can help.”

Brommeland seems surprised but he listens.

He leaves with written instructions on how to ice his ankle and a booklet on how to stop smoking with information on the tobacco reduction clinic that Tapper developed for the Northeast Community Health Centre a year ago. It’s an example of how Tapper tries to go that extra mile.

“An emergency nurse practitioner is not about dealing with major trauma situations,” says Tapper. “That’s more the role of emergency physicians with years of specialized training. What I can offer is health promotion, illness prevention and continuity of care.”

Tapper’s interactions with his patients reflect that focus. He gives Shawn Hagen, a young roofer with a very sore back, instructions on proper icing techniques and a prescription for anti-inflammatories, but also advises him to ask his boss for training on proper lifting techniques. Tapper also suggests Hagen begin wearing a back support: “You only get one back. Look after it,” he says.

MIND THE LITTLE THINGS: NP Lloyd Tapper likes to go that extra mile with his patients

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Fall 2008

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Between patients, Tapper walks over to the mental health and addictions services clinic, also part of the Northeast Community Health Centre, to make sure counselling sessions have been set up for a woman he treated the week before, a victim of domestic abuse. “I’m there for them, right now or when they’re ready. I don’t judge. If they let me in, I can help.” He recently linked another seriously abused victim with social workers for placement in a safe house. “She’s been beaten before,” Tapper says. “But it is very difficult for her to leave. The violence is rapidly escalating and, if she doesn’t, her life may be at risk.”

Tapper takes the same caring approach wherever he can, using the encounters with his patients as opportunities to provide referrals to ongoing care. That’s made easier by the many clinics located within Northeast Community Health Centre, an innovative model of primary health care services, including a diabetic clinic, a senior’s clinic, services for new mothers and a children’s asthma clinic.

“He wants to make sure patients don’t fall between the cracks,” says Carol Yeomans, an emergency nurse who’s worked with Tapper for the past four years. “He always tries to link them to whatever they need to get them on track, back on the road to wellness and responsibility for their health. He takes the extra time that an emergency physician doesn’t have.”

From an emergency physician’s perspective, it’s a big benefit to have a nurse with Tapper’s training around. “He has the knowledge and he’s taken on so much. He can do sutures, IVs, followup calls and paperwork. If he wasn’t here, there’d be quite a void. We could use a couple of people like him at other hospitals,” says Dr. Terry Stetsko.

It’s now approaching noon, and Tapper has decided to take lunch since it’s not too busy – by emergency department standards anyways. This afternoon, he’ll see a bit more of everything: sick kids, people with infectious diseases, abdominal pains, breathing problems and maybe this week’s cardiac case. Recently, a mother rushed into the department with a newborn who was near death.

After being stabilized in the emergency department, the child was transported to intensive care at the Stollery Children’s Hospital, eventually making a full recovery. Whatever the day will bring, Tapper feels ready. “Nursing of any kind is a privilege. You have the chance to make an impact on people’s lives. When I see a chance to make a difference, I take it. I really love what I do.”

AHS-Capital Health’s Your Health magazine

BACK IN BLACK: (L-R) The Black Gold Health Foundation’s chair Marilyn Janzen, executive director Lorraine Popik, Leduc Community Hospital ER manager and site manager Tod Pharis, Dr. Colin Oberg, and Leduc Community Hospital site manager Donna Grier pose with a portable ultrasound machine

Gold

Leduc’s

Standard

“I

t’s one of the items that puts us in the big

By Jacqueline Schimpf

The Black Gold Health Foundation supports health programs, services and new equipment in bustling central Alberta

AHS-Capital Health’s Your Health magazine

league and makes us stand out,” says Marilyn Janzen, volunteer chair of the Black Gold Health Foundation, about the new, portable ultrasound machine at the Leduc Community Hospital. “The ultrasound is a piece of equipment that we are so excited about. It makes it much easier for our health care team to provide early diagnosis.”

With financial support from the Black Gold Health Foundation, the hospital, which serves the residents of the County of Leduc and area, purchased the machine in the spring. The $90,000 portable ultrasound machine complements its existing ultrasound services, which are available only during daytime hours. The foundation is the charitable organization that promotes and supports health programs and services in the Leduc area, including the Leduc Commu-

www.capitalhealth.ca

nity Hospital and health centres and home care in Beaumont, Leduc and Thorsby.

Without the need for a technician, the new, portable piece of equipment can be operated by trained physicians in the emergency department or used at patient’s bedside in acute care.

A welcome addition to the hospital’s afterhours services, the technology allows for early or pre-diagnosis, which helps to determine if a patient requires further testing.

“With the ultrasound, we are able to perform services in the emergency department that can assist in quicker diagnosis; there is no waiting for an appointment elsewhere,” says Daryl Wishnowski, manager of inpatient services at the Leduc Community Hospital. “Because we don’t have ultrasound technicians on duty in the evenings or nights, when a patient comes in at night, we have the ability to do some assessment.”

Fall 2008

17

Foundation Series “The ultrasound has enhanced the services foundation, to those who help us stuff enve- passionate about health care and we invite anythat the local hospital provides in that patients lopes. What they have in common is a passion one else who has a passion to join us.” can stay closer to home for diagnosis,” says Lor- for ensuring and enhancing health-care services The community truly supports the foundaraine Popik, executive director of the Black Gold in our community. No donation of time is too tion and its goals. “Our community is close-knit, Health Foundation. “This reduces the number of small.” which sets us apart from larger cities. In a small patients that have to be transferred to Edmonton, Janzen was motivated to join the foundation town, everyone is your friend and neighbor, and as well as the expenses and patient anxiety that go when, as a nurse, one of the physicians she was we all do our best to help each other. We truly care along with that. Before purchasing this machine, working for was discussing some extra equip- about each other,” says Janzen. And that includes all emergency services of this nature had supporting local health care. to be transferred.”

Working in partnership with local “Volunteers are what we like to Leduc is located 15 minutes south of businesses and the community, the call our priceless donations,” Edmonton on the Queen Elizabeth II foundation is dedicated to fulfilling a Highway, along the busy Edmontonvision of offering the highest quality of Popik says. “They form the Calgary corridor, and has a population health-care services by contributing to of nearly 20,000. The local hospital, the enhancement of patient care servbackbone of our success.” which combines the best of small-town ices and health programs offered in the friendliness with state-of-the-art medical care, ment needs. With a friend already involved with community. Currently underway is the Comfort was recently renovated, increasing its bed capac- the foundation board and a lifelong passion for and Care Campaign through which the foundaity from 54 to 70, of which 34 are in acute care. health care, Janzen knew she wanted to be a part tion is raising money to update and redecorate And it has undergone a significant expansion of of the solution. She joined the board in 2006. the hospital’s palliative care room, enhance an its emergency department, to meet the growing “I haven’t regretted a minute,” she says. “Every- additional two rooms and upgrade the patient demands of the region. one who is involved on the foundation board is and visitor lounges.

Each year, the hospital sees 26,700 emergency “The big dream is to create an outdoor courtvisits, 1,700 day surgeries, 1,500 endoscopies, yard wellness garden with solarium,” says Popik.

6,500 outpatient visits and 2,400 inpatient visits.

“If we can enhance that and offer those services to Physical, respiratory and occupational therapy patients – that would be amazing.” provide on-site rehabilitation.

The board raises funds through a few key The foundation supports the hospital and events each year, which are widely supported community health centre by raising funds to by the community. The second annual Art and enhance local health care and support new techEntertainment Charity Affair held in March nology, specialized equipment and innovative raised $15,000, and this year’s 16th annual Black programs. Over the past three years, the founGold Health Foundation Charity Golf Clasdation has contributed in excess of $250,000 sic, held in May at the Leduc Golf and Country towards the hospital and health centres.

Club, raised more than $30,000.

“The foundation means a great deal to our The foundation also encourages organizations hospital,” Wishnowski says. “It assists and and groups to create their own fundraising events encourages better patient care and is willing to where anything goes – from swim-a-thons to participate and promote the hospital and our casual day collections. This past summer, a new health centres to our residents and increase our event raised money on Telford Lake for the founprofile in the community.” dation: the Edmonton Dragon Boat Club’s first Janzen agrees: “The foundation is a link annual Leduc Dragon Boat Festival. between the hospital and the community. We see “People here care about the community and different things that the community might need have no problem reaching into their pockets supin terms of health care and comfort and we go porting local health care. They see that it goes about getting these things.” into the hospital and that we do good things with Founded in 1993 with a volunteer board, the the money.” foundation operates with a part-time administration team to maintain minimal costs. Its success can be attributed to dedicated volunteers.

For more information, to donate “Volunteers are what we like to call our priceto or volunteer with the Black less donations,” Popik says. “They form the Gold Health Foundation, backbone of our success. Their contributions visit www.blackgoldhealthfoundation.com, range from those board members who dedicate call 780-980-4536 or e-mail blackgold@ capitalhealth.ca. their time and expertise to the operations of the 18

Fall 2008

www.capitalhealth.ca

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AHS-Capital Health’s Your Health magazine

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9/11/08 12:47:53 PM

Take the Wheel

Graduated Driver Licensing aims to keep the province’s newest drivers safer. You won’t hear mom and dad complaining

By Phoebe Dey

Illustration by Rodrigo lópez orozco

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Fall 2008

G

razia Dicker has a terrible habit of

back-seat driving. But when it’s her 15-year-old daughter Natalia at the wheel, she’s white-knuckling the arm rests even more than usual. Natalia is not worried; she’s due to get her driver’s licence this fall, just after her 16th birthday.

She has finished her driver training course and practiced as many hours as possible. “I’m taking it pretty slowly,” says the Grade 11 student. “I still haven’t even practised driving with music on in the car.”

Her mother is not complaining. The more experience her daughter gains, the better she’ll be at making quick decisions. “The roads are busier than when I learned to drive in Edmonton,” says Grazia. “There is more traffic and distractions.

It’s harder for new drivers because everyone is in a hurry and they show little respect for people trying to learn.

“Even with a novice driver’s sign on top of the vehicle, people were riding Natalia’s tail, honking or cutting her off. People have no patience. It’s tough on young drivers, who need that extra second to respond.”

New drivers are in the most danger right after the learning period is over, says Kathy Holgate, a coordinator at Kidsafe Connection, AHS-Capital Health’s pediatric injury prevention program at the Stollery Children’s Hospital. One in five 16year-olds experience a collision in their first year of driving, with the crash rate the highest in the first month after becoming licensed. “There are too many kids dying on our streets and highways.

It is frustrating and heartbreaking because the majority of those collisions or injuries have some element of prevention,” says Holgate.

Alberta’s major trauma rate for youths is higher than the national average. About 60% of all major trauma admissions to Alberta hospitals are the result of transportation-related incidents, and casualty collision rates were highest for people between 15 and 24 years. Male drivers between 18 and 19 had the highest

www.capitalhealth.ca

AHS-Capital Health’s Your Health magazine

involvement rate of all drivers involved in collisions. Crash rates are the highest when there are teen passengers in the vehicle, and at night. In Alberta, 70% of crashes causing serious injuries occur to teens driving in rural areas.

Since Alberta adopted Graduated Driver Licensing (GDL) in 2003, Natalia – and any other new driver in the province – will be on probation for two years before she gets her licence.

It works like this: a new driver must first obtain a learner’s licence (Class 7) which will allow them to drive only when accompanied by a fully licensed driver who is 18 years of age or older.

Once a driver has held a Class 7 licence for one year and has reached 16, he or she can take the standard Alberta road test and become a probationary driver. A probationary driver must maintain this status for two years before he or she is eligible to take the advanced road test and become a fully licensed driver.

“Parents are often happy when their teens learn to drive because they get some of their freedom back, but it is so important to take the time to work with them, to protect your child,” says Holgate. Research has shown that GDL reduces crash rates among teenage drivers, who must follow specific conditions. Learners must stay off the roads between midnight and 5 a.m. and must always be accompanied by a licensed driver who is 18 years or older. Then they must keep a clean record for two years before they can earn a full-fledged licence. The idea is that by limiting new drivers’ exposure to the highest risk conditions, they will gain experience and be more likely to come out of the experience without being injured or killed.

“Even before teenagers are driving, they are watching you,” says Holgate. “They will start to copy your habits, so be a good driver yourself.”

As good a driver as you think you are, it has likely been a long time since you earned your licence. Leave the teaching to the professionals, and then help them practise, practise and practise some more. “Handing over your keys isn’t enough,” says Holgate. “Once driver’s education is completed and the child has a basic understanding, take them out at night, in rush hour, and on slick roads. Most courses offer 10 to 14 hours behind the wheel and it is not nearly enough time to gain the complex skills good drivers need.”

A parental commitment means putting in about 60 additional practice hours, says Mike Caverhill, special project co-ordinator with Alberta Transportation. “We can put off a fullfledged licence for as long as possible, but they are still going to go out on their own,” says Caverhill.

“It’s like a musical instrument. You have to practice to be good at it, but in this case, the stakes are much higher.

“The province has set the baseline measures, but parents are the gatekeepers,” says Caverhill.

Parents should also remember that they are still in charge of their kids. Set curfews; limit passengers and take the keys away if the rules aren’t followed. Grazia Dicker has informed Natalia there will be a strict vehicle curfew and limits on how many friends are allowed in the car once she has her licence. “I have mixed emotions about sending her off on her own,” she says. “It’s like everything else. At some point, you have to let them go and hope they will be OK.”

*

For more information on the Graduated Driver’s Licensing program, visit www.saferoads.com , or to learn more about prevention go to Kidsafe Connection: www.capitalhealth.ca

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9/11/08 12:53:30 PM

Goodbye,

Couch Potato

By Sharon Gafka

O

ctober 26, 2006 was a defin-

ing day in my life. I had an appointment with a new doctor for a yearly physical. I knew the dreaded topic of my weight would come up, and it did, but not in the way I expected. My doctor talked to me about nutrition. She pointed out that I was quite savvy about it and asked why I wasn’t following what I knew. That caught me off guard. “I don’t know,” I said. In retrospect, I think I was avoiding confronting the issue.

But my doctor was very caring in her approach and told me, as I was crying, that I was a nice lady and she wanted me to have a healthy life and retirement. But given my current weight, that outcome was not going to be in my future. She sent me off with a couple of assignments: first, she wanted me to look into taking aquasize classes, which would be gentle on my chronically injured knee. When I tried hiding behind my allergy to chlorine she countered with the fact that there are salt water pools. Next, she wanted me to go onto AHS-Capital Health’s website and check out the courses that they offer. She also wanted me to look into signing up with Weight Watchers.

I left her office depressed and in need of comfort foods. I was trying to decide what to feed my self-pity when something clicked. I decided that I was going to start right then and there.

I had known for a long time that I needed to make lifestyle changes that would last a lifetime.

I also knew I ate too much, badly, and never exercised. Ever! I realized I had to take responsibility for my obesity. I had to stop blaming my mother for making me finish everything on my plate; stop making excuses for why I couldn’t go for a walk at lunch time. (My knee hurts; I have shin splints;

22

In the summer issue of Your Health we asked you to tell us your weight loss successes; this is Sharon’s story

Fall 2008

my feet hurt; I’m tired; and on and on.) No more.

Over the next few days I sat down with the people I’m closest to and told them that my doctor had read me the riot act; that I need to lose weight and I needed their help. I would recommend everyone do this, as my friends and family have been my strongest supporters.

I enrolled in Weight Wise in December.

I didn’t look into Weight Watchers (don’t tell my doctor!) because I knew that I wouldn’t be able to count my calories on an ongoing basis. After all, I was going to make lifelong changes. I needed something I would stick with for the rest of my life. Then I threw out all the junk food in my cupboards. I started eating more vegetables and www.capitalhealth.ca

fruit. I looked for healthier snacks with a vengeance. I ordered a pair of corrective goggles and dug out my old bathing suit. A friend of mine agreed to go to aquasize classes with me twice a week.

Then I attended the classes, even though I struggled with my allergy to chlorine; because even salt water pools have a bit of chlorine in them.

Keeping motivated was the hardest part; I attended the first of the Weight Wise courses and then didn’t want to go to the second. My sister forced me to go, something I am eternally grateful for.

That was the session that drove home the importance of portion control, among other things. I highly recommended this course to anyone. Almost two years later, I am 140 pounds lighter. I am attending aquasize classes up to six times a week and I walk during my lunch hour every day, rain or shine. One of my aquasize instructors once told me that I’d start to crave exercise. I thought he was crazy.

Nearly a year later, he was right. Go figure! I try to listen more to my body, to know when I am hungry and when I am full.

I will always be a couch potato, but that doesn’t mean I can’t fit exercise into my life. I’m constantly broke from buying smaller-sized clothes, but, hey, that’s a small price to pay. I have never felt better or had more energy. If you had asked me two years ago if I’d ever say these things I would have laughed myself silly. I know better now. But I’m not done yet. I’m not sure what’s ahead but I will forevermore eat healthier and make exercise a priority in my life. If I can find my way out of the rut, anyone can. *As a reward for sharing her story with us, a slim new Sharon Gafka will get a free Company’s Coming cookbook!

AHS-Capital Health’s Your Health magazine

Get off the

Gravy Bloat

By Sally Johnston

W

elcome to the holiday season. Please take a (smallish) plate, help yourself to a (modest) amount of food. Remember, the next few months will be a merry-goround of opportunities to eat and drink until you’re bloated, lethargic and two pants sizes bigger. Beginning with the Labour Day barbecue and Thanksgiving dinner’s pumpkin pie, Christmas’ cakes and cookies, to New Year’s drunken debauchery, there’ll be lots of reasons to sabotage your otherwise healthy diet. Here are some tips and a healthy recipe to get you in the mood and on the right track:

On The Road: • Don’t guzzle down grease and carbohydrates between shopping sprees; pack some fruit, granola bars and nuts in a bag. Have something healthy ready for when you get home laden with packages.

• Stay active. Go for a walk after dinner, build a snowman, or go ice skating. After all, the holidays are as much about spending time with your loved ones as they are about food.

• Plan ahead. Creating a menu in advance will help you buy only what you plan to consume

Make a Mexican Christmas Salad You will need: 3 to 4 medium red apples, cubed 1 cup (250 mL) shredded carrot 1 can (398 mL) pineapple chunks packed in own juice ¼ cup (60 mL) raisins 3 Tbsp. (45 mL) toasted chopped walnuts or almonds 1 cup (250 mL) light sour cream 2 sticks chopped celery

At Home: • Cook with chicken or vegetable broth instead of fat. This works for roasting and sautéing.

• When baking cakes or muffins, replace half the sugar with an equal amount of unsweet ened apple sauce. Use egg whites instead of whole eggs, and opt for low-fat cheeses.

• Try different recipes, even if they aren’t a traditional addition to your table.

At a Party: • Eat from a medium-sized plate about the size of a frisbee. Fill half the plate with vegetables and fruit.

• Limit grains or potatoes to one quarter, and meat, fish or vegetarian alternatives to the remaining quarter.

• Skip alcoholic drinks, punch, egg nog and pop.

• Don’t starve in anticipation of a big feast.

Snack on something healthy before you go to a party. And once you’re there, don’t park your butt by the buffet table.

• Stay away from appetizers: two chicken wings, two sausage rolls and one mini-quiche can add up to a full meal’s worth of calories.

In a large bowl, mix everything except the sour cream. Gently fold in the sour cream and sweeten to taste with some of the pineapple juice. Serves 6 to 8 people. Alternatively, replace the sour cream with plain or vanilla yogurt, or a mix of both.

AHS-Capital Health’s Your Health magazine

Fall 2008

23

GENERATION FIT: Jeff Gonek, right, talked his grandfather, John Heck into expanding his horizons with meditation, tai chi, and bird watching

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AHS-Capital Health’s Your Health magazine

to Be My grandfather and I were looking for safe physical activities for seniors; along the way we found each other

By Jeff Gonek

M

y grandfather, John Heck, is pretty active

AHS-Capital Health’s Your Health magazine

www.capitalhealth.ca

Photograph by curtis trent

for an 87-year-old. He golfs every morning with his buddies, and then comes home to garden. Like many seniors, he needs a physical activity that’s a little on the careful side, that engages his mind and his body.

Logging miles on a treadmill or slugging weights at the gym are not really this Second World War veteran’s style. Recently, I undertook a mission to find the perfect activity for him, one that would be stimulating but not too hard on his dear old heart. He agreed, but there was one catch: we had to go together.

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25

Fit to Be Tried It seemed natural to start with birdwatching, an activity that consists of wandering the bush trying to identify and recall different bird species. It’s enough to get the heart rate up, but is so much fun you barely notice you’re exercising.

Grandpa and I embarked on a five-kilometre journey in St. Albert with an extremely fit 80year-old named Peter Demulder. It was magical walking along the Sturgeon River past ponds full of bulrushes. The wind rustled through our hair as we trekked through the tall grass over slightly rough terrain. The slow pace was relaxing, allowing us to connect with our surroundings. Surprisingly, it’s quite a workout; even at the ripe old age of 24, I was unprepared for the challenge.

Demulder identified a variety of ducks, pelicans, herons and swallows in only an hour. We would only see limited species in summer, he said. “The best time to observe birds is during the spring and fall migration, with September and April being peak times.” During these periods there are groups that lead expeditions, such as the Edmonton Nature Club, which meets from September through the winter months at the Royal Alberta Museum. If you’re interested

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in birding, you’ll need a few essentials: a good set of binoculars, comfortable clothes and a Peterson Field Guide to help you identify any feathered friends. Demulder has had the same book and pair of binoculars for 30 years.

We continued up along the grassy nooks, taking in our surroundings and spotting species after species of bird. At one point, Demulder suddenly closed his eyes to listen to a distant

Birdwatching was a great success, but soon I had appointed myself the task of introducing my grandfather to something new. To be sure I chose safe activities, I contacted Lisa Tremblay, exercise specialist for AHS-Capital Health. Vigorous exercise is not required in this age group, she said.

“Most of the activities needed should be of low to moderate intensity,” said Tremblay. “Flexibility is especially important for the elderly as it helps to keep joints healthy and promotes a wide Birdwatching is enough to get range of motion, allowing people to perform their daily activities with less effort, the heart rate up, but is so prolonging independent living.” Armed this information, I set about to look much fun you barely notice with for an activity that would promote flexibility. It wasn’t long before I had settled on you’re exercising. the perfect thing: tai chi. The only probchirp, saying how fascinated he was with how lem was, my grandfather balked. “I’m not doing the mind works, “memorizing the songs and some sort of new age Chinese exercises,” he said. training your mind to recall them at the blink of “I’m not going to stand there and do this stuff.” an eye.” The distant chirp turned out to be a cliff I explained that tai chi is a 200-year-old pracswallow. This was the first of many observations tice that consists of a series of slow, repetitive and stories shared between my grandfather and movements that emphasize flexibility and selfDemulder, of wars won and lost, travels, stories control. It has many health benefits, including from their lifelong marriages. improvements to the immune system. According to a 2007 study led by the University of California, 112 adults between the ages of 59 and 86 who practised tai chi for more than six months had immune system levels that were comparable to being vaccinated for disease. When tai chi was combined with vaccination, the test groups’ immunity levels reached those normally seen in middle age.

Over Grandpa’s continued objections, we went to the Hunyuantaiji Academy, a small studio in south Edmonton, where we were greeted by warm, friendly people of all ages. Grandpa was smiling nervously as we moved to the centre of the room. Fellow senior Allen Belsheim led us through basic movements to strengthen our muscles and joints, improve balance and posture.

I glanced from time to time at Grandpa and to my surprise I saw he was keeping up with me.

And he was smiling! “Holy hell, this loosens up the back in a hurry,” he said.

As my joints unlocked and my hips loosened I felt a warm sensation all over my body, and my fingertips began to tingle. I discovered how the mind and body work together, controlling my movements so they eventually flowed on their own.

There are a variety of places throughout the AHS-Capital Health region that offer tai chi classes. It’s easy to get started, and all you need www.capitalhealth.ca

AHS-Capital Health’s Your Health magazine

are clothes you can move freely in. Prices vary, from $15 for a drop-in class to $1,100 annually.

“It is amazing to get in touch with the senses,” Grandpa said, “using the mind to memorize, but the body to control the movements. I didn’t even feel like I was exercising.” He was so won over by it that he spent that evening trying to convince my grandmother to join him next time.

Having led my grandfather through the woods to engage his mind, and tai chi to challenge his body, it was now time to tackle his spirit – in a group meditation session at the Woodcroft Public Library in Edmonton. Meditation is a 5,000-year-old discipline, in which one tries to get beyond everyday thinking into a deeper state of relaxation and awareness. It involves turning your attention to a single point of reference until you achieve greater focus, creativity or self-awareness, or simply a more relaxed and peaceful frame of mind.

By letting go of thoughts and worries one at time, you can clear your mind and become fully aware of who you are and what you are doing, said Rod Walker, layminister from the Edmonton Buddhist Meditation Group. “It’s not physically demanding,” he said. “You can meditate while sitting or walking, and it is excellent for the elderly or slow-moving individuals.”

The Edmonton Buddhist Meditation Group is only one of many organizations that offer meditation classes in a variety of locations in the AHSCapital Health region. The class we attended was free. All the equipment necessary was provided by the group, including a variety of mats, so all you need are some comfortable clothes for sitting or kneeling.

Participants sat against a wall on their knees or with their legs crossed and tried to let their thoughts slip away. Grandpa sat on a chair.

We discovered how to touch base with different parts of our bodies and senses. We sat for 15 minutes and then did a walking meditation, following one behind the other in slow, easy steps. I became very aware of every little sound, and when my tape recorder stopped abruptly, I felt the sound travel up my spine. Walker said that was because I had achieved a meditative state, and my body was in tune with my surroundings, heightening my senses. Grandpa had also achieved it and was shocked how memories from more than 70 years ago flitted in and out of his mind. He said he felt like he suddenly understood how all kinds of events from his life fit together into a whole.

What have I learned? I think Lisa Tremblay put it best when she said we all have to find activities that we enjoy so that we are motivated to continue. “To maintain our physical and mental health as well as our quality of life, we need to regard physical activity as a lifelong pursuit. It should not be regarded as a temporary fix.”

Since we began this journey together, my

grandfather and I are closer than ever, and that is a reward in itself. In fact, over brunch at his house recently, he said he had learned a lot from doing these different activities with me. “It really opened my eyes,” he said. “I want your grandmother to try them, but she is too stubborn.”

And then he went into the basement, turned on the TV and began to practise some tai chi.

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AHS-Capital Health’s Your Health magazine

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8/13/08 9:39:23 AM

That Certain Glow

Fed up with receiving incomplete health care, Roxanne Ulanicki decided to do something about it

By Malcolm Azania Photograph by 3ten

F

ormer athlete Roxanne Ulanicki

knows how spina bifida can land a person in the penalty box of life.

Her four-year tenure on the national women’s wheelchair basketball team, which competed in the 1988 Paralympics in Seoul, ended in 1990 because multiple childhood surgeries had left little “hooks” made of scar tissue on her spinal cord. Her spinal cord became hooked to the bottom of her spinal column, jiggling her brain when she moved and triggering agonizing headaches. “That’s when the depression and anxiety started,” she says, “knowing I couldn’t do what I wanted to do.”

Although she was an adult, Ulanicki had to see her former pediatric neurosurgeon for treatment.

At the time, few doctors specialized in treating adults with spina bifida, because few children with it lived to adulthood. But things are different now. Not only are spina bifida rates dropping, but AHS-Capital Health’s Glenrose Rehabilitation Hospital opened the Adult Spina Bifida Clinic in June 2008. And they can partly thank 39-year-old Ulanicki, now a patient at the clinic, for leading the charge that led to its creation.

Prior to the clinic’s existence, says Ulanicki, people with spina bifida had to go to a family doctor for their medical needs. “Family doctors work for a fee – about one patient every 11 minutes – which doesn’t work for people who have ‘complicated’ bodies,” she says.

Growing up in rural Alberta, she underwent many, many surgeries and procedures, was fitted with a variety of braces, both half-leg and full-leg, a cane, then crutches and finally a wheelchair by the time she was 17.

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AHS-Capital Health’s Your Health magazine

As an adult, Ulanicki struggled to overcome There is no single known cause of this birth Capital Health, she’s been able to accomplish the physical and emotional pain imposed on her defect. Researchers are looking into heredity, almost everything she set out to. by a medical system at a loss with how to treat nutrition, environment and pollution, all of “My family never said I couldn’t do things,” her. She had more surgery to repair the scarring which can physically damage a fetus. However, she explains. “I was shocked out in the real world on her spinal column so she could continue to the incidence of spina bifida decreases by 70% to find out other people didn’t treat me that way. play sports, but the surgery failed. For the next when women take folic acid supplements prior But we’re all here for a reason. Maybe people with 20 years, she would struggle to get the help she to conception and during the first trimester of disabilities are born to slow everyone else down desperately needed. their pregnancies. and make them grateful for what they can do.

At the new clinic, there are specialists of every Trying to cope with the condition with“Had I been born in most countries other stripe, from neurologists to physiatrists (reha- out help is a herculean task. Ulanicki came to than Canada, I wouldn’t exist, because there isn’t bilitation physicians) who give patients the time Edmonton from La Corey, north of Bonny- medical care, or there are weird beliefs about peothey need. Dr. Mario DiPersio, the clinic’s medi- ville, in 1987. After she quit playing sports, she ple with disabilities.” cal lead, says the services offered should It took two or three years to make fill the gap in the continuum of care “Had I been born in most countries the clinic happen. A group of people, for patients with spina bifida. “Our including Ulanicki, from a variety of new clinic has an integrated approach other than Canada, I wouldn’t exist, community and health organizations to care,” he says. “Patients can access their resources, knowledge and because there isn’t medical care, or pooled specialized medical services, including talents to create the first multidisciplinursing, rehabilitation medicine, uro- there are weird beliefs about people nary adult spina bifida clinic in Canada. logy, neurology and neurosurgery.” The Open since summer 2008, the clinic with disabilities.” clinic will also educate other health prooperates the first Monday of every fessionals in the latest means of support month inside the Glenrose adult outfor these patients and help adults with the con- spent the next 17 years searching for housing patient clinic and the third Thursday for adolesdition navigate its many physical, psychological and struggling to keep a job. “Even bungalows in cents. Patients requiring emergency medical help and social effects.

Edmonton have three steps up and three down,” are handled immediately in the emergency ward.

The term spina bifida comes from the latin for she says. “If you’re going to function as a citizen, Referrals are not needed; patients can call for “split spine.” It is a birth defect which results in you need adequate housing. I’d literally have themselves and schedule an appointment. an incompletely formed spinal cord. The verte- to crawl in and out of the bathroom. I’d come “The clinic’s amazing,” beams Alisha Brown, brae over the open portion of the spinal cord also home exhausted at the end of the day to a non- “absolutely stunning. It’s going to be revolutiondo not form properly, remaining open. Babies functional home.” The resulting stress taxed her ary, with all kinds of effects on the health-care with it may be born with the abnormal portion physical and mental health. The day she had to system for people with other disabilities. People of their spine sticking out through the back. take medical leave from her job at Canada Cus- will no longer be so left behind.”

The defect can be surgically closed after birth, toms, she wept. “It was further validation that The Glenrose’s new clinic is also proof of what but this does not restore normal function to the I didn’t fit in this world.” someone with heart can accomplish if they keep lower back and limbs. Every year, one in 2,500 In 2004, Ulanicki was accepted at Edmonton’s trying. As Ulanicki says, “Why fight this fight for Canadian children is born with the condition, ArtSpace Housing Co-operative, where 29 out of just me?” whose side-effects include leg paralysis, scoliosis 88 units are adapted for people with disabilities. and deformities of the hips, feet and legs; poor For the first time in her life, Ulanicki began meetThe Three Forms of Spina Bifida or non-existent bowel and bladder control; poor ing other adults with spina bifida. But the joy of Myelomeningocele: the most severe form, co-ordination; urinary tract disorders; bone frac- it faded as her awareness grew of their collective in which the spinal cord and its protective tures; psychological, social and sexual problems, need for proper health care. Incensed, she began covering, the meninges, protrude from an and more. It’s also linked to hydrocephalus, a writing letters to officials at Capital Health, opening in the spine. buildup of excess fluid in the brain which can Health Canada, Health and Wellness, her MP, Meningocele: the spinal cord develops cause developmental delays.

MLA, doctors and whomever else she felt needed normally, but the meninges protrude from “Usually what happens is when people with to know about “the fragmented service offered the back, created by damaged or missing spina bifida hit 18, they’re no longer cared for by to people discharged from care at age 18, who vertebrae. the health system,” says Alisha Brown, program struggle not only with the physical barriers of Occulta: meaning “hidden.” This is when manager of the Spina Bifida and Hydrocephalus living with a disability, but also the emotional one or more vertebrae are malformed, but Association of Northern Alberta. “They have to barriers created by lifelong treatment.” Ulanicki covered by a layer of skin. Occulta is the do all the co-ordinating of services by themselves, wanted formal changes and, after writing more mildest form of spina bifida. relying on the good graces of their pediatricians letters, surveying her peers, and drafting and to get them through adult care.” submitting a position paper on her findings to AHS-Capital Health’s Your Health magazine

www.capitalhealth.ca

Fall 2008

29

SERVICE WITH A SMILE: Phyllis Anderson offers some of her home-baked goodies to a cherished guest in her home in Stony Plain

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AHS-Capital Health’s Your Health magazine

By Cait Wills |

Photography by AMY SENECAL

U

Volunteers are the beating heart of most charitable and non-profit organizations.

Without them, the world would be a much lonelier place

nder darkening skies and the rumble of

thunder, Phyllis and Lorne Anderson bustle about in their backyard in Stony Plain, moving chairs under the shelter of trees and worrying about whether their guests will arrive for their sixth annual homemade pie party before the threatening clouds above break open.

“It wouldn’t dare rain,” says Phyllis, resolutely.

The skies, it seems, are listening. The sun breaks through and illuminates dozens of meticulously planted flowers in the Anderson garden.

The wind picks up and the clouds quickly disappear, just in time for buses to begin to arrive and disgorge their passengers. This isn’t just any afternoon tea, and the Andersons aren’t just any hosts. They’re volunteers with the continuing care unit at the WestView Health Centre, and

AHS-Capital Health’s Your Health magazine

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their guests are residents from WestView and the Good Samaritan George Hennig Place, a long-term care and assisted-living facility in the AHS-Capital Health region. WestView also provides primary health services through acute care, continuing care, 24-hour emergency services, obstetrics, diagnostic imaging, lab services, day surgery, public health, community care, rehabilitation services and mental health services.

Because of the breadth of medical coverage, the health centre has an ongoing need for people like the Andersons, says site director Ellen Billay.

“Volunteers play a huge role in enhancing our patients’ quality of life,” says Billay. “They are a very important connection to the community.”

In 2004, over 11.8 million Canadians volunteered their time, contributing almost two

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SERVED WITH LOVE: The Andersons have been hosting their annual homemade pie parties for home and long-term care residents for six years

Flowers for Vera

by the cause supported by the organization.

If you live in the AHS-Capital Health region and want to help, there are plenty of opportunities to do so. Volunteers are expected to contribute a minimum of two hours a week and placements are available seven days a week, morning through evening. There are 13 facilities within the region that require assistance.

Volunteering isn’t just about filling the hours between waking and sleeping. It’s about the power of human interaction to transform lives, and the bittersweet opportunity to help others regain their independence. Esther Lieneu, a guest at this year’s pie party, says she used to have parties in her home in Spruce Grove. “It hurts every time I think of it,” she says. “But it’s like the Garden of Eden here.”

In their garden, the Andersons nurture petunias, delphiniums, geraniums, lilies, rosebushes, lilacs and frequent guests. The garden is also open to the public. The mayor regularly brings visiting dignitaries by for a tour and a cup of tea. Every spring, they plant flowers for the residents who’ve passed away. And this year, “there are petunias, geraniums and lamium for Vera,” says Phyllis.

The Gift of Giving A University of Alberta researcher and profes-

billion volunteer hours – the equivalent of one million full-time jobs. Volunteers are the heart of Canada’s charitable and non-profit organizations. That human touch is crucial everywhere, but especially for residents in continuing care, says Becky Caldwell, recreation facilitator at George Hennig Place.

“The relationships volunteers have with the residents are so important,” says Caldwell.

“They really look forward to outings. They don’t get a lot of visitors, so it’s especially nice for the residents to have one-on-one time.”

That sentiment is one that many volunteers, including the Andersons, share. But becoming a critical spoke in the wheel of volunteer services in Stony Plain was never their intention. After reaching retirement age, they decided to cut back on work and focus on their garden. They became very active in the Stony Plain Horticultural Society, and were so successful at raising money they were asked to run the silent auction fundraiser at a local extended living facility. While he was acting as an auctioneer, Lorne, now 80, was asked if he ever volunteered, and the rest is history.

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They’ve lost count of the hours and care they’ve invested in WestView residents since 2002. “I think it was something we were supposed to do,” says the 77-year-old Phyllis. “We were supposed to be here for these people.”

But it’s not always easy to remain cheerful.

This past year, Phyllis became especially close to a resident named Vera. She brought her a loaf of fresh bread every time she visited. One night she was making cinnamon rolls and decided to bring the rolls and loaf of bread to the centre the next morning. Vera passed away that night. “Losing friends is the biggest challenge, and the biggest heartbreak,” says Phyllis. “Sometime we lose eight or nine in a row. Sometimes we have really hard times. They are our family. But it is also very rewarding, and you have to keep going.”

The Andersons will continue volunteering as long as they’re able, partly because of the ongoing need.

According to a national survey, the top three reasons for volunteering are: wanting to contribute to the community; to use one’s skills and experiences; and because the individual was affected www.capitalhealth.ca

sor has shown that it truly is better to give than to receive. In 2007, a marketing professor in the U of A’s School of Business, Robert Fisher, led a study that found that people are more inclined to give their time, energy or money when there is a perceived altruistic element.

The study looked at donations to a television station during its annual fundraising appeal.

Fisher discovered that “selfish benefits” – where donors received recognition or tangible items in return for a pledge – actually decreased the amount of pledges received.

“The appeals that were most effective were those that emphasized the benefits to others, such as the station, the community or disadvantaged groups,” he says. Fisher’s findings suggest that people expect self or social censure if they don’t help a needy person or organization they care about. “Failing to help under these conditions leads to shame,” says Fisher. “This is a powerful negative emotion that is experienced when there is an inconsistency between a person’s actual, and desired, self.”

AHS-Capital Health’s Your Health magazine

Advertising FeAture

Dental hygienists offer introduction to oral health

By Erik Froese

E

ight-year-old Rhiannon Stott is having a ball. After all, she is lying on a comfortable reclined chair, wearing a pair of funky pink sunglasses, casually watching a few cartoons, while dental hygienist Kim Ehrman spreads some cool looking blue dye onto her teeth.

“I like the painting best,” says Rhiannon, referring to the dye, which changes from blue to pink in areas with plaque, exposing crevices that need better attention with a toothbrush. Very little pigment is turning pink. Obviously, she’s got the brushing thing nailed.

Today, Ehrman will teach Rhiannon how to floss for the first time and, after a brief cleaning, a strawberryflavoured fluoride treatment (Rhiannon’s favourite) and a few more cartoons, the third-grader will run into the waiting room and show her mom, Chantalle, the prizes she got for being a good patient.

It’s almost like this is… fun. And that’s the point.

Strong teeth and healthy gums contribute to overall good health, clear speech and personal confidence. Many parents recognize the benefits of having their children get regular checkups and learn about the importance of oral health. But children can sometimes be a little skittish when it comes to things dental, and that can make it tough for everyone involved. That’s where a dental hygienist can help. →

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Dental hygienists at work, at the clinic, in the community and in your home...

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“Dental hygienists have always taken care of everyone – children and adults,” says Brenda Walker, Registrar and Chief Administrative Officer, College of Registered Dental Hygienists of Alberta. “We know if we can work with children from an early age, we have a much better chance of ensuring they enjoy lifelong dental health, so we are focused on making that happen by providing children with an introduction to dental care.” roviding oral health education is a large part of a dental hygienist’s job. Since 1951, dental hygienists have been providing care in community health settings and, since the 1960s, in private practice settings.

According to Vickie McKinnon, Manager, Oral Health Education and Community Services, Calgary Health Region, dental hygienists working in community health build oral health capacity in other health professionals and service providers. They work collaboratively with other agencies and stakeholders to address the oral health needs of the population and influence policy change. Using a targeted population approach, they provide oral health services to priority (at-risk) populations. These health professionals research evidence-based community dental health practices and develop resources to promote oral health messages. A big focus of community health dental hygienists is to work with other health professionals and stakeholders on multidisciplinary projects.

Melanie Garrison’s work illustrates this collabora-

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Photos: Sean Dennie

tive approach. She worked as a private practice dental hygienist for 10 years before entering the public health sector seven years ago. She is now employed with community health in Edmonton, working with community head start programs that support at-risk pre-school children and their families. Beyond connecting children and their families to helpful health and wellness programs and resources, Garrison teaches children about the importance of good oral hygiene. “When I’m in the classroom, I’m trying to make it a positive experience,” says Garrison. “It’s often the first time these children have seen a dental health professional. It can seem pretty invasive when I approach them wearing a mask and going into their mouth with a mirror.” arrison uses puppets, books, colouring sheets, videos, stuffed animals and roleplay games to try and dispel any anxieties. This enables her to better inform the children about how oral health affects a person’s overall well-being. For example, eating a balanced, low-sugar diet containing all the major food groups is good for teeth, but it also benefits the rest of the body and mind. Brushing and flossing prevents cavities and gum diseases, which in turn aids in avoiding behavioural changes connected to painful mouth issues, as well as improving confidence by ensuring a nice, bright smile.

In contrast to Garrison, Greg Fode, a registered dental hygienist in Raymond, Alberta, provides dental

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hygiene services to clients of all ages in a private practice setting. As part of this care, Fode makes mouthguards for athletes after educating them about a mouthguard’s role in preventing dental damage and concussion in all games, not just contact sports.

Thanks to legislative changes in 2006, dental hygienists are able to establish their own practices separate from a dentist’s office. As a result, dental hygienists are developing new approaches to the delivery of services, including to children. he approach is working. Kim Ehrman and her sister, Melanie Johnston-Dore, opened The Edge, a dental hygiene practice in northeast Calgary in October 2007, and Rhiannon loves it, according to her father, Garreth Stott. “It’s all about being able to relate to the patient, no matter their age,” says Stott. “They (the dental hygienists) do a fantastic job. Rhiannon enjoys coming here, which is nice.” And that means more than just cleaning teeth: it encompasses education about proper nutrition as well as tooth and gum care at home. It also means making sure that children like Rhiannon are comfortable in their office.

“It’s very important that you don’t push the child,” says Johnston-Dore. “You want children to be happy ...You want to make it fun for them.”

Johnston-Dore agrees with the American Academy of Pediatric Dentistry’s recommendation that dental visits begin with the appearance of a child’s first tooth, typically around six months, but no later than

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Advertising FeAture

Message FroM Brenda Walker, registrar and ChieF adMinistrative oFFiCer, College oF registered dental hygienists oF alBerta

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4 one year. This way a child can become accustomed to a visit and learn positive oral health practices.

A mother’s prenatal visits are also important. Dental hygienists can help explain the connection between a mom’s diet and the impact it can have on the dental and overall health of a child. They will encourage the expectant parents to become informed about the oral health of their newborn. This will include teaching about the causes of early childhood caries (tooth decay) such as how bacteria can be transmitted from parent to child; using bottles containing milk or sugary liquids at bedtime and prolonged, frequent use of sippy cups. Early childhood caries, if left untreated, can destroy baby teeth and reach the nerves of the teeth, causing severe pain and infection. Even though these teeth are not permanent, they are extremely important for the normal growth and development of the face and jaws, speech development, chewing, esthetics and space maintenance for adult teeth. y being able to open their own practices, dental hygienists can now offer a range of options for clients. Trish Clayton is an Edmonton-based dental hygienist who recently opened a mobile dental hygiene business.

Clayton packs all the technology she needs to do her job into a vehicle and drives to wherever her clients live. She often deals with seniors and individuals living with physical disabilities, because of their mobility issues, but she is increasingly receiving requests from parents with young children.

B

Front: Sarah Graham gets an early introduction to oral health from her mom and dental hygienist, Tina Graham.

Inside: 1) Trish Clayton uses a portable dental chair to treat Brenna Hein in a “home setting.” 2) Rhiannon Stott, wearing her funky pink sunglasses, flashes a cavity-free smile. 3) Melanie Garrison uses a puppet to teach children like Kennedy Seaborne about oral health. 4) Kim Ehrman with patient Rhiannon Stott. 5) Greg Fode with son, Ashton, shows off a mouthguard.

“It’s a different way to access treatment and hopefully to reach some people who, for whatever reason, have been finding it difficult to attend regular appointments,” says Clayton, adding that mobile dental hygiene services exist in most of Alberta’s major centres. “It makes a big difference for the families and for the clients,” says Clayton, noting that her practice nullifies transportation difficulties. s with all dental hygienists, Clayton works in close collaboration with other oral health-care practitioners around her city.

If she runs across something that requires additional expertise – such as a cavity that needs filling or orthodontic concerns – she is quick to refer her clients to a dentist or specialist. The same is true of Ehrman and Johnston-Dore.

Back at The Edge, Rhiannon is learning to floss.

“Take your middle finger in each hand,” says Ehrman, “and wrap the floss around it.”

“Not too tight?” asks Rhiannon.

“Not too tight,” Ehrman agrees. “Now grab the floss and go like this. See how you have a little more control? Let me give you back the mirror and I want you try doing it on the back teeth.”

Rhiannon giggles as she struggles to reach her molars. “Each time you do it, it’s just going to keep getting easier and easier and easier,” says Ehrman.

Thanks to her dental hygienist, the same can now also be said for all of Rhiannon’s regular dental hygiene visits.

A

oday’s children and adolescents are the key to a strong and viable future for Alberta. Their oral health is critical to speech development and positive self-esteem and the ability to eat healthy foods, grow strong and concentrate at school. Strong teeth and healthy gums are integral components of good general health and well-being.

Since the 1970s, dental decay has been on the decline for most segments of the population due to the widespread use of fluoridated toothpastes.

However, the decay rate in young children has actually been increasing over the past decade.

Dental decay affects children from families of every income level. The consequences are far-reaching, and children can experience a multitude of problems as a result of tooth decay. These include pain, infections, abscesses, gastrointestinal disorders, chewing problems, malnutrition, insufficient physical development, low self-esteem, diminished ability to learn, and missed school. For their parents, a child’s dental problems mean lost work days, financial costs, worry and stress.

Through screening, education, therapeutic WALKer and preventive procedures, dental hygienists can help reduce the risk of oral health problems for young Albertans. Dental hygienists work with parents to help them understand the decay process, make healthy food and drink choices for their children, and recognize the early signs of decay. At the early stages of decay, dental hygienists apply fluoride varnishes that may inhibit the decay process. Children with later stages of decay are referred to a dentist for treatment. Dental hygienists also help children and adolescents reduce the risk of sports mouth injuries and provide information on lifestyle choices that impact oral health.

The College of Registered Dental Hygienists of Alberta has an important role to play in supporting dental hygienists and their work. Under the Health Professions Act, the CRDHA plays a public protection role by setting entry-to-practice and continuing competence requirements, establishing standards of practice and a code of ethics, and operating a complaint and discipline process.

But we also believe in public education. The CRDHA works to provide information that will help individuals and communities prevent oral disease, maintain good oral health and increase awareness of the relationship of oral health to general health.

In striving to achieve these objectives, it is our hope that we can better serve the people of Alberta.

Info bItes

Attention, parents!

What parents can do to enhance the dental health of their children: l less than a pea-size: fluoride toothpaste effectively reduces tooth decay, but children should use very small amounts of it. Until age six, use less than a pea-sized amount of toothpaste. l Rethink your drink: Reduce the risk of tooth decay, obesity, diabetes and osteoporosis by selecting healthy beverages such as water or milk. l lift the lip: Check for early signs of tooth decay in babies and young children.

Lift the upper lip once a month, and carefully examine the tooth enamel along the gum-line. l Healthy mouth, healthy body: oral health influences general health. Maintain oral health to limit risks of heart disease, lung infections, diabetes and low birthweight babies. l strong baby teeth start with you: Moms with good oral health are more likely to have healthy babies with good oral health. Moms can limit the risk of early childhood tooth decay by making sure their own teeth are healthy. source: Courtesy of Calgary Health Region

teen talk

What teens can do for their teeth: l Take care of your teeth: natural teeth are meant to last for a lifetime. Keep your teeth, and keep them healthy with daily home care and routine dental office visits. l Don’t smoke: Using tobacco products like cigarettes or spit tobacco increases the occurrence of oral cancer and throat cancer. tobacco can also cause bad breath and stain teeth. l Avoid drugs: Using street drugs like crystal meth can cause severe decay in all teeth and eventual loss of teeth in a very short time-span. l Think twice about decorations: oral piercing can cause oral infections, bleeding and nerve damage. Metal jewelry can crack or chip teeth.

Advertising FeAture

Did you know? l Dental caries (tooth decay) is the single most common chronic childhood disease, five times more common than asthma and seven times more common than hay fever. l early childhood caries (tooth decay) is an infectious, transmissible, preventable chronic disease. l in young children the upper front teeth are the most often affected. Parents should lift the baby’s lip to watch for white lines or spots on those teeth. l in very young children, treatment for early childhood cavities must be done under general anaesthetic, costing the public health system millions of dollars annually. l Dental decay affects 60 to 90 per cent of school-age children. l The United states surgeon General reports that more than 51 million school hours are lost each year to dental-related illness. the situation in Canada parallels the U.s.

interested in a career as a dental hygienist? Want to learn more about the profession? Visit these websites: l COlleGe OF ReGisTeReD DeNTAl HYGieNisTs OF AlBeRTA eRTA www.crdha.ca l FACUlTY OF MeDiCiNe AND DeNTisTRY, UNiVeRsiTY OF AlBeRTA www.dent.ualberta.ca/dentalhygiene.cfm l CANADiAN DeNTAl HYGieNisTs AssOCiATiON www.cdha.ca l GOVeRNMeNT OF AlBeRTA: HeAlTH PROFessiONs ACT www.health.gov.ab.ca/professionals/about_HPA.pdf

oral health online AlBeRTA HeAlTH seRViCes – CAlGARY HeAlTH ReGiON www.calgaryhealthregion.ca/programs/dental/dentalservices. html Community and oral health provides preventive services and education in targeted schools, daycares and community groups. Look here for information about early childhood caries, Re-Think Your Drink.

AlBeRTA HeAlTH seRViCes – CAPiTAl HeAlTH www.capitalhealth.ca Use the search function to find information on the Early Childhood Oral Health Service (ECOHS) for children at risk for early childhood caries as young as 12 months and the school screening and fluoride program in schools.

NATiONAl MATeRNAl AND CHilD ORAl HeAlTH ResOURCe CeNTRe www.mchoralhealth.org Find early childhood care and prevention of oral disease information.

AlBeRTA MilK www.albertamilk.com Want to learn more about nutrition for your child? Get a copy of SNACKS, a special brochure produced by the College of Registered Dental Hygienists of Alberta, Alberta Milk and the Alberta Dental Association and College. It has detailed information to help you send your child back to school with healthy lunches and snacks. To get your copy, contact the College of Registered Dental Hygienists of Alberta at 780-465-1756 or toll free (Alberta) at 1-877-465-1756.

Suite 206, 8657 – 51 avenue nW, edMonton, aB t6e 6a8 Phone toll-Free: 1-877-465-1756; Fax: 780-440-0544 WWW.Crdha.Ca

S

uper-sized suckers. Mountains of M&Ms.

This Halloween, some parents are tricking their kids into forgetting about treats

By Jim Veenbaas | ILLUSTRATIONS BY Caroline hamel

Sweet Nothings

Gobs of gobstoppers. Halloween is a smorgasbord of everything sticky and sweet. Every year, thousands of Albertan kids come home dragging pillowcases stuffed with candy, lug them up to their bedrooms and pig out. Halloween can be downright spooky for health-conscious parents, but it doesn’t have to be a nutritional nightmare. With a little preparation, Halloween can be fun and healthy. Crystal Kean and her family manage to ward off the true evils of Halloween– cavities and tummy aches – every year. The amount of candy her children could collect and consume on this holiday gives her the willies.

“There has been this really big push to make Halloween a bigger event, with bigger portions and a bigger buzz about it,” says Kean. “It promotes the idea that more is good. We just don’t see the need for our children to go out and come home with a bag full of candy. We try to make better choices.”

What frightens Kean the most is the refined sugar found in candy and other mass-manufactured sweets. Refined sugar is particularly unhealthy because it has no vitamins or minerals, raises insulin levels in the blood, depresses the immune system, causes weight gain and promotes the storage of fat. But rather than lecture her children about the evils of tooth decay and obesity, Kean makes the night so enjoyable her

Fall 2008

37

Sweet Nothings

Sick or Treat AHS-Capital Health community dietitian Ivonne Sanchez recoils in horror at the thought of children stuffing themselves sick on Halloween, but she knows it’s not always possible to deny them the excitement of trick-or-treating. The only thing for it is to make sure other aspects of their diet are healthy, she says.

“Candy is really high in calories, sugar, provides no vitamins or minerals and will have an influence on a child’s appetite. It’s important to make sure kids eat well on Halloween day,” says Sanchez.

Make sure everyone eats a healthy supper and snack right before they go out trick-or-treating. That way, junior will be less tempted to scarf down all that candy at once. Limit how much time the kids spend collecting their stash. Once they get home, let them choose a few treats and then put the rest somewhere out of reach. Don’t let kids bring their goody bags to their bedrooms. Ensure your kids’ attention is focused on what they are eating and not a movie or the TV. Selectiveness and moderation are skills that will last them the rest of their lives.

Parents can also set a good example by giving out healthy snacks to trick-or-treaters or fun items like stickers and washable tattoos. “If you are giving out homemade treats, include a little tag with your name and a way for people to contact you. That will create awareness with other parents and make them feel comfortable, knowing that it is safe,” says Sanchez.

And if you think your kids have too much junk, just bite the bullet and get rid of it.

38

Fall 2008

www.capitalhealth.ca

kids have no interest in trick-or-treating. Every year she throws a huge party and invites people throughout her Edmonton neighbourhood to her home. The event has become so popular she expects to see upwards of 40 kids this year.

“It started with about 10 kids but over the years it has spread,” she says. “We bob for apples and have a treasure hunt. We have a mummy contest where the kids get wrapped up in toilet paper. It’s really fun. I don’t think our kids have missed out on anything by staying home.”

Kean serves up lots of homemade sweets – like candied apples and fresh cupcakes – to satisfy the little ghouls and goblins running around. But when the party is over, all the junk food is gone. Her kids, and their guests, don’t spend the next week gorging on chocolate bars and chips. “It’s a more controlled environment.

That’s what we like about it. We have one night with treats and then we’re done with it.”

Kean’s approach is becoming a lot more popular throughout the AHS-Capital Health region as families attempt to banish candy to the nether reaches of the dietary universe.

But parents in search of activities don’t have to stage their own; there are plenty of alternatives throughout the region. The biggest is the Scarecrow Festival at Northlands Agricom in Edmonton. It runs from October 17 to 19, and upwards of 25,000 people will attend the three-day howler, which has haunted the city for the past 16 years. The cost of admission is a treat too: it’s only $3, and all of the proceeds AHS-Capital Health’s Your Health magazine

www.capitalhealth.ca

Give Treats a Healthy Twist: • Small bags of pretzels or popcorn • Single-serving boxes of cereal • Individual hot chocolate packages • Pre-packaged cheese sticks or cheese and

crackers

• Small boxes of raisins or fruit leathers • Fruit cups or applesauce cups • Granola bars • Sugar-free gum

are donated to ABC Headstart, a preschool program for low income families. The festival features two haunted houses, a simulated ride through a haunted forest, a whispering tomb that tells ghost stories, and crafts. “We decorate the entire Hall B and it’s full of games for the little ones. It’s a huge event and we use up to 600 volunteers,” says festival co-ordinator Bernice Gordeyko. “The list of activities is incredible.”

On Halloween night there are parties aplenty in communities throughout the region. If you’re not sure where to go, start with your local recreation centre. Many will be hosting their own events, giving children a safe place to celebrate.

The Tri-Leisure Centre in Spruce Grove will be hosting Halloween Hoopla again this year, and the price is right: it’s free. It features a haunted house, games, cookie-decorating, familyfriendly entertainers and more.

Fall 2008

39

Sweet Nothings

Toys, Not Tooth Decay • Stickers or temporary tattoos • Finger puppets, rubber spiders • Plastic rings or beads • Coloured chalk or individually wrapped

play clay

• Bubbles, wands, balloons or noisemakers • Crayons, pencils, fun-shaped erasers and

40

pencil toppers

Fall 2008

One of the largest parties in the region is Hallo-baloo at Millennium Place in Sherwood Park. Thousands of kids will attend the event again this year and enjoy a smorgasbord of games, swimming and entertainment at no cost. The event is spearheaded by the Park Church and has become a staple in the community. There will be carnival games, crafts, two different stages for entertainers, cookie-decorating, face-painting and more.

“Last year was my first, and I was totally amazed. There were so many kids and it’s such a big, exciting event. There were great performers, and the kids had a wonderful time,” says Randy Young, youth pastor for the Park Church. “It’s a safe, fun night.”

If you’re interested in embodying the spirit of giving and community service on Halloween, the University of Alberta has created a tradition called Trick or Eat, the Campus Food Bank’s most important fundraiser of the year. University students dress up and go door to door collecting donations. Trick or Eat has generated

www.capitalhealth.ca

up to 4,500 kilograms of non-perishable food items in past years – almost enough to last the entire school year – and organizers are always looking for volunteers.

“It stocks our shelves from November until the end of April so it’s really essential for us,” says Lauren Price, executive director of the Campus Food Bank. “It also raises awareness that hunger exists on our campus. Some students are really struggling and we can help make their lives a little bit easier.”

Clearly, there’s hope for people of all ages seeking a healthier approach to this holiday.

In a few years, your kids might start declining trick-or-treating on their own in favour of healthier activities. Crystal Kean’s 12-year-old son went trick-or-treating for the first time last year and was unimpressed with his sugarloaded bag of goodies.

“He has reached the age where he is capable of making his own choices. He did go out last year, but he tired of it very quickly. He got a bit of candy and came home,” she says.

AHS-Capital Health’s Your Health magazine

The Comprehensive Tissue Centre provides up to 1,500 tissue grafts annually from less than 100 donors. It needs more donors, so more lives can be saved

Life

After Death

42

Fall 2008

By Katherine Fawcett |

Photography by KELLY REDINGER

G

reg Walsof doesn’t know it, but he’s

a hero. In 2003, the father of two was fighting serious depression. He refused treatment for his illness.

He gave up on life’s pleasures. And just before Christmas, he gave up on life itself. Walsof ’s wife, Stephanie Ostrander, and their children, aged three and six, were devastated. But even in her shock, Ostrander knew one thing: if there was a way her husband’s death could bring some benefit to another living person, he would want that. The couple had discussed organ and tissue donation after a close family friend who nearly died of liver disease was saved by a donor. When the police arrived, Ostrander told the officers of her husband’s wishes.

Jayden Holmes* is still waiting for her hero.

Six and a half years ago, she contracted parasitic infections in both eyes, causing her to lose her vision. Her life became one of excruciating pain, continuous medications and complete darkness. She missed most of Grade 9 and was unable to keep up her active lifestyle.

Within a month of being placed on the emergency list, two corneas became available through the Comprehensive Tissue Centre (CTC) at the University of Alberta Hospital in Edmonton.

As soon as her transplant surgery was complete, the pain went away and she was able to see again.

Unfortunately, those corneas did not thrive in her body. More surgeries, more complications later, Holmes is once again on the waiting list after losing her vision in both eyes for the second time.

Her mother, Suzanna, tries to stay positive.

“She’s 21 now,” she says. “She’s studying business at the U of A. She’s very bright, plays three instruments. She’s not putting her life on hold.

“As a parent, you wish it could be different. I’d give her my eyes if I could – in a heartbeat. It’s frustrating, feeling so powerless. Her doctors feel powerless too. You wonder, why does life have to be this hard? Especially when there is a solution.”

The bridge to the solution is the CTC. It operates as part of transplant services for the AHSCapital Health region, a national centre for the procurement and processing, storage and distribu-

tion of transplant tissues. Formerly operated as the Firefighter’s Skin Bank and the Lions Eye Bank, the two branches amalgamated and became a full-service tissue bank in 1996. The CTC is also one of the few agencies in Canada licensed to distribute heart valves for transplant, a tissue that is in critically short supply. Today it works in conjunction with the Human Organ Procurement and Exchange (HOPE) Program. With a budget of $1.4 million per year, the CTC provides between 1,000 and 1,500 tissue grafts annually from an average of 90 donors.

Mike Bentley, the CTC’s patient care manager of transplant services, says it’s very gratifying work. “We know that what we do ultimately benefits people,” he says. “It motivates us to do our best work and be sure we get as many healthy tissues as possible.”

Bentley’s staff of 20 runs the gamut: they are educators, biologists, detectives and grief counsellors. They consult with the family when someone has died, take them through the consent process and then proceed with recovery and

A GIFT OF BONE: CTC tissue specialist setting up for bone processing

Fall 2008

43

NEW DIGS: A CTC tissue specialist at work in the brand new Class 100 Clean Rooms, the only ones of their kind in Canada

Curling for a Cause Andrea Vavrek was only 25 years old when her life was cut short in a tragic car accident in January 2007. It is of small but not insignificant consolation to her family that, through organ and tissue donation, Vavrek’s body was used to ease the suffering of two dozen people.

Last spring, Andrea’s father, Larry, organized the first annual Andrea Vavrek Bonspiel for HOPE in her memory. He was inspired by the good that came from the donation of her tissues and organs to children and adults alike. “We decided we had to do something, to raise money and awareness. We’ve always been a curling family.

So I said ‘I’m gonna put together a bonspiel.’”

The second fundraiser is set for November 2123 in Sexsmith. Instead of prizes, participants will receive tax receipts for money that is donated to HOPE. “It’s a win-win situation,” says Vavrek.

“You get the receipt to claim on your taxes, the charity gets the cash and everybody has a great time.” For more information, call 780-876-0999, or e-mail lmvavrek@telusplanet.net

preparation for transplantation. They also provide donor families with support as needed. “We tell the families what tissues we were able to use,” he says. “We facilitate anonymous letter-writing between donors and recipients.”

Corneas are often in short supply. The fragile eye tissue can be easily damaged or scratched.

To be suitable for a transplant, the cornea must be removed from the donor’s body within hours of death. In the Edmonton area, the wait for a sight-restoring cornea transplant may be as long as four years. Donor heart valves are also in high demand. They must be dissected from whole hearts and are transplanted to people with heart defects. Skin can be used for burn victims. Bone and tendons are often used for joint mobility restoration and bone repair in reconstructive surgeries for trauma and cancer patients.

The CTC also has a living donor program.

Patients scheduled for hip replacement surgery may offer to donate bone that would otherwise be discarded. That bone can often be used by another patient in need. Women scheduled for C-sections may be able to donate placenta; CTC’s tissue specialists can dissect away the amniotic membrane, which can be used for sight-saving eye surgeries. Bentley is very excited about the CTC’s three new “Class 100 Clean Rooms” – the only ones in Western Canada.

These rooms are highly sterile environments that allow for on-site processing of bones and tendons without risk of contamination. On Bentley’s wish list is a recovery suite for retrieving tissues on 44

Fall 2008

site. Currently, CTC tissue specialists use operating theatres at the U of A Hospital. However, Bentley says the centre’s most urgent goal is to try to increase the number of people who choose to become donors.

According to CTC educator Erik Williams, Canada has one of the lowest donation rates of all industrialized nations. “We’re in a critical shortage of tissues for transplants,” says Williams. “Europe and the U.S. are ahead of us.

Spain has a program of mandatory consideration where you can opt out of being an organ/ tissue donor but, unless otherwise specified, you are automatically in.”

The Human Tissue and Organ Donation Act is designed to help facilitate and support organ and tissue donation in Alberta. It states that anyone who dies in a hospital is a potential donor, and the doctor can give the family the choice to proceed or not. If the body does not have a transferrable disease, doctors will refer subjects to HOPE or the CTC, and the family will become involved in the donor process. The act passed in 2006 but has not yet become law. Bentley is optimistic the act will mean more donors, shorter waiting lists and fewer people suffering and dying because they can’t get the transplants they need.

“I think it will make a difference because it will encourage physicians to seriously consider organ and tissue donation as an important part of endof-life care,” he says.

In the meantime, Williams says that signing the back of your Alberta Health Care Insurance www.capitalhealth.ca

card is not enough. It is important to discuss your wishes regarding organ and tissue donation with your loved ones as they are the ones dealing with medical staff in the event of a tragedy. Transplantation starts at home, with families sitting down together, talking about and recording their wishes. He says that people don’t want to discuss death, and medical staff may be reluctant to bring the issue up when someone has recently passed away. When you tell your family what your wishes are, it helps them make a decision based on what you would have wanted and will often be a great comfort to them, not to mention to the more than 4,000 people in Canada and 500 in Alberta currently waiting for life-saving organ transplants. There are many more waiting for tissue transplants.

“We’ve got to shape up and talk about it,” says Stephanie Ostrander. It was too late to use her husband’s organs but the CTC ensured that the useful parts of Walsof’s body were either preserved or sent immediately to surgeons for use in patients who had been waiting for a donor.

Tissues from Walsof ’s body went to approximately 80 people, including a severe burn victim, a blind grandfather and an infant with a heart condition.

“Greg saved an 18-month-old’s life,” says Ostrander. “When I talk to people about being organ and tissue donors, that should be all I have to say.” *Name has been changed AHS-Capital Health’s Your Health magazine

It’s Your Choice Attention Amputees: The chief complaint we hear from clients who eventually find their way to our facility is, “Why didn’t I hear about you sooner?” Did you know there are a number of prosthetic providers in Alberta from whom to choose your care? In northern Alberta, the publicly funded rehabilitation hospital is strongly represented in the hospitals where amputation surgeries occur. The rehabilitation hospital is equipped with a number of beds, so new amputees, and those with multiple amputations or complications, are directed to the public facility to convalesce. This process frees up beds at the surgical hospitals. When there are no beds available at the rehab hospital, however, otherwise healthy amputees are sent home (where they receive wound care by trained nursing staff—a service available to all Albertans) to wait until a bed becomes available.

This delay is inexcusable, unnecessary, and in violation of health policy in Alberta. Capital Health makes an effort to inform the public of choice. The message, however, seems to get lost in the paper/people administrative shuffle.

We encourage amputees who require the services of the public facility to take advantage of those services. In situations where an amputation is pending (usually related to disease or infection versus a life-threatening accident or bacteria), the patient will have time to take charge of his or her rehabilitation. There are a number of amputees who do not wish to return to a hospital setting and who are physically able to remain at home. These amputees should avail themselves of the skilled community prosthetist. We advocate that those facing amputation, those newly amputated, or those who may be dissatisfied with current services explore their options. There are 20 free-standing prosthetic facilities throughout

Alberta. Seven of these are located north of Red Deer.

Typing “AADL prosthetics vendor list” into a Google search brings you to the government’s Alberta Aids to Daily Living website listing all approved vendors.

AADL/Alberta Blue Cross is the primary payer in the province. The list is arranged alphabetically and by location. All facilities, whether public or free-standing, adhere to the same fee schedules.

Either by telephone or, where possible, in person, an amputee should interview the prosthetist/s who will be making the prosthesis. We recommend interviewing a minimum of three facilities. The amputee/prosthetist relationship will be ongoing; therefore, you want to ensure that you communicate well, that you are listened to, treated with respect, encouraged to resume your daily activities, and supported in many ways beyond the mechanical device. The prosthetist should be educated, accredited by the Canadian Board for Certification, and should keep abreast of new technologies as they become available. The facility should be clean, wheelchair accessible, and have parking designated for the disabled. The staff should be friendly, interested, and helpful.

One of the best sources for finding out about prosthetic care is to speak with other amputees. Many of our clients are willing to do this. Just give us a call. Also, the AASRA organization at www.aasra.ab.ca is a wealth of information. We encourage you not to settle for a partial list of facilities. Ensure that you, as the key member of the rehabilitation team, are the one who makes the decisions concerning where you go and who your provider will be. You may have lost your limb, but you have not lost your mind or your free will.

Amputation or complication from disease or trauma?

Let education and experience work for you!

Pre-surgical consultations Accessible, effective service Free parking

Stan Wlodarczyk, BPE

Certified Prosthetist (Canada & US) Fellow, American Academy of Orthotists and Prosthetists

By the Numbers

Boost

Give Yourself a

With the autumn drop in temperatures comes a tide of dripping noses and a heat wave generated by fevered foreheads. By Halloween, influenza has come a-calling in many Alberta households. Why open the door to it?

AHS-Capital Health will once again be hosting drop-in clinics for influenza immunization in October, at specific community sites throughout the Edmonton area. The service is free for children under two; seniors or residents of continuing care, lodges, or other chronic care facilities; pregnant women; and adults and children with chronic illnesses such as heart disease, asthma or diabetes. But if you’re still unsure, check out these sobering facts:

1 to

7

The incubation period (the time between

days

with a range of one to seven days

The infectious period (when people can spread

50

Gastrointestinal manifestations, such as nausea, vomiting, diarrhea and abdominal pain, are found in

the virus) typically starts 24 hours before the symptoms appear. It continues for three to five days after onset of clinical illness in adults and up to seven days in children

8 to

13

38º to

Children and elderly patients generally have

days ºC

39.5

40 to 50% of patients, but mainly in young children

ºC

40

Fever usually runs in the 38˚C to 40˚C range and a second spike in fever may occur around the fourth day of illness. Backache, sore throat, burning,

watery eyes and nosebleeds may be present

high concentrations of the virus in their secre-

tions, and may continue spreading the virus for longer periods of time (eight to 13 days)

Young children usually develop higher temperatures (frequently over 39.5˚C) and may have

febrile seizures. A variety of central nervous

3 to

4

times

Three or four times a century, a radical change will

occur in the genetic material of the influenza virus and a new subtype appears. Because the new subtype is a different strain, the worldwide population becomes vulnerable to epidemics, or pandemics, with high rates of illness and death

system manifestations may appear in as many as 20% of infants www.capitalhealth.ca

AHS-Capital Health’s Your Health magazine

SOURCE: ALBERTA HEALTH & WELLNESS

hours

Fall 2008

40 to

virus is estimated to be one to three days,

%

24

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infection and symptoms) for the pandemic

So O ld ut

Be Strong, Be Healthy, Be In Charge Speaking of Women’s Health Conference October 4, 2008 at the Shaw Conference Centre Hosted by the Lois Hole Hospital for Women, this conference promises to be an exciting and entertaining day of more than 800 women who want to focus on building a healthier foundation for themselves and their families.

The conference will give attendees access to information, tips and resources to help them take positive steps to improve their health and well-being. It will also raise funds for the Lois Hole Hospital for Women and another non-profit group serving women in the region.

Thank you to all our sponsors and partners that have made this conference possible.

NATIONAL SPONSORS

R

FEATURED SPONSORS

®

®

Petroleum Ltd.

MEDIA SPONSORS

®

CONTRIBUTING SPONSORS Edmonton Cardiology Consultants Halkier + Dutton Strategic Design Elite Sportswear & Awards Ltd. The Area Rug Gallery Blu’s BMO Bank of Montreal Cura Physical Therapies Reid Built Homes Sun Life Financial The Fairmont Hotel MacDonald Display Design

Here are four great reasons for you to get an Alberta Blue Cross individual health plan today.

1. Practical benefits you can use every day Alberta Blue Cross individual health plans provide practical benefits you will use on a regular basis, including prescription drugs, vision, dental care and more.

Protect your health Without coverage from Alberta Blue Cross, you could face significant out-of-pocket costs for prescription drugs, dental and vision care, ambulance trips and much more.

And without coverage, an accident, medical condition or unexpected illness could cost you thousands of dollars.

If you’re without employer sponsored health benefits, we’ve got an individual health and dental plan to meet your family’s needs...and your budget.

2. Family protection If you’re healthy right now and think you don’t need a plan, you are taking a risk. Qualify for a plan today with or without medical review, and a current or future illness, accident, medical condition or health problem won’t leave you and your family in a financial bind.

3. Affordable rates With sizeable tax savings, a plan is a lot more affordable than you might think. Combine those savings with what you’ll save on out-of-pocket expenses each year, and you’ll be surprised how little an individual health plan actually costs.

4. Peace of mind from the name you know and trust Alberta Blue Cross serves the health needs of well over a million Albertans.

As an Alberta-based not-for-profit organization, we serve your best interests—and deliver the value and affordability you deserve.

www.ab.bluecross.ca

Please call us today for your free information package

Edmonton 780-498-8008 Toll-free 1-800-394-1965 ABC 82447 (R09/2008)

vision

dental

prescription drugs

ambulance

extended health benefits