Thursday, July 24, 2014

The myths of medical marijuana abound...

OTTAWACITIZEN.COM

Representatives of licensed medical marijuana companies are being sent to doctors' offices as part of the push to get hesitant physicians to prescribe the drug more often. 

President of the Canadian Medical Association shares concerns about Medical Marijuana – Tweed Inc. responds

July 24, 2014 by 




This is ridiculous. The president of the CMA feels that Tweed should be sending out drug reps to explain the use, not abuse, of medical marijuana. What fearmongering, that doctors will be intimidated by patients, based on one anecdote.
What makes me laugh is the negative headline in the Ottawa Citizen story. Pharmas have wooed doctors with free samples for expensive drugs, and office visits for years!

Tweed tweets:
"We are proud of our R&D team and the work they are doing in partnership with and "

Interesting the research finally begins, from two of my three alma maters (B.A. and B.Ed.), which are excellent teaching hospitals. We've found that the prostate cancer treatments from our c

We have big pharmaceuticals pushing heavy-duty opiod drugs, and I don't know why the Canadian Medical Association president is so afraid of this. Many of my hospice clients could find relief from this drug. The CMA president needs to move into the new millennium! Many patients are prescribed drugs, to determine if they work. My students were often put on Ritalin and we had an intense, sophisticated set of observation forms to ensure that they were working properly, or were contraindicated. Physicians need to do the same. Individual trials for individual patients. Doctors are also afraid of pain medications. The myths of pain management abound, especially in the medical profession.





Friday, July 18, 2014

Book Review: Deadly Errors


Deadly Errors 

This book, originally out in 2005, is a great read. Now released in eBook, and all that jazz, it is easily accessible. Published by Astor and Blue, they seem to carry a lot of great mysteries, with several physicians in their stable of writers.

A mystery, I found the prologue a bit confusing, and yet, to quote my hubby, "Soon all will be revealed!" It deals with something that is a huge problem on this continent, medical patient-care errors. There is much written and posted about preventing errors. (You can read more on my healthcare blog:

Wyler has 
6 books out!
This author is a "neurosurgeon pioneer," according to his bio. This is evident in the detail of the book. He knows the ins and outs of a hospital, especially when speed and stealth are of import! The hero, Dr. Tyler Matthews, experiences trials and tribulations, with a great plot that had me sitting reading all afternoon! He retired from his profession in 2007 to write full-time. You can tell that he loves the genre, as with any good writer, he understands the skill and has mastered his writing craft.

You can read an excerpt here, but, like this well-read author, I've read a fair number of mysteries, and you should just jump into this one!

Re: Medical Errors From the author

In November 1999, the Institute of Medicine (USA) concluded a study entitled "To Err Is Human: Building A Safer Health System". It focused attention on the issue of medical errors and patient safety by reporting that as many as 44,000 to 98,000 people die in hospitals each year from preventable medical errors. This makes medical errors this country's eighth leading cause of death — higher than motor vehicle accidents, breast cancer, or AIDS. About 7,000 people per year were estimated (at that time) to die from medication errors alone. In spite of efforts by health care providers to decrease the rate of these preventable errors, they are still a cause of morbidity and mortality.  

Our Toronto ER physician, Dr. Brian Goldman, is calling up Canadian doctors to come to terms with errors. (You can view Dr. Brian's TED Talk here.) This is a problem in the US, where their litigious society depends upon lawsuits in order for patients to get recompense. It's not the same in Canada, where we have universal healthcare.
Patients must be proactive in this day and age of large hospitals and complicated healthcare practices. We've been confronting cancer for more than a year, and it pays to make notes, ask and prepare questions, and do a certain amount of research.

Prostate Cancer and Robotic Surgery

I'm often sent information, most want me to provide free ads. This one was interesting, in that hubby already had his robotic surgery and we are in Canada.
An ad by a US-based urologist advertising his robotic prostatectomy practice. The US has such an interesting, if dysfunctional, healthcare system based on user-pay, and insurance plan companies who can reimburse you for fees, or not.
Prostate Cancer and Robotic Surgery

Prostate Cancer and Robotic Surgery

Innovations in Prostate Cancer: Robotic Assisted Surgery. The Future is here. 
This infographic was interesting.
Our GPs refer us to a specialist nearby. HelloMD asked me to advertise for them. I imagine the PR firm then sends out requests for people like me to provide an information piece for their clients. Interesting way of doing business in the healthcare world. I hope he is a good physician!
This firm is advertising for the priority access to the 'world's best doctors.'
In Ontario, we don't provide healthcare by those who can pay the most.

Aphasia Institute Connections A World of Possibilities - Learn, Work, Share -

Over 30 AI Logo
Aphasia Institute Connections
A World of Possibilities
- Learn, Work, Share -


Greetings from the all of us at the Aphasia Institute.
 
Gerry Cormier 
1928-2014
Many of us in the Aphasia Institute (AI) community never had the pleasure of meeting Gerry. He was a true optimist who embraced life despite his aphasia. Some of you may recognize him as the individual around who the "Gerry Series" was created; a key teaching tool which quite likely made Gerry the most famous person with aphasia in the world. Although the video footage is dated and grainy, its message is clear in powerfully demonstrating the difference the right communication tools make to having a successful conversation.
We are saddened to let you know that Gerry passed away in April at the age of 86.  We were moved that over a dozen of his loved ones walked in his memory at our annual Walk, Talk 'n Roll fundraiser last month. We're honoured that Gerry was a valued member of our community. He will be forever remembered for his resilient, hopeful spirit and his significant contribution to improving the lives of people living with aphasia.
 
In this issue of Aphasia Institute Connections you'll find updates on resources, training, knowledge transfer and direct programming.

We hope that you will share Aphasia Institute Connections with your colleagues, to help benefit their work and outcomes for their clients. 

Thank you for your time. We look forward to connecting with you.

Sincerely,


Marisca Baldwin
Education and Learning Coordinator
mbaldwin@aphasia.ca 
Knowledge Exchange
 Knowledge Exchange DayFour Day SCA™Training Workshop in Northern Alberta, Canada   
This past May, we travelled to the city of Edmonton, Alberta to train 22 Speech Language Pathologists who live and work in the North Zone of the province. The four-day training was funded by Alberta Health Services
The majority of participants drove up to five hours to attend the workshop with some even flying in from more remote regions.
These SLPs face challenges very different to clinicians living in big city centres:
  • Approximately 80% describe their case-loads as "birth to death"
  • They see patients for a very limited amount of time
  • Family access is difficult due to remote areas and large distances
  • Isolation - most are the only SLP in the region
  • Insecurity around counselling - many felt ill-equipped to handle difficult conversations
  • Distance - it is not uncommon to drive 1.5 hours to see one client
The trainees were familiar with the 'language' of Supported Conversation for Adults with Aphasia (SCA™) but it was new learning for them to work 
with adults with aphasia. They were eager for exposure and input, and for gaining knowledge and experience. Trainees were keen to pass on their acquired expertise to colleagues in other healthcare professions. In fact, one condition of attending the workshop is to schedule two SCA™ training sessions for colleagues in the next year.
 
If your organization would like find out more about hosting an AI training workshop in your area, please contact Marisca Baldwin, Education and Learning Coordinator.
 
 Ontario Aphasia Centres Interest Group Knowledge Exchange Day  
The Ontario Aphasia Centres Interest Group (OACIG) is made up of program staff from aphasia groups and centres in the province of Ontario. Once a year, clinicians working in the field of aphasia spend the day together, sharing insights and experiences.  Aphasia Institute hosted the annual event this past June. It was an informative day as over 50 participants learned about new initiatives and pilot programs at different centres in the province and got an opportunity to network and connect. 
Professional Development Training
March Training Institute 2012The Aphasia Institute training workshops teach Supported Conversation for Adults with Aphasia (SCA) and how to apply these techniques to clinical situations such as assessment, counselling, group therapy and working with clients and their communication partners. 
ASHA Insignia 
The Aphasia Institute is an accredited Continuing Education Provider by the American Speech-Language-Hearing Association (ASHA).
 
 
Professional Training Institute: 27 October - 4 November
Now accepting registrations for full and half-day workshops.
 
**NEW** 
C2: Going Beyond Transaction: 
 
Life Story Book, SCA
 
™ 
 
and Aphasia 
Piloted in March, this is a day and a half workshop, co-taught by Speech-Language Pathologist and Social Work Instructors. You will learn to work with clients to co-construct their own personal narratives ... their past, present and future. You will learn how to use a Life Story Book template - developed and researched at the Aphasia Institute - to its maximum potential. On Day Two, you will have the opportunity to practice with a group of people with aphasia.

"After learning about the "Your Life" tool at an education session in March 2014, our Aphasia Program incorporated it into our assessment visits with our clients. We use it as a tool to learn about our clients' lives and  to revisit the story of their stroke. I find it is a wonderful way to establish rapport. But I also feel like I have a good idea about their communication skills by the end of our visit, communicating about the things that are important to them. I love that it is about their life and not just their aphasia." 
SLP from the Waterloo-Wellington Regional Aphasia Program (WWRAP)
Complete details on training workshops and schedules are available in the  
To register, contact Marisca Baldwin, Education & Learning Coordinator

**NEW** Aphasia Institute Knowledge Exchange Speakers Series
You will soon be able to register for a series of webinars, featuring experts in the field of aphasia presenting on a variety of topics related to aphasia. To be launched in the Fall. Stay tuned!

Resources Updates
**Coming Soon** 
Talking About Your Hearing
If you are an audiologist or hearing healthcare practitioner this resource will help you communicate more effectively with patients who have aphasia or other communication challenges. Stay tuned ...


Events
In June 2013, Judith Leitner, co-founder of the Toronto Heschel School, art educator and photographer, approached AI to volunteer her time and expertise to create and facilitate a self-portrait photography program.
As the pilot and intermediate workshops progressed, we witnessed a small group of clients blossom as photographers. Their self-portraits became powerful vehicles for self-expression as they drew on their knowledge, skills and depths of courage to reveal themselves and tell their stories.
It also became clear that the impact on our clients went beyond self-portrait photography; they were overcoming the language challenges of aphasia, education, and self-discovery through art, and that their work needed to be shared in a professional forum. MaRS, a landmark of innovation in down-town Toronto, embraced Judith's vision and agreed to host the exhibit My Voice, Through My Lens in early June.
  
The exhibit took place during Aphasia Awareness week, the first week in June.  The artists interacted with anyone and everyone who passed through MaRS, including professionals in healthcare, the sciences, education and people on their way to appointments at nearby hospitals. This interaction between the artists and virtual strangers regarding aphasia and stroke, alongside the work of the Aphasia Institute and self-portrait photographs, elicited an extraordinary response.
One of the artists, standing beside his photograph and an infographic.
"Grease" The Musical
After months of dedicated rehearsals, members of the Aphasia Institute "Spotlight" musical drama group gave an electrifying performance of "Grease the Musical" to a packed and enthusiastic audience at the Al Green Theatrein down-town Toronto in June. The adapted script, written by SLP, Eavan Sinden (passionate visionary and director!) enabled each cast member to deliver a heart-warming performance regardless of the type or severity of their aphasia. During the months of  
"Grease the Musical" dress rehearsal before the big performance.
rehearsals and preparation leading up to the big day, members who had been known to be shy and introverted, began to overcome the challenges of aphasia by discovering new ways to express themselves dramatically and musically. By performance day, they went on to deliver inspiring and moving performances that impressed everyone in attendance. This entertaining community event raised over $1,600 towards the community "I Care" campaign which helps fund initiatives such as the purchase of iPads for the Conversation tables.
 
 Aphasia Institute wins the award for most participants at the Toronto Challenge
On June 8, over 150 clients, family, friends, volunteers and staff participated at our signature fundraising event, the "Walk, Talk 'n Roll". For a second year in a row, our agency won theToronto Challenge award for most participants. Thanks to such overwhelming support and community spirit, over $70,000 has been raised! 

Thursday, July 17, 2014

Landscapes of Aging Conference

Registration Now Open!

CAG2014

Landscapes of Aging

 

Critical Issues, Emerging Possibilities


October 16 - 18, 2014
Niagara Falls, Ontario, Canada


http://CAG2014.ca

Hosted by the Gilbrea Centre for Studies in Aging at McMaster University
The Canadian Association on Gerontology is pleased to announce that registration is now open for CAG2014: Landscapes of Aging, the 43rd Annual Scientific and Educational Meeting of the CAG, October 16-18, 2014 in breathtaking Niagara Falls, Ontario, Canada.

CAG members receive a discount on conference registration, in addition to other member benefits. Read more about joining the CAG!

To register and view the preliminary program, please visit http://CAG2014.ca.
 

Hotel & Travel


Visit our website for discounts on rooms at the conference hotel, Sheraton on the Falls!

It’s easy to get to Niagara Falls by airtrain, bus or car! Take advantage of a discounted shuttle service from Toronto Pearson (YYZ) and Buffalo, New York (BUF) airports or save on private car service. Also see our travel discount codesfor air and train travel and car rentals.
 

Program Highlights


The CAG extends its great thanks to our CAG2014 sponsors, supporters and exhibitors.

Preconference Workshops 

Student and Recent Graduate Events

Keynote Addresses 
  • Julia Twigg, PhD, University of Kent, “Clothing, Embodiment and the Cultural Turn” 
  • Malcolm Cutchin, PhD, Wayne State University, “Beyond Environmental Gerontology: The Many Geographies of Aging” 
  • Christopher Phillipson, PhD, University of Manchester, “Transforming Work and Retirement: Problems and Prospects for Extending Working Life” 
  • Irene Turpie, MD, McMaster University, “Global Aging: Challenges and Opportunities from a Health Care Perspective” 
Symposia Paper, Poster, Symposium and Workshop Sessions Exhibit Hall

Social Events

We’ll see you in Niagara Falls, October 16-18, 2014!

Please note, all conference events are subject to change.
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Thursday, July 10, 2014

End-of-life care - it's your choice

LogoShows Importance of Discussing End-of-Life Wishes With Family

Completing Advance Directive Is Imperative, but Not Sufficient by Itself

WASHINGTONJune 13, 2014 /PRNewswire-USNewswire/ -- The tragic legal battle between legendary radio host Casey Kasem's wife and children over his end-of-life care is a teachable moment for his millions of fans, according to the nation's leading end-of-life choice advocacy organization, Compassion & Choices.
A judge Wednesday upheld Casey Kasem's advance directive to stop providing nutrition and hydration to him, as his children wanted. The decision reversed the same judge's order on Monday to continue feeding and hydrating the 82-year-old Kasem at the request of his wife.

Violence in Hospitals: How It's on the Rise but Can Be Reduced

Excellent article

How Do We Know If We’re Creating a Safer Environment for Patients and Staff?

Type II workplace violence (NIOSH, 2006), where the victim is a provider and the patient is the perpetrator, is an issue for all acute hospitals and is increasing (Privitera, 2011) as hospital stays decrease in length and patient acuity increases in strength.

Wednesday, July 9, 2014

Stars announce Stand Up to Cancer Canada

Four Levels of Patient Activation

I was terribly disappointed by a recent PR news conference. It's all about the Stand Up To Cancer movement moving to Canada. It is sad, really. All this money they plan on raising going to cancer research. How many billions have the Pink Ribbon, Inc. people raised through expensive fundraisers where participation costs you $200 per team, with money going into their coffers.

This is a tragedy.

Stars announce Stand Up to Cancer Canada

Dan Aykroyd, Jesse Tyler Ferguson and Kyle MacLachlan open up at launch in Toronto

Dan Akroyd's speech was one of battle-speak, which has no place in healthcare treatment. He spoke of battles, a war and fights, while citing numbers such as two in five people getting cancer. We prefer, in our household, to speak of confronting our cancer. This is a concept many have missed, including the media, as well as the spokespersons.
"The statistics are staggering: two out of five Canadians are expected to develop cancer in their lifetimes," Aykroyd told a news conference. "Every hour of every day, 22 Canadians will be diagnosed with some type of cancer — nine of these people will die from the disease. It is the leading cause of death in Canada."
He doesn't cite any statistics about those who are successfully treated. Many of us do recover.
What is missing in all of these media events, and telethons, is a sensible voice of reason.
This year, approximately 1.65 million Americans will be diagnosed with cancer and about 585,720 will die of the disease.

Where does the money go?


  • SU2C’s unique funding model, developed with the help of prominent cancer researchers, encourages collaboration and innovation through two new types of scientific grant. 
  • Dream Team grants are awarded to multi-institutional groups of scientists who work collaboratively, rather than competitively, to develop new treatments quickly in order to save lives now. 
  • Innovative Research Grants support groundbreaking cancer research projects that are high-risk but could also be high-impact, and have the potential to significantly affect patient care. 

Prevent cancer

Monitor your BP
Eat well, mostly plants; exercise and stay active; practice sleep hygiene; monitor your body; be proactive; keep toxins away from your body; avoid too much alcohol, smog, carcinogenic substances, or cigarettes; look after Mind, Body, Spirit.

Even so, some of us will contract cancer. Our cells wear out. It is all the more difficult when it is a young person. That is when we worry about what kind of chemicals we put into land, sea and air. This is where we should concentrate on improving the environment, cleaning up waste, oil spills, pollution.

Sunday, July 6, 2014

PART XXIII: follow-up PSA test

Cystoscope
No, the news was not good this spring. We've had time to digest it, agonize over it, and come to terms with it. Post-surgery the PSA test result was 0.32, a month later a retest: 0.24. Last month, it had risen to 0.46. Once the prostate is removed, it should be zero. What we were told was that the surgery had a 50-50 chance of getting rid of all of the aggressive prostate cancer cells. Despite not finding cancer in the CT Scan, Bone Scan, or MRI, there were cancer cells that have spread somewhere. The surgeon got out all of the nearby nerves, and he was fairly certain it wasn't in any of the tissue nearby.

What our neurologist has said is that once the PSA level gets to be 4 or 5, we must begin to get any testosterone out of the system. Doing this will provide another 5 - 10 years of protection to prevent the prostate cells from multiplying.
The answer is: Androgen deprivation therapy injections to suppress the PSA cells.

We went for another cystoscopy, June 26th, to check and see if there were any more sutures in the bladder, irritating it. We also had to and discuss our treatment plan.
Bladder looks fine.
Nothing further until Sept., when there will be another PSA test.

Well, procedure went well. Things look good on the plumbing part of things. I made a video of the cystocopic procedure! It's good to focus on this type of thing, for me. I also make copious notes.vim

Bladder from the inside from Jennifer Jilks on Vimeo.
Cystoscopy: to quote our nurse, Leonard, "Make your bladder gladder!"

The PSA of 0.46 doesn't worry our Dr. now. The next step is intermittent androgen therapy. Next appointment is Sept. 15th. I am so tired. Damn awful drivers out there, passing on curves, 4 x 4 trucks screaming around us; incident with fully deployed air bags, crap on the road, two cops, ambulances, on the way in on the highway. Deep breath!
That said, another man in the waiting room had been driven down by the Cancer Society volunteer, a 3-hour drive.

Here is the update hubby sent his buddies, who are fretting needlessly. We remain focused in the present moment.

We have been off to the big city again.
Another cystoscopic treatment, to determine if there are issues, all looks good.

However my PSA  is up from 0.24 to 0.46
0 would be the expected, and anything over 0.2 is likely to be a spread of my cancer.

We will test again in Sept., At the 4 to 5 point , I would go on hormone treatment.

So really no change in the diagnosis nor prognosis.
.
I was in a store in Arnprior yesterday, where the owner has a box with blue bands for donations to help their neighbours with expenses in their trips to Ottawa to get treatment for Wayne. 

Wayne is 4 years old with brain cancer.

If I hadn't perspective on my situation, and I think that I had, this certainly reinforced it for me, and it should for you.

Everything else is great, all my post operative symptoms are gone.

Grandkids and Caitlin are coming Sunday and Monday. 

Yes, we focus. Read as much as we can, but trust the doctor, who is fabulous, as all said in his waiting room. Men sitting around in hospital gowns waiting for Dr. C to shove an endoscope up their urethra. I helped a man, 88 yrs. old, who couldn't figure out the gowns. First one on with opening in back, next reversed. His butt cheeks open to the folks in the room!

 Hubby's next plan: to get as physically well as possible. He's gone back to the physiotherapist for the back exercises to improve that. Once he does, he can go back to the treadmill and walking that helps him keep more fit. He is watching his diet, off dairy, lost weight. It's all good, but stressful nonetheless. The 90 minute drive into the city, past accidents, ambulances, being passed by speeding drivers, hell bent on going faster, all make me upset. I'm trying to centre, too.
loud noises startle me, this is part of my depressive symptoms, which I duly monitor. Canoeing, working in the garden all help, as well as daycations out and about. I have doubled my anti-depressants until things calm down.

Thursday, July 3, 2014

Canadian Critical Care Forum

The Canadian Critical Care Forum is a 3 day international conference that happens in Toronto every year. This year the meeting will be from Oct. 29 – Nov. 1, 2014. This is the largest Critical Care related meeting in Canada. The CCCF is a forum to showcase cutting edge research and share new ideas with researchers and clinicians interested in the care of critically ill patients. 

This year we are celebrating our 10th anniversary and we are looking to expand our scientific session by reaching out to scientists all over Canada and abroad with a research interest in Critical Care or critical care related topics (e.g. pediatric ICU, acute myocardial failure, shock, sepsis, transplant, respiratory failure, acute kidney injury, acute liver failure, traumatic brain injury, resuscitation, bioimaging, etc.).

See links below: