Wednesday, October 22, 2014


CCC logoccc free media registration



WHEN: OCt. 25 - 28

  • Getting to the Heart of the Matter: Lack of physical activity, tobacco use, poor diets, inappropriate advertising of poor food and beverage choices to children and excessive consumption of sugar, particularly in sugary drinks, and salt. HSF Lecturer Dr. Perry Kendall, B.C.’s provincial health officer, opens the Congress by looking at how our health system is threatened with being flooded by these challenges ─ and how health professionals can lead the push for changes to the environment that contribute to these deep-seated problems.
  • How do mental health disorders impact your risks for heart disease or stroke?Study investigates how psychiatric medications, unhealthy behaviours and issues accessing care impact one’s risk.
  • When it comes to the blood used for heart surgery...does age matter? A study looking at the age of stored blood used for transfusions in over 2,000 heart surgery patients has some surprising results.
  • Ethnicity and heart disease: A Toronto study looks at the widely varying differences in Canada’s ethnic groups’ risks for developing heart disease – and at their awareness of what is and isn’t a risk factor.
  • Robotically assisted bypass surgery: A look at the impressive results of this rapidly evolving technology, which is now being used in Vancouver, Montreal and London.
  • First Canadian recommendations on inherited high cholesterol: If not detected early, inherited high cholesterol can lead to severe cardiac disease and death at an early age, but if detected early it is so eminently treatable you can essentially normalize the patient’s cardiovascular risk. Establishment of a national registry and family-screening program aims to save lives.
  • Women play dangerous waiting game with heart symptoms: Study looking at how people perceive their heart symptoms and at what stage they are prompted to seek medical care, finds that women are putting their lives at risk by how they respond to their symptoms.

Tuesday, October 21, 2014

Questions to ask your healthcare team

Navigation can be tricky
 Your family or primary doctor will refer you to a specialist, you wait a week or two, or a month or two, and finally get in to see him or her.

In the meantime, you've forgotten all of the things that happened. This is why I counsel all of my clients to visit a doctor with either your spouse, a family member or a family friend. In case you do not have anyone to accompany you, you can talk to Community Home Support in your area and ask for a volunteer to go with you. I have done this many times. I've been with clients to see a family doctor, the Pain Clinic in Ottawa, the Heart Institute, a Communicable Disease specialist, as well as other individual specialists.

How many hours waiting?
Your doctor will ask: When did you first begin noticing symptoms?
How often do you have symptoms?
Have your symptoms been continuous or occasional?
Does anything seem to make your symptoms better or worse?

This list is appropriate for all patients. 
  1. Write down symptoms, use an agenda, notebook or planner, filling extra notes. 
  2. Save the list from the pharmacy, which lists all of your prior medications. Tape it into your agenda.
  3. Write down all over-the-counter medications. They may be important, including vitamins and other supplements, e.g., creams, herbs, lotions.
  4. take notes
  5. Create questions for your doctor. They may include: 

  • What might be causing my signs and symptoms? 
  • Are tests needed to confirm the diagnosis? 
  • What treatment approach do you recommend? 
  • What are the side effects from this treatment?
  • What are the alternatives to the primary treatment approach that you're suggesting? 
  • What health routines do you recommend to improve my symptoms?
What I've found is the busy specialists often fail to speak slowly and clearly, rushing through to get to the next client. They have no idea if their patient understands what they are saying, either due to dementia (a hidden symptom for many people) or a physical barrier, such as a hearing impairment.
It is up to us to ask the right questions, get answers we understand, and feel valued.

  1. What might be causing my signs and symptoms? 
  2. What is my diagnosis? (Write this down, and ask how to spell it.)
  3. Are (other) tests justified to confirm the diagnosis? 
  4. Which treatment approach do you recommend, or are there other options? 
  5. What are the side effects from these treatment(s) on my quality of life?
  6. What health routines do you recommend to improve my symptoms? (E.g., exercise, diet, nutritional supplements, massage, complementary therapies.)
  7. Are there others who can provide assistance? (E.g., specialist, pharmacist or a naturopath.)
  8. Are there any other sources of funding for these treatments?

Sunday, October 19, 2014

FLU Season 2014/15 - Canadian Fluwatch has begun!

With all the attention on Ebola, and zero cases in Canada, we should turn our attention to those more common viruses, like the flu.

There are a lot of infectious diseases that deserve as much attention as Ebola.

Flu has hospitalized many (22,492 Canadians), and killed 1333 since 2009. These are only those cases which were tested and confirmed.

Enterovirus D-68  has begun to increase, for example.
On October 16, 2014 the British Columbia Centre for Disease ControlExternal link confirmed that a young man who died earlier this week had EV-D68. The patient had a history of severe asthma and was in the hospital when he developed respiratory failure.

The barrier to education and good practices is that it isn't mandatory for the provinces and territories for reporting of all of the viruses to the National Microbiology Laboratory (NML).

As of October 6, 2014, a total of 75 specimens tested positive for EV-D68 at the NML, with specimen collection dates between August and September 2014, and were received from several provinces across Canada. One person has died.

What did we learn from SARS?

After SARS, the more expensive protective gloves were replaced with the previous, lesser quality ones, I heard in a CBC radio interview with an ER nurse.
We have learned about the efficacy of hand washing. Patients are learning to demand this from their healthcare workers.

Infectious Diseases - Public Health Agency of Canada

They manage reports by weeks, and flu season has started! This, of course, only includes those who have had tests confirmed for influenza. Many of us are home sick (I hope) rather than out at work.

 Figure 3. Number of positive laboratory tests for other respiratory viruses by report week, Canada, 2014-15
Week 40 tests positive

Chart Key
What do you think? I think Ebola is getting far more attention than it deserves. 

Look at the cases in long-term care, vs. hospital.
  • In week 39, five influenza outbreaks were reported in long-term care facilities
  • Two outbreaks of influenza-like illness in schools.
  • One outbreak of A(H3N2) in another facility were also reported in the same week. No new outbreaks were reported in week 40.
With all the attention on Ebola, and zero cases in Canada, we should turn our attention to those viruses, like the flu.

Friday, October 17, 2014

Parkinson Support Group –Look for one in your community!

  • Have you been diagnosed with Parkinson’s? 
  • Are you supporting a person with Parkinson’s? 
  • Would you like to learn more about the illness? 
  • Would you like to talk with others in a similar situation?

Consider joining a:

for people with Parkinson’s
and their carepartners

Perth Parkinson Group
Last Monday of every month
1:30 p.m.

40 Sunset Blvd., Suite D, Perth, ON

This local support group for people living in Perth and surrounding communities is a partnership with Community Home Support Lanark County. This group provides a supportive environment where questions are answered, ideas for coping are shared, and friendships are formed. This group can help you cope with your emotions, frustrations and changes that may accompany Parkinson’s disease.

Thursday, October 16, 2014

Dying With Dignity: what a powerful day!

Our Voices for Choice
Resounded Across the Nation

Yesterday, hundreds of Canadians from St. John’s, Newfoundland to Vancouver, British Colombia, and 7 other cities in between, rallied in support of assisted dying. 

Missed the hearing? Watch the podcast here.

Thousands more have signed the pledge and we continue to build our voice through social media. We raised our collective voices and stood in solidarity with Gloria Taylor, Kay Carter, Sue Rodriguez and many others who wished for an assisted death.

Yesterday, the Supreme Court of Canada heard compelling testimony in support of assisted dying. Although it will likely be months before a decision is released, it's clear that this is a discussion that is not going away.

Today, we continue onward as there is still so much to do. In the past three months, Dying With Dignity Canada has hired new staff; commissioned with Ipsos Reid, the most comprehensive national poll ever conducted on the issue of assisted dying, and with the help of dozens of dedicated volunteers, organized the first ever National Day of Action and Solidarity in support of assisted dying.

Friends, our work is not done yet. 

Tomorrow and in the months to come, we need to continue our work to make sure the Canadian public and our leaders recognize the magnitude of support for assisted dying. We could not have gotten this far without you, our generous supporters. Please donate now to help us keep the momentum going.

With appreciation and hope,
Wanda Morris, CEO
Dying With Dignity Canada

Wednesday, October 15, 2014

Dying with Dignity Supreme Court Challenge

We had a blue jay smuck into the window. It was so sad. We don't have this very often. In fact, this is the first since I began keeping track. We had one die in April, I sheltered it in the shed until it passed over.
Birth, life, death. It's all pretty certain.

The Supreme Court comes out with a decision on physician-assisted death today.
PM Harper refuses to deal with it.

Right to Doctor Assisted suicide

The B.C. Civil Liberties Association, along with two women who have intractable and progressive diseases — Kay Carter and Gloria Taylor — have taken the case to Canada’s top court seeking to allow seriously and incurably ill, but mentally competent adults the right to receive medical assistance to hasten death under specific safeguards.

"Euthanasia Prevention Coalition"
Some in the disabled community are fearmongering about 'slippery slopes' and murder of the intellectually disabled. They've created this lobby group to fight it.

Some in the medical community, who don't want the responsibility, cite Dutch horror stories of the 1990s. This is something we learned from, and several countries have excellent programs.
Truthfully, most of my clients have a good death. One with dignity and grace.

Very few of my clients would want it, but for the very few who may, it would give them peace of mind.  Physicians are so bad at house calls, pain and symptom management is the key to a good death. It is the nursing case manager who calls the doctor to order pain relief meds.

For the very few who would choose it: those with difficult disease trajectories, like ALS - where you drown in your phlegm, unable to breathe or cough, perhaps it would be a gift from a society that understands dignity of life and death.
We shall see.
Top court hears arguments for and against assisted suicide
Assisted suicide should only apply to cases involving patients who are never going to get better, the Supreme Court heard today as it confronted the question of whether Canadians have the right to seek help to end their lives.

The court had last considered the issue in 1993, when it ruled in the Rodriguez case that where assisted death is concerned, certain rights enshrined in the Charter of Rights and Freedoms are trumped by the principles of fundamental justice.
But 20 years later much has changed, Arvay argued, including the way charter rights themselves are interpreted.

Lawyer urges top court to decriminalize physician-assisted death because politicians fear “political hot potato.”

Arvay: there are 3 types of euthanasia; voluntary, non-voluntary and involuntary. We only support 
voluntary euthanasia. ‪#‎CarterSCC‬

From a lowered podium, Arvay addressed the critics of physician-assisted death head on, saying “I would be the very last person to ever suggest one is ‘better off dead than being disabled’ ” which is the slogan used by some disabled groups who oppose a decriminalized scheme.
But he argued no one, including disabled advocates fighting “able-ism,” should be allowed to “leverage” the suffering of others while claiming they haven’t gotten the proper societal supports and prevent others from accessing a dignified death.

Monday, October 13, 2014

Airport screening for Ebola = a waste of time

I think they are doing to appease those who fear it. It is in potential carriers best interests to lie about it – before be readmitted into Canada. There are no direct flights from W. Africa to Canada.

Once you are home, THEN you exploit your healthcare system. You watch for the 21-day incubation period, then watch for a fever.
I also think it is more communicable, not just exchanging of bodily fluids. Either that or healthcare workers are taking this bug for granted.

THOSE who got sick, and there were many, developed large, dark blisters that oozed pus and blood. Later came fever and bloody vomiting. Long before Ebola, there was...

Thursday, October 9, 2014

How stressful is a Stress Test?

Perth Hospital
Stressful enough, I was sweating!

As many know, hubby is confronting Prostate Cancer.
I've been having chest pains, checked out in February, but they came back just after another visit to hubby's doctor in the city. Both hubby and my GP wanted them checked out, and I went for a stress test.

Not a complicated thing, but a good idea to rule out heart attacks.
Initially, one has to have an ECG to ensure that your heart, at rest, is relatively normal. They don't want you popping off in the test! I had that done on Monday, it was a quiet day in the hospital.

Today, not so quiet. The ER waiting room was somewhat busy, and an Ornge helicopter came in.
Ornge Emergency helicopter
ECG & body monitor
One makes an appointment for the Stress Test, since they require a doctor to be present during the test. The nurse, Kelly, was such a sweetie. When I made the appointment (over the phone) she said, "We'll look forward to seeing you on Thursday!"
I told her, when I met her, that it was so nice to hear. People don't normally say this kind of thing when they are doing a healthcare job! She is a precious employee!

Firstly, she did an intake form with me, checking out my symptoms, whether I smoked or not, what types of exercise I did, any medications I am on, that sort of information.

She asked if I had asthma, seeing as I was prescribed a puffer after one horrible cold, which I didn't think I did.
I told Kelly that I often got pneumonia and chest complications with bad cold viruses. She explained that if a cold gets me to an asthmatic symptomology, I really do have viral-induced asthma. I've had this all my life. Colds should involved the head not the chest.

I found an interesting infographic that explains the difference between a cold and a flu virus, BTW.

Then, I removed bra and shirt and she hooked me up to the blood pressure cuff and the ECG.
That was funny, since she scrubs the sites with both alcohol and sandpaper to ensure good contact between me and the machine.
Next, she checked my BP, while I was prone on the bed, then standing up.
The doctor came in, and he read my form and asked a few pertinent questions, then he called in 'the boss', my new pal, Kelly.
You have to get your heart up to 166, it's according to your age, and they do this on the treadmill, with increments of speed, gradually speeding you up.

I passed.
My heart is good. My exercise routine, the elliptical for 30 mins. per day, or so, as well as forest walkies with the cats and outdoor chores, have keep me going. My BP went down to 130, lower than it was when the test began.
It's been up over 200 some days. It's all around the emotional stress managing my life.

Prostate cancer webinar

Dr. Anthony Joshua: genital urinary malignancy and melanoma Princess Margaret, Toronto.
Many men die of other things than prostate cancer as it is very slow growing.
Specialist in radiation and chemotherapy.

Including riding a bike.

Can tend to spread to bones.
Bone pain is a symptom.

Gleason 1 - 5
At Gleason 7+ you don't know how will behave. 

Pioneered by Canadians: treatments
Over the last decade: safe treatment options.

Hormone treatment:
cancer lives on testosterone, add hormone therapy.
if you add radiation on top of better cure rates.

Take away testosterone which cancer feeds on. Chemo can also work when therapy doesn't work anymore.
Watchful waiting vs. active treatment.

They won Nobel prize for this.
When Hormone Therapy doesn't work any more, cancer cells make their own testosterone and feeds off of it.
Strategy: block effect of testosterone. Live longer and live better with these drugs.
Drugs work in two diff. ways: Abiraterone stops DHEA from being made into DHT,
Enzalutamide Doc. stops it from working.

Not done lightly, due to side effects.

Chemo Canadian, Dr. Tannic. Pioneer.
Radium 223 - for those too sick for previous
Tested on elderly men, balance age
Treatment may be nothing, to test quality of life.

Phase 1 - early on in trials: works in a mouse, want to test on humans. Test on 5.
Phase 2 - perhaps 50 people.
Phase 3 - compare new and old treatment.

Q. 2; can you have surgery after radiation?
       Yes - not often done.   Salvage prostatectomy.
Q. 3; using an exercise bike affects PSA results, does it matter if prostate is removed?
     A: No. Sitting on bike squishes prostate and releases extra PSA. If the prostate is removed, it won't affect the test scores.
Q. 4; Can cordisone treatments for arthritis interfere with hormone. Prednisone.
Q. 5; What is the success rate of chemo?
     A: Success: live longer, bringing down PSA, when hormones no longer work.
It is effective, the degree of success cannot be guarnteed, more often than not achieve results, longer life. Better quality of life.
Q. 6; Do you have any knowledge Galitilone.
     Works well with the other drugs, recently finished a clinical trial. Have ideas about best patients for response. It is coming. May be effective for certain types of prostate cancer.
Q. 7; How long does radiation treatments.
     Weeks: type of radiation: looking at up to 6 weeks of treatment.
Q. 8; If experiencing pain: feels like muscle pain and lower abdomen.
     A: generally prostate cancer goes to the bones.
     Very late in the stage: boney ache, sharp shooting pain, sciatic pain,
Q. 9; Is there any evidence that biopsies spread prostate cancer.
Q. 10; Is there any evidence HPV virus causes prostate cancer.
Q. 11; Why colein 11 test not used in Canada to detect location of prostate cancer.
     A: Still in trials. Under investigation in some clinical trials in the US, not done in Canada.
Q. 12; Why is proton beam radiation not used in Canada?
     A: Too $$ in Canada, can do a lot more, not clear it achieves better results than radiation. We are very advanced in Canada, leading techniques, leading machines, not based in efficacy demonstrated.

Enzalutimide helps lengthen life. Bicalutimide doesn't help live longer.

Only in bones, hormone treatment, not strong enough to have radiation, not strong enough to have chemo: Radium 223 helps. Only a small proportion of men die of prostate cancer (US data: 3.5%), despite being diagnosed with cancer.