Month: May 2022

What is monkeypox?

Monkeypox is a viral infection, native to Africa, that has recently been attracting some attention in the news. Like COVID, it’s a zoonotic virus—it usually occurs through contact between animals and humans. It is found in rodents and primates, and was first identified in 1958 in lab monkeys, hence the name.

About 9,000 cases are reported in Africa each year, but experts say many more cases are probably missed due to poor reporting systems. Previously, cases that occurred outside Africa were associated with travel there. This outbreak is attracting attention as there appears to be human to human spread, a new behaviour for this virus.

Why is it in the news?

Monkeypox causes skin rashes, fever, chills, swollen lymph nodes, headaches, body aches, and exhaustion in people who are infected, symptoms like smallpox but milder. It is newsworthy because recently this virus has begun spreading between humans and to several other countries outside Africa, including Canada and the US. It’s been noted to pass from one person to another during close skin contact (for example during sex, although it’s not considered a sexually transmitted disease). It can also spread through air droplets, body fluids, and virus-contaminated objects.

Young children and people who have weakened immune systems tend to have more severe symptoms from monkeypox. Three to 6% (or 3 to 6 out of 100 people who catch it) will die. This compares to a 30% death rate from smallpox (or 30 out of 100). The World Health Organization (WHO) is watching this development closely, of course, as they do with all new contagious diseases. After the past 2 years of pandemic, we all know how viruses can mutate when they jump to a different species.

Since the virus responds to the smallpox vaccine, these vaccinations are recommended for contacts of those who are sick, especially if they are at higher risk of complications. Those who are infected are being recommended to isolate until more is known about the virus and how it spreads. The incubation period is 5 to 21 days, and recovery takes 2 to 4 weeks.

Interesting stuff about smallpox…

What is also interesting to me, is that this newly spreading “pox” has fostered some discussion of the history of its viral cousin, smallpox. That virus was around for thousands of years before it was declared eradicated in 1980.

The first vaccine ever developed was for smallpox and it’s a medical success story. Although it took 20 years for success, eventually international governments committed to the vaccine program, providing proper funding and donations to less wealthy countries, plus reporting of cases. It’s estimated that more than 300 million people worldwide died with smallpox. Those who survived often had disfiguring scars on large areas of the body, including the face, and were sometimes left with blindness.

Smallpox killed 30 to 50% of Europeans who contracted it, but was even more devastating to some other populations. I knew that colonists accidentally introduced the smallpox virus (and others) to native peoples in the Americas, where it decimated the indigenous population. However, I didn’t realize that British soldiers intentionally spread it to native villages as a form of biological warfare in 1863-64, distributing infected blankets and other items, which resulted in the annihilation of entire villages.

Seeing the system “at work”…

The last case of smallpox was reported in 1977 and children are no longer given the smallpox vaccination. This has added to the concern around monkeypox, as young people would have less potential immunity, should this virus develop more infectious abilities, and those of us vaccinated as children may have waning immunity after so many years. It certainly is interesting to see the world monitoring system at work detecting and tracking contagions that could possibly become our next pandemic!

This is an example of infectious disease monitoring doing what it is supposed to do—identifying potential infectious diseases, warning us to be careful, and alerting medical workers so they will recognize the infection quickly. It’s what was missed with COVID-19 where large numbers were sick and dying before the world was aware it had started, and by then it was too late to contain it. Although the monkeypox virus seems to be much less infectious than SARS-CoV-2, at least we all know what we need to do to better protect ourselves, thanks to public education programs in the past 2 years.

So, don’t throw away those masks yet… they’re still a useful part of protecting ourselves, and each other, that we may need again in the future! But take comfort in knowing the system is working when you hear these reports in the news…

References:

What to Know About Monkeypox and the Latest Cases—Medical News Today

EXPLAINER: What is monkeypox and where is it spreading?–Canadian Healthcare Network

“Mandala Sun”, by Jeannie Collins Beaudin

I love it when I see research that shows us how we can prevent a disease—especially an all-too-common one like diabetes. I just read this week that vitamin D is now thought to help decrease the chance that a person with pre-diabetes will progress to full diabetes. We’re always better off when we prevent illness, rather than have to treat it after it develops, so I thought I’d tell you about it!

So, this study is good news! People with diabetes are at higher risk of many conditions, like cardiovascular disease (heart disease and stroke), kidney disease, vision loss, foot problems (diabetes is the greatest cause of amputations in adults), and more. It’s not a disease you want to develop. Being diagnosed with pre-diabetes is a time to pay attention and make some real changes in your lifestyle.

Diabetes is a lifestyle disease

Diabetes is closely related to our lifestyle… your food choices, how much you exercise, heavy alcohol use, and carrying extra pounds increase your risk, along with factors you can’t control, like your family history, having had temporary diabetes during pregnancy, and just getting older. Smoking, excessive uncontrolled stress, poor sleep, and uncontrolled blood pressure can worsen potential complications if you do progress to full diabetes.

The study I read found that taking a daily vitamin D supplement of 1000 units or more reduced the chance of developing full Type 2 diabetes (the type that most commonly begins in adulthood, although increasingly it’s being seen in teenagers, sadly). Although Vitamin D didn’t appear to make a difference for those with average risk of diabetes, or those who were obese, it could be a good strategy to ask your doctor about if you’ve been told you are “insulin resistant” (meaning you need more insulin to handle the sugars in your diet), or that you have “pre-diabetes”.

The researchers couldn’t say for sure why vitamin D supplements didn’t make a difference in those who were very overweight but I have a theory that comes from my many years of studying hormones (vitamin D is considered a hormone, by the way). Like all hormones, vitamin D is fat-soluble so the body will store it in fatty tissues. Our vitamin D supplements are actually made from fish liver oils, because fish store their vitamin D in fats in the liver too. So, those with more fatty tissue will store away more of the vitamin D they ingest, leaving less to have an effect on the body. Remember, this is just my theory, yet to be demonstrated in research, but it holds true for other hormones. I don’t know about you, but I always like to understand the reason something happens…

Of course, vitamin D supplementation is just an additional strategy you can consider for a healthier future. A diagnosis of pre-diabetes is a signal to improve your diet (seeing a dietician can help) and to get more exercise (even a 30 minute walk every day can make a difference). Change is difficult, but remember that one small change each week can make a difference to your future. The good news is that pre-diabetes can be reversed in many people with just lifestyle changes… and now we know vitamin D can help too.

The Sunshine Vitamin

You may remember from my earlier blog, Is Your Body Dying for Vitamin D?, that vitamin D is called the sunshine vitamin. Our bodies make vitamin D when our skin is exposed to sunshine, as much as 10,000 to 20,000 units in 30 minutes of sun. A session of 5 to 30 minutes 2 or 3 times a week, depending on weather conditions and skin type, is considered enough to supply a person with sufficient vitamin D during the summer. So, with summer coming up, at least here in the northern hemisphere, we just need to get outside for a short while before putting on sunscreen, which could block exposure to the vitamin producing rays of the sun.

During the winter months, depending on how close you live to the equator, it may be a good idea to supplement. Here in Canada, they recommend taking a vitamin D supplement from October until April, as the sun’s rays are not strong enough to help us produce enough of our own (plus we usually have lots of layers of clothing on when outside to keep warm, blocking the sun from reaching the skin!!).

Having enough vitamin D also helps the immune system to function, making it a factor in preventing and recovering from infections (including COVID-19), as well as reducing inflammation, aiding absorption of calcium from our diet (and thereby helping to reduce risk of osteoporosis), and reducing how much we feel chronic pain.

So, for all these reasons, get outside and enjoy those sunny days, and mark your calendar with a reminder to start an inexpensive vitamin D supplement this fall, available at any pharmacy!

References and More Reading:

Preventing type 2 diabetes with the “sunshine” vitamin?—McMaster Optimal Aging Portal

Vitamin D supplementation of 1000 IU or more per day may reduce the risk of type 2 diabetes in patients with prediabetes—McMaster Evidence Summary

Could Sunshine Be Good for You?—Jeannie Beaudin’s Blog

Sunshine, Viatmin D, and COVID-19…What’s the Connection?—Jeannie Beaudin’s Blog

Hola! I’m back after a wonderful 3 months in Costa del Sol, Spain this winter. I’m over the jetlag and busy setting up an apartment for our daughter, who is moving back home for a while as she searches for an affordable house to buy—a hard task these days, at least in Canada! I’ve been reading that multi-generational living arrangements are becoming more popular these days, and I can understand why. We’re enjoying having her here, sharing cooking, conversation, and ideas for what we’ll do next!

But I want to tell you about an interesting aspect of our winter in Spain…

This year, we travelled there with my sister and her husband who has problems with his memory. There are various ways memory loss can occur, and his doctors determined his is a vascular dementia, where decreased blood circulation to parts of the brain cause damage to memory centers. His Mom had received the same diagnosis years ago.

As a pharmacist, I learned about memory loss and how the symptoms often progress as time passes. But too many of us know about dementia firsthand, having experienced various types of dementias in family and friends, with Alzheimer’s Disease being the most common type. Before the trip, we had spent lots of evenings with my sister and her husband, sharing dinners and socializing. We noticed he could remember new information only briefly, while he could easily talk about the sports he played when he was a young man.

However, spending significant time with him every day for 3 months was still an eye-opener to the life my sister has been sharing with him for the past few years. Several times, my hubby voiced concerns about whether he could live with a dementia patient every day… all day long. I suppose we all do our best, for as long as we can manage it, and we marveled at my sister’s coping abilities and positive outlook.

There are many difficulties that can arise for someone with damaged short-term memory, especially when travelling—like worsening of symptoms from travel fatigue, confusion from changes in daily routine, disorientation from a change in surroundings, unfamiliar foods, decision-making over what to order in restaurants and, for travel companions, fear of them just getting lost in another country.

Here’s just an example…

I learned that, despite the need to explain things multiple times, showing respect for the person with dementia is very important. We all need and deserve respect, a basic human right. So, even after the 20th time he asked whether the mountain we could see from our balcony was Lutes Mountain, a landmark near his home, we needed to explain calmly that Lutes Mountain was in Canada, while we were in sunny Spain! Patience and politeness are necessary virtues when caring for a person with dementia. They don’t understand why you would be angry or impatient, with no memory of conversations that might have taken place just minutes before. Caring for a person with dementia is an exercise in controlling one’s emotions.

But his questions inspired us to find out the actual name of the mountain (part of the range of Andalusian Mountains). There was no point in expressing frustration that he’d already asked the same question, because we knew he remembered neither the question nor its answer. The funny thing was that none of us could remember the name of that mountain either, though we looked it up several times! The exercise created a little empathy in all of us.

The mountain is called Calamorro, by the way (I just had to look it up yet again!!). On a clear day, you can see from Gibraltar to Granada from its summit. In previous years, we’d taken the “teleferica” (cable car) we could see from our apartment balcony up the mountain, then climbed steps carved into the rock to the viewing platform at the summit. We did that excursion 3 years ago when we were all there together. The photo above was taken from the viewing platform at the top, looking toward Fuengirola in the distance.

Support for caregivers

Spending every day with someone with dementia is no small feat, although it does have its rewards. The emotional toll of controlling your feelings, not just anger and frustration, but also the sadness of gradually losing someone you love, are coupled with extra responsibilities, as the affected person gradually loses the ability to do their share of tasks in the household and requires more assistance. But keeping any disabled person in their home is a goal worth pursuing and is an achievement one can be proud of. My sisters and I had done this for our mom, who passionately did not want to go into a nursing home, keeping her in her apartment until she passed away at age 91. It’s something we can feel good about.

The Alzheimer’s Society suggests it’s a matter of balance between the quality of life for the caregiver and that of the affected person. The caregiver needs to respect and satisfy their own needs while considering the preferences and emotions of the person they are caring for and understanding what those are for them, especially as communication becomes more difficult. It’s always desirable to keep the person in their home with familiar surroundings as long as possible, but that is contingent on the caregiver’s continuing ability to give adequate care and cope with their situation.

Support can make a significant difference to the wellbeing of those living with someone with dementia and their ability to continue in this role. This support can come from friends and family members, from professional support workers, or through information from organizations dedicated to educating caregivers both about dementias and how to deal with them on a daily basis.

I think it also helps for caregivers to educate friends and family, not only about what to expect, but about what their needs are and how to best satisfy them. Those of us on the sidelines are often willing to help but don’t really know what is best to do. Communication is key, as always, and asking what support is needed and offering to help is important.

Points to remember

People with dementia are individuals and need to be treated with respect, dignity and compassion, while maintaining their privacy and safety. It’s important to consult the person about their likes, dislikes, and opinions, but they may need assistance in completing the action that has been decided upon.

I noticed on our trip that, although a decision about what to order was made ahead of time when eating in a restaurant, in the confusion and stress of ordering it was easier for him to just order what everyone else was having, resulting in a meal that wasn’t what he wanted. Knowing when to help to ensure needs and desires are met, while continuing the person’s independence, can be a balancing act for caregivers.

Experts recommend focusing on abilities even though they will change over time, rather than losses, as much as possible. Sometimes this means finding new activities and hobbies, keeping in mind that new skills would be difficult to learn. My sister tells me that her hubby is enjoying gardening this spring, something that he used to do out of necessity but wasn’t previously a major interest. I’ll want to share some of my tomato seedlings with him!

Meanwhile, I’ll need to remind myself to check in with my sister more often to see what I can do to make her life easier, less stressful, and more fun…

Additional reading:

Quality of Life–Alzheimer’s Society