Categories
Health Public Health

Fat vs sugar – time to rethink!

Sugar is the problem — not fat. Years of advice to choose low-fat and fat-free foods does not appear to have been based on sound research…

New Canadian research found no significant association between eating more than the recommended amount of fat (30% of total calories) and developing heart disease or having a stroke. In fact, they found that those who got 35% of their energy from fat had a lower overall risk of dying than those who ate less than the recommended 30%!

In addition, they found that the low-fat diets recommended to us for many years have resulted in many people overeating carbohydrates, resulting in a higher risk of dying when their carbohydrate intake exceeded 60% of their total calories. Replacement of dietary fat with sugary carbohydrate is also being suggested as a cause of the current increased rates of obesity.

Scientists lead by nutritional epidemiology expert, Mahshid Dehghan at McMaster University in Hamiltion, Ontario, studied diets of 135,000 people in 18 countries for an average of 7 years. She observed “When you recommend lowering fat, by default, people increase their carbohydrate consumption, and increasing consumption of carbohydrates results in higher risk of mortality.”

Study in Japan

This Canadian finding agrees with another article I recently read describing how the stroke rate in Japan dramatically fell almost 6-fold from 1,334 to 226 per 100,000 between 1958 and 1999, after the government encouraged the population to increase their intake of fat. Cholesterol levels rose from an average of 3.9mm/l to 4.9mmol/l due to dietary fat rising from 5% to 20% of total calories. Heart disease rates, interestingly, also decreased although not as dramatically. This is a stark contrast to our current recommendations to lower cholesterol in the blood as much as possible to reduce the risk of heart disease…but more about that in a future blog!

Population studies

Studies of diets from diverse healthy populations suggest that there is not one single “best” diet. The high-fat diets of the Innuit of the north, the Maasai tribes of Africa and the French in France seem as healthy for their populations as the low-fat Mediterranean diet of Italy.

This has lead some to speculate that it is not so much what we eat (as long as the diet is a traditional balanced one) but how much we eat and ­how we eat. Avoiding overeating and enjoying food in a relaxed environment with family or friends (rather than eating on the run or in your car!) seem to be positive factors for overall health too!

Canada Food Guide 2018

Even our Canada Food Guide is being revised…and I hear the meat and dairy industries are not happy with the plans. Although the new finalized guide will only be released in two stages over 2018 -19, Health Canada says less emphasis will be placed on individual nutrients and more will be placed on:

  • avoiding processed foods (that commonly have added sugar, trans fats, salt and other ingredients),

  • reducing consumption of sugary drinks, and

  • limiting portion sizes.

This seems to agree with other experts like University of Toronto’s nutritional scientist, Richard Bazinet who advises “Moderation is the solution. Don’t eat too much of any single thing” and Michael Pollan’s Food Rules: “Eat food (real food, not processed). Mostly plants. And not too much.” Check out my previous blog on his Food Rules here.

It seems difficult to understand why low-fat diets have been recommended for so long – some suggest that influence from the sugar and grain industries may have been a factor. Currently, news outlets have reported meat and dairy industry lobbyists are “up in arms” against the suggestion that the new Canada Food Guide may decrease emphasis on consumption of these food groups.

However, the purpose of any food guide or advice is to improve the health of a population, not to support food industries. Health Canada has stated that it will not be consulting with food producers, although they are permitted to engage in open public consultations.

Trans fats

When it comes to fats, however, there seems no question that trans fats should be avoided. Trans fats, also known as hydrogenated oils, are stable artificially created fats that have been used to extend the shelf-life of processed foods…good for food, but not good for our health! Trans fat content appears on food labels so you can avoid buying foods containing these fats, and some governments are moving to ban these completely from food!

Trans fats often occur in foods that also contain saturated fats and may be responsible for the bad reputation assigned to saturated fat. Wikipedia has an interesting summary of studies comparing the effect of saturated fat (SFA) with unsaturated fat (PUFA). At the very least, one could say there is conflicting evidence when it comes to the dangers of saturated fat, with newer studies being less likely to find that fat in the diet has any effect on heart disease. It will be interesting to see what the new Food Guide recommends as an ideal amount of fat in the diet, considering the results of new studies!

Have you been cutting fat out of your diet? Leave a comment below!

References:

Categories
Health

C. Difficile…so difficult!

Clostridium difficile is a bacterium that is resistant to many antibiotics – hence the name “difficile” since it’s difficult to treat! It is the most common cause of infectious diarrhea in hospitals and nursing homes in Canada and other industrialized countries.

Most cases occur in patients taking certain antibiotics that kill a wide range of bacteria (referred to as broad-spectrum antibiotics) in high doses or for a long period of time. The normal bacterial flora in the digestive system that keep c. difficile in check is destroyed by the antibiotic, allowing the resistant c. difficile to take over. These infectious bacteria produce toxins that damage the bowel, and cause diarrhea and inflammation in the lining of the bowel.

Some people can have c. difficile in their bowel and not show symptoms, likely because other bacteria are keeping its growth in check. There are different strains of c. difficile and some cause more serious illness.

Stomach acid helps to kill unfriendly bacteria like c. difficile if we happen to swallow some. Acid-suppressing drugs, especially proton pump inhibitors (like Losec®, Tecta®, and Nexium®) that strongly block acid production, can increase the risk of a symptomatic infection of c. difficile.

How is it passed from person to person?

C. difficile bacteria and their spores are found in feces. People can get infected if they touch surfaces contaminated with feces and then touch their mouth… (How gross!) This helps you understand how important it is to wash your hands regularly!

If you are healthy, generally there is actually little risk of developing an infection. But in the elderly and those with other illnesses whose immune system may be less healthy, there is a greater chance of infection.

It’s important to keep the normal gut bacteria healthy. When there are fewer normal healthy bacteria in the gut, c. difficile have a better chance to grow and cause infection. Include fermented foods that contain live bacteria in your diet, and take probiotics after a course of antibiotics. This will help to replace the good bacteria that are often destroyed along with the bad ones that caused the infection and maintain a healthy gut flora.

What are the symptoms?

C. difficile infection causes watery diarrhea, fever, decreased appetite, nausea, and abdominal pain or tenderness. The diarrhea usually does not respond to regular diarrhea medications and will last more than the 2 or 3 days of diarrhea from other causes. A stool sample is often tested to confirm that the cause of the diarrhea is c. difficile.

How can you prevent c. difficile?

Wash your hands often with soap and water. Healthcare workers should always wash their hands after touching every patient to prevent passing bacteria and other infectious organisms from one patient to another (or to themselves!). At home, always wash your hands after caring for an ill person, using or helping with toileting and before preparing or eating food.

Alcohol-based hand washes help but are not as effective as soap and water as they do not kill c. difficile spores. Wearing disposable gloves when caring for someone with c. difficile is recommended and hands should be washed with soap and water when the gloves are removed.

How is c. difficile infection treated?

The antibiotic that caused the infection should be stopped right away, and a new antibiotic that kills c. difficile will often be started. Very mild cases may clear on their own.

C. difficile is resistant to many antibiotics, hence the name “difficile – difficult to treat! Metronidizole (Flagyl®) is an antibiotic that may be effective for mild to moderate infections. Vancomycin (Vancocin®) is used for more severe infections and it is considerably more expensive than metronidazole. A new antibiotic, fidaxomicin (Dificid®) showed better results against c. difficile in studies, but it is very expensive.

Taking probiotics (good bacteria in capsule form) in large doses has been reported to help when all else has failed, or as an add-on to antibiotic treatment. It also helps to prevent reinfection, which occurs in 20% of cases.

In extreme cases, the diseased part of the bowel may be surgically removed. Fecal microbiota transplantation (also known as stool transplant) is another new therapy that may be tried in recurrent infection. Donors are screened for infections, parasites, viruses and other bacteria. Stool from the donor is then placed into the infected person’s bowel using a colonoscope or nasogastric tube.

References

https://www.canada.ca/en/public-health/services/infectious-diseases/fact-sheet-clostridium-difficile-difficile.html

http://www.mayoclinic.org/diseases-conditions/c-difficile/diagnosis-treatment/treatment/txc-20202426

Join my mailing list (see box in side bar or at the bottom) to receive a weekly email link to more health information… and to help me grow my blog! I really appreciate your support…

Categories
Health

Artificial sweeteners may cause weight gain!

You could be gaining weight because you are using sugar substitutes… A new study suggests use of artificial sweeteners is linked to weight gain (not loss!) and increased risk of developing diabetes…

Considering the widespread use of sugar substitutes, it is surprising that there are comparatively few long-term studies that have been done. Most are “observational” studies rather than the higher level intentional type of study (randomized groups, placebo-controlled studies referred to as “randomized controlled trials” or RCT’s), so cannot prove a cause-and-effect relationship.

However, in the long term RCT’s averaging 6 months that the researchers found, regular users of artificial sweeteners had an increased risk of type 2 (adult onset) diabetes, higher blood pressure, and modest increases in weight and waist circumference.

The Canadian researchers could find no solid evidence for long-term benefit from artificial sweeteners, and there was some evidence of harm from long-term consumption.

But why would artificial sweeteners be linked to weight gain, not loss? Researches couldn’t explain, but had some thoughts:

  • Artificial sweeteners may disrupt healthy gut bacteria.

  • They may confuse metabolism. For example, the sweet taste may cause the body to be expecting sugar, stimulating a release of unneeded insulin. Increased blood insulin is the first stage in the development of type 2 diabetes. It also would cause a decrease in blood sugar that would stimulate appetite.

  • The appetite-stimulating mechanism may overcompensate for missing calories from sugar when eating other foods.

  • Artificially sweetened foods may simply be a common part of an overall unhealthy diet.

An Australian study suggests that artificial sweeteners may increase appetite for calories by up to 30%. When sweetness versus energy is out of balance for a period of time, researchers say, the brain re-calibrates and increases total calories consumed. They called this the “starvation response”.

They also learned that the brain produces 2 waves of “pleasure” producing dopamine – one with the taste of sweetness and a second wave when the blood sugar rises. If there is no blood sugar rise (because an artificial sweetener was used) the brain sends hunger signals.

A US study, published in the American Journal of Public Health in 2014, found that overweight and obese people ate more when they drank artificially sweetened drinks.

The Australian study also noted increased hyperactivity, insomnia and glucose intolerance as well as an increase in appetite and calories consumed in animals they studied.

Altogether, these studies suggest that we would be much better off to avoid sugar substitutes completely and use a small amount of sugar instead. Better yet, switching to water (flavoured with a herbal tea if you like) might be a good way to promote a healthier waistline!

References:

Categories
Public Health

If you take them, you could be at risk…

Anyone regularly taking narcotic pain medications (“opioids”) is at risk of an overdose if taking more than 90mg of morphine or its equivalent per day, even if it’s being taken for significant pain.

Morphine 90mg per day is equal to:

  • Hydromorphone (Dilaudid) 11.25mg per day

  • Oxycodone (Oxycontin, Percocet, Endocet) 45mg per day

  • Codeine 200mg per day

  • Fentanyl (Duragesic Patch) 2.4mg per day (100mcg/hour as a patch)

Opioids depress the central nervous system and, if depressed enough, the person will stop breathing. New opioid prescribing guidelines for non-cancer pain recommend that anyone taking more than 90mg or morphine per day, or equivalent, should have their dosage gradually reduced to the safer 90mg limit. Even lower doses can be risky in some individuals, especially if they are taking other medications that depress breathing. Any drug that causes drowsiness (including alcohol) depresses the central nervous system and breathing. The person may simply look like they’ve fallen asleep…

If you see someone you know or suspect may have taken an excessive amount of narcotic pain medication (legal or illegal) here is what you should look for:

  • Breathing – slow or absent. May hear choking, gurgling or snoring.

  • Skin – cold or clammy

  • Pupils – tiny

  • Lips – cyanotic (blue)

  • Lack of consciousness – not responding to sound or touch, can’t be woken up

S.A.V.E.M.E. is an acronym to help you remember what to do.

Stimulate

Airway

Ventilate

Evaluate

Muscular injection

Evaluate again

Here are details of what you should do:

  • Stimulate: Try to wake them:

    • Talk loudly: Call their name. Identify yourself. Say “can you hear me?”

    • Shake them by the shoulder.

    • Tell them you are going to apply pressure. Rub knuckles vigorously on their chest bone.

    • Can’t wake them? CALL 911

    • Stay with the person.

  • Airway: Check their airway:

    • Look for chest movement

    • Tilt head back and listen for breath

    • If not breathing, ventilate

      • Use a breathing mask, if available

      • Pinch nostrils, head is already tilted back as you listened for breathing

      • Breathe into mouth

      • Watch that the chest rises and falls

  • Evaluate:

    • If not responding, give Naloxone (Narcan) if available

      • Available as nose spray or as injection (most common)

  • Muscular injection: How to give an injection of Naloxone:

  1. Prepare the syringe:

    1. Open syringe packaging part way to expose plunger, set aside

    2. Hold ampoule by the pointed top and swirl in a circular motion to collect liquid at the bottom

    3. Snap off the top (direction: away from you)

    4. Remove syringe from package, remove needle cap and draw up all liquid into syringe

    5. Push out excess air (a little air in syringe is OK)

  2. Inject the medication

    1. Insert the needle into a large muscle (meaty part of the thigh, butt, upper arm) like a dart at 90˚ angle (straight in, all the way to the hub), through clothing if necessary.

    2. Press plunger all the way in

    3. Most syringes included in Naloxone kits are safety syringes: pulling back on the plunger will pull the needle into the barrel of the syringe, preventing injury and any need to recap the needle. Other types of safety needles have a built-in system to cover the tip of the needle. If no safety mechanism is available, dispose of the needle and syringe in a glass or hard plastic container to prevent a needle-stick injury.

  • Evaluate again:

    • If effective, the person should wake up within 3 – 5 minutes or less

    • Keep watching the person – the effect can wear off after 20 minutes and you may need to administer Naloxone again, especially if a long-acting opioid was taken.

    • If no response in 3 – 5 minutes, give Naloxone again.

    • Repeat until they wake up, the emergency response team arrives, or you run out of Naloxone.

    • Giving Naloxone when it wasn’t needed won’t hurt the person.

When the person wakes, explain what happened. They may be confused or angry. They may have mild symptoms of opioid withdrawal. Do not allow them to take more narcotics – when the Naloxone wears off, they will have an increased chance of overdose again. Withdrawal effects usually wear off in several minutes.

Wait for the emergency response team. Tell them what you have done. Dispose of needle and glass ampoule in a sharps container (the ER team will have one) or in a bottle with a lid.

A video with detailed instructions is available here.

Adding to the opioid problem, some illegal versions of narcotics sold on the streets are copies made by amateurs that have been found to contain unlabelled dangerous potent drugs like fentanyl. Fentanyl is approximately 100 times more potent than morphine – when potent powders are not mixed to high standards, some tablets can easily contain stronger medication than others. Just a barely-visible speck, not mixed in properly, could provide a fatal amount.

Naloxone kits are increasingly being made available for free through pharmacies in Canada. If you are a caregiver for someone taking more than 90mg of morphine per day (or its equivalent), talk to your doctor about keeping a Naloxone kit on hand. If you work at a youth center or other facility that services youth or adults at risk, keep one or more kits on hand and review their use. It isn’t difficult to administer, and you could save a life…

Categories
Environment

It’s a shitty problem…

There seems to be a problem in the water…fecal bacteria above acceptable limits are showing up in water tests in some areas of the New Brunswick coastline.

I had a great discussion with my neighbour, Natasha Bell, this week about issues that increase the risk of pollution on our beaches. Initially concerned about the impact of a large proposed campground nearby, she quickly realized that the greater issue is damage to the delicate ecology of the shoreline along the entire coast of our province – and the potential for it to worsen with further development of the coastline. This lead her to become involved in a growing movement to protect our New Brunswick coastline. She established a local group, along with another concerned neighbour, Pierre Gagnon, to create awareness in members of our village council about our concerns.

They subsequently joined forces with 3 other similar groups, creating a large group that has been named SWWAT (Save our Waters, Wetlands and Tourism) to have a stronger voice with our provincial government. I attended a meeting last evening with Natasha and Pierre to discuss future actions concerned citizens can take to identify and correct existing problems and to prevent development of future problems along the NB coastline. It was attended by people from Shediac to Murray Beach, ready to exchange ideas and take action.

The issues are similar along the entire Atlantic coastline and, in fact, in many watershed areas of both fresh and salt waterways. Wetlands have been seen as “wasteland” and simply filled in to create developments for human use. Even my home was built into the wetland before existing regulations were in place. We have returned a swath of land along our property to natural vegetation along an area of water drainage from higher ground, both to try to restore some of the filtration function that was lost and because we love the appearance of the natural vegetation.

But as I thought about what we had discussed after talking to my neighbours and attending a SWWAT meeting, I wondered what I could do to help. I realized that in many ways this is an issue of education and awareness:

  • We need to educate people who use the coastline for recreation or industry that every small action is cumulative – everyone needs to be aware that actions that cause a small amount of damage can add together to cause significant problems for humans, birds, sea life and the overall ecosystem of the coastline.
  • We need to create awareness in municipal and provincial government employees and elected politicians who make decisions that affect our shores:
  • about the facts around issues that are causing damage now;
  • about the importance of finding and correcting the sources of existing problems that are potential health hazards;
  • and about the importance of considering both the current and future impact of decisions and legislation that are passed.
  • It isn’t simply about testing water quality so Public Health can predict when beaches should be closed, it’s about finding and correcting the causes of bacteria in coastal waters and taking action through legislation and policy that will correct existing problems and prevent future deterioration of the ecological systems along our shores.
  • We also need to educate our youth – the next generation – to ensure this wonderful resource is available in the future. Just on our small stretch of beach, we have had late night fires that consumed snow fencing used to prevent erosion of dunes and burned Christmas trees placed against damaged dune areas to trap sand. We’ve also had to pick up broken glass and garbage from impromptu midnight beach parties! But youth can also be a passionate force for positive change, educating their parents at the same time. We realized that the way to reach young people is through engaging their schools and increasing our reach through social media and our website. Youth communicate through electronic media!
  • We need to continue to research solid facts surrounding this issue and communicate these to government and the public to create knowledge and an awareness of the severity of the problem.
  • We want to continue to engage the attention of news media to enable wider awareness of our concerns.

Because I am a blogger and have already created a website and marketing materials when I had my business, I volunteered to work on similar approaches to spread the word about these environmental issues. It’s not only the health of people like me who use the beaches for recreation that is at stake, but also the tourism, fisheries and ultimately the economic health of coastal areas.

The SWWAT group has two requests of government:

  1. Moratorium – We are asking the Provincial Government to impose a temporary moratorium on significant development within 500 meters of wetlands draining into Northumberland Strait until the sources of fecal contamination have been identified and mitigated.
  2. Legislation – We are asking the Government to legislate a long-term wetlands protection plan supported by strict enforcement of protective regulations.

These actions will protect the health and safety of families and visitors to the beaches, as well as the future of the tourism and fisheries industries in the area.

Will you join our cause? Whether you are a resident of the area, enjoy vacationing there, or just want to help a worthy cause, please sign our petition. Help us to direct government attention to saving our shores for all to enjoy in the future!

#Environment #Wetlands

Categories
Environment

It's a shitty problem…

There seems to be a problem in the water…fecal bacteria above acceptable limits are showing up in water tests in some areas of the New Brunswick coastline.

I had a great discussion with my neighbour, Natasha Bell, this week about issues that increase the risk of pollution on our beaches. Initially concerned about the impact of a large proposed campground nearby, she quickly realized that the greater issue is damage to the delicate ecology of the shoreline along the entire coast of our province – and the potential for it to worsen with further development of the coastline. This lead her to become involved in a growing movement to protect our New Brunswick coastline. She established a local group, along with another concerned neighbour, Pierre Gagnon, to create awareness in members of our village council about our concerns.

They subsequently joined forces with 3 other similar groups, creating a large group that has been named SWWAT (Save our Waters, Wetlands and Tourism) to have a stronger voice with our provincial government. I attended a meeting last evening with Natasha and Pierre to discuss future actions concerned citizens can take to identify and correct existing problems and to prevent development of future problems along the NB coastline. It was attended by people from Shediac to Murray Beach, ready to exchange ideas and take action.

The issues are similar along the entire Atlantic coastline and, in fact, in many watershed areas of both fresh and salt waterways. Wetlands have been seen as “wasteland” and simply filled in to create developments for human use. Even my home was built into the wetland before existing regulations were in place. We have returned a swath of land along our property to natural vegetation along an area of water drainage from higher ground, both to try to restore some of the filtration function that was lost and because we love the appearance of the natural vegetation.

But as I thought about what we had discussed after talking to my neighbours and attending a SWWAT meeting, I wondered what I could do to help. I realized that in many ways this is an issue of education and awareness:

  • We need to educate people who use the coastline for recreation or industry that every small action is cumulative – everyone needs to be aware that actions that cause a small amount of damage can add together to cause significant problems for humans, birds, sea life and the overall ecosystem of the coastline.

  • We need to create awareness in municipal and provincial government employees and elected politicians who make decisions that affect our shores:

    • about the facts around issues that are causing damage now;

    • about the importance of finding and correcting the sources of existing problems that are potential health hazards;

    • and about the importance of considering both the current and future impact of decisions and legislation that are passed.

      • It isn’t simply about testing water quality so Public Health can predict when beaches should be closed, it’s about finding and correcting the causes of bacteria in coastal waters and taking action through legislation and policy that will correct existing problems and prevent future deterioration of the ecological systems along our shores.

  • We also need to educate our youth – the next generation – to ensure this wonderful resource is available in the future. Just on our small stretch of beach, we have had late night fires that consumed snow fencing used to prevent erosion of dunes and burned Christmas trees placed against damaged dune areas to trap sand. We’ve also had to pick up broken glass and garbage from impromptu midnight beach parties! But youth can also be a passionate force for positive change, educating their parents at the same time. We realized that the way to reach young people is through engaging their schools and increasing our reach through social media and our website. Youth communicate through electronic media!

  • We need to continue to research solid facts surrounding this issue and communicate these to government and the public to create knowledge and an awareness of the severity of the problem.

  • We want to continue to engage the attention of news media to enable wider awareness of our concerns.

Because I am a blogger and have already created a website and marketing materials when I had my business, I volunteered to work on similar approaches to spread the word about these environmental issues. It’s not only the health of people like me who use the beaches for recreation that is at stake, but also the tourism, fisheries and ultimately the economic health of coastal areas.

The SWWAT group has two requests of government:

  1. Moratorium – We are asking the Provincial Government to impose a temporary moratorium on significant development within 500 meters of wetlands draining into Northumberland Strait until the sources of fecal contamination have been identified and mitigated.

  2. Legislation – We are asking the Government to legislate a long-term wetlands protection plan supported by strict enforcement of protective regulations.

These actions will protect the health and safety of families and visitors to the beaches, as well as the future of the tourism and fisheries industries in the area.

Will you join our cause? Whether you are a resident of the area, enjoy vacationing there, or just want to help a worthy cause, please sign our petition. Help us to direct government attention to saving our shores for all to enjoy in the future!

Categories
Uncategorized

Why I blog…

I hope you are enjoying your summer! I’m just back from a vacation in Miscou Island that included mackerel fishing and spending time with extended family, some of whom I hadn’t seen for over ten years. I’ve also had some special events with neighbours that included a fabulous lunch with 9 great women who live on my street. Not surprisingly, I’ve had no time to research a health blog for this week. This is how to take a vacation from retirement, I guess! I hope your summer is including similar activities…

So, instead of a health blog, this week, I thought I’d tell you a little about me – why I blog and how I got started writing.

I’ve been writing for a long time – probably over 20 years – usually volunteering to write an article for a local newspaper or a pharmacy journal. I have always liked sharing what I know, with the hopes that my knowledge may help someone. I quickly discovered that I enjoy writing and that I continually learn as I research new information for my articles.

But when I owned my pharmacy, it was also a great way to promote my business at the same time. As a pharmacist, I certainly preferred having clients, new and old, come to my store because they were looking for help with a health problem, rather than just to pick up something that was on sale (especially non-pharmacy items!).

When I first started my pharmacy in the mid-90s, a good friend and mentor, who already owned her own business, suggested I host a short seminar at my pharmacy. I had already spoken to a support group of parents with children who had asthma, so my first talk was already prepared.

The asthma talk was a great success, and afterward I was able to help one attendee, who was being treated for asthma, to learn that he actually had an incorrect diagnosis. He had asked me about the difference between asthma and a condition called Sarcoidosis, which he had been diagnosed with 10 years earlier. The symptoms are similar but the treatment is different. It was very rewarding to know I played a part in the dramatic recovery he experienced once he started taking the correct medication. Now, 20 years later, most pharmacists are compensated by Medicare to do this type of work, and it’s called a Medication Assessment.

I decided to host an event once a month, researching and writing presentations on many different topics. I learned a lot in the process, as I organized what I already knew and learned more with each presentation. It was also another effective way to promote my pharmacy as a place to learn about medications and the diseases they treat. I began receiving invitations to speak to various groups and, as they say, the rest is history… as my husband and I built a successful pharmacy business together.

I found I really enjoyed writing so, when I retired from active pharmacy practice, I decided to continue. In addition to writing articles for a national pharmacy journal, Pharmacy Practice Plus, I have been working on a book based on the specialized hormone work I did for clients for over 10 years. I hope that my book will help to inform women about how their reproductive systems work, how hormones function in the body, and what options are available to treat hormone imbalances. Through my work with women, I learned that greater understanding can help women communicate their hormonal issues more effectively with their physicians.

One recommendation for writers is to develop a “platform” – a way to reach potential readers. Hosting a blog and developing a list of subscribers is one suggested component of a good platform, as well as developing a following on social media, such as Facebook, Pinterest and LinkedIn. This was my inspiration to start my blog, as well as to set up a Facebook page and social media accounts. This gives me several ways to share the link to my weekly blog and reach out to people who are interested in learning about health issues.

“Likes” and “shares” on social media are positive parts of a writer’s platform, but a list of subscribers is the most helpful when talking to publishers. So, if you enjoy my blog, can you please subscribe to it, as this will help me to find a publisher for my book! I promise I will never share your email address – I use my list only to send a link to my weekly blog and, eventually, to tell you when my book is available.

As well as clicking the pop-up window (sorry about that irritating function, but blogging experts say they do work!) I also have a “Join my mailing list” box on the right side of my blog page. On a phone or tablet, scroll to the bottom to find the box.

And if you know someone who might also appreciate the information I share, please pass along my link: http://jeanniebeaudin.wixsite.com/author or just tell them to Google “Jeannie Beaudin blog” to find me! I really appreciate it, and you just might help me to get my book published sometime in the (hopefully) near future!

Thank you for your support!

Categories
Environment

How clean is the water you swim in?

Would you boil your lobster in ocean water these days? Might want to think twice about that…

Water quality at beaches in our area is being questioned, with beach closures more than once already this summer due to excessive fecal bacterial counts. Some types of pollution can be less obvious than the photo above. How clean is the water your kids are swimming in? Is it even being tested so you know?

The factors that contribute to increased bacteria in our coastal waters, rivers and lakes are not all known. However, it seems likely that the more crowded and popular an area is, the greater the likelihood of a problem developing. Population density, surface water run-off, and aging septic systems are all suspected contributors to high fecal bacteria counts. These bacteria put swimmers at risk of illness and infections…

Adding to the problem, is that government water testing requires 48 hours – water samples are being taken on the weekend and results are only announced on Monday, after many have spent the weekend swimming in potentially polluted water. Government officials insist that results cannot be provided in a more timely manner.

A quick internet search found a do-it-yourself test, Aquavial, developed and manufactured at University of Waterloo in Ontario that detects several bacteria (including E.coli, Pseudomonas, Salmonella, and Staphylococci), biofilm and fungi, even when levels are very low. It can be used for testing drinking water as well as any fresh water you plan to swim in, and gives results in 15-30 minutes. Check it out at https://aquabsafe.com if you want to check the river or lake you swim in – a single kit costs $20 and they sell a 6-pack for $100…enough to do weekly testing for the rest of the summer!

Unfortunately, it is the presence of enterococci that confirm fecal matter in salt water as E. coli grown only in fresh water so, to my knowledge, this test could not be used in ocean waters to detect fecal contamination. Currently the only fast test is for E. coli DNA, requiring only 4 hours, but this test is very costly and not widely available.

Much of the economy in coastal areas – especially tourism and fisheries – is tied to the environment. Our shores and coastal waters need to be kept clean to ensure these industries remain healthy. Those who use coastal areas for recreation or commerce need to be educated in how to preserve important wetlands and prevent damage to sensitive coastal areas. It is much easier (and less expensive!) to prevent damage than it is to try to repair the damage later.

Coastal areas, with their dunes and wetlands, are an ecosystem that serves many functions:

  • Filtration

    • Run-off water flows slowly through a marsh, allowing sediments to settle.

    • Wetland plants consume excess nutrients (including heavy metals) preventing accumulation in lakes, rivers and oceans.

    • Wetlands filter out and absorb bacteria from surface run-off water. Marshes can filter out up to 90% of bacteria.

  • Storage of water

    • Slowed water flow allows ground water to be replenished

  • Biological productivity

    • Because they absorb nutrients, wetlands are highly biologically productive. Freshwater wetlands compare to tropical rainforest in plant productivity.

  • Wildlife habitat

    • 95% of commercially and recreationally harvested fish are wetland dependant. Many bird, animal and insect species also rely on wetlands.

  • Erosion protection

    • Dunes and wetlands protect the coastline against storms, erosion and rising sea levels.

What can we do to help protect our dunes and wetlands?

  • Stay out of the dunes

    • Use only designated walkways when crossing dunes and wetlands.

    • Beach grass and dune vegetation protect against loss of dune sand and dunes provide habitat for animals and birds, and protect wetlands during storms. Simply stepping on beach grass can kill the plant.

  • Leash your dog

    • Leashing keeps dogs out of dunes where they can damage plants and disturb wildlife, and away from other people who may not love dogs as you do.

  • “Carry in, carry out”

    • Be sure to take everything you brought with you when you leave (including doggie do-do!)

    • Litter can take years to decompose (even when it’s out of sight in the ocean) and it can be a health hazard to birds, wild life and sea creatures.

  • No open fires

    • Using driftwood for fires removes a valuable natural resource that can trap sand and stabilize dunes.

Pollution of coastal waters is tied to destruction of wetlands along the coast. We all need to do what we can to preserve these natural filtering structures so everyone can enjoy our beaches and oceans for generations to come.

In eastern Canada, several environmental groups have sprung up demanding a governmental moratorium on further commercial development within 500 meters of wetlands until the sources of current problems are identified and corrected. Meanwhile, simple testing with confirmation of the more complex government testing later may be an effective way to protect your family from unnecessary exposure to bacteria and fungi while enjoying your favourite summer water activities in an area that is at risk.

Educate yourself and others who use coastal areas about how to prevent damage to natural structures that protect the health of our coastal areas and the people and wildlife who use them!

Categories
Health

Waking up with a stiff one in the morning???

Of course, I’m talking about a stiff neck, back or, heaven forbid, a Charley-horse! What causes those awful muscle spasms and can you prevent them?

Skeletal muscles are the muscles attached to our bones that are generally under our conscious control. We use these muscles to move parts of our bodies and to make facial expressions, such as smiling.

A muscle spasm, or muscle cramp, is an involuntary contraction of a skeletal muscle. Spasms of the skeletal muscles are often caused by overuse and muscle fatigue, by electrolyte imbalances or can be associated with a previous injury. Usually they occur abruptly and don’t last long. If they are extremely painful and don’t resolve on their own, you should seek a medical assessment to look for possible underlying causes.

Causes

Although the precise cause of a muscle spasm is not always known, electrolyte imbalances are believed to contribute. Spasms occur more frequently when exercising or doing physical work in hot weather, when dehydration and electrolyte loss occurs due to sweating. Muscles require enough water, glucose, sodium, potassium, calcium and magnesium to allow the muscle proteins to develop an organized contraction. A lack of any of these elements can cause the muscle to become irritable and develop spasm. The muscle soreness and increased risk of spasm that occur after new or increased exercise is thought to be due to a lack of electrolytes. With continued exercise, blood flow capability increases, bringing increased electrolytes, nutrients and oxygen to the muscle, and soreness no longer occurs.

Other causes of muscle spasms include:

  • decreased blood supply to the muscle, due to narrowing or disease of the arteries,

  • arthritis or other injury of a joint (where muscles spasm to try to support the damaged joint),

  • obesity, where increased weight can cause stress and strain of the core muscles of the trunk, leading to spasms of the neck and upper or lower back

  • diseases like diabetes, anemia, kidney disease and thyroid or other hormone issues (can potentially disrupt electrolyte balance)

  • diseases of the nervous system, such as amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), or spinal cord injury

Treatment

If a skeletal muscle goes into spasm, the initial treatment is to gently stretch the muscle lengthwise to break the spasm and resolve the acute situation. A physiotherapist or massage therapist can teach you exercises to stretch less obvious muscles, relieving spasm and pain. Heat and anti-inflammatory medications, such as ibuprofen (Motrin, Advil) or diclofenac (Voltaren Gel) can also be helpful for short-term pain relief. Your doctor may prescribe stronger pain medication and/or a muscle relaxant in more severe situations when the spasm does not readily subside. In Canada, the muscle relaxant, methocarbamol (Robaxicet and generic versions) can be bought without a prescription.

Quinine, an anti-malaria drug, is a very effective medication for nocturnal leg spasms and was used for many years for prevention of the nighttime “Charley-horse”. However, quinine was found to have serious side effects (vision problems and abnormal bleeding) and is only used now in severe cases where other medications do not help.

Trigger Points

A “trigger point” is a small area of contraction in a muscle, that shortens and weakens it, creating pain where the muscle attaches. The trigger point is often not located where the muscle pain is perceived. In medical terms, this is described as “referred pain”, much like the way a heart attack (damage in the heart muscle) is often felt in the left shoulder or arm. A trigger point is defined as a “highly irritable localized spot of exquisite tenderness in a nodule in a palpable taut band of muscle tissue” — so it’s an area that is painful when pressed and can be felt as a lump under the skin in the muscle. Drs. Travell and Simons wrote extensively about trigger points starting in the 1940s, mapping out common muscle trigger points and the areas where pain from each is commonly felt. Their work is the basis for today’s therapeutic massage and for some physiotherapy.

Massage, either by a professional or self-massage, can be helpful for muscle spasm. Massage can increase circulation to the muscle, bringing nutrients and removing breakdown products. Pressure on the trigger point of a muscle can also help to relax a spasm and trigger points are sometimes used as the site for acupuncture or accupressure. If you are interested in learning self-massage for relief of pain from chronic muscle spasms, I could suggest The Trigger Point Therapy Workbook, by Clair Davies, an excellent self-treatment guide that I have used with my clients (and myself!) for many years.

Conclusion…

So, if you are exercising or doing physical work, especially in a hot environment, be sure to drink extra water to replace fluids you are losing. If you are prone to muscle spasms, consider also replacing minerals, for example, by consuming a supplement or electrolyte containing foods or drink during activities on warm days. Ensure your diet contains adequate minerals: calcium, magnesium, sodium and potassium. If the spasm lasts more than a few days and is not due to an obvious overuse of the muscle or dehydration, see your doctor or physical/massage therapist and, together, look for an underlying cause.

Categories
Menopause

Vaginal Dryness…Ouch!

Vaginal dryness, part of a condition known as Vulvovaginal atrophy (VVA), is a common and progressive problem that can affect the health and quality of life of many post-menopausal women.

Vaginal tissues require estrogen – as estrogen levels decline after menopause, women can experience dryness, itching, irritation, soreness, and pain during sex and afterward. They may also have associated urinary problems, needing to go frequently or urgently. Almost 50% of women will experience these symptoms, but often don’t discuss them their physician because they may feel the symptoms are not important enough or are too embarrassed to bring up the subject.

As the vaginal lining thins, fewer cells are shed from the surface, leading to lower production of lactic acid and higher pH (or less acidic environment). This decrease in acidity can make women more vulnerable to bacterial infection.

As well, decreased estrogen results in less vaginal blood flow and a decrease in vaginal lubrication. Muscles also respond to estrogen including those that support the bladder and uterus, so low estrogen can result in decreased support in the pelvic floor. Several effects of low estrogen can lead to a variety of vaginal problem for women.

What can women do if this happens? Well, depending on the severity of symptoms, there are several options…

If the main symptom is mild vaginal dryness, a basic sterile lubricant can be helpful – KY Jelly is one brand name, and many generics are available. This can be very effective if the main problem is discomfort during sex, and can simply be applied by either partner as needed.

The next “step” up, is an adhesive lubricant, such as Replens. This moisturizer is designed to adhere to the lining of the vagina, staying there for 2 to 3 days, providing ongoing moisture and lubrication. It’s designed to be inserted with the provided applicator 2 to 3 times a week.

If neither of these options are sufficient, or if there are associated urinary problems, then it makes sense to discuss the possibility of replacing estrogen with your doctor to help these tissues become healthier. But there are different choices when it comes to estrogen replacement too…

Some estrogens have stronger action in the body than others, and estrogen replacements come in different forms and milligram strengths. If the only problems are in the vaginal area, it makes sense to just replace estrogen in that area. Using a suppository or inserting a cream into the vagina would be preferred to taking an estrogen tablet by mouth or using an estrogen patch, where estrogen would be supplied to the entire body.

Of course, estrogen stimulates the growth of many cells in the body, not just the ones in the vagina. This group of hormones attaches to receptors and stimulates growth of cells in the breast, uterus, bone, skin, hair, muscles, brain and blood vessels – almost every part of the body.

There are 3 main estrogens in the body: estriol, estradiol and estrone, and the actions of these are not all the same throughout the body.

Estradiol is considered the main and most active form of estrogen, and it’s produced by the ovaries as the egg develops and after it is released at ovulation. It’s the estrogen used in most supplements.

Estrone is thought to be a less favourable form of estrogen, as it is more readily stored and can be converted into more active estrogen later. Estrone and estradiol can be converted back and forth, and estradiol that is swallowed is mostly converted to estrone before it reaches the circulation. After menopause, estrone becomes the dominant estrogen and is created by conversion of male hormones produced in the ovaries and adrenal glands by enzymes in fat and muscle.

Estriol is a weaker estrogen that does not stimulate breast cells or lining of the uterus and only weakly improves hot flashes. It is the end product of the breakdown of other stronger estrogens and, when administered, is not changed. It is very effective in improving vaginal tissues, making it a useful estrogen for women with only vulvovaginal atrophy who wish to avoid any stimulation of breast tissue or uterus. It is not absorbed when swallowed and, perhaps for this reason, it has never been commercially manufactured. However, compounding pharmacists regularly prepare it in cream form for vaginal use. Estriol 0.5 mg inserted twice a week is often enough, although most women will use more initially to speed healing (up to 1mg daily, at bedtime for about 2 weeks, then reducing amount and frequency).

If you don’t have a compounding pharmacist in your area, vaginal estradiol would be my next choice. Be aware that it comes in various strengths, though, and only a small amount of estrogen is needed when it is being applied inside the vagina. Using larger amounts increases the likelihood of estrogen activity in other parts of the body.

To compare available products containing estradiol:

Premarin vaginal cream contains 0.625mg of estrogens per gram (about half is estradiol and the other half is equine estrogens that are also active), making it one of the stronger versions of vaginal estrogen on the market now.

In comparison, Vagifem is a suppository that contains only 10mcg (0.01mg) of estradiol per suppository – a huge difference! It is recommended to be used nightly until improvement (generally 2 weeks) then reduced to twice a week. It is interesting that Vagifem initially was sold as a 25mcg suppository, but the dose was reduced to 10mcg after further research. When using hormones in any form, it is recommended to use the lowest dose that will give satisfactory improvement.

Of course, estrogen is available in tablets and patches, but these are only recommended when additional intolerable symptoms occur in other areas of the body – hot flashes that interrupt sleep multiple times a night, for example. This type of hormone supplementation would help vaginal and bladder problems along with the other estrogen related symptoms, but the estrogen should always be balanced with progesterone to prevent over-stimulation of estrogen sensitive tissues and increased risk of cancer.

Lastly, due to a history of problems with hormones that are different than what our bodies produce, I always recommend using “bioidentical” hormones – those that are identical to what our bodies produce. And, although progesterone is thought to be unnecessary in those who do not have a uterus (since it was originally introduced to therapy to avoid an increased risk of uterine cancer), it makes sense to me after years of studying hormones to maintain the balance between estrogen and progesterone that nature provides whenever hormone replacement is being administered to the entire body, again using the same progesterone molecule that our bodies make.

Whatever therapy you and your doctor choose, however, remember that you always want to use the lowest level of treatment that will give sufficient improvement of your symptoms and to use it for the shortest time necessary.

If you have any questions, you can email me privately using the “Questions/Comments” button on the right side of the screen…