Jeannie Beaudin, Artist and Author

This article is about how to have less fear and pain when getting an injection, so I decided to be kind and use a photo of a different kind of needle… not to further upset anyone! A friend told me that just seeing news reports about COVID upset her because they so often showed needles being given… she was terrified of needles and couldn’t watch, even on TV.

And she’s not alone. Twenty five percent of people report being afraid of getting an injection and 5 to 10% are reported to actually refuse injections because of needle phobias. But with a deadly disease like COVID-19, we need to have as many people vaccinated as possible to stop the spread of the virus. An ideal scenario would be to have enough people immunized to make the virus extinct, as was done with polio. Perhaps we were so successful with it because they developed an oral form of the vaccine. Remember the drops on the sugar cube? Nothing to fear there!

But, until they find a way to present the COVID vaccine as a sweet treat, we need to remove all barriers we possibly can to getting immunized.

When I started giving injections, I worried about causing pain… I didn’t want to hurt anyone! I knew there had to be something in the administration technique that reduced pain, as some flu shots I’d had in the past were completely painless while others had quite a sting, so I read everything I could about reducing needle pain. I learned there are lots of things both you and the injector can do that help.

This year, after seeing some dubious injection technique in TV news reports, I wrote an article about how injectors can drastically reduce the pain of an injection, making the needle itself almost (or in some cases, completely) painless. Our national pharmacy journal ran my article 3 times, and it was published on an American nurse practitioner website too! I hope the information is helping to lessen the pain of immunization for some people. Injections really can be pain-free—I can honestly say I didn’t feel the needle at all at my second COVID shot. It’s all about technique and that nurse was very good! 😊

So, if you’re afraid of needles, read on…

Pain-free injections

Some key actions for injectors to take to reduce injection pain are to let the alcohol dry, make sure the needle goes into the belly of the muscle (not too shallow, and not too high or low on the arm), put a little pressure on the skin near the injection site (so your brain will register pressure not pain), insert and remove the needle quickly (avoids pain, just like a quick paper cut is often painless), and put pressure on the injection site (with a cotton ball) immediately afterward. It also helps to do something to distract the person, even if it’s just by telling them to take a deep breath.

As a patient, it’s absolutely your right to ask the person giving you an injection to let the alcohol dry before injecting, or to give the needle at a certain spot if you know where a deltoid (arm) injection is supposed to be given. You could also ask them to make it as quick as possible and offer to hold the cotton ball afterward to continue the pressure on the injection site while the injector completes records and prepares a bandage. If you’re an injector and interested in reading the article I wrote, here’s a link to the post on the Nurse Practitioners for Women’s Health website.

What you, as a patient, can do: Play the “CARD” system…

CARD is an acronym for 4 activities that reduce pain, fear, fainting and other symptoms some people experience when getting an injection or before and after. It stands for Comfort, Ask, Relax and Distract. The system was scientifically tested in schools in Niagra, Ontario, and was found to reduce fear of needles by almost half. The system is easily adapted to work in most settings where injections are given.

Here’s what they suggest:

Comfort—Wear short sleeves so it’s easy to expose the injection site. Bring a snack: eating something can keep you busy and distracted.

Ask—If you’re worried about anything, for example side effects, don’t hesitate to ask. The person giving the injection usually knows the answers to most questions about injections or can easily find the answer for you. Did you know there is a numbing cream/patch you can use? Ask about this before you go if you think it will help (It is available at most pharmacies and has to be applied to the injection site an hour before the injection. Make sure you know exactly where to apply it.). Should you look at the needle or look away? Do you want to be told just before it’s given, or would you rather not know? Tell the injector for your preference.

Relax—If the muscle that is being injected is contracted or tense, the needle is more likely to hurt. Make sure your arm is completely limp and relaxed. Although it’s more difficult right now with COVID restrictions, having a friend accompany you can help you feel more confident and relaxed. Make your appointment at the same time as a friend or family member so you can boost each other’s confidence while waiting. Take a deep belly breath just as the needle is being given to help you to relax. This works as a distraction too (discussed next).

Distract—Distraction can actually reduce the pain you feel. I used to let younger children play a drawing game on my iPad to distract them (especially effective when iPads were new!). After the injection (when they didn’t like me anymore), I would ask if they’d like me to send their drawing to Mommy or Daddy’s computer… that almost always made me a cool person again and distracted them from what just happened! But even chatting with the injector can also help you relax. Tell them your worries—there’s often something extra they can do to help resolve your fears, or just talk about the weather to distract yourself. One elderly gentleman that I gave a flu shot to insisted that I hadn’t given him his injection—he had been busy chatting with an attractive assistant and didn’t even notice when I gave him his needle! It only took me about 2 seconds to give the actual injection, so it was easy to miss, I guess…

In addition to addressing the pain of injections, the CARD system also considers the stress that many people experience when getting an immunization. And it’s not just children and adolescents… adults fear injections too. It’s time for us all to improve injection experiences by working together to make them easier, more comfortable and more pleasant.

Click here to learn more things you can do to squelch your fear of needles… CARD for adults: https://immunize.ca/card-adults

…A softer kind of needle

References:

Tips for Giving a Pain-Free, Effective Injection—Jeannie Collins Beaudin (NPWH website)

Improving the vaccination experience with CARD—Government of Canada, Public Health Services

CARD for Adults—Immunize Canada

#FearOfNeedles #PainFreeInjections

Privacy is important these days, and nothing is more private than our medical information. But when it comes to being safe in a pandemic, it’s also important to know how safe stores, restaurants and businesses are, especially as they start to fully re-open and masks are no longer mandated. Whether a person has been fully vaccinated makes a huge difference in how likely they are to catch the coronavirus and transmit it to others, as well as how sick they might become if they contract the virus.

Do we have a right to ask a person’s vaccination status before they provide a service, especially if unmasked? Can an employer require their employees to disclose their immunization status and make this information public? Can you be required to show proof of COVID vaccination before travelling to another country?

CTV News interviewed several personal injury, employment and privacy specialists to get their expert opinion on these questions. Their comments were interesting, I thought, so I wanted to share some of what they said. Quite a can of worms…

What if you can’t get vaccinated?

Of course, there are some people who cannot be vaccinated for medical reasons, such as allergy to a component of the vaccine, or who do not respond well to vaccines, due to low immune function or medications that block the immune system. These people need to be protected from discrimination.

Employers cannot force employees to disclose their vaccination status to clients and they certainly cannot disclose this information on the employees’ behalf, the lawyers emphasized. One suggested businesses could post a sign on their door saying that no personal health information would be divulged about their employees. But that sounds like something that might have the potential to reduce business…

Safety first

However, employers have a right and requirement to provide a safe work environment for other employees and their clients. This means that employers may need to know who is unvaccinated… whether they cannot, or choose not, to take the vaccine. In the name of safety, these employees may find themselves required to work from home or in a modified position that reduces contact with others, if there is a potential safety risk to others. If that’s not possible, due to the nature of the work, they may be considered unsuitable for the position and not be hired.

Can you ask if employees are vaccinated?

Yes, as a customer you have a right to ask an employee or service provider if they are vaccinated, but they are not legally required to answer. Employers are not allowed to reveal health information, like immunization status, without the employee’s permission. However, customers may start to “shop around” for safer places to do business, if this information is not revealed.

An alternative, is for businesses to continue to provide safety measures, like physical distancing, altered store layout, sanitization and perhaps continued masking to make customers feel safer when shopping there or using their services.

With COVID-19, vaccination status has become less of a privacy issue. Many people (like me!) are excited and happy to be fully vaccinated, and want to tell the world, even though it’s really private medical information. It’s quickly becoming a minor privacy issue for most people—in fact, it’s becoming the norm.

Of course, it can work the other way too—businesses may want to ask customers whether they are vaccinated. In fact, some already are, like airlines who will only allow those who are fully vaccinated to book a flight. Countries and even some Canadian provinces are only allowing those who are 2 weeks past their second shot to enter without restrictions, citing safety of their citizens. Many are also requiring proof of a negative COVID test as well… all medical information that, in other situations, would be private.

Can vaccination be required before travelling to another country?

Yes, certain vaccines, like yellow fever, are already required for travel to certain countries. This sets a precedent for requiring any vaccine that is deemed necessary to improve safety while travelling. Although we’re still waiting for the dust to settle on travel vaccine requirements, no-one will be surprised if full COVID immunization is required by many countries to protect their citizens as well as travellers. International discussions about the form that “COVID-19 vaccination passports” will take emphasizes that these will be a likely requirement for travel when international borders open.

Safety trumps privacy… always

Employment lawyer, Sunira Chaudhri, discussed whether a business could be held liable if a customer were to become sick after contact with unimmunized employees. While she said it isn’t completely clear yet, she also said it’s certainly possible an employer who allows unvaccinated employees to contact clients unmasked (after mask restrictions are lifted) could be sued if a client or other employee became very ill. To make the workplace as safe as possible, she indicated, employers are going to have to ask about vaccination status and employees are going to have to disclose it. “Safety trumps privacy, always” she said.

So, just like airlines and other countries are requiring proof you are 2 weeks past your second COVID-19 vaccination, employers may develop policies and protocols that require proof of vaccination before an employee returns to the workplace or works in close contact with clients. It’s not the law that you have to get vaccinated, but there may be consequences for those who are not, like an assignment to a position with little or no contact with other employees or the public, or losing a job altogether.

What about insurance?

They didn’t interview an insurance specialist, but their comments would have been informative as well. If the insurance industry becomes involved and senses increased liability (and future costs), choosing not to be immunized against COVID-19 could become very expensive for employers and employees. I guess it all depends on how low case counts and risk of contracting coronavirus infection become. Epidemiology experts predict that COVID is here to stay and will continue to circulate in the human population, hopefully as a less severe infection as our immunity builds. Perhaps even most of the unvaccinated population will eventually develop immunity from having recovered from an actual infection.

The bottom line is that we may not have a true choice (other than to just stay home) as to whether to disclose our vaccination status. Safety first… But hopefully, eventually enough of us worldwide will be vaccinated to stop or at least drastically slow the circulation of this deadly virus and these requirements will become a temporary measure. It’s already happened with polio and some other diseases that are included in childhood immunizations. Until then, be ready to produce proof of vaccination if you want to travel and possibly if you want to apply for that new job.

Next week…

And if the reason you (or someone you know) hesitates to get your COVID shots is that you’re afraid of needles (common in 25% of the population!), next week’s blog might help you!

References:

Customers can ask about an employee’s vaccination status, but employers can’t share it: experts–CTV News

6 Frequently Asked Questions: Vaccinations + the Workplace–Miller Titerle + Company

Some time ago, I was chatting with a friend who had had ovarian cancer and the topic of vaginal dryness popped up. She was suffering terribly and knew that she shouldn’t use any hormone treatments because of her hormone-related cancer, but no-one had mentioned anything she could try that was safe for her to use. I was surprised to find out no-one had told her there were non-hormonal treatments she could use that would help.

Treatments for vaginal dryness are common knowledge for pharmacists and many other health professionals, and sometimes we forget that our knowledge is specialized. It’s easy to wrongly assume that everyone knows about lubricants and moisturizers. But I learned from my friend that this isn’t always the case. I was glad I was able to help her, and thought I’d put the information out there for anyone else who might need it!

What causes vaginal dryness?

The cells that line the vagina grow in response to the hormone estrogen, making the vagina walls thicker and more elastic. These cells also produce moisture called mucus, much like the inside of our nose and other “inside linings” in various parts of the body. When estrogen levels drop, though, these cells slow down their growth and mucus production, resulting in a thinner lining and less mucus to lubricate and keep the area moist as it should be.

This moisture is moderately acidic and this helps prevent infections. It also helps sperm survive and travel through the woman’s genital system, making mucus production important for those who are trying to become pregnant.

Low estrogen levels, like women often experience after menopause, are a common reason for vaginal dryness, but they aren’t the only reason. Women can notice more dryness any time estrogen levels are falling, such as during breastfeeding, after childbirth, with heavy cigarette smoking (another reason to quit!), during depression or excessive stress, with immune system disorders (such as Sjogren syndrome), during some cancer treatments (for example, hormone blocking therapy, chemotherapy or radiation to the pelvis), and after surgical removal of the ovaries.

Some women will even notice less mucus being produced during parts of their normal cycle, as estrogen cycles through its normal ups and downs. Estrogen is highest at the time of ovulation, roughly at day 14 of a normal cycle (although this varies from woman to woman) and lowest when her period begins.

Women can use this mucus production to predict how high their estrogen is, and when they have ovulated. After the menstrual period, estrogen and mucus production gradually increase. The highest or “peak” production of mucus occurs when a woman is ovulating, and the mucus changes in colour from clear, slippery in texture, and “stretchy”; to creamy, yellowish/white and non-stretchy immediately after ovulation occurs. (“Stretchy” refers to the ability of estrogen mucus to form strings when stretched between 2 pieces of toilet paper.)

Being dehydrated or taking medications that cause mouth dryness, like decongestants and some antidepressants, can also cause the vagina to be dryer. These “anticholinergic” medications that reduce secretions throughout the body as a side effect, provide a helpful action for a stuffy, runny nose in the case of decongestants. Drinking extra water throughout the day can help reduce this drying side effect when it is bothersome.

What does vaginal dryness feel like?

Women will commonly notice pain or discomfort during sexual intercourse because of a lack of lubrication. This can lead to a loss of interest in sex, since it is no longer pleasant and sometimes downright painful. Some women will notice light bleeding after intercourse, due to small tears in the vaginal lining caused by friction.

In worse cases of vaginal dryness, women will notice ongoing soreness and/or irritation. They may also experience vaginal itching, stinging or burning. Just the friction of clothing against the area can even become uncomfortable.

How is it treated?

There are several different types of products that can be helpful for vaginal dryness. I think of these as “steps” to progress through, depending on how bothersome the dryness has become:

• Vaginal lubricants (e.g. KY Jelly®, Taro Gel®, other generic brands)—I refer to these as the “lowest level” of treatment. Think of lubricants as a replacement for the mucus that is missing. Lubricants can give immediate relief, but the effect doesn’t last. They are useful before or during intercourse and can be inserted or applied to the outer area of the vagina or applied to the man’s penis before entry. Water based products (essentially water with a gelling agent or silicone added) are both effective and recommended over oil-based products like Vaseline®, mineral oil, or other oils. Note that oils can break down latex products like condoms, increasing the risk of breaking.
• Longer-lasting lubricants (e.g. Replens®)—I think of these as the next step in vaginal dryness treatment, and would be recommended for women with ongoing symptoms. When inserted, these products adhere to the walls of the vagina for several days. They are recommended to be used every 3 to 4 days for continuous relief of symptoms.
• Vaginal moisturizers (e.g. RepaGyn® vaginal suppositories)—When you need more than just lubrication, a moisturizing product may work better. Moisturizers contain ingredients that “plump up” the cells of the vaginal lining, helping to heal and thicken the lining while providing moisture. RepaGyn® has been demonstrated to promote healing after gynecological procedures including chemotherapy and radiation. Its effect is similar to estrogen therapy, but without hormones. RepaGyn® comes as a suppository, inserted 2 or 3 times a week, making it less messy and more convenient to use than gels.
• Hormone treatments (Estrogen creams, suppositories, rings, patches, tablets)—These are usually reserved for women who don’t find sufficient relief from non-prescription treatments, or who have additional bothersome hormone-related symptoms such as urine leakage, hot flashes, night sweats, etc. Since these symptoms are often caused by menopausal hormone changes, women may benefit from replacing hormones, either vaginally or systemically (by mouth or through the skin as a patch or gel). Of course, these are considered inappropriate for any woman who has had a hormone-dependent cancer, due to increased risk of a return of the cancer. Your doctor would assess your risk factors vs benefits from this therapy before prescribing. If estrogen is only needed for vaginal problems, generally a very low dose is used, and the treatment is inserted into the vagina or applied directly to the area.

Effective treatments are available in any pharmacy without a prescription. So don’t be shy—it’s OK to ask to speak to your pharmacist in a private area about your health problems. And talk to your partner about any dryness, even temporary, so they will understand and help too.

However, if you aren’t getting relief from non-prescription treatments you’ve tried, ask your doctor or other health practitioner for advice. He/she can prescribe higher-level hormone treatments if needed. Remember vaginal dryness is a fixable problem…

References:

Vaginal dryness—Mayo Clinic

RepaGyn information brochure

Replens information

#VaginalDryness

First, I want to tell you I received my 2nd shot this week… I’ve finally joined the list of those fully vaccinated (well, I will once a couple of weeks have passed for the vaccine to do its magic). It feels good to be better protected and helping to make our world safer!

COVID-19 still has a fascination for many of us—it’s still often the first item on the news each day, especially here in Eastern Canada where provincial borders have been closed for months except for essential travel. I don’t know about you, but I can’t resist reading the latest study or statistics on the coronavirus. I expect we’ll be learning about it for many years to come.

So, this week I thought I’d write about some of the COVID (not-so-trivial) trivia I’ve been reading in the medical news, as researchers work to solve the mysteries and questions about the coronavirus and how it behaves.

Can we stop wearing masks once fully vaccinated?

Dr. Theresa Tam, Canada’s chief public health officer, gave the perfect answer to this question we all want answered: “It depends…”. Here’s how she explained it: Vaccines are never 100% effective, so you need to consider how much risk you can tolerate and how risky your surroundings are when deciding whether to wear a mask. You should think about:

Personal risk:

• Are you vaccinated? One shot or two?
• Do you have any underlying health conditions that could add to your risk if you do get sick?
• Are you taking any medications that suppress your immune system? (steroids, organ rejection drugs, certain arthritis/psoriasis/inflammatory bowel disease medications, etc.)

Environmental risk:

• Are you indoors or out? (Outside is safer)
• What is the infection rate in the area?
• Are the people you are with vaccinated?
• Can you physically distance from others?

As you can see, having a strong ability to fight off any potential coronavirus infection plus a low to non-existent risk of close contact with anyone with the virus means the event is much safer and a mask might be unnecessary. Those who are less healthy will want to keep using a mask in crowded places, like a grocery store, and we all would be wise to use one if there are any cases in the general area. I plan to continue using one for a while yet.

Officials are warning that, as we open up our communities, there is a good chance cases will increase again as people travel more. Our province waited until 75% of adults were partially vaccinated and 20% were fully vaccinated before beginning to reopen, and changes will be gradual to minimize the potential of a 4th wave of infections until 75% are fully vaccinated (hopefully by mid-summer!).

Can dogs and cats catch COVID-19?

Yes! A small study found that 1/3 of cats and 1/4 of dogs, whose owners were infected with COVID-19, also tested positive for the coronavirus. Animals were at less risk if they spent more time outdoors and away from their owners, but they only displayed mild symptoms or none at all. There have been no reported cases of humans catching the coronavirus from their pets, including from virus being transported on their fur, and risk is considered low.

Should you get vaccinated if you have long COVID?

Yes! Those with “long COVID”—lingering symptoms like fatigue and loss of taste and smell that persist for weeks to months after recovery from an acute infection—will sometimes notice an improvement in symptoms after receiving immunization. Researchers suspect that the response to the vaccine enables the immune system to eliminate lingering low levels of virus that may be causing ongoing symptoms.

How much does the first shot help?

Studies find varying levels of response to the first injection of COVID-19 vaccine, depending on the person’s immune system response and the virus variants in the area, but a recent study found 81% response to the first shot and 91% to the second. Another study predicted a 40 to 50% reduction in ability to transmit the coronavirus after a single shot. Because of a worldwide shortage in vaccine, several countries have decided to delay the second shot by up to 4 months with the goal of reducing total deaths from the virus. Interestingly, older people have been noted to mount three and a half times larger response when the second dose is delayed to 12 weeks after the first. This suggests we should get an excellent response when boosters are needed.

What can we do to fly more safely?

Here are some suggestions I found to help keep you safer if you’re thinking of taking a flight:

• Avoid non-essential air travel unless fully vaccinated (2 weeks after 2nd shot), as currently advised.
• Check conditions (infection rate) at your destination.
• Wear a mask in taxis, airports and planes. Consider double-masking and ensure mask fits properly (no gaps). Remember children cannot yet be vaccinated and a recent survey suggests that as many as 20% of unvaccinated adults stated they would lie if necessary to gain access to “vaccinated only” venues… 😮
• Roll down windows in taxis going to and from airports to improve air circulation.
• Bring snacks/lunches. Service is limited on many flights. If possible, eat before boarding the plane to avoid the need to remove your mask. If it’s necessary to eat on the plane, having your own food make it faster for you to eat, meaning your mask will be off for less time.
• Note that large aircraft all have HEPA (high-efficiency) air filter systems, but smaller, older aircraft may not. Exercise extra caution when taking smaller, regional flights.

Are rashes a symptom of COVID?

Yes, weird skin rashes are now recognized as another symptom of COVID-19, along with fever, dry cough, loss of taste and smell, headaches, muscle and joint pain, nasal congestion, and fatigue.

Chilblain-like red/purple, swollen, or blistered skin on toes (mainly in children and young adults) were recognized first and nicknamed “COVID-toes”, but now they realize these can occur in fingers as well as toes. Sometimes this is the only symptom that is noted. Other types of rashes are now known to occur also. These include:

• Macropapular rash (flat and raised areas of discoloured skin) found on the trunk of 47% of patients, usually those middle-aged to elderly.
• Hives (aka uticaria—raised areas of itchy skin), in 26% of patients, although sometimes these occur as a side-effect of medications used to treat COVID-19.
• Vesicular lesions (fluid-filled sacs under the skin, similar to chicken pox) that appear about 2 weeks after infection in about 9% of cases.

It’s affected us all…

During the past year and a half, we’ve all suffered at least a little from “COVIDosos”—my made-up name for the effect the virus has on us even if we didn’t catch it. We’ve gone through difficult changes like learning to physical distance and getting used to wearing masks, and we’ve experienced stress and worry, as the virus waves crashed over us.

Closed gyms, cancelled activities, and spending more time at home to avoid potential exposure to the virus have made it more difficult to stay in shape. And closed borders, quarantines and cancelled trips have left us missing family and friends. Thank goodness for video chats! But I’m excited to be starting to get back to normal, or at least the “new normal”, whatever that turns out to be.

I sometimes think how strange our great-grandchildren will think this time must have been. I had started an art/travel journal in January 2020, when we arrived in Spain for a 3-month winter escape. When the pandemic hit, it became my COVID journal, as we watched Spain begin to close down, travelled through airports on the way home and then self-isolated for 2 weeks at home. I still write in it from time to time. Sometimes I wonder if journals such as mine will survive and possibly be of interest to a future generation one day…

#COVIDfacts #DoWeStillNeedMasks #CanPetsCatchCOVID #HowToFlySafely

References:

COVID-19 and pets: Can dogs and cats get coronavirus? https://www.mayoclinic.org/diseases-conditions/coronavirus/expert-answers/can-pets-get-coronavirus/faq-20486391

How to fly safely this summer—CNN Travel http://www.cnn.com/travel/article/flying-safely-summer-2021-wellness/index.html

In Surprise Twist, COVID-19 Can Cause Weird Skin Rashes. Here’s What to Look Out For—Science Alert https://www.sciencealert.com/in-surprise-twist-covid-19-can-cause-weird-skin-rashes-here-s-what-we-know

Delaying 2nd Pfizer vaccine dose may protect better against COVID-10: study—Global News https://globalnews.ca/news/7861754/pfizer-vaccine-second-dose-delay/

Celebrating blogs and books…

It’s a celebration week! It’s been five years since I started this blog… five years and 225 articles! And I’ve learned a lot about writing as well as health along the way. My style has changed from quite “clinical” in early blogs (just the facts, ma’am!) to a much more personal and, I hope, more entertaining style.

My goals have been to keep being curious about health, to continue to read and learn as I did in my years as an active pharmacist… and to get you curious and interested in learning how to be healthier–and live longer and better–too. I hope you’ve enjoyed the journey as much as I have.

To celebrate my milestone, I ordered some author paperback copies of my newest book, The Pharmacist is IN; Answers to Health Questions You Didn’t Know You Had, just for fun. There’s something about holding a book in your hands, isn’t there? Especially one that you’ve written yourself! If you didn’t get a chance to look it up when it was first published as an e-book in May, the book is a sampling of my blogs, gathered together in an interesting way, to be sold inexpensively (or given away!) to “showcase” and introduce people to my blog, while getting them to focus more their health.

Not on Amazon this time…

Unfortunately, unbeknownst to me, Amazon has changed its rules regarding books made from previously published blogs. “Blogged” books aren’t allowed on their platform now, although I’ve bought books there made this way in the past and thoroughly enjoyed them (even knowing I could have found the same material in bits and pieces for free by spending time searching for it).

Strangely, my book shows up in an Amazon search, but only as an “out of stock” paperback. However, it’s available as an e-book at many other online retailers. The paperback version is also available to local bookstores, to order in through their regular wholesalers, on request. I was disappointed that there don’t seem to be other online stores that do “print on demand” (printing and shipping single copies for individual customers). If you know of one, please let me know–many of my readers prefer print books!

So, to celebrate my 5 years as a (somewhat) serious writer, I’ve put the e-book version on sale (for free!) for anyone who is interested for a few weeks. Here is the link to all stores where it’s available as an e-book: https://books2read.com/u/bwoB1Z (Note: all links work except the Amazon one, so you can go to Kobo, Apple, Google Play Books, Barnes and Noble or others—all have my book for $0.00 for the next few weeks). Feel free to share the link with anyone who might be interested (or who you think ought to be thinking more about their health 😊)

Have you tried audiobooks?

I also decided to create an audiobook and it’s available now too through all major online bookstores (except Amazon!). I did this for 2 reasons: it helps me edit better when I read the material out loud, and my children (and, I’m learning, many others!) love the audiobook format because they can listen on their smart phone, usually with headphones, while doing other things like walking the dog, driving to work or doing the laundry!

The audiobook publishing company I use also provides 100 codes I can give away to provide free copies. So, if you’d like to listen instead of read, or are just interested in trying out the format, email me and I’ll send you a code for a free copy!

The audiobook, like the e-book, can be loaded onto any smart phone, tablet or computer and, I understand, the program to listen is built into the code link (I’m new to this…let me know if you have any problems and I’ll find the answers!). The free app to read the e-book format can be downloaded by clicking a link on the page (usually at the bottom) of any of the online stores, so they make it easy to try out e-books and audiobooks!

I have both the Kobo and Kindle (Amazon) apps on my phone and tablet. Of course, reading on a tablet is more like reading a book because of the size of the screen, but I like having a few books on my phone too, in case I end up sitting in a waiting room somewhere, with nothing to do. I also have a storage card in my phone for extra space to download lots of books, although it’s not necessary. I find the apps very easy to use, and both of the apps I have work in a similar manner.

Extra benefits of e-books…

The great thing with e-books is, when you’ve finished reading a book, you can have another one ready to go. And, when you go on vacation, it’s much easier to pack all those juicy beach reads! There are tons of books that are free or very inexpensive in e-book form. I subscribe to two services, Kindle Buffet (all the books you can eat!) and The Fussy Librarian, that send a selection in book categories of your choice every day.

And library books too!

You can also access library e-books, through a program called Libby, using your local library card number. Hoopla is another library service that works similarly–my first book, Can I Speak to the Hormone Lady? Managing Menopause and Hormone Imbalances, is available there and The Pharmacist is IN has been submitted to Hoopla, too, and should be available soon. I’ve been a library user since I was a child and love to support libraries!

Lastly, I’ll let you in on a little secret—online companies monitor how many times a book is looked up, downloaded and commented on (or “reviewed”) and they use this information to decide how often they will show the book to people who are browsing their site. So, if you find my compilation of blogs interesting, I hope you will leave a little comment to help others find it.

And THANK YOU in advance! Every little bit helps…

Here are the links to get the e-book or audiobook for free:

The Pharmacist is IN e-book https://books2read.com/u/bwoB1Z

My email to request a code for a free copy of the audiobook: Jeannie.Beaudin@gmail.com

#FreeAudioBook #FreeBook #HealthyLifestyle

We know that the COVID-19 mRNA vaccines (Pfizer and Moderna) can give 90 to 95% immunity within a few weeks of having both shots. But how well do they protect after only one shot? Do we really need a second shot? And how long is it safe to delay it? Lastly, what can we expect to be able to do differently while we wait for our second injection (about 3 months for most Canadians).

Here in Canada, our government decided to delay the second COVID-19 injection, to allow more people to get their first shot while supply is limited. It seems to me that this is a smart decision, even though it’s not what is recommended by the manufacturer. But the government has based its decision on emerging science and, like so many aspects of this new pandemic, we’re learning as we go and adjusting what we do as the science emerges.

How well do our bodies respond after the 1st shot?

Creating immunity is a process. You can think of it as your immune system learning something new. Just like in school, lessons are presented to you, then you have to study for a while to actually learn the material. With vaccines, the shot is the “lesson” and then your immune system has to get to work and learn what it has to do to protect you from the virus. This can take several weeks, and during this time, your immunity will gradually rise.

I found results of testing with the Pfizer vaccine and, since the Moderna vaccine works in the same way, results could be expected to be similar. Here are some numbers for how much protection was found after one shot:

· 70% protection against getting COVID-19, 3 weeks after the 1st shot

· 90% protection against hospitalization, 4 to 5 weeks after the 1st shot

Do we really need a 2nd shot?

While some may think that the first injection must give you half immunity and the second tops it up to the 85 to 95% we’ve heard about in the studies, it’s not quite like that. As you can see from the numbers above, at 4 weeks and longer, experts say you are probably still increasing immunity from the first shot.

But remember when you were in school, how reviewing the material would help you remember it much longer? With vaccines, the second shot picks up from the first, giving your immune system some extra training so it will remember how to fight the virus longer… In other words, your immunity will last longer if you get the second shot. So, yes, you do need the 2nd shot to keep the effect lasting longer.

How long does the first shot last?

Since the vaccine is so new, scientists still don’t know how long our immune systems will be able to recognize and fight off the coronavirus, even after the 2 injections. They suspect we may need a yearly booster. Remember “cramming” to refresh the knowledge stored away earlier so you could recall it more quickly during an exam?. Similarly, getting a yearly booster just before the virus season starts, as we do for the flu, can help our immune systems recognize the coronavirus more readily when risk of infection increases, as we stay inside more during the cooler weather in the fall and winter. Scientists will continue to measure how long immunity lasts and future immunization schedules will be based on what they learn.

This is the third coronavirus we’ve had to deal with in the past few years… SARS (aka SARSCoV1 or Severe Acute Respiratory Syndrome), MERS (Middle East Respiratory Syndrome that fortunately didn’t reach North America) and now SARS-CoV2 that causes COVID-19.

Scientists warn us that, the longer this virus circulates in humans anywhere in the world, the greater the risk it will mutate into an infection that can evade current vaccines. I was happy to hear that patents may be suspended on the current vaccines, opening up production to any company with an appropriate facility. We need to get vaccines to every country in the world for their protection now and for our protection in the future. The more the virus spreads anywhere in the world, the greater the risk of variants and new strains that can cause another wave.

Happily, I’ve read that researchers are also working on a vaccine that will work against all coronaviruses. If they are successful, we could expect that it might give at least some protection against the next SARS-CoV virus that comes along as well as the current one.

What can we expect to be different after the first shot?

Prime Minister Trudeau told us this week our communities should be able to open up somewhat, once 75% of the population has received their first shot. However, our top doctors warn that we will still need to continue some level of restrictions (although likely not quite as strict) to prevent a 4th wave… something none of us wants. It’s looking like we won’t be going to big music concerts this summer but the border to NS should be able to open up, allowing us to visit our kids. We love the “Atlantic bubble” we have when all provinces have low case counts!

But it all depends on making sure every case is tracked to its source, and everyone exposed is isolated to stop the spread. No exceptions. The variants are so contagious, it only takes one person doing a few errands or attending a gathering to start an outbreak.

And once you’re fully vaccinated?

Studies are ongoing to ensure fully vaccinated people cannot transmit the virus to others, even if they don’t get sick themselves. There’s also the problem with variants: will the existing vaccines protect us from these viruses that are slightly changed? Unfortunately, new variants continue to be found as the virus spreads around the world, and each will need to be tested and verified to be susceptible to the vaccine. I read this week about a triple-mutated variant that’s been discovered in India, dubbed the Bengal Strain. More changes in the virus increase the chance that it can evade the vaccines.

Supplies of vaccine are increasing quickly here in Canada, and our injection rate may soon be limited by the number of people who are trained to administer injections. At this point, that sounds like a good problem to have! Pharmacy technicians are being trained in some provinces to increase the capacity of pharmacies to immunize—a great idea, in my opinion. And many nurses and doctors have come out of retirement already to staff many of the government-run vaccine clinics.

Until significant numbers of people everywhere are vaccinated, the coronavirus will continue to circulate and mutate. I was glad to hear talk of suspending patents on vaccines so many more manufacturing plants can be more easily set up, greatly increasing world supply.

The future…

Once this virus has been brought under control around the world, the work needs to begin to build better global systems to monitor for new viruses, share information and develop systems to control contagious diseases. If not, we could be facing another pandemic all too soon.

As for me, I’m thinking that a mask or two will become a regular part of my travel gear, especially when flying. And it might just be a good idea to keep one handy during flu season too. It’s amazing that we didn’t have enough cases of the flu this year to declare that flu season had started! I think I’ve gotten over the discomfort of wearing a mask in public and will keep using one both to protect myself when it seems necessary and to protect others when I have a cold… how about you?

References:

Why your 1st COVID-19 shot is more protective than you might think—CBC News Second Opinion

#CovidVaccinationFirstAndSecondDose

Finding cures, debunking myths, searching for causes

Cancer research is gradually turning cancer into a chronic disease for many and a cure for significant numbers. Cancer is a generic term for a collection of diseases that can affect any part of the body. While there are similarities in these diseases, there are differences that require tailored approaches. The causes vary with various types of cancer.

Similarities

All cancer involves uncontrolled growth of cells in the body, caused by damage to the growth control mechanism in the cell. Most of the time, damage is repaired by our immune system or the cell just dies, preventing cancer from developing. Too high a rate of damage (for example, caused by daily cigarette smoking) or too little repair (for example, increases in rates of cancer as we age and our immune systems become less efficient) can increase the chance of a damaged cell growing and dividing unchecked.

Differences

Some cancers are easier to detect, either because of where they are located (e.g. on the skin) or because we have a test that will detect changes early (e.g. mammograms for breast cancer, PSA blood tests for prostate cancer). Like any disease, cancer is easier to treat successfully when detected early, while the growth is small and hasn’t spread.

Cancer myths debunked

Myth—Cancer is a death sentence

In increasing numbers, cancer is becoming a chronic disease or is cured completely. We all know someone who had cancer 10 or more years ago and is doing well. I have a friend whose cancer was 25 years ago and has had no sign of recurrence.

The 5-year survival rate for all cancers combined is now about 67%; those for breast, prostate and thyroid cancers are 90% or better. Researchers are constantly finding better treatments and methods to detect cancers early when they are more easily treated. Survival rates have increased by 1.5% on average each year since 2001.

Of course, ideally we want researchers to find the causes of cancers and to recognize pre-cancerous changes so we don’t need to suffer through treatments and worry. Cell changes in the cervix, and bowel polyps are now recognized as potentially pre-cancerous changes that are searched out and treated before cancer can develop.

Myth—Cancer is contagious

Cancer cannot spread from on person to another. However, a few cancers are caused by an infection that can be passed to another person. Two examples are cervical cancer, caused by human papillomavirus (HPV), and liver cancer, that can be caused by hepatitis B and C viruses. We now have vaccines to prevent these infections which are reducing the cancers they cause.

Myth—Cell phones cause cancer

Somehow the rumour that 5G cell signals cause cancer has been spreading through the internet. While we do know that exposure to ionizing radiation (e.g. X-rays) can cause cancer, cell phones emit radio waves, a type of non-ionizing radiation that has never been found to cause cancer.

Myth—Artificial sweeteners cause cancer

Although older sweeteners, like cyclamate combined with saccharin, were found to cause bladder cancer in lab animals, currently used sweeteners, like stevia and the sugar-alcohols (e.g. erythritol, sorbitol), have been well tested and were found to be safe. Aspartame has also been tested in over a half million human subjects and no links were found to various cancers, like lymphoma, leukemia or brain cancer.

I’ve found that aspartame and some of the other artificial sweeteners tend to have an unpleasant aftertaste, however, especially when too much as been added. Of course, we know that too much added sugar is bad for our health. Excess artificial sweetness may fit into the same category by keeping up our cravings for the sweet taste. But it’s surprising how quickly our taste will adjust to less added sweetness, as it does for decreased salt. Since cutting back on sugar and salt, I find many commercial baked goods too sweet or salty for my taste preference now. I commonly reduce sugar in recipes by 1/3 to 1/2.

Myth—Herbal medicines can cure or treat cancer

While some natural medicines or treatments like acupuncture and massage may help with side effects or the stress of cancer or its treatment, none has been shown to cure or treat cancer.

Remember that herbal medications are medicines still in their natural form, and can have side effects or drug interactions you need to watch out for. For example, kava kava may cause liver damage and St. John’s wort can increase the effects and side effects of some antidepressants, since it works by a similar mechanism. Be sure to discuss any use of herbal medicines with your doctor or pharmacist.

Myth—Most cancers run in families

While an estimated 3 to 10% of cancers are the result of inheriting a faulty gene from a parent that increases cancer risk, most cancers are not inherited. Most cancers are believedthoroughtly to be caused by damage to one or more genes that starts in a single cell during a person’s lifetime.

A newer alternative explanation for cancer, being investigated, is that damage occurs to the energy-producing mechanism of the cell (the mitochondria), providing the cell with unending energy to grow and divide faster and longer than normal cells that die off after a finite number of cell divisions. Interesting research… hopefully it will result in new ways to treat or prevent cancers.

But even inheriting a bad gene doesn’t necessarily mean you will get the associated cancer. Genes need to be “expressed” or turned on to have an action, in this case, increasing a person’s chance of developing cancer. Epigenetics is the study of the factors that turn particular genes on and off, and these factors can be controlled and changed. This research is also working toward new treatments and prevention strategies for cancer.

Myth—There is no cure for cancer

Many cancers today can be cured, especially if detected early. Testicular and thyroid cancers have a 60% cure rate. Breast, prostate and bladder cancers are cured around 50% of the time. These percentages increase each year, as cancer researchers do their work.

Cancer prevention

Many cancers are preventable. For example, according to the WHO report on Cancer in 2020, 2.4 million deaths occur every year due to use of tobacco products. Other known risk factors are heavy alcohol consumption, excess body weight, physical inactivity, and poor nutrition.

There are also known environmental factors, like exposure to certain pesticides and herbicides, asbestos, second-hand tobacco smoke, radiation and excess exposure to the sun’s ultraviolet rays that cause cancers. Too few of the chemicals we use have been thoroughly tested for carcinogenic (cancer-causing) activity.

And there are many chemicals produced inside our bodies that cause or stimulate cancer growth too, like oxygen radicals, excess hormones and other substances that induce inflammation or stimulate growth of malignant cells.

I keep watching for research into causes for cancer, so we can all take steps to avoid this terrible group of diseases, but it’s also important to take advantage of screening strategies for early detection that scientists have developed. Researchers tell us that about half of all cancers could be prevented.

More resources need to be directed toward cancer causes and prevention. While cures are increasing, overall rates of cancer are increasing too. And even when the science is there (for example, smoking has been known to cause cancer since the 1950’s) it can take decades for change. We need better systems to turn scientific discoveries into action and results. This is called “knowledge translation”… on average, it takes 17 years for a scientific discovery to be implemented as regular practice or policy. COVID research has been a refreshing and inspiring exception, thank goodness! It’s been inspiring and informative to watch the science evolve and be implemented in such a short time.

During the month of May, Cancer Research Month, please pause a moment to thank and support the researchers who continually strive to eliminate cancer by researching treatments, causes and prevention strategies.

References:

Medical myths: All about cancer – Medical News Today

Colon polyps – Mayo Clinic

Cancer-causing substances in the environment—National Cancer Institute

Tobacco use causes almost one third of cancer deaths in the WHO European Region – World Health Organization

A Call For More Research On Cancer’s Environmental Triggers—NPR

#CancerResearch #CancerResearchMonth