What's New
Looking to quit smoking??? Check out this motivation....
http://www.driventoquit.ca/english/home/index.php
New Year ... New You!
Check out all the great programs we have to offer in the new year to help you adopt a healthier lifestyle!!
Looking to Adapt a Healthier Lifestyle??
Healthy Heart
Did you know that Heart Disease is the leading cause of death in Grey Bruce
Register today for this 4 week program that provides information and support regarding risk factors, signs and symptoms of heart disease, medication, stress management and exercising safely.
February 7th, 14th, 21st & 28th, 2012 10:00 AM - 12:00 PM Walkerton Clinic Meeting Room
For more information or to register contact us 519-507-2021 x24 or click here to email us!
Cholesterol Class
Learn what your numbers mean and what you can do to improve your cholesterol levels and reduce your risk for cardiovascular disease.
February 24th, 2012 10:30 am - 12:00 pm Walkerton Medical Clinic
February 29th, 2012 2:00 - 3:00 PM Durham Medical Clinic
For more information or to register contact us 519-507-2021 x24 or click here to email us!
Chronic Pain Self Management Program
People often assume their pain is the sole cause of their symptoms. However, each symptom contributes to other symptoms creating a vicious cycle. Learn how to break this cycle and gain control back in your life!
January 10th - February 14th 2012 1:00 - 2:30 pm Walkerton Medical Clinic Meeting Room
For more information or to register contact us 519-507-2021 x24 or click here to email us!
Wanting to get more active??
Check out this great video that explains the number one thing you can do for your health!
What Is the Single Best Thing You Can Do For Your Health
Click on Above Image to Find Out More!
Functional Fitness for Older Adults
A 60 minute class geared to seniors to help them maintain their physical independence.
Class is held at three of our locations monthly.
Elmwood Fire Hall 1st Tuesday 10:00 - 11:00 am
SBGHC Walkerton 3rd Thursday 3:00 - 4:00 pm
Mildmay Medical Clinic 4th Tuesday 10:00 - 11:00 am
SBGHC Chesley 4th 4th Friday 3:00 - 4:00 pm
**Paisley Functional Fitness has been discontinued at this time due to low attendance**
Click here to register online now or contact us 519-507-2021 x 24.
All of our programs are offered free of charge!
Just the Basics Activity
February 16th, 2012 10:00 - 11:30 am Walkerton Clinic Meeting Room
A 90 minute session to help you incorporate activity into your lifestyle!
For more information Contact Us (519) 507-2021 x 24 or 1-866-507-2021 x 24
or click here to register online.
Looking to Adopt Healthier Eating Habits ??
Just the Basics Nutrition
Find out what small changes you can make that will help you manage your weight, prevent or manage diabetes, or simply improve your nutritional health.
February 13th, 2012 1:30 - 3:00 PM Mildmay Medical Clinic
For more information Contact Us (519) 507-2021 x 24 or 1-866-507-2021 x 24
or click here to register online.
**For more updates check out our facebook page**
Memory Clinic -
Held once a month in Chesley, Durham and Walkerton. A nurse, social worker, pharmacist and physician meet with you and your family/ friend. Our goal is to identify and manage your memory issues early, helping you to maintain your independence as long as possible through early treatment and proper supports to help you.
Weight Management -
Our team provides information, support and monthly follow up to help you achieve your health goals.
Chronic Pain Self Management Program -
A series of workshops (2.5 hrs. each) that run once a week for six weeks. Topics include healthy eating, depression management, medications, working with your health professional, making informed treatment decisions and much more to help you manage your condition. Please call to find the session nearest you.
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Article List (Click on article title to jump to article)
- High Blood Pressure (Hypertension) - By Sharon Musehl, RN
- “I Just Found Out I Have Type 2 Diabetes” What Next? - By Marion Cooper, RN, CDE
- Keeping Abreast of Lactation - By Marion Cooper, RN, IBCLC, RLC
- On the First Day of Christmas… - By Michelle Walter, RN BScN
- Non-compliant...Not! - Lorne Alexander B.Sc.Pharm., R.Ph., C.R.E., Pharmacist
- Food & Mood - Jennifer MacTavish, Registered Dietitian
- Warts - Danielle Bannerman, B.Sc (Hons), D. Pod M.
- Salt & Garden Hoses! - Kim Biesenthal, RN and Kathleen Keeshan, BSc
- Measure Your Waist, Not Your Weight! - Kim Biesenthal, RN and Kathleen Keeshan, BSc
- The Team Approach To Health Care -Kathleen Keeshan, BSc
- Dealing With The Winter Blues - Susan Dietz, RSW
- Regular Physical Activity? A Fountain of Youth? - Gillian Hurley RN BScN
- The Dance - Daphne J Williams, MSW, RSW
- Words - Daphne J Williams, MSW, RSW
- Holiday Eating -Heather Bal, Registered Dietitian
- Eating Together...For your Health - Jennifer MacTavish, Registered Dietitian
- Break the Fast with Breakfast - Gillian Hurley RN BScN
- Falls in Older Adults: Are you at risk? - Pat O'Neil, Kinesiologist
- Feeding Your Picky Eater - Jennifer MacTavish, Registered Dietitian
- Brockton & Area FHT Takes Part in Diabetes Initiative-Kim Biesenthal, RN
- Know Your Numbers By Michelle Walter, RN BScN
- The Kids are Heading Back to School...What do I send in their lunches? By Jennifer MacTavish, RD
-Flu Shots & Pneumovax By Kim Biesenthal RN
-Your Nurse Practitioner By Heather Barrett NP-PHC
-Be Smart About Your New Years Resolutions By Natalie Kerr, RN BScN
-The Potential Risks of Texting - Daphne J Williams, MSW, RSW
High Blood Pressure - Hypertension
By Sharon Musehl, RN
High blood pressure (sometimes called hypertension) affects 45% of Canadians, yet half of those with high blood pressure are not even aware that they have a problem. You can have high blood pressure and still feel fine which is why high blood pressure is referred to as the “silent killer”.
Blood pressure is the pressure or force of the blood flowing through your blood vessels as your heart beats. A top number of 140 or higher and/or a bottom number of 90 or higher mean that you have high blood pressure. If you are diabetic, the recommendation is that your BP be no higher than 130/80.
High blood pressure can damage the lining of arteries anywhere in the body. If untreated, it narrows and stiffens the arteries, reducing the amount of blood flow. High blood pressure can double or even triple your risk of heart disease, including heart attack and congestive heart failure, lead to stroke, and increase your risk of kidney disease.
There are risk factors for hypertension that you cannot control. These include age, gender (males over 55 and women after menopause), family history and ethnicity.
There are many risk factors that you can control. Maintain a healthy weight – even losing 5 pounds will lower your risk of high blood pressure. Thirty to 60 minutes of moderate physical activity most days will help prevent and manage high blood pressure, high blood cholesterol, unhealthy weight and stress. Eat more fruits, vegetables, whole grains and low fat dairy foods. Cut down on salt in your diet. Prepackaged foods, canned vegetables and snack foods are very high in salt. Limit your alcohol intake to no more than one to two drinks a day, or a weekly maximum of 14 drinks for men and 9 drinks for women. Smoking contributes to the build up of plaque in your arteries, increases the risk of blood clots, reducing the amount of oxygen in your blood, and causes the heart to work harder. Control your diabetes. Take time to relax.
The Brockton and Area Family Health Team is available to help you manage your high blood pressure. We can arrange for a dietitian to help develop a menu plan, a kinesiologist to look at activity that is appropriate for you, and a nurse educator to give you the information that will allow you to manage this condition. Please call the Family Health Team in Walkerton, Mildmay, Paisley, Durham or Chesley to take your first step to reducing your risk.
“I just found out I have Type 2 Diabetes” What Next?
By Marion Cooper, RN, CDE
A diagnosis of Type 2 diabetes can be met with feelings of surprise or disbelief. Patients will often say, “But I don’t even eat sugar”; “ The test was high because I was away on holidays”; “I feel fine, so it can’t be serious”. There are many misconceptions about Type 2 diabetes. Eating too much sugar does not cause diabetes. It is a disease in which your pancreas does not make enough insulin, or your body does not use insulin properly. High blood glucose (sugar) levels often have no symptoms; the first symptom may be detected because of a complication such as a heart attack, or at an eye examination.
Good management of diabetes can help slow down the progression of the disease and eliminate or delay the risk of heart attack, stroke, kidney disease, blindness and other complications. A diabetes team can help you manage your diabetes.
Your family physician focuses on your overall health and will work with you to achieve healthy targets for blood sugar, blood pressure and blood fat levels (cholesterol). Lab tests and examinations will be ordered to screen for complications.
A dietitian, diabetes nurse educator and your pharmacist can increase your awareness of healthy living and appropriate treatments, and coach you through everyday challenges. Support is available when difficulties occur.
Poorly controlled diabetes can lead to dry mouth causing ulcers, fungal infections and tooth decay. Dry mouth can cause dentures to be uncomfortable. Regular dental care is important. Foot problems are common in people with diabetes. Your chiropodist, or a nurse with advanced skills in foot care, can help take care of your feet preventing serious complications to your feet.
If needed, a social worker or counsellor can guide you to community resources and provide you with support for emotional stress, and personal or financial problems. Your optometrist should be seen each year to examine your eyes, looking for potential problems. Early detection of damage to your eyes (even before symptoms arise) can be treated and prevent serious complications including blindness. A kinesiologist or exercise specialist can offer guidance in exercising safely and teach you how to stay active even when there are challenges that make exercising difficult.
If complications occur or if diabetes is difficult to manage, your family doctor can refer you to an endocrinologist - a diabetes specialist. Other specialists such as nephrologists, cardiologists, neurologists or internists may be needed.
The most important member of the diabetes team is YOU - the person living with diabetes! You will have the information to manage your diabetes by making sure you:
• monitor your blood glucose levels regularly
• have laboratory and screening tests done
• have your glucometer checked regularly by bringing it to the laboratory to correlate with the laboratory readings
What else can you do? Choose a healthy lifestyle by maintaining a healthy weight, eating 3 balanced meals, keeping active and taking medication as prescribed. Take care of your feet and ask for help when needed.
“Keeping Abreast of Lactation”
By Marion Cooper, RN, IBCLC, RLC
Many people wonder why someone would need help with breastfeeding. Isn’t it natural? Breastfeeding is a normal physiological process, but the art of breastfeeding is influenced by many external factors. Some of these factors may relate to sleepiness due to jaundice, medications used during labour, a difficult delivery or low blood sugars at birth. Some babies refuse to latch on because of positioning or because of mucous in their airways. Early supplementation with a bottle may cause confusion when learning to breastfeed. A baby may have a small mouth or need to learn how to use his tongue correctly. The mother may be too uncomfortable after delivery to get positioned correctly without help, or have nipples that are difficult for a new baby to latch on to. Some mothers have had surgery to their breasts in the past, which may affect their milk supply. Fear of not having enough milk may also influence how breastfeeding starts out. Conflicting information from books and well meaning people can also be a factor. Most concerns can be addressed and with support and early intervention, can be corrected.
Societies traditionally had women who would assist with the delivery of babies, and women who helped mothers with breastfeeding challenges. Today, many babies are surviving that would not have in the past, such as premature or special needs babies. These babies, due to their health condition, may have special feeding needs. That, and the relatively new invention of infant formula (late 1800s), which gained popularity in the 1920s and then again in the 1960s, have many new mothers in a situation that makes breastfeeding unfamiliar to them. Many traditional societies encourage the mother to rest for up to 6 weeks following birth. Her only duty is to tend to her baby; household help and childcare is obtained from relatives or is hired.
When should a mother call for breastfeeding help? If the mother is feeling overwhelmed or has questions; for latch-on difficulties, nipple or breast pain, low milk supply, slow weight gain, premature babies, special needs babies, breastfeeding and returning to work, re-lactation, information on pumping and storing milk – these are some of the reasons to seek assistance. A Lactation Consultant will have up-to-date information, provide options, let you know the advantages and disadvantages of each option, and support the mother in what she feels is best for her and her baby.
The Brockton and Area Family Health Team provides support and information to mothers who are breastfeeding. This service is provided by an International Board Certified Lactation Consultant (IBCLC). An IBCLC is a health care provider who specializes in the clinical management of breastfeeding and is certified by an International Board of Lactation Examiners. The IBCLC offers prenatal breastfeeding education, postnatal support, and information to help manage breastfeeding challenges.
Together with the Grey Bruce Public Health Unit, the BAFHT offers a breastfeeding clinic each Wednesday, in Walkerton. New mothers can schedule an appointment to discuss any aspect of baby care with a Public Health Nurse or breastfeeding concerns with a Lactation Consultant. Whether you are having breastfeeding problems or just need reassurance, feel free to call the Brockton and Area Family Health Team.
On the First Day of Christmas…
By Michelle Walter, RN BScN
This holiday season give your true love or yourself the gift of health and wellness. When it comes to chronic disease, 80% of Canadian adults over the age of 45 can expect to live with one or more chronic conditions. Depending on the condition, 80-90% could be avoided with healthy lifestyle choices. A healthy lifestyle means managing the five modifiable risk factors: nutrition, activity, stress, alcohol and tobacco.
Lifestyle changes can be overwhelming. Whether we are aware of it or not, we all make numerous decisions each day that impact our health. During this holiday season think about the following Twelve Days of Christmas to help you develop habits that will help keep you or your loved one well.
On the First Day of Christmas, get 10 minutes of activity. Try parking on the far side of the parking lot; when you get home, walk out the lane or around the block; take stairs over the elevator. Activity accumulates throughout the day. The aim is 30 minutes most days of the week.
On the Second Day of Christmas, compare a set of food labels. Food labels can seem overwhelming, but practice makes perfect. Start by comparing labels between your favourite products. Remember to note the serving size.
On the Third Day of Christmas, wash your hands to prevent the transmission of germs. Before you eat; after being in public places; after using the bathroom. Hand washing is your primary defence system.
On the Fourth Day of Christmas, eat breakfast. Breakfast continues to be the most important meal of the day. To rev up your metabolism, you need to fuel your body with nutritionally sound food - start with 3 out of the 4 food groups at breakfast.
On the Fifth Day of Christmas, have your blood pressure checked. Five million Canadians have high blood pressure and almost half don’t know it. High blood pressure along with high cholesterol and diabetes are the leading risk factors for developing heart disease - the highest cause of death in Canada. Optimal blood pressure is 120/80. Automated blood pressure machines are located at multiple locations - give it a try!
On the Sixth Day of Christmas, find and experience a moment of joy. In the beauty of a falling snowflake; the freshness of the air; holding the door for someone; or smiling as you greet a stranger on the street. Research is demonstrating the positive healthful impact of joy in the management of chronic disease. Joy is in our hearts to be felt!
On the Seventh Day of Christmas, add a fruit and vegetable to your lunch. Five - ten servings of fruit and vegetables each day provide your body with vitamins, minerals and fiber, all needed to keep your body functioning optimally. The way to get them is one at a time.
On the Eighth Day of Christmas, if you choose to smoke, delay your first cigarette of the day. Your success with breaking your habit will increase if you delay your first cigarette by 30 minutes after you wake up.
On the Ninth Day of Christmas, spend 5 minutes in the morning stretching. Stretching lengthens your muscles and keeps them from tightening. By staying flexible, you will be able to help maintain your activities of daily living and independence.
On the Tenth Day of Christmas, follow your 5 minutes of stretching with 5-10 deep belly breaths. Most of us only use a fraction of our lung capacity. Filling our lungs to the fullest helps nourish our body with needed oxygen. It also helps promote relaxation, therefore a great stress buster too!
On the Eleventh Day of Christmas, drink smart. Christmas holidays are social times and with that goes social drinking. Bruce County is above the Canadian and Provincial averages for binge drinking. Low risk drinking guidelines suggest 1-2 standard drinks per day, adding up to less than 14 drinks per week for men and 9 for women.
On the Twelfth Day of Christmas, enjoy your holiday food and keep your waistline in check with portion control. By simply cutting back the amount you consume and aiming to fill half your plate with vegetables, you will save calories and in turn save inches.
Best wishes for health and happiness in 2010 from the Brockton and Area Family Health Team!
By Lorne Alexander B.Sc.Pharm., R.Ph., C.R.E., Pharmacist
As we reach different milestones in life, we come closer to the realization that we are not immortal. Our joints start to protest, our blood pressure and/or sugar rises, our indulgences of youth make themselves known, gravity takes effect in many different ways, and all the diverse changes associated with aging take place. Some of these changes are the genetic gifts passed to us from our parents, some of them we can hold off with targeted modifications to our lifestyle, and some of these risk factors we can modify with medication or some other surgical or medical intervention. Risk factors for chronic disease, whether heart disease, arthritis, osteoporosis, COPD or many more, are well documented and hopefully, we are all becoming more aware of what they are in today’s more open healthcare system. Knowing them is one thing, taking steps to modify or improve our personal risk factors is the next logical step. No matter the time of life, it is always the right time of year to make adjustments to our lifestyle in order to improve our chances of spending more time above ground enjoying the changing seasons. New Year’s resolutions anyone? Our involvement with our health should go further. Within today’s healthcare system, rarely are we told what to do without any background information. More commonly, our input and involvement are asked for in formulating a treatment plan that is both acceptable and achievable. Our commitment to that plan is expected and we can certainly benefit from the results whatever the disease modifying processes are. Our plan will generally be flexible to accommodate changes as we progress through the different stages of life. As always in life, there are no guarantees and extended warranties are not yet available, however... In the future, our diet, exercise, surgical and certainly our medication options may be chosen with regard to our genetic makeup, as already it is realized that certain drugs are more or less effective depending on our origins. Our adherence to our personalized treatment plan is a measure of our commitment to life and is our responsibility. No longer can we be deemed non-compliant if we fail to follow our healthcare providers’ plans, as we actually had a hand in shaping them! Indeed, self-management of our health conditions is the model towards which chronic care is striving in the developed world. Use of lifestyle management techniques, such as maintaining a healthy varied diet and regular aerobic exercise within our capabilities, coupled with the use of a personalized medication plan targeted to our individual characteristics is the best chance we have of maximizing our lifespan. Slàinte Mhath! (Good Health)
By Jennifer MacTavish, Registered Dietitian
While the importance of healthy eating on our physical health is well established, many people do not realize that what we eat also affects our mental health. Our brain is an organ, just like our heart or our liver, and our brain chemistry is sensitive to nutrition. Food can affect how we feel, think, and behave.
Our brains are made up largely of fats and water, making these nutrients an integral part of brain health. While fat is not hard to come by, the typical North American diet is low in omega-3 fats. Increasing our intake of foods rich in omega-3 fats such as fatty fish (salmon, trout, mackerel, and sardines), canola oil, almonds, walnuts, and flax oil will help to tip the ratio of fats into better balance for optimal brain health.
A steady supply of fuel, in the form of glucose, is also required for our brains to function. Whole fruits, vegetables, legumes, and whole grains are good sources of fuel. Glucose is also important in helping certain amino acids enter into our brains. Amino acids come from protein-rich foods and are the building blocks for neurotransmitters (messenger cells) such as serotonin and dopamine. These neurotransmitters influence our mood, memory, and cognition.
Limiting our intake of trans fats is also good for our mental health. Abundant in processed and convenience foods, snack foods, and commercial baked goods, trans fats impair our brains ability to use omega-3 fats. In addition, while refined grains and simple sugars (from food or beverages) deliver glucose into our blood stream, they do so too quickly and therefore do not provide a steady and consistent fuel supply for our brains.
So what can you do to ensure you have the right nutrients available to help maintain your mental health?
• Eat regular balanced meals and snacks throughout the day.
• Include protein-rich foods with your meals (fish, lean poultry, eggs, low fat milk products, legumes, and soy products).
• Emphasize whole grains, fruits, vegetables, and legumes. These foods are more filling, release glucose more slowly, and have a higher nutritional value than refined grains and high sugar foods and drinks.
• Increase your intake of omega-3 fatty acids, emphasizing fish sources. Include 2-4 servings of fatty fish per week. Choose healthy fats such as canola and olive oil more often than saturated and trans fats.
• Stay well hydrated. Include water throughout the day, and limit your intake of sweet and caffeinated beverages.
• Alcohol can decrease your mood in the long run, and your body uses up some important nutrients (thiamin and zinc) in the process of detoxifying, which may further reduce your mood.
• Don’t forget – activity releases endorphins that make us feel good and help us relax. Outdoor activities also expose you to sunlight, which can be uplifting as well.
• If you’re hungry before bed – skip the chips and pop. Grab a protein rich snack with a small sweet or starchy food (such as a glass of milk and a banana) to help increase your serotonin levels which will have a calming effect.
• Eating a balanced diet high in whole foods will help you meet your vitamin and mineral needs. Some people may benefit from a multivitamin, or from supplementation with specific nutrients. Talk to you health care provider.
By Danielle Bannerman, B.Sc (Hons), D. Pod M.
One of the most common complaints seen in a chiropody office is plantar warts. These are noncancerous growths caused by the Human Papilloma Virus (HPV). Different strains for this virus will result in different types and patterns of warts. While they may die naturally within two years, they may need to be removed sooner if irritating, painful, or continue to multiply. Because the incubation period for warts is 1-20 months, it is impossible to tell exactly when the virus was introduced into the body.
Anyone can contract the Human Papilloma Virus but plantar warts are most often seen in children and young adults. Incidence is also higher in people who share common bathing areas such as gym members and swimmers. In essence, HPV invades the body through tiny cuts of breaks in the skin. Normally, antibodies in the blood will destroy the virus but sometimes it takes refuge in the skin resulting in a plantar wart. Therefore a plantar wart is more likely to develop with repetitive HPV exposure or a weakened immune system because of certain drugs or illness.
Warts can be firm, rough, bumpy lesions with tiny pinpoint dark spots inside or they can have a smooth surface with a grey-yellow or brown appearance. They can occur anywhere but those located on areas of pressure or bony prominences tend to be the most irritating. Some strains will result in clusters called mosaic warts.
Most often, a health care professional will apply a mild topical acid to treat plantar warts. This may include salicylic acid or cantharidin. These treatments usually require multiple applications over the course of several weeks. They work by disintegrating viral cells to allow healthy tissue to replace them. Cryotherapy involves freezing the wart with a very cold solution such as liquid nitrogen (sodium nitride). This destroys the virus, causing it to turn black and fall off within a few days. This treatment is ineffective in some cases, as the solution cannot penetrate deep enough to completely destroy the virus. Other treatments include laser therapy, debridement, and immunotherapy. With any wart, expect a minimum of three treatments, as warts can be very persistent. The sooner a wart is treated, the better the treatment success.
Many simple habits can help prevent contracting a wart. Avoid walking barefoot whenever possible especially in public shower rooms. This predisposes the foot to cuts and scrapes and allows better exposure to HPV. Check children’s feet periodically. Avoid direct contact with warts on other people or other body parts. Do not ignore growths or changes in the skin. Keep a strong immune system with a balanced diet, adequate sleep, non-smoking, and good stress management techniques.
Just because you can squeeze into them, doesn’t mean they fit…
By Danielle Bannerman, B.Sc (Hons), D. Pod M.
As a parent, it’s natural to worry about your child’s health. Children’s teeth, eyes, ears, and most other body parts are examined regularly as they mature. However, the normal developing foot often goes unnoticed as typical signs and symptoms won’t arise until adulthood. Wearing the wrong footwear can result in hammer toes, ingrown nails, foot corns, calluses, and bunions. Heavy shoes with poor support can also alter a child’s natural gait and muscle development resulting in general foot fatigue, flat feet, and soft tissue complications. By improving a child’s footwear, risk of common foot disorders can be minimized to prevent associated pain and discomfort.
At any age, the most important thing to look for when buying shoes is fit. Children’s feet are very malleable with a lot of fatty padding. Therefore, they can adapt easily and will rarely complain about scrunched toes or areas under a lot of shoe pressure. It is more likely that a child will avoid wearing shoes, prefer to be carried, or trip regularly if they are having difficulties with their feet.
Ideally, kids should have their feet measured every three months to ensure they are wearing the correct size. This means there is at least a thumb width (1”) between the end of the shoe and their longest toe when standing. In general, the foot will grow a half size every 2-3 months for children 16-24 months old, every 4 months for 2-3 year olds, and every 4-6 months for those over 3 years old.
Make sure the general shape and function of the shoe is similar to the shape and function of the child’s foot. Typically, children have wide, straight feet so the sole, or last, of a shoe should not be overly curved. Avoid buying shoes in the morning, as feet will be their longest and widest at the end of the day. The less the foot slides or lifts in a shoe the better. Velcro, laces or buckles along with a firm heel counter at the back will keep the heel in place and help stabilize the foot without having too tight of a fit. The sole should only bend at the ball of the foot where the foot flexes, not in the arch. Toe boxes should be round, wide, and deep to give the toes room to move.
With children being so active, their feet need good airflow. Shoes made from leather or canvas material will have better breathability then a synthetic or plastic material. Fungus thrives in warm, dark, and moist environments so good airflow can help prevent athlete’s foot from developing.
It is important to remember that shoes should not need to be “broken in”. If they do, they are either poorly designed or poorly fitted. Similarly, avoid buying shoes that are too big in hopes that the child will grow into them. This requires a greater muscle action that results in muscle fatigue and strain. Due to foot structure, biomechanics, gait patterns, and activity type, different areas of the shoe will break down differently with each individual and change the overall structural properties of the shoe. Avoid wearing worn out or hand me down shoes as they can place the foot into an abnormal position. Remember, prevention is always easier and cheaper than treatment!
By Kim Biesenthal, RN and Kathleen Keeshan, BSc
Despite its bad reputation, salt is essential for animal life. Refined table salt is composed mainly of sodium (Na) and chloride (Cl). In chemistry, sodium and chloride are called ions and both are necessary to sustain human life. Salt is also a great preservative – that’s why so many canned and processed foods contain such high levels of sodium. Salt controls the water content of the body. Too much, or too little, salt in the diet can cause muscle cramps, dizziness and problems with our electrolyte balance. Managing our salt intake in today’s world of refined and processed foods is less daunting a task than it seems. Just remember - it is nearly impossible to get too little salt in our diet. The bigger problem is getting too much!
It may not seem like a lot, but a pinch and a dash of salt soon add up quickly to unhealthy levels of sodium in our diets. Too much sodium (Na) is a factor in the escalating number of individuals being diagnosed with high blood pressure, or hypertension. The more salt we eat, the more fluid our bodies retain. The more fluid we retain, the higher our blood pressures.
Think garden hose! Crank open the faucet, keep the nozzle closed and the pressure inside the hose builds up. Either open the nozzle, or the hose will split. The same is true with our bodies. Build up the pressure inside our blood vessels and they, and our organs, will suffer the same fate as the garden hose. Sometimes physicians will prescribe water pills or diuretics – these flush water and sodium from the body – this is equivalent to opening the nozzle. Other times, physicians will add drugs that relax or widen our blood vessels – like buying a more flexible, wider hose – or drugs that slow our heart rate – similar to reducing the amount of water, and hence the pressure, coming through the faucet from the pipes!
Health Canada recommends a daily sodium intake for healthy adults of less than 2300 mg, or about 1 teaspoon.
Here are a few basic tips to reduce your salt/sodium intake:
1. Choose processed and canned foods less often. Whenever possible, rinse canned foods like tuna or vegetables to remove the salt that is used to preserve them or purchase sodium-reduced brands.
2. Remove the saltshaker from the table and use herbs and spices in its place.
3. Use less salt when cooking.
4. Choose fresh and frozen fruits and vegetables more often.
5. Avoid smoked, cured and pickled foods.
6. Reduce the amount of convenience and fast foods that you eat – salt enhances flavour and is used extensively in the fast food industry.
7. Always read labels! Limit products listing salt, sodium, monosodium glutamate, sodium nitrate or sodium caseinate.
As you slowly reduce your salt intake, your taste buds will adjust and you might notice a change in your blood pressure!
FACT: Reducing your salt intake by 1 teaspoon per day can lead to a drop in blood pressure of approximately 6 points for systolic blood pressure (top number) and approximately 3 points for diastolic blood pressure (bottom number).
For improved cardiovascular health, be a mover and a shaker, but leave the saltshaker in the cupboard!
Measure Your Waist, Not Your Weight!
By Kim Biesenthal, RN and Kathleen Keeshan, BSc
If you have been eating healthier, following Canada’s Food Guide for meals and snacks, and adding physical activity to your daily routine, congratulations on choosing a healthier lifestyle! Take the next step and evaluate your success by measuring your waist instead of stepping on the bathroom scale.
Initially, your weight may not decrease with the introduction of exercise (even though your clothes will be fitting better!). This can be very discouraging and interfere with your ongoing success. Muscle tissue is more dense than fat – this means that there are more muscle cells than there are fat cells in the same volume of either. Although five pounds of muscle weighs the same as five pounds of fat, five pounds of muscle takes up less space because the muscle cells are more tightly packed. Imagine, if you change five pounds of fat to five pounds of muscle, then you will look, and feel, slimmer. In addition, muscle cells burn calories more efficiently than fat cells and as your muscle mass increases, so will your metabolic rate. Be patient and in time, you will notice a difference on the scale!
Your waist measurement WILL improve if you are following Canada’s Food Guide and have added regular physical activity to your daily routine. Waist circumference is a strong predictor of your risk of diabetes and cardiovascular disease. In the past, the risk of chronic diseases, such as these, has been measured by calculating Body Mass Index (BMI) and by using blood and other tests. Now, physicians can also use your waist measurement to monitor your risk.
To take a proper waist measurement, clear your abdominal area of clothing. Stand upright with your feet a shoulder’s width apart, facing a mirror. Locate the top of your hipbones and align the bottom edge of the measuring tape with the top of your hipbones on both sides of your body. Make sure the tape is parallel to the floor and not twisted. Relax and take two normal breaths. After you let the second breath out, tighten the tape around your waist. The tape should fit snuggly around the waist without depressing the skin (keep your stomach relaxed at this point). Still breathing normally, observe the measurement on the tape.
Target waist measurements for men should be no more than 40 inches, or 102 cm, and for women, 35 inches, or 88 cm. If you fall outside of the targets, you can make changes to improve the numbers. Please speak with your health care provider.
Losing excess weight may make you feel better about the progress of your diet, but reducing the size of your waist may reduce your risk of some chronic diseases!
The Team Approach to Health Care
By Kathleen Keeshan, BSc
The Brockton & Area Family Health Team (BAFHT) is one of the 150 Family Health Teams (FHTs) currently established by the Ministry of Health and Long-term Care in the Province of Ontario. The Family Health Team concept is a new approach to provincial healthcare and is designed to reduce wait times, and to improve community access to healthcare services at the local level. Family Health Teams are fully funded by the Ministry and use “state of the art” information technology to provide secure access to health records and lab results. Family Health Teams offer a “holistic” approach to healthcare. This means that the “whole” person is treated, and that, in addition to physical symptoms, psychological and social factors affecting the individual’s health are also considered during the healing process. Family Health Teams use a “population” approach to healthcare – that is, the needs of the entire population served by the FHT are considered, not just the needs of those individuals who come in for appointments. This gives the FHT a better understanding of the programs and services required in the community.
The Brockton and Area Family Health Team (BAFHT) is a group of healthcare professionals, each with their own area of expertise. Like any good team, we have great players; we work together; and we share a common goal. That goal is to provide the local community with the highest level of healthcare possible – we strive to find new ways to improve healthcare and we evaluate both current practices and new innovations for their success in meeting that end. The BAFHT works collaboratively with local health and community service providers, forming community partnerships.
The BAFHT has administrative offices in Walkerton, Chesley and Durham, and satellite clinics in Mildmay and Paisley. Our team consists of Family Physicians, Nurse Practitioners, RN/Health Educators, Kinesiologists, Social Workers, Dietitians, Pharmacists, Foot Care Specialists and Administrative Staff.
If your family physician is a member of the BAFHT, he/she will have the support of the BAFHT healthcare professionals and you will benefit from their on-going care. You will continue to see your family physician on a regular basis; however, other members of the Brockton and Area Family Health Team may assist your physician in providing primary healthcare services, chronic disease management, and self-help tools to help you manage your health and well-being. Our team members will help you navigate through the healthcare system, offering support and encouragement along the way.
By Susan Dietz, RSW
Do you dread winter and wish you could hibernate like the bears? Are you counting down the days until Spring? Are your moods low, are you eating more and do you wish you could sleep all the time? If so, you could be suffering from Seasonal Affective Disorder or SAD.
Seasonal Affective Disorder is a mood disorder in which people who have normal mental health throughout most of the year experience depressive symptoms in the winter or, less frequently, in the summer, spring or autumn, repeatedly, year after year. Studies done in Ontario indicate that 1 per cent to 3 per cent of the general population has SAD. Another 15 per cent of people have the ‘winter blues’, symptoms similar to SAD, but not to the point of having a clinical depression. Recent studies estimate that SAD is more common in northern countries because the winter day gets shorter as you go farther north.
There are a few different theories as to what causes SAD including a lack of serotonin (which has various functions, including the regulation of mood, appetite, sleep, muscle contraction, and some cognitive functions including memory and learning). It could be the production of melatonin, which tells our body that it’s nighttime. Bright light at daybreak is the signal for the body to stop producing this melatonin. But on dull winter days, especially indoors, not enough light is received to trigger this waking up process. Another explanation is that vitamin D levels are too low when people do not get enough Ultraviolet-B on their skin.
Symptoms of SAD tend to start from around September each year lasting until April, but are at their worst in the darkest months. They include changes in mood like irritability, depression, despair, misery, guilt, anxiety, and normal tasks become frustratingly difficult. Sleep is also affected in that you have difficulty waking up in the morning, you tend to oversleep and need naps throughout the day. Some people crave carbohydrates and chocolate, which leads to weight gain. You might experience joint pain or stomach problems, have a lowered resistance to infection, experience sweating, cramps or frequent urination. Other symptoms include difficulty concentrating on completing tasks, withdrawal from friends, family, and social activities and the potential risk of suicide in some people experiencing SAD. Women are twice to three times more likely to suffer from the winter blues than men. Though symptoms can be severe, they usually clear up.
Fortunately, SAD can be effectively treated. One of the most effective treatments is the use of light. One useful tool is a light box because it enters through the eyes, not through skin exposure to light. Light boxes work by reducing the release of melatonin in the brain. For best results, use a light box daily, in the early morning, and for around 30 minutes a day. You don't have to stare at the light, so you can watch TV, just make sure that light reaches your eyes. These light boxes are available through your pharmacist. People using light therapy can experience improvement during the first week, but increased results are evident when continued throughout several weeks. Other tricks include exposing yourself to sunlight as early in the morning as you can, exercise, go on a trip to a sunny destination, eat a balanced diet, maintain your schedule and routine, seek out family and friends for support, antidepressants, vitamins, and counselling. If you believe you are experiencing symptoms of SAD, please consult with your doctor to confirm this. It is also important to consult with a pharmacist before trying over the counter and prescriptions interventions.
Regular Physical Activity: A Fountain of Youth?
By Gillian Hurley RN BScN
It’s not unheard of anymore for people to reach the ripe old age of 100. Thanks to medical advances, hitting 100 is not all that rare. The number of Canadian Centenarians climbed by 21 percent between 1996 and 2001 and is expected to increase significantly by 2050.
The sad news is that despite this trend in longevity and medical advances, a staggering number of Canadians are still facing death due to being overweight and obese. In fact, nearly 60 percent of people residing in Ontario die of factors related to being overweight. This percentage is even higher in our own Grey and Bruce Counties where there is a 63.2% mortality rate for those who are overweight and obese.
People with unhealthy weights have an increased likelihood of developing life-threatening conditions such as heart attack, stroke, high blood pressure, cancer, and diabetes. Studies tell us that those who carry excess weight around their middles are at an even higher risk of lifestyle related health problems. In most cases, these conditions can be prevented by choosing a healthy lifestyle and by participating in regular physical activity. Even a modest weight loss of 5-10 lbs can make a huge difference in improving your health.
Regular Physical Activity can boost your mood, metabolism, circulation and heart in order to ward off conditions that can drastically shorten your life span. Increased activity will also have an impact on increased brain health as well. What is good for your heart is good for your brain! It is estimated that even if you are currently inactive, and then become active, you can reduce your risk of heart attack by 35-55%. It’s never too late to begin an activity that’s right for you! Try to enjoy some moderate activity such as biking, walking, swimming or dancing for at least 30 minutes most days of the week. An active lifestyle, paired with a healthy diet can drastically improve your health, enabling you to look, and feel younger and healthier.
Even though reaching the age of 100 may not be in the cards for each and every one of us, we can at least dip into some regular physical activity and reap the benefits of youth and health at any age.
By Daphne J Williams, MSW, RSW
Relationships have been described in many ways. My favourite is to see it as a dance and our partner as just that, our partner. Dances are varied, salsa, waltz, merengue, polkas, and require different skills and strategies. However, if you think about it, the key to dancing well together is that the partners focus on one another – watch each other – hold each other – support one another – and either lead or follow each other. If one takes their eyes off of the other there is often a misstep. The dance begins to look awkward and if they focus on the mistake the dance will worsen. If they place their focus back on their partner they are back in step and the dance continues. If we take a salsa dancer and a merengue dancer and put them together as partners, they will need to create new strategies for the dance. One will need to slow down; they will need to remember the new steps. One thing is certain; they will not dance well together if they keep doing what they are comfortable with.
Some couples dance so easily together they appear joined and connected to one another. The reason, they are connected. They know the steps; the music and they know to trust one another. Other couples look clumsy while dancing. They make it look like a lot of work. Some couples look like they do not even care about one another or the dance. The bottom line is that if you want to dance well together you must focus on the dance and on your partner.
Relationships are exactly the same. Some couples make it look easy. They fit together and move through their lives together. If one of them looks away and there is a misstep, they refocus and the dance is strengthened. Other couples compete to lead because neither wants to follow or be seen as the follower. But neither the dance nor the relationship will work if no one follows. That does not mean that one or the other always gets to lead or follow. It does mean that at all times there is an identifiable leader and follower. Now before you stop reading, imagine this. One of you has a remote control (leader), the other asks to watch a different programme (lead changes), the remote holder changes the channel (follower). There is nothing wrong with following. The mistake is in either wanting or needing to lead at all times.
As in any task, if we focus on what we are doing rather than something else we have a better chance of being successful. We may need to learn new skills or strategies in order to get there but if we are willing to work and willing to change – we will succeed.
So, what does your relationship look like? Are you dancing well? Are your eyes on your partner? Are you enjoying the dance? If so, continue! If not, are you willing to take lessons? Are you willing to refocus your attention on the partner you chose to dance with? Dances can last a lifetime.
By Daphne J Williams, MSW, RSW
Words are what we use to communicate. Sounds simple enough, right? After all, we have been using “words” since we learned to talk, and for the most part, if we use words well, others understand what we mean. However, there are a few words that (although we are using them in the correct manner) tend to change the meaning of what we mean to say. Let me say before I let you in on this little known secret, that when I first heard these words I actually said to myself “I’ll never be able to talk again”. And yet, when you realize how they change the meaning of what you are saying; when you realize that they can actually prevent you from having your question answered directly; and when you realize that by using one word in a sentence you are actually telling your child to do what you want them not to do; eliminating these words from your vocabulary is not all that difficult. Of course, as with most grammatical rules, there is an exception, but, even the exception will work in your favour if used correctly when you communicate with others. Ready?
Now, before you panic, there are only four words you need to remember, and two that will make a significant change in how you speak and how you are understood. I will explain in order of least important to most important. That way, I will leave you with the ones which will (when used consistently) change how you communicate with others.
SHOULD: “shouldisms” are in truth parental instructions. We “should” eat broccoli. We “should” wear a hat in the winter. We “should” never, ever go outside with wet hair. (But, what about the beach?) We “should” always listen to our elders. Etc. Etc. When I think of this word, I usually see the body stance of the person talking. Standing, with one hand on the hip and the other pointing at you with one finger wagging. The position indicates that they know more than you do, and that you had better listen and do what they say. The answer to “shouldisms” is usually “Who says?”.
BUT: this word “negates” everything that went before it in the sentence. If I were to tell you that I really loved you new green dress, “but” that it would look better in blue, what would you hear? Would you believe that I liked your new dress? Or not? “I believe you, but...” “That’s a good point, but...” “I’d love to do that with you, but...” Etc. What is interesting about this word is how often it is used, and often, it is used without any intention. It is used as a filler word, or something to say while we are thinking of what to say next. Yet, the person we are talking to hears it as a negative, which then causes them to defend themselves. When we cause someone to “defend” himself or herself, we change the rest of the conversation. We change how we are talking and how the other person is listening. One little word, and yet, so significant.
WHY: a why question makes the presumption that the person being asked could have, if they wanted to,prevented that action which causes the question to be asked. For instance, “Why did you break the glass?” If I can answer that question, then there is the likelihood that I could have prevented the glass in question from being broken. So, if the answer is that I walked into the table – bumped the glass off – thus breaking it; then if I had walked around the table, the glass would not be broken. “Why were you late?” “Why did you say that?” So, what do you say instead? When asking questions use the other “action” words. Who. What. When. Where. How. If I ask what happened to the glass, the answer can be “I bumped into the table”. How come you were late? - “I had a hard time getting out of the house this morning”. Etc. If you think this word cannot make a difference like that, all I ask is that you test it out.
DON’T: if you are only going to try one of these, try this one. Don’t is the single most favourite and overused word spoken by parents. “Don’t slam the door”. “Don’t talk back”. “Don’t wander away”. “Don’t touch anything”. What happens nearly every time is that the child slams the door, talks back, wanders away, touches what you have asked them not to. The reason this happens is interesting. Don’t, as a word, has no access to the brain. If I ask you to think of a green alligator dressed up like the Easter Bunny, what do you do? You will either visualize what this might look like or tell yourself what it would look like. Now if I say “Don’t think of a pink flamingo dressed up like Santa Claus”, what do you do? The same thing, right? This word does nothing for what follows it – and the instruction then is in the words that come after “don’t”.
Thus, if you tell your child “Don’t slam the door”, what you have said to them is “Slam the door”. Say, “Don’t wander away”; you have told them to wander. Etc. The consequence then of their obeying your instruction is they get into trouble for not obeying you. The parent is angry, and the child is confused. The other factor of using the word “don’t” is that it can be said in an angry sounding way. We can yell “don’t” quite loudly.
So, what can you say instead? You can ask your child (and it works with adults as well) to do what you want them to do. You can say “listen to me”, or “stay with me in the store”, or “close the door quietly”, or “do not touch anything”. In case you are wondering, “do not” is heard differently than “don’t”. And, it is difficult to yell “Please listen to me”. In my practice I have tested this. Say to a child “Don’t slam the door” (as they leave the office) and then ask them to “Close the door quietly” and you will get what you asked for both times. The door will slam, and be closed quietly.
Four little words used every day with often-negative consequences. There is an exception, but I am out of space so will talk about that later. So, test these words out. I think you’ll be surprised at the results.
By Heather Bal, Registered Dietitian
‘Tis the season of sweets and treats! Staying committed to healthy eating and active living can be tough over the holiday season. Being surrounded by tasty temptations is hard enough, but many holiday foods and beverages are also higher in calories and fat. Don’t despair – you can still take part in the festivities and enjoy your favorite foods, without compromising your waistline. Here are some tips to keep healthy eating and active living on your mind over the holidays.
Plan ahead. Before you attend a Christmas party or dinner with friends, have a game plan. Think about what foods and beverages might be offered and what choices you want to make. Having a healthy snack before you go will help prevent overeating. It is easier to make healthy choices when you are not feeling ravenous.
Stick to the basics. When at home, make healthy food choices regularly. Remember to include three meals daily and enjoy healthy snacks between meals. Proper meal spacing can help you from getting too hungry. When eating out, watch for the appetizers and desserts. Choose small amounts of foods that are your favourites or that are not available to you on a regular basis.
Keep healthy choices on hand. Stock your fridge with brightly coloured vegetables and fruits. Use low fat dips such as yogurt or hummus to add flavor. Purchase lean meats, low fat cheeses and un-salted nuts. Try to make healthy choices 80% of the time; this will allow 20% for indulging in your favourite treats. When bringing food to parties, be the one to offer the fruit or vegetable platter. You might be surprised how popular these items can be.
Watch your portions. Remember that our eyes tend to be larger than our stomachs. Take a few small appetizers that are your favorite and skip the others. During the main course, remember to fill half your plate with vegetables, a quarter of your plate with your grain and the remaining quarter of your plate with your protein. Avoid going back for seconds. When dessert arrives, take a few small pieces and some fruit on the side. Remember not to stand next to the food table, to help prevent mindless overeating.
Choose your beverages carefully. Alcohol, drink mixes and eggnog can be high in calories and fat. At parties and gatherings have some non-alcoholic options such as sparkling water with lemon and lime slices, virgin drinks and non-alcoholic or light beer. If you are serving eggnog, make it low fat. Try having a water or low calorie drink between alcoholic beverages to pace yourself.
Keep moving. Aim for at least 30 minutes of activity every day. Make moving around fun for the whole family. Build a snowman, go tobogganing, take a winter hike, skate, ski or just run around the house. Remember, activity is also a great way to get rid of some of the holiday stress.
Enjoy the festivities this season and keep these tips in mind for a healthy holiday!
Eating Together...For your Health
By Jennifer MacTavish, Registered Dietitian
Are extracurricular activities and demanding work schedules getting in the way of your family meals? Despite the potential benefits, 25-33 % of families report rarely, if ever, eating together as a family.
Families who frequently eat meals together are more likely to eat healthy balanced meals, have higher intakes of fibre, fruit and vegetables, and lower intakes of fried foods, soft drinks, and saturated and trans fats. Frequently eating family meals together may also reduce the risk of substance abuse and improve social adjustment in adolescents.
Increasing opportunities for your family to enjoy meals together requires a team effort. Everyone in the family can participate.
- Eat meals together as often as possible
- Involve the whole family in planning meals ahead of time
- Everyone has a role in meal preparation. Preschoolers can wash vegetables and set the table. School aged children can read recipes, gather, measure, and mix ingredients. Older children can take responsibility for 1 part of the meal (such as a salad or vegetables).
- The first person to arrive home can get the meal started.
- Clean up can be done by everyone.
- Adopt a flexible meal-time to accommodate changes in evening schedules. Make sure there is a healthy snack available for days when your evening meal is later than usual.
And don’t forget to turn the TV off during your meals. Watching television during meals may counteract the benefits of eating together as a family.
Are you looking for more information about nutrition? Try this website: www.dietitians.ca/eatwell. Dietitians of Canada has launched a new interactive tool called the recipe Analyzer. Plug in the ingredients of a favorite recipe and it gives you a nutritional analysis. That includes a full nutrient profile, the number of food guide servings and tips on how to change the recipe to make it more nutritious. On the same website you'll find EATracker. It lets you track your day's food and activity choices and compares them to guidelines set by Health Canada.
By Gillian Hurley RN BScN
Unfortunately, skipping breakfast seems to be increasingly common. If you’re someone who has been known to miss this essential meal of the day – whether you’re trying to save time or slash calories – you may want to reconsider this decision, especially if you’re trying to control your weight.
When you don’t eat breakfast, you’re actually fasting for several hours at a time causing blood sugar levels in your body to decrease. Blood sugar, or glucose, is what our body relies on for energy to think and do. In other words, if we compare our body to a car engine, without sugar for fuel, we would certainly tucker out mid-trip. For this reason, a balanced breakfast can certainly break the fast and provide necessary energy for optimal functioning during the day.
Our body is governed by metabolism, which is the rate at which the body’s internal engine operates as it performs functions such as breathing, and regulating heart beat and body temperature. As one ages, metabolism can slow down making weight loss and maintenance more difficult. A healthy, balanced breakfast can jump-start metabolism and ensure a revved up engine for the day ahead. Without a morning meal, we can remain sluggish and miss out on burning extra fuel, or calories, during the morning hours and beyond.
Studies have shown that obesity rates are undoubtedly increased in people who do not consume a healthy breakfast. Eating in the morning, preferably within one hour of rising, reduces hunger later in the day, making it easier to avoid overeating later on. Just as skipping breakfast is highly not recommended, skipping any meal is equally disadvantageous. The human body recognizes when we deprive it of necessary nutrition. When it cannot locate food energy, it takes necessary body water and muscle for fuel. Muscle is what burns calories and fat in the body.
So, if you think you’ve fooled Mother Nature by cutting out meals, and excitedly see the scale numbers decrease… beware. In all likeliness, this lost weight is not fat as desired, but rather, water and muscle mass. If for whatever reason breakfast has not made it into your daily routine, you may wish to do your mind, body and health a favour and include it every day!
Falls and Older Adults: Are You at Risk?
By Pat O’Neil, Kinesiologist
Do you have difficulty rising from a chair without assisting with your hands? When you walk through your house, do you often touch the edges of furniture for a little support? Do you limit your physical activity because you are afraid of falling? Are you a little unsteady on your feet but choose not to use a cane as you’re “not quite ready” for that yet? If your answer is “yes” to any of these questions you could be at an increased risk of having a fall.
Of course, falling is common across our lifespan; but unlike the scrapes or bruises we’ve all had as youngsters, the consequences of falling as we age become more significant. Every year, 1 in 3 adults over age 65 will have a fall that may result in the inconvenience of a fractured wrist, the loss of independence of a fractured arm, or the life threatening fractured hip. That’s right; life threatening. Statistics have shown that if we follow four people who have had hip fractures, we will likely only find one to have returned to his previous lifestyle a year after the fall. Two from this group will have moved from their home to a residence where they can be provided assistance with daily activities. The fourth individual will have died.
However, many falls can be prevented. Researchers have found that 30% of those who have fallen were thinking of other things or not paying attention and another 30% were taking risks such as rushing, carrying objects heavier than they could handle, or wearing unsupportive shoes.
As the winter months approach, make plans to stay active so as not to lose the muscle strength needed to keep you steady on your feet. Check for activity programs in your community or for opportunities to walk indoors such as at community centers, churches or stores. If you use a walking aid, make sure the rubber tread is in good condition and consider the addition of an ice pick for use when walking outdoors.
In addition to our physical strength, flexibility and balance, there are many other factors that can affect our risk of falling. Changes in vision, certain medications, nutrition, blood pressure, posture, pain and conditions such as arthritis and osteoporosis can all increase our risk or affect the severity of the injury if we do fall.
The assistance you need to help prevent you from falling may be as close as your Family Health Team. Check our Community Calendar for upcoming programs. Ask our pharmacist about your medications. Check with our dietitians about your nutrition. Ask about having a falls risk assessment or check with our kinesiologist for a fall prevention activity plan.
By Jennifer MacTavish, Registered Dietitian
Whether it’s a half eaten lunch returned from school, or a supper plate still full of vegetables and meat, parents often become frustrated by their children’s eating habits. Parents may describe their children as “picky” eaters or worry that they aren’t getting enough nutrition. It is not uncommon for parents to give in and offer less healthy foods in an effort to get their children to at least eat something.
The truth is that children’s appetites fluctuate day to day. While we may have an expectation of how much our children should be eating, we need to trust that they are following their own hunger cues. Only the child (and not their parents) can decide if, and how much to eat of the food and beverages offered. As a parent, it is important to honour that division of responsibility. By persuading our children to eat more than they want, we undermine their own hunger and satiation awareness.
And yet, as parents, we too have responsibilities to help ensure our children obtain good nutrition:
- Parents are responsible for what food and beverages are available to their children. If your child opens the cupboard to see it full of chips and cookies, they (much like us adults) are going to be tempted by those yummy treats. If, however, those less healthy foods are not regularly available, your child will be more willing to eat healthy foods. Keep a bowl of washed and ready to eat fruit sitting out on the kitchen counter, or set out a plate of cut up vegetables with some dip around snack time. Healthy snacks help children obtain adequate nutrition, so make healthy foods available for both meals and snacks and you’ll be setting the stage for healthy eating.
Make one meal that the whole family can enjoy and offer a variety of foods at each meal. Include 3–4 food groups from Canada’s Food Guide at each meal. Avoid making a separate meal or offering alternatives for your “picky” child. They will learn to accept the family foods, if that is what is consistently available.
- As a parent, you are also responsible for deciding when food will be offered. Children (and adults) thrive on consistent meal and snack times. Space your snacks at least 2 hours prior to meals to ensure your child has time to build up their appetite again before mealtime.
- Your final responsibility in the feeding process is to establish where food is offered. Eating at the table, as a family whenever possible is important. Keep distractions like toys, television, and other electronic devices (yours included) away from the table. Children and adults should not be walking around eating unconsciously, nor should parents be intentionally distracting their children in an effort to get more food into them.
Keep in mind that children are naturally resistant to new and unfamiliar things. Food is no exception. It takes multiple exposures to new foods before children will accept them. If a child sees you eating something, they will be more likely to try it. Children like to use their senses to explore a new food prior to tasting it. Give your child the opportunity to look at, feel and smell new foods before putting them into their mouths. Often we give up too early and assume that just because our children did not enjoy the food the first time, it will never be accepted. Children’s taste buds are changing all the time – continue to offer new foods in different ways in a relaxed and non-judgmental environment. You’ll be surprised what foods your children eventually will come to enjoy. Involving your child in meal planning and preparation is another great way to expose them to foods. Finally, keep in mind that children’s tummies fill up easily, so avoid offering sweet beverages or excess milk throughout the day, which can compromise little appetites. Water between meals is recommended. Limit fruit juice to ½ cup per day and milk to 2 cups per day. Keep meal times relaxed and avoid using food as a reward or punishment.
Happy Eating!
Brockton & Area FHT Takes Part in Diabetes Initiative
By Kim Biesenthal, RN
Partnerships for Health (PFH) is an innovative South West LHIN initiative that helps primary healthcare providers improve the care they provide to patients with diabetes. The Walkerton site of the Brockton and Area Family Health Team has been part of ‘Wave One’ of this project since May of 2008. The Durham and Chesley sites came on board later, as part of ‘Wave Three’.
This project provided a unique opportunity to apply the Ontario Chronic Disease Prevention and Management (CDPM) framework. With support from the Ontario Government, health practitioners are able to integrate components of the healthcare system by sharing information across the continuum of care. For example, through our attendance at Learning Collaboratives and monthly teleconferences, we were able to see other teams’ successes and challenges, learning from their processes and resources.
We focused on patient needs in an effort to improve diabetes related complications. Our pilot group of patients focused on patients with Type 2 diabetes in Drs. Paul and Sue McArthur’s practices. We have been able to plot specific benchmarks such as A1C results, blood pressure, diabetes foot exams, cholesterol and depression screening to name a few. Within our pilot population, we have seen all benchmarks improve and have learned where we still need to concentrate our efforts to improve our diabetes care. One area identified as still needing improvement is the number of diabetes patients having received the pneumococcal (pneumonia) vaccine. Since the beginning of the project, we have improved our numbers by 40%, however, the goal is 90% and we still fall short. We therefore need to focus our efforts on patient education and on regularly offering this vaccine.
Our work was not solely evaluated on the specific benchmarks for Gold Standard Diabetes Care. An evaluation team from the Centre of Studies in Family Medicine at the University of Western Ontario is responsible for evaluating the clinical team integration. The evaluation methodology includes multiple approaches and measures such as patient interviews, provider surveys and chart audits. It is anticipated that, when all the results are in and tallied, the PFH initiative will show improvement in the following four key outcome measures: partnership development (i.e. with the local CCAC, optometrist etc.), patient empowerment, clinical measures and improved communication and sharing of information between partners within the circle of care.
A project such as this would not be possible without the cooperation from the patients. Thank you to the patients who have participated in the past three years – know that your input will impact diabetes care and resources in the future.
By Michelle Walter, RN BScN
Do you know what your numbers are and what they mean to your health? When it comes to preventing or managing diseases of your heart and blood vessels (called cardiovascular disease), numbers such as blood pressure, cholesterol, blood sugar, weight and waist circumference are vital to your health. According to Heart and Stroke Canada, controlling these numbers can reduce your risk for developing a heart attack or stroke by up to 80%. These numbers can be controlled through a combination of lifestyle choices related to nutrition, activity, stress management, and the avoidance of alcohol and tobacco.
Blood pressure that is left too high over time will cause your blood vessels to “stiffen”. This process is the leading cause of heart failure. Optimal blood pressure should be 120/80 mmHg.
LDL or “bad” cholesterol clogs your blood vessels, filling them with plaque that causes hardening or stiffening, thereby increasing your blood pressure. LDL cholesterol for most people should be under 3.5 mmol/L, or less, if you have diabetes or cardiovascular disease.
High blood sugars damage the blood vessel. When your pancreas can no longer keep up with the demand for insulin, or if your body resists insulin, your blood sugar will rise. This process is called diabetes. When you have diabetes, a blood test called Hemoglobin A1C will be checked every 3 months to monitor how well your blood sugars are being managed. This number should be less than 7.0% mmol/L. Your physician or nurse practitioner can order a simple blood test to check for diabetes. One third of people with diabetes are undiagnosed (CDC, 2006).
High blood pressure, cholesterol and blood sugar together create a catastrophic effect on your blood vessels; left uncontrolled for long enough, it is not a question of if you will have a heart attack or stroke; it is a question of when.
Small healthy choices regarding your activity level and nutrition create a positive impact on your numbers, in turn creating a positive impact on your weight and waist circumference. As much as a 5% reduction in your weight will gain you benefits such as reducing your blood pressure and blood cholesterol. Even more important than weight is where you carry your weight. The weight you carry around your waistline is the most harmful. For men, the waist line (not belt line) should be less than 40 inches and for women less than 35 inches. An accurate waistline measurement is the mid point between where the rib cage ends and where the hip bone starts. Healthy lifestyle choices create a foundation to prevent and manage cardiovascular disease.
Depending on your medical conditions, you will have specific targets of where your numbers should be. For some, medication can be an invaluable tool to help manage and control blood pressure, cholesterol and diabetes. To get an individualized plan, speak to your doctor or health care professional. They can work with you to help you understand and manage your numbers.
The Kids are Heading Back to School...What Do I Send in Their Lunches?
By Jennifer MacTavish, RD
Good nutrition is important for learning, growth, and activity. Here are a few ideas for back to school lunches that will help your child obtain the nutrients they need to get through the school day, and minimize food wastage:
Pack it together:
- School aged children can help plan, shop for, and pack their school lunches and snacks.
- The more involved they are, the more likely children are to eat their food.
- Pack your own lunch at the same time so your child can learn from you.
Remember the fruit and veggies:
- Let them pick two servings of fruit or vegetables in their lunch every day.
- Cut fruit and vegetables up to make them more appealing.
- Pack a small container of “dipping sauce” such as vanilla yogurt for fruit or salad dressing for vegetables.
- Fruit sauces and fruit cups without added sugar are another good option.
Include variations of old favourites:
- Try different types of breads for sandwiches. Let your child pick out small whole grain bagels, pita pockets, tortilla wraps, or buns.
- Experiment with sandwich fillings – use left over meat from last night’s supper, canned fish, or cheese and cucumber in sandwiches.
Try something different:
- Homemade pizzas on whole grain bagels or English muffins are always a hit.
- Let your child pick out a fun thermos, and pack it with left overs such as chicken drumsticks, homemade stews and chilies, pastas or stirfries.
Skip the packaged convenience items:
- Although they are handy, many of these pre-packaged foods are high in salt, sugar, refined flours, and artery clogging fats, while lacking in nutrients.
- These convenience foods are often more expensive then home-prepared foods, and the packaging ends up in our landfill sites.
- Be careful of the marketing – many pre-packaged snack foods have packaging that makes them look healthy (think pictures of fruit, or words like “fruit flavoured”). Look again – many of these foods have little if any fruit and are nothing more than fruit flavoured candy. Many granola bars are chocolate bars in disguise. One hundred calorie snack packs are a great way to portion food, however aren’t always healthy choices. Buy some healthy snacks and package them yourself into small snack bags or container.
- Steer clear of things like cookie and dip snacks, which are loaded with sugar and artery clogging fats.
- Make your own snack packs. Pick up a compartmentalized container and pack some cheese, lean meat, or boiled egg, along with whole grain crackers or pita cut into triangles; add cut up fruit or vegetables.
Remember to pack healthy beverages:
- Include milk and a bottle of water.
- It’s okay to include a small amount of 100% fruit juice – aim for no more than one cup per day.
- Avoid offering sugary drinks or artificially sweetened beverages regularly such as pop, fruit drinks, sports and energy drinks.
Make snacks a healthy part of the day:
- Include cut up fruit or vegetables for snacks, whole grain crackers with cheese, milk, ½ sandwich (try the peanut-free soy nut butters), cottage cheese and fruit, homemade muffins or fruit loafs.
- It’s okay to include a small treat once in a while, as long as most of their food is healthy.
Use small containers:
- For younger children with smaller appetites, or limited time to eat, pack small portions of cut up foods that are easy for them to eat.
Have a healthy school year…
Find more ideas at Eat Right Ontario www.ontario.ca/EatRight
The Brockton and Area Family Health Team (BAFHT) provides many elements of care for a variety of ages and stages of life. Whether you are trying to quit smoking, prevent or manage a chronic medical condition, learn more about a health issue, medications or exercise, or obtain counselling, we can help. You can pick up a copy of our Community Programs Calendar at your local pharmacy, library, or medical clinic, or on the web at www.thehealthline.ca, “health events” section or www.bafht.com.
By Kim Biesenthal RN
Public Health recommends that all people (>6 months of age) in Ontario get an annual influenza vaccination. Influenza is often referred to as the “flu”, but is not to be mistaken for nausea, vomiting and diarrhea. Influenza is a respiratory illness with symptoms of fever, cough, muscle aches, weakness, sore throat and headache. While these symptoms are unpleasant and should keep you at home from work or school, it is the complications of influenza that are more concerning. Pneumonia, heart and kidney failure are very serious especially for the young, the young at heart, and those living with chronic illness (diabetes, heart disease, COPD, to name a few). This vaccination is FREE.
To compliment the flu shot, GOOD, FREQUENT HANDWASHING is vital in limiting the spread. You may also use hand sanitizers, however, they are not recommended to replace hand washing. Avoid groups when there is a flu/respiratory outbreak and be mindful of your personal space – keep your distance. Have a heightened awareness about shopping carts, public phones, door handles, etc.
This is also a good time of year to consider pneumococcal vaccination (pneumonia shot). This is recommended and FREE for those living with any chronic illness, and those 65 years of age or older. Pneumococcal disease is serious and caused by a strep infection that can cause pneumonia/meningitis and an infection in the blood stream called bacteremia.
FACT – invasive pneumococcal disease can be prevented with a safe, effective vaccine. You cannot get pneumococcal disease from the vaccine. Pneumococcal vaccine can be given at any time of year. It can also be given at the same time as the flu shot but in the opposite arm.
A single dose of pneumococcal vaccine is recommended for most persons. Some people may require a second dose if they were younger than 65 years of age when they received their first dose and it is now >5 years since that dose.
The most common side effects experienced with either the flu or pneumonia shot include swelling and tenderness at the injection site. A few people may experience mild fever and muscle aches. As with any medication, there is a small risk that serious problems could occur after getting a vaccine. However, the potential risks associated with influenza or pneumococcal disease are much greater than the potential risk associated with the vaccine.
(Adapted from the National Foundation for Infectious Diseases and from the Grey Bruce Public Health Immunization Fact Sheet.)
The Brockton and Area Family Health Team (BAFHT) provides many elements of care for a variety of ages and stages of life. Whether you are trying to quit smoking, prevent or manage a chronic medical condition, learn more about a health issue, medications or exercise, or obtain counselling, we can help. You can pick up a copy of our Community Programs Calendar at your local pharmacy, library, or medical clinic, or on the web at www.thehealthline.ca, “health events” section or www.bafht.com.
By Heather Barrett, NP-PHC
A Nurse Practitioner (NP) is a Registered Nurse with advanced university education and an expanded legislated scope of practice, providing personalized, quality health care to patients. We offer a full range of evidence-based services to individuals and families, which are provided locally through the Brockton and Area Family Health Team. We work autonomously and collaboratively with physicians, nurses, pharmacists, social workers, dietitians and other health care professionals to keep you and your family well.
As a member of your health care team, we provide care to patients of all ages with an emphasis on preventing disease, promoting good health and curing illness. Our knowledge and skill include the ability to:
- Diagnose and treat illness and/or injuries
- Order and interpret diagnostic tests
- Prescribe pharmaceuticals
- Provide treatments and/or procedures
- Make referrals to physicians, specialists and other health professionals.
We offer a variety of health care services, which include:
- Wellness care (i.e.: annual physicals, monitoring infant growth and development, manage women during and after pregnancy)
- Patient counselling (i.e.: mental health, family planning, medication compliance)
- Health promotion (i.e.: smoking cessation, weight management)
- Immunization against disease
- Screening for diseases (i.e.: breast cancer, colon cancer, osteoporosis)
- Treatment for short-term acute illnesses (i.e.: ear and throat infections, minor injuries)
- Management of individuals with chronic diseases (i.e.: diabetes, hypertension, asthma)
We have an approach to care that addresses the physical, emotional, mental and social aspects of your health. Studies about the benefits of Nurse Practitioners and about patients’ experiences tell us that NPs involve patients in decisions related to their care; improve access to primary health care; reduce pressures to the health care system; are valued and trusted by patients; and provide high-quality management of a variety of illnesses. In essence, NPs blend the medical knowledge required to diagnose and treat illnesses with the values and skills of nursing.
There are more than 3,000 Nurse Practitioners in Canada with the majority practicing in Ontario (more than 1,500). The Brockton and Area Family Health Team is fortunate to have four Nurse Practitioners covering clinics in Walkerton, Mildmay, Paisley, Chesley and Durham. As the most studied profession in Canada, we know that Nurse Practitioners provide safe and quality health care. To find out more about Nurse Practitioners, please visit the following websites:
Nurse Practitioner Association of Ontario: www.npao.org
College of Nurses of Ontario: www.cno.org
Canadian Nurses Association: www.cna-aiic.ca
The Brockton and Area Family Health Team (BAFHT) provides many elements of care for a variety of ages and stages of life. Whether you are trying to quit smoking, prevent or manage a chronic medical condition, learn more about a health issue, medications or exercise, or obtain counselling, we can help. You can pick up a copy of our Community Programs Calendar at your local pharmacy, library, or medical clinic, or on the web at www.thehealthline.ca, “health events” section or www.bafht.com.
Be Smart About New Year's Resolutions
By Natalie Kerr, RN BScN
It is hard to believe that yet another year has come and gone. This is the time when people reflect upon the past year and anticipate what the upcoming year holds for them. It is often a time of mixed emotions – sadness for the year gone and excitement for the future. The New Year is a time when many of us make resolutions for the upcoming year. This is a tradition that has been around for thousands of years and dates back to 153 B.C. The Mythical God Janus was placed at the front of the calendar because he had two faces – one to look back at the outgoing year and one to look ahead at the upcoming year – he became the symbol for change and resolutions.
Some of the most popular resolutions include: losing weight, eating better, quitting smoking, saving money, drinking less, and exercising more. Each of these resolutions can have a positive impact on health and well-being; however, we often struggle to maintain these resolutions because they are vague or unclear. For example, the resolution to lose weight is unclear. How much weight? If 2 lbs are lost is this acceptable? How will the weight loss be achieved? Research has shown that 22% of people stop trying to achieve their resolutions in as little as three weeks because they don’t incorporate SMART goal guidelines for creating their resolutions.
What are SMART goals? These are goals that are Specific, Measureable, Attainable, Realistic, and Timely.
Specific – This is a clearly defined goal that describes exactly what we want to achieve. It answers the question ‘What do I want to do?’
Measureable – This is a goal that is based on criteria that can be quantified to attain the goal. It looks at time, duration, and frequency. It answers the question ‘How much and how often will I do it?’
Attainable – When an important goal is identified, we try to figure out a way to achieve this goal by identifying barriers and determining solutions to overcome these barriers. It answers the question ‘How will I do it?’
Realistic – This is an achievable goal that we commit to and work towards. It answers the question ‘Can I do it?’
Timely – A specific time line is set for achieving the goal. It answers the question ‘When will I do it?’
By using the SMART goal guidelines, a framework can be developed to create an action plan for the successful achievement of goals. For example, a SMART resolution can be as follows: “I want to lose 8 lbs over the next two months. I will work to achieve this goal by walking at a moderate pace for 30 minutes five days a week before work and by increasing my fruit/vegetable intake to seven servings per day as outlined in Canada’s Food Guide. To keep myself accountable I will keep a daily record of my walking and fruit/vegetable intake to ensure I am meeting my goals.”
Following the SMART guidelines created the above goal; it describes exactly how to work towards achieving the goal and the steps taken to be accountable. When goals are achieved (no matter how big or small) it is important to celebrate your successes as it provides motivation to continue with SMART goal setting.
Healthy lifestyle changes can be successfully achieved through goal setting. Even though you may set an individual goal, there are many supports available to help you succeed. Look in your community for resources that may be available: fitness/walking programs; programs offered through the library or local school; Good Food Box program; health care providers; Municipal Offices; local gyms – the possibilities are endless.
When you are making your New Year’s resolution (or setting any goal) remember to make it a SMART resolution.
Wishing you a safe, happy, and healthy New Year from the Brockton & Area Family Health Team.
The Brockton and Area Family Health Team (BAFHT) provides many elements of care for a variety of ages and stages of life. Whether you are trying to quit smoking, prevent or manage a chronic medical condition, learn more about a health issue, medications or exercise, or obtain counselling, we can help. You can pick up a copy of our Community Programs Calendar at your local pharmacy, library, or medical clinic, or on the web at www.thehealthline.ca, “health events” section or www.bafht.com.
The Potential Risks of Texting
By Daphne J Williams, MSW, RSW
Admittedly, I grew up in an era without computers, without Blackberries, iPads, cell phones and other texting devices. My house had two phones – one in the kitchen and one in the den. Yes, they called it the den. As children, we never even considered using that phone. We used the one in the kitchen – the one with the two-foot cord. There was no privacy. When we wanted to speak with a friend, we either went to their house or waited until we saw them at school. We dealt with problems or concerns face to face. It takes considerable courage to do this. As we got older, we might write a letter to express our feelings. As the letter was written long hand it gave us time to settle down before mailing it. Letters often did not get mailed.
But, the years went by. Along came computers, email, cell phones, and texting. We are now able to type or even speak a few words into a machine and the message (text) arrives at the intended address immediately. Once we hit the send button, the message is out of our hands. Forever. We can never alter either what we actually wrote or the message they received. And they can be quite different. Our young people have been raised with a cell phone in their hands. For them the thought of not being accessible to others at all times is odd and in some ways frightening. Text messages are sent and received at all times of the day and night. We can now say anything to anyone at anytime. It is an amazing technology. If used well.
When not used with integrity, texting can become a verbal weapon against someone else. If we respond to a perceived slight with a negative comment, if we share it with others, or if we misunderstand the meaning of the message, the outcome can be damaging. In reading a text (written) message we often read tone into it, and with no verbal or visual opportunity to alter our perception, we accept that perception. We need to remember that the written word has no tone.
In my practice recently, I have been told repeatedly by parents and their children, about text messages being received which trigger significant emotional responses. When the teenager responds, there develops a volley of messages back and forth which often ends with negative, dismissive comments being made. If these comments are believed the results are damaging to the individuals self esteem who may be left feeling worthless, isolated, unimportant and even hopeless. And if this occurs over time, it can have permanent consequences.
The sad reality is that I am certain no one decides one morning to forever alter someone else's life. But, it does happen. And with the new age of texting and twittering, it is occurring all too often. When we text we are simply typing in words, not feelings. However, these words can and do affect others lives. So, I leave you with a word of advice, written on my iPad. Before you push the ‘send’ button, ask yourself whether you would say the same thing if you were talking face to face to the person. Ask whether you would want these words written to you? And then consider that although we can say anything to anyone at anytime, we can never take it back. We can never alter the message that someone else heard in your text. And, we can never feel sorry enough if we change their lives or some else's life forever.
The Brockton and Area Family Health Team (BAFHT) provides many elements of care for a variety of ages and stages of life. Whether you are trying to quit smoking, prevent or manage a chronic medical condition, learn more about a health issue, medications or exercise, or obtain counselling, we can help. You can pick up a copy of our Community Programs Calendar at your local pharmacy, library, or medical clinic, or on the web at www.thehealthline.ca, “health events” section or www.bafht.com.