Your Health Magazine - Fall 2008


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Your Health Magazine, fall 2008
Managing editor - Noemi Lopinto

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Your Health Magazine - Fall 2008

  1. 1. Won’t Back Down: An Edmonton woman fights for what’s right AHS-Capital Health’s magazine for living well Fall 2008 FREE Fit to Be Tried How to get in shape the Zen way The Power of Resistance Lifting weights will lift your spirits Goodbye, Couch Potato A reader relates her recipe for success Final The Gift of Issue Giving How and where to volunteer Return undeliverable mail to: Circulation Department, 10259-105 Street, Edmonton, AB T5J 1E3. Publications Mail Agreement #40020055
  2. 2. Contents Fall 2008 37 Features Departments 20 Take the Wheel 4 Capital Comments New licensing laws keep young drivers 6 Health First safer than ever Peanut problems; Smoking and teeth; By PHoEBE DEy Listless with listeria; Fish oil formula; Yoga at your desk; HPV quiz; Events calendar 22 goodbye, Couch Potato A slimmed-down reader stands in one 9 Pound by Pound leg of her old pants Tracy reflects on 12 months of challenging herself to be better By SHAroN gAFkA 10 The Fitness Edge 23 get off the gravy Bloat Strength training will test your mettle A few holiday eating tips so you don’t 12 Ask the Experts tip the scale by 2009 Who has a hernia?; My elderly dad 24 By SALLy JoHNSToN can’t pee; Little pitchers’ big ears; Got macular? ON THE COVER Writer Jeff Gonek and his 24 Cover Story: 14 A Day in the Life grandfather John Heck Fit to Be Tried A male nurse already stands out in a crowd; Lloyd Tapper wants to do more A grandfather and grandson team up to PHoTogrAPH By CurTiS TrENT get fit without getting hurt 17 Foundation Series The Black Gold Health Foundation By JEFF goNEk digs deep 28 Won’t Back Down 42 Frontiers of Medicine A profile of a champion of AHS-Capital The Comprehensive Tissue Centre’s Health’s new Spina Bifida Clinic scope gets bigger By MALCoLM AzANiA 46 By the Numbers 30 Flowers for Vera A Stony Plain couple embodies the best of the volunteer spirit By CAiT WiLLS 37 Sweet Nothings How to protect your kids from candy overload this Halloween By JiM VEENBAAS 20 30 Your Health – AHS-Capital Health’s magazine for living well Fall 2008 3
  3. 3. Fall 2008 • Volume 6, No.4 In publisher Ruth Kelly With associate publisher Daska Davis the New executive editor Ronna Bremer Managing editor KEN HUGHES Noémi LoPinto Interim chair of the Alberta Health Services Board copy chief Alberta Health Services’ mission information, innovation and expertise are no Kim Tannas is to build the best health care longer going to be constrained by imaginary delivery system in the world lines on the map. An example of how this can editorial advisors A Mark Dixon, Sandra Huculak work: three years ago, a new pilot project test- Dr. Gerry Predy, Marianne Stewart utumn feels like a time of new begin- ing a new care path for patients needing hip and art director nings for many of us, but this year is knee care began in three health regions in our Charles Burke especially important. Recently, the province. A team of health professionals guided province’s regional boards and boards for cancer, patients from the assessment and pre-surgery graphic designer Rodrigo López Orozco addictions and mental health were replaced with stage through to recovery and rehabilitation production technicians a single governance board that is responsible for much faster. The results, as measured in wait Betty-Lou Smith and Geoff Cwiklewich overseeing the entire health system in Alberta. times, were fantastic: conventionally, it took 145 circulation coordinator Alberta Health Services, as it is now known, is days to get from a referral to the first orthopaedic Amanda Dammann on a mission to provide a patient-focused health consult. Those wait times were cut by 85%, or advertising representative system that is accessible and sustainable for all down to 21 days. Similarly, it took 290 working Alicia Kuzio Albertans. Every citizen of this province deserves days to proceed from the first orthopaedic con- contributing writers equal access to health care services – from acute sult to the operating room. The new project cut Phoebe Dey, Cynthia Dusseault, care, to wellness services, to preventative health that wait time by 87%, or down to 37 days. Malcolm Faust, Katherine Fawcett, initiatives. Whether they live in the far north or We want these kinds of improvements to be Sharon Gafka, Jeff Gonek, Greg Hudson, Sally Johnston, Lindsey Norris, Lisa Ricciotti, south, in an urban or rural setting, every man, the standard of care for all Albertans in many Jacqueline Schimpf, Jim Veenbaas, Cait Wills woman and child must be able to get the care different specialties. It is a model that makes contributing photographers they need when they need it. We act in trust on sense; providing support for the physicians and illustrators 3Ten, Bluefish Studios/Christy, your behalf, and every decision made going for- and simplifying care for patients and provid- Lance Burns, Daniel Chen, ward must place your interests first and foremost. ers alike. This initiative will have clear benefits Dustin Delfs, Caroline Hamel, Rodrigo López Orozco, Kelly Redinger, Since May, we have established a new health all across the province. We will build our sys- Amy Senecal, Curtis Trent leadership team, drawn from expertise across the tem on the foundations in place today, and province, to help guide this new structure. This work together to shorten wait times, to improve Your Health is published by venture team will build on the excellence in health care access to primary care, mental health resources, publishing inc. for ahs-capital health. that already exists in Alberta. It will create the wellness and preventative health initiatives. connections and relationships vital to an inte- We will build on the momentum of research grated, co-ordinated system that will provide fast and leadership cultivated here. We will attract 10259-105 street and consistent access to services for all Albertans. world-class researchers to augment the deliv- edmonton, ab t5J 1e3 tel: 780-990-0839 • fax: 780-425-4921 Unfortunately, this will be the last issue of Your ery of health care, for the benefit of all. We will toll-free: 1-866-227-4276 Health magazine in 2008, but we have big ideas build a health-care system that is efficient, effec- One year subscription: $12.00 (plus GST) for the future, which will be an integral part of our tive and financially sustainable. I invite you to stay Two year subscription: $24.00 (plus GST) provincial approach to promoting wellness. informed and involved as Alberta Health Services E-mail subscription requests and address changes to In conjunction with the Minister of Health, evolves and to use the contact form on our web- Call toll-free 1-866-227-4276 ext. 237 we have begun to fill the remaining board posi- site ( to provide us the information in this publication is not meant to be tions. We have a chief executive officer and a pro- with feedback. Your perspectives are critical and a substitute for professional medical advice. always seek vincial management team which is structured I hope you will share them. Our goal is straight- advice from your physician or other qualified health provider regarding any medical condition or treatment. around four portfolios: Continuum of Care, forward: to build the best health-care system in printed in canada by transcontinental lgM graphics Planning and Programs, Corporate Services the world. It’s as simple as that. publications agreement #40020055 and Financial Services. The key priority for all of contents copyright 2008 by ahs-capital health. content may not be reprinted or reproduced these groups is to think provincially while pro- Capital Comments is written by Alberta Health without permission from ahs-capital health. viding effective services locally. The sharing of Services - Capital Health. Fall 2008 AHS-Capital Health’s Your Health magazine
  4. 4. THE HEALTH CARE PRODUCTS WELLNESS WELLNESS Results SUPERSTORES RENTALS • SERVICE • SALES Matter Senior’s Day! The Last Thursday of Each Month 20% Off Regular Priced Items - Save Up To $200! • Balance and Exercise Products • Sports Medicine Supplies • TENS Supplies Complete • Speciality Shoes Foot Care Products Home • Physiotherapy Supplies • Hospital Dressing Supplies Medical • Hospital Beds/Luxury Beds Did you know that up to 85 percent • Lift Chairs Scooters • First Aid Kits of decisions about your diagnosis Equipment and treatment are based on • Wheeled Walkers • Wheelchairs laboratory test results? • Bladder Control Products • Bathroom Safety Aids • Commodes Medications, alcohol, nicotine, • Complete Line of Braces Supports caffeine, food intake, and exercise can affect the accuracy • Support Stockings of your laboratory results. AADL/WCB/DVA VENDOR Follow these three steps to ensure you are properly prepared for your FREE DELIVERY AVAILABLE next test. North Location Hours: M-W 8:30-6:00pm Th F 8:30-8:00pm 1 Ask your doctor why the test is necessary, what the test Sat 10:00-5:00pm South Location Hours: results could indicate, and the M-F 8:30-6:00pm potential treatment. Sat 10:00-5:00pm 2 Check with the laboratory facility regarding directions for collecting the sample, and preparing for your test. 3 Go to (public access, health tips) and download the FREE laboratory checklist. NORTH 780 406-3500 780 SOUTH 780 434-3131 780 97 St. 137 Avenue-Northgate Centre 97 St. 137 Avenue-Northgate Centre 5405-99 Street 5405-99 Street Complete this document and you’ll be properly prepared. 000.HCS_1-2M_nBL.indd 1 9/2/08 10:12:40 AM 1. Wet your hands. 2. Put soap on your hands. 3. Rub all surfaces of your hands until you have a thick lather. 4. Rinse your hands with water. (780) 435-5452 5. Dry your hands with paper 1-800-265-9351 towels or a hand dryer. As the regulatory body for medical laboratory 6. Turn the tap off with a technologists (MLTs), the Alberta College of paper towel. Medical Laboratory Technologists strives for the highest standards of care, professional conduct and competent service to the public. 000-ABColMed_1-3V_nBL.indd 1 9/2/08 10:25:54 AM 000.CapHealth_1-6H_nBL.indd 1 9/2/08 2:08:27 PM
  5. 5. Tips to manage a food allergy • Don’t eat unlabelled food. • Read all ingredient statements. Different brands of the same food can have differ- ent ingredients. The same brand may be safe to consume for one product size but not another. A Tempest in a Peanut • Don’t rely on common sense to determine if foods are safe. Surprise ingredients are everywhere, such as wheat in soy sauce. The article “Edible Enemies” in our summer multiple-food-allergy family. We consulted • Take precautionary warnings seriously, but 2008 issue resulted in an unusual volume of with AHS Nutrition Service Manager Kim know they don’t appear on every food. letters. In the article, pediatric allergist Dr. Brunet about labelling. • Beware of hidden allergens. Potent allergens Stuart Carr was asked if schools should ban “Health Canada and the Canadian Food such as sesame and milk can hide behind the peanuts. “Absolutely not,” he said. “The smell Inspection Agency have jointly identified 10 words “natural flavours” or “spices.” Become doesn’t carry any protein to trigger an allergic food products that are primarily responsible familiar with names of hidden ingredients, reaction. Food allergies need to be respected, for 90 per cent of the adverse food reactions such as “casein” (milk) or “albumin” (egg). but you’re not a time bomb.” in the Canadian population,” she said. “In • Know where the food is made. Seek out Our readers responded passionately. One Canada, manufacturers must label priority products that say they are made in a mom with peanut/tree nut allergies (and a allergens, which includes peanuts, tree nuts, “dedicated peanut-free, nut-free, soy-free son with the same) said the allergist didn’t sesame, milk, eggs, fish, crustaceans and or allergy-free facility,” depending on your understand the school environment. “Many shellfish, soy, sulfites and wheat.” Products diet restriction. children have no forethought to the effects of that contain these allergens are declared on their behaviour when they’re eating, causing the label when sold separately. However, cross contamination of utensils, desks, when that food is added as an ingredient platters,” she wrote. A Leduc writer said her of another food, components do not have daughter nearly died of anaphylactic shock to be declared. “For example,” Bunet said, in school two decades ago when her class was “bread may also contain milk and egg. If making peanut butter. “Most people will not have an allergic reaction unless peanut bread crumbs are added to a product, these components don’t have to be declared.” The Just Say AAAAA products are consumed,” she wrote, “but absence of a warning is not a guarantee. there’s no way of knowing, before an incident, Manufacturers currently list ingredients who will have a severe reaction.” on the labels, but these may be reported by a Dr. Carr responds: “Please do not scientific name, such as albumin or lysozyme Doctors aren’t the only ones pressuring smokers misunderstand me. It is critical to treat for egg. Voluntary statements (“Made in a to give up their nasty habit. Albertan dentists are food allergies with the respect they deserve. facility that processes nuts,” for example) are also stepping up efforts to get their patients to butt But it is equally critical not to add to our often included on labels. But the language out. The Alberta Dental Association and College (ADA+C, not to be confused with AADAC, who affected children and their families’ burdens isn’t standard, so statements lack clarity. incidentally also want people to stop smoking) with unproven fears. Avoiding accidental Planned changes to Canada’s labelling are not only concerned with tooth discoloration, ingestion of food allergens remains the best law would ensure that food manufacturers bad breath, and gum disease, but a more serious management strategy for patients with a food use plain language. Instead of listing illness: cancer. Dentists are being encouraged by allergy. The next critical issue is the prompt lactoglobulin, for example, a label would the College to follow the five As, as in: recognition of the symptoms of anaphylaxis simply say “milk.” But the fish, shellfish 1. ASK if patients smoke or chew tobacco. and administration of epinephrine in and crustaceans would still be listed by their 2. ADVISE them about the harmful effects suspected cases. A recent European study common – but not well known – names, to oral health. established the risk for a fatal reaction to be such as escolar and barramundi. 3. ASSESS their willingness to quit. approximately one in a million. My patients Health Canada published proposed 4. ASSIST those wanting to quit by referring take a greater risk driving to my clinic on our amendments in Canada Gazette, in July, them to resources and programs. over-crowded roads.” 2008 to allow for public comment and 5. ARRANGE for followup phone calls and Still another writer challenged that food will take into consideration any comments support as they attempt to quit. labels, contrary to what we printed, are received for three months. Manufacturers No matter what you do for a living, it looks like a confusing, and invited us to come to the will have one year after the final regulations pretty good method for supporting a smoker who grocery store with her as she shopped for her are published in January 2010 to comply. is ready to quit. For more information on that, go to Fall 2008 AHS-Capital Health’s Your Health magazine
  6. 6. Stretch Your Limits Bend your front leg until you Release tension in your hard-working calf Step one foot behind the muscles with this easy stretch. other, keeping your heel feel the stretch in your calf. flat on the floor. (If this feels Hold the stretch for 30 seconds and Stand facing a wall. Place uncomfortable, shorten the release. your palms at shoulder distance between your front height flat on the wall. and rear legs.) Repeat on the opposite side. Pap quiz Answers on page 8 Capital Health is taking steps to protect young women from the consequences of contracting Human Papillomavirus, or HPV. The publicly funded Alberta HPV Immunization Program is for girls in Grade 5 and 9. The vaccine is licensed for girls and women from nine to 26 years of age. But before you decide whether or not you want it, do you know enough about HPV to answer these questions? 1. HPV is a concern because it can 3. If you or your daughters don’t get HPV lead to: vaccine: a) Penile cancer a) Genital warts are inevitable b) Genital warts b) Cancer is inevitable c) Cervical cancer c) HPV will continue to spread d) All of the above d) None of the above 2. What are the chances of contracting 4. If you provide the HPV vaccine to girls HPV? early, they will: a) Negligible a) Begin experimenting with sex right away Always check with your doctor before b) You probably already have it b) Stop using condoms starting a new exercise program. c) About one in 10 c) Develop autism d) About one in 1,000 d) None of the above A Very Bene-fish-oil Study Fish are already remarkable creatures. They’re November, indicates that giving babies a fat emulsion quiet, make a good first pet, and can breathe under- IV containing fish oil before and after surgery reduces water for remarkable periods of time. Fish oil is also swelling, fever and infection. This is especially good beneficial for human heart and cholesterol for critically ill infants, who benefit from its anti- levels. And, according to research led by Bodil inflammatory effects. Currently, the standard Larsen, an advanced practice dietitian with practice is to use soy bean oil, but Larsen hopes fish AHS-Capital Health’s Regional Nutrition Food oil will become the new status quo within the next Services, fish oil might also help save your child’s two to three years. This is good for parents and their life. Her research, which won’t be completed until sick children, but not so much for the fish. AHS-Capital Health’s Your Health magazine Fall 2008
  7. 7. Desk Strain What are you doing for your coffee break? Instead of downing another cuppa, the Alberta Centre for Active Living wants you to get moving. To help, it has launched a new website that guides viewers through a few exercises to counter the harmful effects of a desk job. The first video, the Stretching atYour Desk series, is designed to help counter some of the pun- ishing effects of computer work, such as wrist strain. Mark Your Calendar Or try Yoga atYour Desk for an eight-minute break of serenity in the hectic pace of your day. Each video is AHS-Capital Health offers a variety of workshops less than 10 minutes long. Everything shown is low- impact, so there’s no warm-up required. Do follow and programs to help you improve your health. the site’s guidelines before starting the exercises. Here is what’s on the agenda this fall. For more Visit information, visit Success Over Stress Live Better Every Day Workshops Answers to the This three-week stress management course is A six-week workshop series, to help people HPV Quiz provided by AHS-Capital Health occupational learn how to take care of chronic health therapists from the Community Rehabilitation problems, carry out normal activities and 1.d. All of the above; although the real Program. This course is practical, interactive manage their emotional changes. proven link is to cervical cancer. and fun. Classes are free and held once a For more information or to register, phone There are hundreds of types of week for three weeks. Call 780-413-5779 for 780-401-BOOK (2665). HPV. The vaccine is effective at information on locations or visit stopping the two types of the virus for a schedule and registration. Steady As You Go This program is intended to prevent falls responsible for 70% of all cervical Boosting Your Memory among older adults who are at risk. Two cancer and 90% of genital warts This memory enhancement program is for sessions are offered. For more information, cases. adults, age 50 and over, who are interested in visit To register, call 2.b. About 70% per cent of women will addressing concerns around memory in rela- 780-401-2665. come into contact with HPV dur- tion to normal aging. Classes are held once a ing their lifetime. The virus can week for six weeks. There is a registration fee Diabetes Health Radio Shows stay dormant in the body for up to of $15 per person. For more information, call Diabetes Compass Radio interviews diabetes two years, and sometimes more, 780-735-3490. health experts and people with diabetes. before becoming symptomatic. Listen at 9 a.m. each Saturday morning on 3.d. By taking the vaccine, you are pro- Weight Wise Adult Education AM930 CJCA Radio or visit www.diabetes tected from the most dangerous Learn how to make healthier choices by For more information, call form of HPV, and by practicing safe attending a Weight Wise session. AHS-Capital 780-970-0060. Health offers two, two-and-a-half-hour work- sex your risk of infecting others shops to help you create your own plan or 12 Weeks to Weight Loss and Wellness diminishes even further. support your family in weight management. 12 Weeks to Weight Loss and Wellness is 4.d. Research has shown that fear Register by calling 780-401-BOOK (2665). a non-diet, balanced approach to weight of getting a sexually transmitted loss. Weekly group sessions facilitated by infection does not affect a young Child Safety Seat Inspection Clinics a certified coach, facilitate self-awareness person’s decisions to have sex A guide to choosing and correctly installing a and change. This program is run by Wholly for the first time. However, being child safety seat. Clinics take place in Spruce Hannah! Coaching Training, a member of immunized for HPV may oblige an Grove, Edmonton, St. Albert, Beaumont, AHS-Capital Health’s Weight Wise Community open familial discussion about sex, Sherwood Park and Leduc. Call your local fire Network. STIs and unwanted pregnancy. hall or Health Centre for an up-to-date sched- or call Claudette Pelletier-Hannah at ule of clinics in Edmonton and area. 780-481-0313. Fall 2008 AHS-Capital Health’s Your Health magazine
  8. 8. Pound by Pound The New Me T his is my summer in a nutshell: Mon- better at work. My exercise time has become days I go for a gruelling one-hour bike “me” time. On my bike or in the gym, I’m not ride through the river valley. The next stressing about deadlines or worrying about that By Tracy Hyatt day I wake up feeling sore in unmen- maintenance light in my car. Instead I’m tak- PhotograPh by tionable places. Most Wednesdays, I hit the ing in all of my surroundings and concentrating bluefish/Christy Dean treadmill for a 30-minute run. on my breathing. Exercise has renewed my sprit At about the 12-minute mark, my hand is and boosted my self-esteem. Tracy’s transformation hovering over the red stop button, but I elect to The new me shops for groceries with pride, turned out to be from spend the next 18 minutes listening to the voices in my head that tell me to keep on running. filling my biodegradable shopping bag with sea- sonal fruits and vegetables, a complete change the inside out, rather Saturday is my “I’m-having-so-much-fun-this- from the processed foods that stocked my fridge than the outside in doesn’t-feel-like-exercise” day. Recently, I went for my first dip in a swimming pool since Grade and cupboards a year ago. It’s never just a quick jaunt to the grocery store anymore. A typical 10 PE class. I got a stinging sensation up my trip lasts an hour because I spend most of the nose every time I dove into the deep end. Not time reading food labels. I’m shocked at what to mention, I scratched my skin raw later after food manufacturers try to pass off as healthy. A reacting to the chlorinated water. word from the newly wise: stay away from the There are many days when I question why I inside aisles. That’s where the big stores stock am going through with all of this. Being skinny all the processed foods. Circle the perimeter is so overrated, and there are better things I for the fresh goodies and then get out of there. could be obsessing about. Such as how to attract That being said, there are some things that will and keep a man, or how to make the mainte- never change. As I’m writing this column, I’m nance light go off in my Honda. Fortunately, munching away on a bag of zesty tortilla chips. there are more days when I wake up and ask It’s a small bag, though, and today is Wednes- myself why I didn’t start doing this a long time day. I’ll be hitting the gym after work. ago. To answer the latter question, I turn to Joanne McLeod of those annoying Body Break Tracy’s Top Five episodes I used to catch on TV: “Exercise helps Weight Loss Tips me to feel good about myself while doing some- • Some diet programs lump all carbohydrate thing good for my body,” she said. This is what foods together and give them a bad name. regular exercise has done to me. Quoting Joanne But grains, beans, potatoes, rice and pasta McLeod. But it’s true. give you a lot of nutrients and can help pre- I didn’t even come close to dropping 40 vent disease. Don’t ban carbs as a rule; a pounds but I’m confident that I’ll get there. I balanced diet is key to weight loss no longer roll my eyes when someone suggests • Think of pop, iced tea, fruit beverages, sports we spend the evening playing baseball or ten- drinks and slurpees as “liquid candy.” High nis. “Count me in” is my usual reply to my new in sugar and low in nutrients, limit these friends, a more active and energetic set than the drinks to only one cup (250 mL) every once bunch I usually hang out with. Instead of fill- in a while. ing my closet with sandals and sundresses this • Don’t skip breakfast; meal skippers often summer, I bought a new pair of Nikes, a base- overeat later, which may lead weight gain. ball glove and a new tennis racket. I even bought Start and finish your day off right. a mountain bike online from a lady who said • Eating on smaller plates can help you avoid she’d only used it twice. “I just never have the taking large portions just to fill up space, and time to go for a ride,” she wrote in an e-mail also makes smaller portions look bigger, so Tracy’s Stats when I asked why she was getting rid of it. Her you don’t feel restricted. Height: 5 feet 4 inches loss, my gain. • When you’re eating out, ask your server to Starting weight: 186 pounds (Nov. 2007) One of the spinoffs that I never expected is wrap up half of your meal right away. Not Present weight: 171 pounds my improved mental health. Despite all the only will you be watching your portions, you Pounds lost: 15 physical aches and pains, I’ve got more energy won’t have to make tomorrow’s lunch! Goal: To keep going throughout the day. I can concentrate and focus AHS-Capital Health’s Your Health magazine Fall 2008
  9. 9. The Power of Resistance You don’t have to be an aspiring Mr. Universe to lift weights, but it might help to be willing to reach for the stars By Cynthia Dusseault | Photograph by Lance Burns STRONG ON FITNESS: Trainer Susan Agrios (right) gives tips to a willing client 10 Fall 2008 AHS-Capital Health’s Your Health magazine
  10. 10. Y ou can do it with free weights, resist- ance bands or exercise machines; you can even do it with nothing at all. “You can do some pretty incredible things with just your own body weight,” says Susan Agrios, on your own. No doubt, having an appointment with a buff athlete who can bench-press 300 pounds can be a great motivator. “Ultimately it’s about setting a goal and work- ing towards it until you see a result,” says Agrios. an Edmonton-based fitness trainer and yoga “That’s very empowering, especially for the peo- instructor. ple who started out feeling very nervous.” Also called weightlifting, strength training is all about using increasing amounts of resistance Top Three Weightlifting Myths to build muscle strength. It is ideal for people 1. You’ll look like the Governator. “The amount who can’t attend a regular fitness class, home- of work that goes into that is absolutely incred- bodies who keep odd hours or people who prefer ible,” says Agrios. Professional bodybuilders an activity they can do on their own, anywhere. also work at it full time, so stop worrying. However, technique is very important, especially when you’re first starting out. Get some expert 2. More is better. Train smarter, not harder. advice, and a training program that works for Slowly increase your weights, always allowing you based on your body shape, strengths and your body time to rest and recover. Workouts weaknesses. Using trial and error can result in a of 30 to 60 minutes per session, three times serious injury. “One of the biggest mistakes I’ve a week on non-consecutive days, are all you seen in the gym is people lifting heavy weights need to see results. with improper technique,” says Agrios. “Strength 3. Stretching is for cats. As you build mus- training is all about getting that muscle memory cle, your body starts to lose some flexibility, and that pattern ingrained correctly.” so stretching before and after a workout is When developing routines for her clients, extremely important. Agrios considers their ages, goals, fitness back- grounds, medical conditions, past and present injuries and strength levels. If someone does a Calling the Kettlebells Black great deal of travelling, she develops a program Cast iron kettlebells represent a very old that’s portable. If someone wants to work out at form of resistance training that is once again home, she helps them set up a home gym. Peo- becoming popular in North America. They ple with obesity and related illnesses such as dia- originated in Russia as counterweights for betes, heart conditions or high blood pressure balance scales in the marketplace. Vendors should focus on weight loss before they try to used them to impress each other with their buff up. “There’s a difference between discom- strength. In the late 19th century, kettlebells fort and pain. I am not of the mindset ‘no pain, became the conditioning tools of choice for no gain.’ If there is pain, you stop.” “strongmen” doing the travelling circuit and Free weights are ideal because machines tend in the 1900s, they became the main training to restrict your movements, and many don’t fit tools of the Russian military, a tradition that different people properly. With free weights you continues to this day. can work with your own range of movement Kettlebells are unique because they’re asym- and patterns. We don’t move our muscles in iso- metrical, which makes them unpredictable, lation in our regular daily activities, so instead much like human movement. This explains their of leg extensions, for instance, which only work popularity with martial artists and boxers, who the quadriceps, she recommends clients do are training to react quickly to the unpredic- back squats, which engage a host of muscles in table. But because they’re like nothing you’ve the legs, but also the abdominals, back and pel- ever worked out with before, if you want to vis. You want a whole body workout, designed give them a go, work with a certified kettle- to help you do whatever it is that you do, better. bell trainer. Otherwise, far from looking like a Agrios is quite passionate about the importance strongman, you may end up being carried out of getting expert advice until you’re motivated of the gym by one. and knowledgeable enough to keep working out AHS-Capital Health’s Your Health magazine Fall 2008 11
  11. 11. QA Dr. braD hinz Staff Ophthalmologist, Regional Eye Centre AHS-Capital Health Ask the Experts Macular degeneration; Hernia; Pee problems; Infant hearing photography by Dustin Delfs Question: My mother has macular Other factors that appear to contribute are: degeneration. What are my chances of diet, smoking, high blood pressure and exposure getting it too? to ultraviolet light. We do know that if you have Dr. Brad Hinz, staff ophthalmologist a particular gene (complement factor H) and with AHS-Capital Health’s Regional Eye you smoke, your risk of getting AMD is almost Centre and assistant clinical professor nine times greater than for a non-smoker who in the Department of Ophthalmology has the gene. You are stuck with your genes, but at the University of Alberta, replies: smoking, a major factor in AMD, is within your Age-related macular degeneration (AMD) is a control. painless disease that blurs the sharp, central vision that is needed for “straight-ahead” activities such Question: I have a lump in my lower as reading and driving. It affects the macula, the abdomen. Could it be a hernia? central part of the retina that allows you to see fine Dr. Ernst Schuster, family physi- detail. It doesn’t usually affect peripheral vision. cian and medical director of primary Sometimes, AMD advances so slowly that people care for AHS-Capital Health, replies: may not notice the gradual vision change. Other A hernia is a weakness or disruption of fibro- times, the disease progresses faster and may lead muscular tissues in the abdominal wall through to a loss of vision in both eyes. AMD is a leading which other structures, such as a part of the cause of vision loss in patients over 60 years and bowel or abdominal fat, can protrude. In most comes in two forms: wet and dry. cases, it’s not painful; it just presents itself as a If you have vision loss from dry AMD in one lump. But it can be serious, because if you can’t eye only, you may not notice any changes in your get the bowel to go back into the abdominal cav- overall vision. You may notice changes in your ity, it can become trapped in there, a condition vision only if AMD affects both eyes. So-called called an incarcerated hernia. This can lead to dry AMD can damage vision slowly. Wet AMD bowel obstruction, requiring immediate surgery. can damage vision quickly. In most cases, there’s no particular event caus- More than 85% of people with AMD have the ing hernia. Most are congenital; people are born dry form. It tends to run in families. Although with them even if they are not evident until later. genetics plays a role, we don’t fully understand Men are nine times likelier to develop a hernia how. If there’s a gene that determines AMD and than women. There are several different types. multiple family members have it, why don’t they An inguinal hernia is the most common in all get the eye disease? A lot of research is focused males, usually felt as a lump above the groin. A on figuring out why some people get it and femoral hernia is more common in females and others don’t. shows as a lump in the groin or crotch. (Such a 12 Fall 2008 AHS-Capital Health’s Your Health magazine
  12. 12. Dr. howarD Evans Urologist Royal Alexandra Hospital Dr. Ernst schustEr Kathy PacKforD Medical Director, Primary Care Audiologist AHS-Capital Health Glenrose Rehabilitation Hospital lump could also be caused by other things such infection or past catheterization (tube inserted guage skills may be slower to develop. Some as an infection, a tumour or a swollen lymph through the penis to drain the bladder during signs that may indicate hearing loss include: node.) surgery). Treatment includes dilation (gentle • Failure to startle to loud sounds If a lump is painful and raised, you can’t push expanding) of the urethra or surgery to correct • Lack of response to his/her own name or it back, or it made a sudden appearance, seek the problem. familiar voices by six months immediate medical attention. If it’s not painful Your father’s condition could be due to the • Babbling changes into high-pitched scream- and there are no other symptoms, make an bladder itself. An overactive bladder, one that ing or fails to develop into recognizable appointment with your family physician. clenches and gives the sudden, frequent urge to sounds of speech like “ ba-ba, ma-ma” by six pee, can be treated with medicines. But we rule to eight months Question: My 65-year-old father is having out more serious causes, such as bladder cancer, • Inability to locate where a particular sound is trouble peeing. What could be the matter? first. Finally, problems with urination may also coming from Dr. Howard Evans, a urologist at the have neurological causes, stemming from such • Failure to respond to simple commands, such Royal Alexandra Hospital, replies: diseases as diabetes, Parkinson’s disease or multi- as “get the ball,” by 12 to 18 months There are a handful of possible causes behind ple sclerosis. Treatment of the underlying disease If you suspect a hearing problem, trust your difficulty peeing, also called urination. These may improve the condition. intuition. Contact your doctor or an audiologist. problems can have their root in the prostate, the Damage to any part of the hearing pathway can urethra, the bladder or the nervous system. Question: How can I tell if my infant is cause a reduction in hearing. The most likely reason for a man of his age hearing properly? Is there a test? The audiologist has a number of tools to eval- would be benign enlargement of the prostrate. Kathy Packford, audiologist at the uate hearing. Hearing tests may be completed in This means his prostate, the cherry-sized gland Glenrose Rehabilitation Hospital, replies: a soundproof booth where an audiologist will that surrounds his urethra, is bigger than normal Infants respond differently to sounds at differ- observe the child’s reaction to different sounds. and is obstructing the urethra, which is the tube ent ages. Although there’s individual variation Other objective measures used to determine through which urine leaves his body. The condi- among kids, there are some general guidelines. whether an infant is able to hear are: auditory tion makes it harder to urinate or means he has A baby up to three months of age will startle brainstem response (ABR) audiometry and otoa- to urinate more often. We’d typically prescribe when she hears a loud, sudden sound or may coustic emissions (OAEs). Based on testing, an medicine to relax the prostate. If that doesn’t awaken to loud sounds, such as a door slam- audiologist can help the family plan treatment. help, we might try surgery to ease the blockage. ming. A healthy six-month-old will smile when No child is too young to be tested. But we also look for other causes. These might he hears a familiar voice, music or other sounds include cancer of the prostate, which has a vari- and babies will usually begin imitating sounds Ask the Experts is a regular section in which medical and ety of treatments that might include surgery, and babbling by 12 months. Older infants begin other health professionals answer questions on a variety radiation and chemotherapy, depending on the to develop single words between 12 and 18 of health-related topics. for general health advice or stage of the cancer. months and they understand simple phrases. specific concerns,­ please call health Link alberta at Another cause could be small scars inside Children with hearing loss aren’t able to 780-408-LInK (780-408-5465). outside the local calling the urethra, which might be the result of past learn language by listening, so early lan- area,­ phone 1-866-408-LInK. AHS-Capital Health’s Your Health magazine Fall 2008 13
  13. 13. The Man White in By Lisa Ricciotti | PhotograPhy by aMy SENECaL Alberta’s only emergency nurse practitioner stands out wherever he goes 14 Fall 2008
  14. 14. “H e’s the guy in the white shirt,” and refer patients. Nurses work under the act as working on airplanes, I realized that I liked people says the receptionist, pointing to well, but are not authorized to diagnose, prescribe more than parts. I went to air cadets and started the emergency area at Edmon- or refer patients to medical personnel. “If I am a teaching kids principles of flight and leadership. ton’s Northeast Community registered nurse, I cannot call a cardiologist and By the time I finished, I really didn’t want to be an Health Centre. That’s all the direction needed to say: I want to refer this patient to your clinic. aircraft mechanic.” find Lloyd Tapper among the bustle of staff mov- With my licence, I can pick up a phone and refer He graduated from St. Clare’s in 1997. He ing purposefully around the ER nursing station. that patient to be seen by that service.” worked as an emergency and general surgery For one thing, he’s not in a brightly coloured top For cases beyond his expertise, he consults with, nurse in Kitimat, B.C., then as an emergency like the other nurses, and he’s not in scrubs and or defers to, attending ER physicians or the appro- room nurse at the University of Alberta Hospital a mask like the doctors. In his crisp white dress priate referral service. “If you go to your family in 1999. Somehow he found time to finish a certi- shirt and black dress pants, Tapper stands out. doctor and your problem is beyond him, he’ll fication program in emergency nursing at Mount He also stands out as the province’s only nurse refer you to a specialist or possibly an emergency Royal College in Calgary and earn his master’s practitioner working in an urban emergency physician. If it’s outside the emergency physician’s degree in nursing at the U of A, while working full department. It’s a position that the 38-year-old area, he may also consult with a specialist. At a time. When Tapper joined the Northeast Com- has held for nearly four years, and from day one time when access to health-care services is limited, munity Health Centre’s emergency department he’s worked to define his role, beginning with a the focus is on matching the client’s concern with in 2004, he had seven years of emergency nursing departure from standard medical garb. the appropriate health-care provider. That’s what experience and training to draw from. “Initially when I introduced the role, I wanted makes me different,” says Tapper. It’s now 8 a.m. – time for the IV therapy clinic, to make sure I had an opportunity to develop it, It’s 7:30 on a Monday morning. Tapper starts a service Tapper adopted as part of his scope of but not based on any traditional nursing or medi- the day with a review of charts left by ER physi- practice. He personally follows every patient in cal models,” says Tapper, “so that the added value cians over the weekend. As he briefs himself, he the clinic to make sure their care is continuous, of the role could be identified as different, but outlines his career path for me. (The man’s a born stable and streamlined. Every Monday he follows working in complete collaboration with the entire multi-tasker.) Originally from Newfoundland, up with the patients who have been receiving health-care team.” a fact no longer detectable in his speech, Tapper intravenous antibiotic treatments over the week- Nurse practitioners, or NPs, are still rela- trained to be an aircraft mechanic, but he couldn’t end. Depending on the results of their blood work tively new. There are only a few hundred in the find a job in his field. In the mid- to late-’90s, and his hands-on medical examination, Tapper entire province, men and women who are step- he noticed men were finding more and more determines whether they can be prescribed oral ping beyond the scope of the traditional nursing employment in non-traditional careers, and, fol- medication. practice and into areas usually limited to doctors. lowing the trend, he decided to enrol in nursing at Since these patients have had to come to the Tapper is authorized by the College and Associa- St. Clare’s School of Nursing in St. John’s. ward three times a day, all weekend for IV anti- tion of Registered Nurses of Alberta through the The seemingly radical career shift had its roots biotics, the change is a welcome relief. So is Health Professions Act to assess, diagnose, treat in an earlier self-discovery. “In the time I was having a scheduled appointment, instead of Fall 2008 15
  15. 15. waiting to see an ER doctor who is rushing Brommeland’s shirt pocket, which was exposed as Between patients, Tapper walks over to the men- between critical cases. he bent to put on his shoes. “Have you thought tal health and addictions services clinic, also part Today Tapper has three patients to check up about quitting or cutting back?” he asks. “Because of the Northeast Community Health Centre, to on. Blair Hault, 53, came to the emergency room if you want to, we can help.” make sure counselling sessions have been set up after his leg swelled to three times its normal size Brommeland seems surprised but he listens. for a woman he treated the week before, a victim and Mike McMullan, 44, a paraplegic athlete, He leaves with written instructions on how to ice of domestic abuse. “I’m there for them, right now is suffering from an infection caused by pressure his ankle and a booklet on how to stop smoking or when they’re ready. I don’t judge. If they let me on his legs from his wheelchair. Tapper sees them with information on the tobacco reduction clinic in, I can help.” He recently linked another seri- individually, greeting each with, “Hi, I’m Lloyd. that Tapper developed for the Northeast Com- ously abused victim with social workers for place- It’s very nice to meet you.” He discusses their munity Health Centre a year ago. It’s an example ment in a safe house. “She’s been beaten before,” symptoms thoroughly, gives advice, suggesting of how Tapper tries to go that extra mile. Tapper says. “But it is very difficult for her to an update on tetanus shots for Hault and advis- “An emergency nurse practitioner is not about leave. The violence is rapidly escalating and, if she ing McMullan to try padding his wheelchair and dealing with major trauma situations,” says doesn’t, her life may be at risk.” avoid contact sports in the short term. Both are Tapper. “That’s more the role of emergency phy- Tapper takes the same caring approach wher- now well enough for antibiotic pills, but before sicians with years of specialized training. What I ever he can, using the encounters with his patients passing out prescriptions, Tapper discusses their can offer is health promotion, illness prevention as opportunities to provide referrals to ongo- costs and possible side-effects. “My job is about and continuity of care.” ing care. That’s made easier by the many clinics the little things,” he says. Tapper’s interactions with his patients reflect located within Northeast Community Health Next in line is Brad Brommeland, 42, who is that focus. He gives Shawn Hagen, a young roofer Centre, an innovative model of primary health concerned about numbness in his foot after twist- with a very sore back, instructions on proper icing care services, including a diabetic clinic, a senior’s ing his ankle. Tapper determines that nothing is techniques and a prescription for anti-inflam- clinic, services for new mothers and a children’s broken, recommends ice and ibuprophen and matories, but also advises him to ask his boss for asthma clinic. asks whether Brommeland needs a note to excuse training on proper lifting techniques. Tapper also “He wants to make sure patients don’t fall him from work while he rests. Then Tapper leans suggests Hagen begin wearing a back support: between the cracks,” says Carol Yeomans, an over and plucks a package of cigarettes from “You only get one back. Look after it,” he says. emergency nurse who’s worked with Tapper for the past four years. “He always tries to link them to whatever they need to get them on track, back on the road to wellness and responsibility for their health. He takes the extra time that an emergency physician doesn’t have.” From an emergency physician’s perspective, it’s a big benefit to have a nurse with Tapper’s training around. “He has the knowledge and he’s taken on so much. He can do sutures, IVs, followup calls and paperwork. If he wasn’t here, there’d be quite a void. We could use a couple of people like him at other hospitals,” says Dr. Terry Stetsko. MIND THE LITTLE THINGS: NP Lloyd Tapper It’s now approaching noon, and Tapper has likes to go that extra mile with his patients decided to take lunch since it’s not too busy – by emergency department standards anyways. This afternoon, he’ll see a bit more of everything: sick kids, people with infectious diseases, abdominal pains, breathing problems and maybe this week’s cardiac case. Recently, a mother rushed into the department with a newborn who was near death. After being stabilized in the emergency depart- ment, the child was transported to intensive care at the Stollery Children’s Hospital, eventually making a full recovery. Whatever the day will bring, Tapper feels ready. “Nursing of any kind is a privilege. You have the chance to make an impact on people’s lives. When I see a chance to make a difference, I take it. I really love what I do.” 16 Fall 2008 AHS-Capital Health’s Your Health magazine
  16. 16. BACK IN BLACK: (L-R) The Black Gold Health Foundation’s chair Marilyn Janzen, executive director Lorraine Popik, Leduc Community Hospital ER manager and site manager Tod Pharis, Dr. Colin Oberg, and Leduc Community Hospital site manager Donna Grier pose with a portable ultrasound machine Leduc’s GoldBy Jacqueline Schimpf “I t’s one of the items that puts us in the big league and makes us stand out,” says Mari- lyn Janzen, volunteer chair of the Black Gold Health Foundation, about the new, port- able ultrasound machine at the Leduc Com- Standard nity Hospital and health centres and home care in Beaumont, Leduc and Thorsby. Without the need for a technician, the new, portable piece of equipment can be operated by trained physicians in the emergency department munity Hospital. “The ultrasound is a piece of or used at patient’s bedside in acute care. The Black Gold Health equipment that we are so excited about. It makes it much easier for our health care team to provide A welcome addition to the hospital’s after- hours services, the technology allows for early Foundation supports early diagnosis.” or pre-diagnosis, which helps to determine if a health programs, services With financial support from the Black Gold Health Foundation, the hospital, which serves patient requires further testing. “With the ultrasound, we are able to per- and new equipment in the residents of the County of Leduc and area, form services in the emergency department that bustling central Alberta purchased the machine in the spring. The $90,000 portable ultrasound machine comple- can assist in quicker diagnosis; there is no wait- ing for an appointment elsewhere,” says Daryl ments its existing ultrasound services, which are Wishnowski, manager of inpatient services at the available only during daytime hours. The foun- Leduc Community Hospital. “Because we don’t dation is the charitable organization that pro- have ultrasound technicians on duty in the eve- motes and supports health programs and services nings or nights, when a patient comes in at night, in the Leduc area, including the Leduc Commu- we have the ability to do some assessment.” AHS-Capital Health’s Your Health magazine Fall 2008 17