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
Lifting weights will
lift your spirits
A reader relates her
recipe for success
Final The Gift of
How and where
Return undeliverable mail to: Circulation Department, 10259-105 Street, Edmonton, AB T5J 1E3. Publications Mail Agreement #40020055
Fall 2008 37
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
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;
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
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
Your Health – AHS-Capital Health’s magazine for living well www.capitalhealth.ca Fall 2008 3
Fall 2008 • Volume 6, No.4
KEN HUGHES Noémi LoPinto
Interim chair of the Alberta Health Services Board firstname.lastname@example.org
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
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
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-
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 email@example.com
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 (www.albertahealthservices.ca) 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 www.capitalhealth.ca AHS-Capital Health’s Your Health magazine
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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
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
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
Fall 2008 www.capitalhealth.ca AHS-Capital Health’s Your Health magazine
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
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 www.capitalhealth.ca Fall 2008
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 www.centre4activeliving.ca information, visit www.capitalhealth.ca.
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 www.capital
stopping the two types of the virus health.ca 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,
adults, age 50 and over, who are interested in visit www.capitalhealth.ca. 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 compass.com. 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. www.weightandwellnesscoach.ca
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 www.capitalhealth.ca AHS-Capital Health’s Your Health magazine
Pound by Pound
The New Me
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
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 www.capitalhealth.ca Fall 2008
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 www.capitalhealth.ca AHS-Capital Health’s Your Health magazine
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 www.capitalhealth.ca Fall 2008 11
Dr. braD hinz
Staff Ophthalmologist, Regional Eye Centre
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 www.capitalhealth.ca AHS-Capital Health’s Your Health magazine
Dr. howarD Evans
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 www.capitalhealth.ca Fall 2008 13
By Lisa Ricciotti | PhotograPhy by aMy SENECaL
Alberta’s only emergency
nurse practitioner stands
out wherever he goes
14 Fall 2008
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
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
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 www.capitalhealth.ca AHS-Capital Health’s Your Health magazine
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
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-
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 www.capitalhealth.ca Fall 2008 17