Spring 2013 - St. Joseph's Health Care London

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SPRING 2013

St. Joseph’s Broadcasts Surgery Expertise Worldwide NEW REHABILITATION THERAPY: A GIANT STEP FORWARD

Patients Mark 50 Years with Diabetes

Breath

of Fresh Air

OLYMPIAN CLARA HUGHES SHARES TRIUMPHS OF A DIFFERENT KIND AT BREAKFAST OF CHAMPIONS

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The always perky—and quirky— DIANE KEATON doesn’t let asthma slow her down

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JOIN THE MOVEMENT

APRIL 6 2013 London Convention Centre

It’s a day of movin’, groovin’ and fun. Grab your friends, register a team and

BUST A MOVE!

This hugely popular, national event is coming to London in 2013. Join the movement to support the Breast Care Centre at St. Joseph’s Health Care London.

Register at sjhcfoundation.org

Renowned for compassionate care, St. Joseph’s is one of the best academic health care organizations in Canada dedicated to helping people live to their fullest by minimizing the effects of injury, disease and disability through excellence in care, teaching and research.

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St. JoSeph’S Notebook

Taking a Bold Step St. Joseph’s has plans for even better mental health care New BuildiNg, New Name St. Joseph’s Health Care London’s new forensic mental health facility under construction in Central Elgin will be called the Southwest Centre for Forensic Mental Health Care. The name was decided upon after an extensive information gathering

A rendering of the newly named Southwest Centre for Forensic Mental Health Care, which will be completed this spring.

process that included staff and patient surveys, focus groups, and discussions with stakeholders and others. The name speaks to the geographical location of the facility, provides clarity on St. Joseph’s position as a provincial resource and depicts the type of care provided in the facility. “St. Joseph’s is taking a bold step with this name,” says Dr. Gillian Kernaghan, president and CEO of St. Joseph’s. “People who need care in the forensic program are often double-stigmatized as they have a mental illness and have come into contact with the judicial system. Mental illness of any kind should not be hidden. The earlier people can get help, the earlier they can be on the road to recovery.”

ThaNk You foR ShaRiNg The SpiRiT of The SeaSoN The spirit of Christmas warms the heart and comforts the soul. And although Christmas has come and gone, that spirit lingers throughout the year at St. Joseph’s Health Care London. The outstanding support of the community for the annual Season of Celebration campaign means that caring for patients—body, mind and spirit—remains at the heart of St. Joseph’s all year long. Thanks to generous donations, the 2012 Season of Celebration was another great success, raising more than $350,000 for care and comfort items, such as pressure-reducing mattresses, patient ceiling lifts, a blanket warmer and a portable X-ray unit.

VoluNTeeRS Needed To moVe aNd gRooVe On April 6, St. Joseph’s Health Care Foundation will host Southwestern Ontario’s first-ever Bust a Move for Breast Health™ event, a six-hour group fitness extravaganza that will have participants sweating and laughing their way to better breast health for all. Funds raised will support St. Joseph’s Breast Care Centre. Playing an important role in this day of fitness and fun are many volunteers. From registration and set-up to manning water stations and greeting participants, there is a volunteer role for everyone. Interested in helping out? Visit bustamove.ca for event details and available volunteer positions.

Time To duST off ThoSe RuNNeRS Attracting runners from across Canada, Run for Retina has become a permanent fixture in the London area. For more than a decade, the event has raised awareness of macular degeneration and a total of more than $441,000 for the Ivey Eye Institute at St. Joseph’s Hospital to support research, diagnostics and front-line examination equipment. This year’s Run for Retina takes place April 14 at Harris Park in London. For more details, visit sjhcfoundation.org/ events/community-events. Spri ng 2013

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ConneCting with Our COmmunity

Renewal and Rejuvenation

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ST. JOSEPH’S HEALTH CARE FOUNDATION 2012–2013 Board of Directors

ith the coming of spring and its promise of new growth, we at St. Joseph’s are embracing a season of renewal and rejuvenation—for St. Joseph’s as an organization and for the overall health and well-being of those we serve. Across St. Joseph’s, signs of renewal and rejuvenation are both tangible—in the construction at various corners—and intrinsic in our ongoing pursuit of excellence. Both are important themes in our vision to earn confidence in the care we provide, and make Dr. Gillian Kernaghan, left, and Michelle Campbell a lasting difference in the quest to live fully. Inspiring stories in this issue of Vim & Vigour offer a glimpse of how we are achieving that vision. From recovery after trauma to heart health to helping the mentally ill find pleasure in everyday pastimes, we are focused on care that allows people to reach optimal health and well-being. The coming months are exciting ones as we unveil our new forensic mental health facility in Central Elgin, proceed with the demolition and rebuilding at St. Joseph’s Hospital, and surge ahead in ambulatory treatment of complex medical and chronic disease. Recently joining St. Joseph’s, for example, is the Cardiac Rehabilitation and Secondary Prevention Program, which is providing care and guidance needed by those with heart disease to manage their condition. On April 6 at the London Convention Centre, we look forward to the launch of Southwestern Ontario’s first Bust a Move for Breast Health™. Teams from across our region have been preparing for months for this six-hour health and fitness extravaganza, which will raise vital funds for St. Joseph’s Breast Care Centre. The event, featuring international fitness guru Richard Simmons, promises to be an inspiring and energizing experience. As this season of renewal and rejuvenation unfolds, St. Joseph’s is reinvigorated by the work ahead to create innovative ways to serve those who come to us in need. Rising to challenges and finding solutions has never been more critical as we face some of the most difficult economic times in the public sector. As always, St. Joseph’s remains focused on excellence in care, teaching and research. Thank you for the role you play in supporting that mission.

Ron Martindale Jr. , Chair Tim Brown Michelle Campbell, President Michael Dale Ian Dantzer Samira El-Hindi Dianne Evans Mark Farrow Murray Faulkner Stacey Graham Marcella Grail

John Haasen Dr. Gillian Kernaghan Brenda Lewis Frank Longo Peter Mastorakos Peter McMahon Theresa Mikula Dr. Walter Romano Rick Spencer Mary Ann Wenzler-Wiebe

ST. JOSEPH’S HEALTH CARE LONDON 2012–2013 Board of Directors Marcella Grail, Chair Dr. Pravin Batohi John Callaghan Kimberley Chesney Jacquie Davison Dr. Robert DiCecco Murray Faulkner Phil Griffin Darcy Harris Margaret Kellow Dr. Gillian Kernaghan, President Paul Kiteley

Gaétan Labbé Ron LeClair Dr. Rob McFadden Margaret McLaughlin Rev. Terrence McNamara Karen Perkin Scott Player Pat Pocock Bruce Smith Dr. Michael Strong David Van Trigt

Contributing Writers Kelsi Break, Krista Feddes, Douglas Grant, Amanda Jackman, Anne Kay, Johanna Mesjarik, Dahlia Reich, Renee Sweeney

Editors in Chief Kathy Burrill and Michelle Campbell

Editor Dahlia Reich

Production McMurry

801 Commissioners Road East London, ON N6C 5J1 519 646-6085 sjhcfoundation.org If you prefer not to receive Vim & Vigour from St. Joseph’s Health Care Foundation, please call 519 646-6085. TM

Vim & Vigour, Spring 2013, Volume 29, Number 1, is published quarterly by McMurry, McMurry Campus Center, 1-888-626-8779. Vim & Vigour is published for the purpose of disseminating healthrelated information for the well-being of the general public and its subscribers. The information contained in Vim & Vigour is not intended for the purpose of diagnosing or prescribing. Please consult your physician before undertaking any form of medical treatment and/or adopting any exercise program or dietary guidelines. TM

TM

TM

Dr. Gillian Kernaghan President and CEO St. Joseph’s Health Care London

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Michelle Campbell President and CEO St. Joseph’s Health Care Foundation

Publications Mail Agreement #41661016. Return undeliverable Canadian addresses to: 801 Commissioners Road East, London, ON N6C 5J1.

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CONTENTS

SPECIAL Growing Hope The Wellness Centre at St. Joseph’s Regional Mental Health Care St. Thomas encourages patients to take an active role in their recovery.

50 DEPARTMENTS 1

Notebook A sneak peek at the new Southwest Centre for Forensic Mental Health Care.

2 Connecting with Our Community St. Joseph’s is embracing a season of renewal and rejuvenation. 4 A Day in the Life Thirteen patients are honoured for hitting the half-century mark with type 1 diabetes. 8 Faces Get to know cardiologist Dr. Neville Suskin. 46 Virtual Health A video for dizziness, a stress-reducing app, and much more!

COVER PHOTO BY EVAN AGOSTINI

54 In Your Own Words Grateful patients share their St. Joseph’s experiences. 56 Inspired to Give Local teams get ready to raise money for Bust a Move for Breast Health.

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FEATURES

Changing Lives Meet the next wave of physical therapy: locomotor training at Parkwood Hospital. Taking Charge The cardiac rehabilitation and secondary prevention program at St. Joseph’s Hospital helps heart patients get healthy. You’re the Star Find out how you can take the lead role in your own health care. Heart-to-Heart Four women share their harrowing stories of heart disease, along with life-saving advice. Lighten Up! Get the skinny on how losing a little weight can make a big difference in your health. Have No Fear Don’t let concerns about joint replacement keep you from living. Work It! This easy office makeover can help you stay fit and reduce stress on the job.

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What Are the Chances? Which behaviours are risky when it comes to cancer and which are just hype? We clear up the confusion. 9 Symptoms Never to Ignore When do those minor aches and pains indicate something more? Here are nine reasons to call your doctor. When Allergies Attack Do you know fact from fiction when it comes to allergies? Bringing Surgery Expertise to the World Live surgery broadcasts help St. Joseph’s surgeons share their knowledge on a global scale. Surgical Innovation at St. Joseph’s Honouring advances in surgery at St. Joseph’s Health Care Foundation’s annual Tribute Dinner. Determined to Speak Up Six-time Olympic medalist Clara Hughes will share her battles with depression at the Breakfast of Champions.

ON THE COVER

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Because she has such an effervescent personality, you probably never would have guessed that Diane Keaton has asthma. But she is breathing easier now and living a full, joyful life even with the condition. And so can you!

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A DAY IN THE LIFE OF ST. JOSEPH’S

Joining the Half Century Club St. Joseph’s patients mark 50 years living with type 1 diabetes

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n the world of diabetes, they are considered warriors. Diagnosed 50 or more years ago, these patients struggled through the early years of glass syringes, urine sticks to monitor blood sugar, and a general lack of education and knowledge about how to control their condition. In the beginning, many didn’t know anyone else with diabetes and felt alone in their journey. They have lived the dramatic changes in care and technology, persevered and today are an inspiration for the current generation of patients living with diabetes, says Dr. Irene Hramiak, chair/chief of the Centre for Diabetes, Endocrinology and Metabolism at St. Joseph’s Hospital and a scientist at Lawson Health Research Institute. At St. Joseph’s, patients who reach 50 years since their diagnosis are nominated by their endocrinologist for the

Diabetes Half Century Awards presented annually by St. Joseph’s and Novo Nordisk Canada Inc. As partners in their care and participants in research, these individuals are celebrated for their contributions to great strides in diabetes care and education, and for their commitment to their health. Each receives a print of London’s Banting House to commemorate their achievement. St. Joseph’s is the only hospital in Canada that hosts the awards. Over the past 10 years, 112 patients have received the awards at a ceremony that takes place during Diabetes Awareness Month in November. This year, 13 patients were honoured. With humour and emotion, they recounted some early memories of their long journey and the support they eventually found from the interdisciplinary care team at St. Joseph’s.

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Ten of 13 recipients of the 2012 Diabetes Half Century Awards were on hand for the awards ceremony in November. Allison Lapthorne, far left, representing Novo Nordisk Canada Inc., and Dr. Irene Hramiak, second from left, chair/chief of the Centre for Diabetes, Endocrinology and Metabolism at St. Joseph’s Hospital, presented the framed print of London’s Banting House that each of the recipients will take home.

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When Jim Palmer was diagnosed with diabetes at age 16, he felt like the only person in the world with the condition. “In my small town, I didn’t know another person with diabetes. It was like I was doing it alone.” The 67-year-old has taken part in several studies and now qualifies for the new LONGTIME study focusing on complications in the large and small blood vessels. Here, Lawson Health Research Institute scientist Selina Liu signs up Palmer for the trial.

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Over the years, Cheryle Nother, right, has appreciated the care and expertise of her endocrinologist, Dr. Terri Paul. Diagnosed at age 5, Nother remembers missing out on sleepovers and “breaking a lot of rules” as she got older. “I ate a chocolate bar at age 13 and then sat under a tree prepared to die. That’s what I thought would happen. It was Jersey Treasure Milk. I’ll never forget it.”

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Diagnosed with diabetes in Scotland at age 5, Joyce Neill describes the needles in the early days as “darning needles” they were so large. In her youth, “I did the rebellious thing—looking back I’m horrified.” As an adult, Neill has been very proactive about her health.

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Diagnosed with diabetes in Ireland during pregnancy at age 27, Maureen Hutchman, left, spent almost her entire pregnancy in hospital. At the Half Century Awards, she met fellow Brit Joyce Neill and the two enjoyed comparing experiences.

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Dr. Irene Hramiak chats with her patients Jerry DeZwart, centre, and Jim Palmer. Diagnosed at only 7 1/2 months of age, DeZwart has only known life with diabetes. “There wasn’t the same kind of monitoring available when I was a kid. I would be out playing road hockey and climbing trees, get home and be having a reaction.” Now on a pump, DeZwart says advances in diabetes care technology “has been a huge change in my life.”

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In 1978, under the guidance of pioneer Dr. Wilson Rodger at St. Joseph’s, Carol Guest became one of the first patients in the world outside the United Kingdom to use an insulin pump. “The pump then was about the size of a brick. I remember trying to get into the bathtub and balancing this big thing on the edge. Now it’s the size of a pager and can be unhooked.”

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Irene Barker, with husband John, remembers “my mother shaking me awake in the morning because of my sugar lows and having orange juice at my mouth.” Diagnosed in Scotland in 1960, “no one told us what to do.” SPRI NG 2013

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Changing Lives— One Step at a Time Locomotor training takes rehabilitation at Parkwood Hospital to a whole new level BY KRISTA FEDDES

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Four staff members are needed for the locomotor training session. Here, Shannon McGuire (standing) provides support from behind for Janson Broome, while Janelle Wittig (left) and Sarah McLean (right, partially hidden) move each of his legs. The fourth staff member operates the body weight support treadmill.

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t. Joseph’s Parkwood Hospital is one of the few hospitals in North America using an intensive new therapy to help people with a spinal cord or acquired brain injury regain lower body strength, and, in some cases, even walk again. The rigorous therapy has been a giant step for wa rd—l iter a l ly—for Janson Broome, who hovered near death after a catastrophic car accident Aug. 22, 2011. After multiple surgeries on his shattered bones and more than six months in hospital, the 25-year-old thought he would never walk properly again. But thanks to the new locomotor training (LT) program at Parkwood, and much perseverance, Broome’s recovery has quickly gained momentum. “After months of physiotherapy with little progress, I was skeptical the LT could help me,” says Broome. His outlook changed after only two days on the program. Movement improved in his hips and the pain his back was significantly relieved.

HOW THE LOCOMOTOR WORKS The LT program uses a body weight support treadmill, which has a harness that supports and holds the patient upright on the treadmill. With the patient supported, the therapists’ hands are free to work with the patient’s limbs.

“It’s all hands on deck during the LT workout on the body weight support treadmill,” explains Shannon McGuire, a physiotherapist in the Neurotrauma Rehabilitation Program. “The therapists work together to optimize sensory cues for the participant. Walking is automatic— your brain doesn’t seem to pay attention or put a lot of resources into it—unless you have a neurological injury.”

REGAINING MOVEMENT AND STRENGTH The LT program was developed by the NeuroRecovery Network (NRN), which was started by the Christopher and Dana Reeve Foundation to make this type of intensive treatment available to the general public, explains Dr. Dalton Wolfe, spinal cord injury research lead at Lawson Health Research Institute. With only a handful of health care organizations in the United States and Canada now using the approach, the NRN is developing an evidenceand research-based method of therapy. “The LT program is based on the assumption that the nervous system has plasticity, and that with facilitation of the right movements at a certain level of intensity, we can train or mould it to get more normal movement back,” explains physiotherapist Janelle Wittig. “For some, it means regaining the ability to walk. For others, it means having the strength to support themselves sitting, being more independent with transfers, being able to put on their own shirts, a decrease in pain or reduction in medications needed.” Broome is the fi rst graduate of the LT program at Parkwood, having completed 44 intensive 90-minute sessions. “More people need to do this program,” he says. “It needs to be a necessary component of the recovery journey. It changed my life.”

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Taking Charge At St. Joseph’s, patients with heart disease learn how to get healthy and stay healthy

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push in London to ensure care for heart attack patients and others with heart disease doesn’t stop once they leave the hospital is resulting in many more individuals receiving rehabilitation and the guidance they need to stay healthy. In recent years, the number of referrals to the cardiac rehabilitation and secondary prevention program (CRSP) has nearly doubled and its impact has significantly strengthened thanks to various efforts, such as reaching heart patients before they leave hospital, making the referral process to the program easier, and helping patients turn lifestyle changes into lifelong habits. “To practice innovative cardiac rehabilitation you need an approach with a broad reach and expertise that serves as a resource for hospitals and the region,” says Dr. Neville Suskin, medical director of the program, now located at St. Joseph’s Hospital in London. Done right, adds the cardiologist, the impact can be tremendous. The CRSP program conducted a study that shows preventing a second (or third) heart attack can result in a 30 per cent savings in health care costs from reduced hospitalizations. “There are few interventions in medicine that can do that,” he says.

connected with the CRSP before discharge from hospital. They can even begin smoking cessation therapy before they leave hospital. “We have implemented a strategy in the inpatient setting so that patients are getting the right care and understand the importance of follow-up and risk reduction,” says Dr. Suskin.

BEST PRACTICES, BETTER RESULTS About 500 patients are seen each year at St. Joseph’s CRSP program, which also has four satellite sites in Sarnia, Owen Sound, Ingersoll and Chatham. In a unique partnership with the YMCA in London, exercise prescribed by the CRSP team is carried out at the downtown Y, where patients attend supervised exercise sessions and also work out on their own for six months. “Ultimately, what we want to do is help patients establish and maintain an active lifestyle, gain strength and confidence, and take charge of their

A Leader in the Field Cardiologist Dr. Neville Suskin, born and raised in South Africa, is a leader in cardiac rehabilitation in Ontario. On page 8, read about his journey to London and his passion for this important area of care.

REHABILITATION PROMOTES RECOVERY The CRSP program is designed for men and women with heart disease who have had a heart attack, angina, angioplasty or heart surgery. An interdisciplinary team provides patients with a medical evaluation, including exercise stress testing, a prescribed exercise program, lifestyle education, psychological services, nutrition counselling, smoking cessation therapy and more. Instead of waiting for patients to come to the program, London heart patients are now

Heart patient Vanya Lang receives instruction from kinesiologist Amanda Cunningham in the exercise room of the cardiac rehabilitation and secondary prevention program at St. Joseph’s Hospital.

health, says Dr. Suskin. “The key is sustainable, behaviour change. As part of that, we want people to become habitual exercisers.” SPRI NG 2013

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Faces oF St. JoSeph’S

Care for the Heart with Heart Dr. Neville Suskin is playing a vital role in cardiac rehabilitation in Ontario

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e describes himself as stubborn and persistent—attributes that brought him to the opposite side of Earth to fulfill a passion. Dr. Neville Suskin had never been out of South Africa when he landed in the tiny rural town of St. Lawrence, Newfoundland. It was 1986. The medical school graduate had completed his internship and was seeking opportunities that South Africa couldn’t offer. At the time, Canada didn’t particularly need foreign-trained physicians. Those who came were sent “to places where Canadian-trained physicians didn’t want to work,” laughs Dr. Suskin, a city boy who had never seen snow before. In St. Lawrence he practiced family medicine before pushing on, crisscrossing Canada to pursue his training. He became a cardiologist and established London’s cardiac rehabilitation and secondary prevention program, now located at St. Joseph’s Hospital. Here, Dr. Suskin, who has helped shape cardiac rehabilitation in Ontario, talks with humour and vision about where he’s been and where he goes from here.

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Why did you choose medicine as a career and cardiology as a specialty? My passion was actually sports

Dr. Neville Suskin, medical director, cardiac rehabilitation and secondary prevention program at St. Joseph’s Hospital.

medicine. When I was young, I was almost a semi-pro squash player. But alas, I didn’t have enough skill, or dedication, or earning potential, so my then girlfriend (now wife) strongly encouraged me to stick to medicine. In Canada, I ended up in internal medicine by default when my sports medicine job fell through. I discovered that cardiology, particularly cardiac rehabilitation, piqued my interest. I now had a new passion.

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What brought you to London?

Well, it was the only place where I obtained a cardiology residency spot that matched my wife’s. Following cardiology

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training I did a research fellowship in cardiac rehabilitation and clinical trials in Hamilton and came back to London on faculty at Western University in 1998 with a mandate to start the academic cardiac rehabilitation program.

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What are you most passionate about when it comes to your

work? In cardiology, you can treat very sick patients and they can recover almost completely and are in terrific shape afterwards compared to before. That’s what drives me. It’s also the ability to work in a team and take the best evidence and deploy it into clinical practice across cardiology for the most optimal outcomes.

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What is your vision for the cardiac rehabilitation and secondary prevention program at St. Joseph’s? We

have to change the way we conventionally think about care. We need to get patients the care they need as close to home as they want. The main contact for patients should be with their primary care provider, not specialty care. St. Joseph’s should be the nerve centre, the quarterback for cardiac rehabilitation and secondary prevention, making sure that primary care is able to maintain the highest level of care with our support.

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You could likely work anywhere. What keeps you in London? The pro-

gram recently moved to St. Joseph’s Hospital and it’s an opportunity we’ve been looking forward to for years. It’s very exciting for us. Our interdisciplinary team is now in close proximity with other researchers at Lawson Health Research Institute, which will facilitate collaborative research that improves care and outcomes for our patients.

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Where does your

family tree lead?

It’s about more than tracing your roots. Children of parents with heart disease are more likely to develop the condition themselves. Talk to your parents about their health histories— and talk to your doctor about the screenings you need.

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Are you playing a supporting role in your own healthcare? Find out how to take the lead

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When it comes to TV medical dramas, the lives of the doctors are often more entertaining than the plight of the patient. After all, who wouldn’t want to keep tabs on the ups-and-downs


of the love affairs on Grey’s Anatomy? But in your own life, it’s important to make sure you’re focused on getting the best care, and that means you need to be the leading lady (or gentleman) of your own medical drama. It may not win you any Emmys or score you a date with Patrick Dempsey, but becoming your own healthcare advocate can put you on the path to improved wellness. BY ELLEN OLSON

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SAY GOODBYE TO STAGE FRIGHT REHEARSE FOR THE ROLE

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HAVE A CASTING CALL Once you are comfortable talking to your doctors, it’s time to evaluate their performance. If your doctor doesn’t give you time to talk, doesn’t take your concerns seriously or acts annoyed when you ask questions, it may be time to search for a new physician. “Oftentimes, choosing a healthcare provider really comes down to convenience,” DeWitt says. “It is important to find someone that is close to home and meets your scheduling needs.” DeWitt recommends keeping a few things in mind when evaluating a practice:

PHOTOGRAPHY BY THINKSTOCK

Have you ever left an appointment with your doctor and realized you forgot to ask about the one thing that has been bothering you the most? According to Dr. Dawn DeWitt, a professor of medicine at the University of British Columbia and co-author of Teaching in Your Office, you’re not alone. “Many people come to appointments without mapping out what they want to talk about and often end up forgetting why they’re there in the first place,” DeWitt says. So what’s the best way to combat this brief stint of memory loss? Come prepared by making a list ahead of time of the things you want to discuss with your doctor. “Almost no idea is better than coming armed with a list,” DeWitt says. “It helps keep the conversation focused, and it can help your physician get a more in-depth sense of what the issues are.” But be realistic when making the list. If you have a lot of issues to talk about, prioritize—put the most important ones at the top. “If you have numerous things to discuss, try breaking it up into a couple appointments,” DeWitt says. “If you’re comfortable divulging some information to the front desk staff, go ahead and give them a heads-up about what you’re coming in for. This way, the doctor can be prepared for your visit.” If you do happen to forget one or two specific questions, DeWitt suggests following up through email, if possible. “Email can be hugely convenient for everyone, but be sure to be wary of what you share electronically, as it is never 100 per cent secure. I also encourage text messaging with some of my patients when they have a quick question,” she says. As convenient as technology is, try not to rely on it too much. “Nothing can replace an in-person visit. If you have a new or serious health concern, it is best to schedule a face-toface meeting,” DeWitt adds.

Want to give a five-star performance? Then it’s time to stop being shy. Your doctor isn’t there to criticize or judge, so don’t be nervous about letting it all hang out. Being honest will help your physician provide you with the right diagnosis, the right medicine and the right advice for preventing or treating illness. “If you have something new to discuss, make it clear up front,” DeWitt says. “Don’t wait until the end of the appointment to bring up you biggest concerns.” If you are bashful about discussing certain issues like weight, depression, libido or incontinence, keep in mind that doctors have heard and seen it all. Be honest and forthright about your symptoms, medical history, current and previous medications, past hospitalizations, any herbal or alternative therapies you have used, work, home or personal stress that may be affecting you, any other doctors you have seen and been treated by, and anything at all that might affect your care, DeWitt says. Your honesty about your own health can help your doctor determine a course of action, and can ultimately affect the quality of care you receive. “As doctors, we’re not here to condemn you. We are here to help you look at the facts, the risks and the possible treatments,” DeWitt says. “But as a patient, you have to have the guts to address the issue. Ultimately, it is your life and your health.”

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CALL

Learn More

St. Joseph’s Third Age Outreach program offers London seniors specialized programs and services, educational opportunities, information, resources and special events promoting health and wellness, independence, positive aging and improved quality of life. For more information call 519 661-1621 or visit thirdageoutreach.ca.

• Is the office close to your home and work? • Do patients regularly have to wait a long time to see the

photography by thinkstock

doctor? Will that work for your schedule? • Do they have a support staff that you are comfortable seeing for routine things like blood work or prescription refills if your doctor isn’t available? But more than anything, DeWitt says, it is most important to find a doctor you are comfortable with and is easy for you to access. “If you can’t ever get in to see your doctor, then they aren’t really benefitting your health. And if you don’t ever want to see your doctor, then that isn’t helping you much either,” she says. If you receive a serious diagnosis from your doctor, don’t hesitate to get a second opinion. “When it comes to things like cancer, or a big surgery or procedure, second opinions are a good idea,” DeWitt says. “For more mundane health issues, 80 to 90 per cent of the time, a second opinion won’t give you much new information. But if it is important for your peace of mind, then by all means, seek one out.”

Find Your Supporting CaSt Every great actor needs a solid cast and crew to produce an award-winning show. In addition to second opinions, when dealing with a diagnosis you’ll likely turn to a loved one to be your caregiver.

“With a new diagnosis, the caregiver evolves into de facto manager,” says Bonnie Schroeder, director of caregiving at Victorian Order of Nurses Canada, a partner in the Canadian Caregiver Coalition. “They’ll want to make sure the healthcare provider recognizes their role as a caregiver and includes them in appointments and discussions. It is often a good idea to have it noted in the patient’s chart who the caregiver is.” But make sure not to overstep, Schroeder says. “It is important that there is a conversation between the patient and the caregiver to ensure that expectations are clear.” Even if you don’t choose one specific person to be your caregiver, it helps to have a second person accompany you to appointments. “When dealing with illness, two people hearing the advice of the doctor is better than one,” Schroeder says. “Instructions are often forgotten or misunderstood, so having the two of you there listening, and hopefully taking notes, can help ensure that you get it right.”

Passport to Healthy Aging More than 50 community and business organizations came together last year to promote healthy aging in London and Middlesex. In London alone, an estimated 28 per cent of the population is age 55 and older. The Third Age Outreach program of St. Joseph’s Health Care London, which provides older adults in the community with recreation, leisure and education programs, was a key player in the initiative, called Stepping Out Safely–Healthy Aging 2012. “More than 100 events and activities were offered over a six month period with themes ranging from celebrating aging to physical activity to nutrition,” says therapeutic recreation specialist Bev Farrell. “All these events were geared to helping older adults learn ways to stay healthy and prevent disease so they can maintain a good quality of life as they age.” Those who attended the events—about 4,200 seniors—received passports to track their participation. For more information, visit steppingoutsafely.com.

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Heart-to-Heart Four women sh are their stories of heart disease BY COLLEEN

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“Women’s risk for heart disease, heart attack and stroke increases as they reach mid-life and beyond,” says Dr. Beth Abramson, a Toronto cardiologist and spokeswoman for the Heart and Stroke Foundation of Canada. And as these four women will tell you, if it can happen to them, it can happen to you. So pull up a seat, read their stories and then pass on the message to your girlfriends.


S

ometimes a tête-à-tête with a close girlfriend is all it takes for you to move on from that unhealthy relationship, to get to the bottom of your blind-date bashfulness, to decide that, no, your mother-in-law doesn’t have a right to comment on your cleaning habits. If each of the following women could sit you down for a chat, they’d discuss protecting your heart, too, but from a different threat—heart disease. That’s because they know first-hand the dangers of this disease in women.

RINGER

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Name: Dianne

AGE AT TIME OF EVENT: 52 HER STORY: A fitness instructor and runner, Dianne went to the doctor every year, and every year she got a clean bill of health. So when she experienced numbness in her forearm and a little reflux, she attributed it to the rigorous training she’d been doing. One morning, she couldn’t explain it away. “I grabbed my chest and went down to my knees just like you see in the movies.” Her husband, a police officer, insisted on a trip to the emergency room. Off they went, jammies and all. As the seconds ticked by, her chest pain got worse; she was sweating and vomiting. The EKG, however, didn’t show anything. The ER staff dismissed it as a panic attack, until Dianne grabbed a nurse and said,


“I am going to die.” A second EKG showed that she had suffered a massive heart attack called a widow maker. One stent later, the rhinoceros had been taken off her chest. Dianne soon learned that six other people in her family had experienced the same thing—and died. “Growing up, I wasn’t aware that I had such a strong family history of it,” she says. “I don’t know why my family never talked about it.” LEARN FROM HER: Dianne’s biggest message to women is to know your family history. “You need to ask questions,” Dianne says. “This is not a disease that only overweight or sedentary people get.” Thanks to Dianne’s heart attack, her five sisters, including her twin, Denise, and Dianne’s two daughters are keeping a close eye on their risk factors, especially blood pressure and cholesterol levels. Dianne remains active, exercising five days a week. “I never want to go through that again.” THE DOCTOR SAYS: While it’s helpful to know a little about your grandparents’ and great-grandparents’ health histories, it’s not essential. “Family history really means a close family member,” Abramson says. “A parent or sibling with early heart disease puts you at genetic risk.”

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Name: Marla

“It’s not always a Hollywood heart attack with the clutching of the chest. Women are subtle—it could be neck, jaw or arm pain.”

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AGE AT TIME OF EVENT: 53 HER STORY: Marla was fit and played tennis regularly. But there was more happening on the court than a rousing doubles game. It was the only time in her day when she experienced chest pain. Of course, there was always a reasonable explanation: She’d had orange juice or coffee or both; she didn’t wait long enough after eating to play; maybe she wasn’t as in shape as she thought. Finally, a cardiologist friend suggested she get a stress test. And even though Marla passed her stress test, the doctor told her to call if it happened again. It did. A few tests, three stents and five prescriptions later, Marla was immersed in the world of coronary artery disease. “My life turned upside down.” Aside from the distressing diagnosis, the medications made Marla “feel like a zombie.” Her usual morning-person self was gone, so she told the doctor something had to change. “We started cutting back, adjusting and changing,” she says. “It was a struggle to get the right combination of medications for me.” A year and a half later, Marla felt a pinching in her left arm. This time she knew better. As a co-leader of three women’s heart disease support groups, she is all too familiar with the symptoms of a heart attack. “Because I knew what to do, there was no damage to my heart.” LEARN FROM HER: “You need to put yourself before the dog,” says the mother of three. “Women are busy with children, family, friends, parents. Our health comes down somewhere after taking care of the plants.” And it’s not only that, she says. Women’s heart attack symptoms can be easy to miss. “It’s not always a Hollywood heart attack with the clutching of the chest. Women are subtle—it could be neck, jaw or arm pain.” THE DOCTOR SAYS: “Coronary artery disease can present with stable symptoms

of chest pain all the way to a heart attack. In general, all patients should be on medication to reduce future risk as well as make lifestyle modifications.”

Name: Dina

AGE AT TIME OF EVENT: 41 HER STORY: Dina just thought she had a really bad headache. She was home for the holidays, so she put on a brave face. On New Year’s Eve, the ex-athlete decided to head to the emergency room. Her blood pressure was elevated, but the staff chalked it up to holiday stress. Two days later, she was back at the ER. “I’ll never forget the look on the nurse’s face when she took my blood pressure. It was off the charts,” she says. “She looked at me as if I was going to die right there.” After an EKG, a CT scan and a chest X-ray, the doctor came in with the verdict: She had suffered a transient ischemic attack, or a mini-stroke. Dina was shocked. She ran track in college and had worked part time as a personal trainer—hardly the picture of heart disease. But genetics weren’t on her side. Many of her family members took medication for high blood pressure. “I was walking around thinking I was healthy, but I wasn’t. That’s why they call it the silent killer.” Today, Dina’s daily routine includes taking her blood pressure medication and working out for 30 minutes. She eats a lot of fish and green, leafy vegetables, shuns fast food and tries to keep her stress level in check.

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“I’ve gone through an evolution of what it means to be heart healthy.”

LEARN FROM HER: Dina advises women to focus on the ABCs of heart disease and stroke: Aspirin therapy, blood pressure numbers, cholesterol control and smoking cessation. THE DOCTOR SAYS: “You can’t feel your blood pressure,” Abramson says. “You don’t know if it’s high unless you measure it.”

Name: Tamara

Women and Cardiac Rehab While cardiac rehabilitation after a heart attack or other cardiac event is essential to managing heart disease and staying healthy, less than 30 per cent of women are referred for such care, says Dr. Judith Francis, psychologist with the cardiac rehabilitation and secondary prevention program at St. Joseph’s Hospital. In fact, women are less likely to be referred to cardiac rehabilitation than men. There are various reasons for this, such as: • Women tend to be older than men at the time of referral and have more health problems that make participation difficult. • Women are more likely to be depressed and have problems with anxiety. • Women are more likely to live alone or be caregivers for other family members. Current guidelines of the Canadian Association for Cardiac Rehabilitation call for automatic referral of both men and women to cardiac rehabilitation following particular cardiac events, which should help with the gender disparity, says Dr. Francis. Once referred, she adds, “it’s essential that women try to participate” as studies show that cardiac rehabilitation can reduce the risk of mortality by 50 per cent within the first three years after a cardiac event.

OnlIne

AGE AT TIME OF EVENT: 16 HER STORY: Tamara doesn’t have and has never had heart disease. Still, it has touched her life deeply. The first day of her senior year of high school, she lost her mother, Anita, to a heart attack. Tamara had just fi nished her homework when she heard her mother calling her—her voice sounded odd. “I saw her hunched over on the carpet,” Tamara remembers. “She wanted me to take her to the doctor.” They never got that far. Tamara called 911, and the paramedics rushed her mother to the hospital, but she couldn’t be revived. She was only 46. “Having her die was totally unexpected,” says Tamara, now 34. “She was always walking around the neighbourhood, doing calisthenics. She was very active.” Because her mother kept a detailed diary, Tamara knows that her mother woke up with cold sweats and felt nauseated the day she died. She didn’t realize how serious her symptoms were. “I hear her story from so many other women,” Tamara says. LEARN FROM HER: “I’ve gone through an evolution of what it means to be heart healthy,” she says. “After my mom died, I went to extremes—everything was clogging my arteries, I needed to be super in shape. I was vigilant in a way that was unhealthy.” Now, Tamara takes a more holistic approach. The mother of three does yoga and takes long walks. “Being healthy is a journey, not a destination.” THE DOCTOR SAYS: “You don’t have to run a marathon to be physically fit,” Abramson says. “And it’s OK to have a piece of chocolate cake every once in a while. Remember: most things in moderation, except smoking.”

Learn More

To find out how to enrol in cardiac rehabilitation at St. Joseph’s Hospital in London and what to expect from the program, visit sjhc.london.on.ca/cardiacrehabilitation.

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by AllisON thOmAs

Losing even a little weight can make a HUGE difference in your health

Obesity

by the Numbers one in four adults 1/4About in Canada is obese

8.6%

of children and youthS ageS 6 to 17

are obese

Since 1981, obesity in Canada has

up The Ups and downs of weighT Loss Losing weight does more than shrink your jeans size. Even a 5 per cent weight loss can: Down with the BaD

roughlydoubled

• Reduce diabetes risk • Decrease LDL (“bad”)

in 2008, obesiTy cosT The canadian economy

cholesterol • Lower blood pressure • Cut stroke risk • Reduce pressure on joints and osteoarthritis risk • Reduce sleep apnea risk

—in both sexes and for both children and adults

an EstIMatED $4.6 Billion —an increase of 19% from 2000 18

Lighten

• Increase energy levels • Potentially increase HDL (“good”) cholesterol

• Make movement (and thus exercise) easier

• Improve mood • Boost confidence • Enhance sleep quality Up with the GooD

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Keep the MuscLe

Experts recommend losing no more than

25 per cent of lean muscle during the first weeks of weight loss,

and around 10 per cent as weight loss continues. Besides boosting your metabolism and burning calories, exercise can help maintain lean muscle mass and keep your bones strong. Strength training is the most beneficial for building muscle and includes any exercise in which resistance—either from weights or your own body weight—is used.

What Happens When You ...

Gain Weight?

You gain mostly fat: 60–80 per cent fat versus 20–40 per cent lean body mass.

vs.

Lose Weight?

You lose a combination of lean body mass, fat and water— one more reason proper hydration is important during weight loss.

Making Strides Against

Childhood obeSity

Childhood obesity is reaching epidemic proportions in countries around the world—Canada included. But a team of Canadian researchers and clinicians is taking steps to move the scales in the right direction by creating the Canadian Pediatric Weight Management Registry, which will, over time, study the health of children and adolescents enrolled in weight management programs at eight sites in Canada. “We have data so far that tell us there’s modest improvement in body size when we enroll children in weight management programs for six to 12 months,” says Dr. Katherine Morrison, an associate professor at McMaster University and the study’s lead investigator. “But we want to know, how does it work in the real world? What happens after a year or so? … We hope the registry will help us provide better tools within all of our clinical programs to improve how we work with families and to help them to address childhood obesity.”

Taking Small Steps Losing weight and living healthier starts by making simple changes, says Sarah Doub, a personal trainer and wellness coordinator at The Athletic Club. “People often try doing everything at once and become so overwhelmed that they quit after a short time.” Here are three key small steps to get started: 1. Replace carbonated, caffeinated and prepackaged flavoured drinks with water. Use frozen fruit or a wedge of lemon to jazz up the taste. 2. Aim to add five servings of fruits and vegetables to your daily diet. Prepare them as snacks for work or to go along with your meals. 3. Be physically active for 10 minutes each day doing something you like, such as walking, hiking or biking. Add five more minutes each week with a goal to reach 30 minutes. Incorporate variety and have fun with others to maintain your fitness level, advises Doub. One new group fitness fundraising event coming in April is Bust a Move for Breast Health™ hosted by St. Joseph’s Health Care Foundation. As the fitness architect for the event, The Athletic Club is planning a wide range of innovative fun workouts. “Not only can people at any fitness level participate, but Bust a Move raises vital funds for the Breast Care Centre at St. Joseph’s Hospital,” says Doub.

online

Lose the Fat,

Get Your Groove On

To take part in Bust a Move for Breast Health, you can register as an individual or form a team. Your mission is to raise a minimum of $1,000 (per person) to support breast care across the region. For more information visit bustamove.ca

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PHOTOGRAPHY BY CORBIS

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Have PHOTOGRAPHY BY CORBIS

BY CHEYENNE HART

Fear

Does the thought of joint replacement surgery scare you? We put six common fears surrounding the procedure to rest

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Fear:

It wIll hurt. It’s true that there will be pain. It is surgery, after all. But McFarland and others who have had joint replacement insist it’s worth it. “The pain you’re in now is so much worse than what you’ll have after surgery,” she says. The pain from arthritis is constant and will only get worse, whereas the pain associated with surgery is temporary and will go away in time. “People having these surgeries are accustomed to pain—they have it every day,” says Dr. Ted Rumble, an orthopedic surgeon and past chair of the Canadian Orthopaedic Association National Standards Committee. “But it’s not nearly as bad as people make it out to be. “One of the major advancements in joint replacement in the past 10 years is pain control,” he says. “You will have some pain after the operation, but it’s not as bad as you’ve heard and it will subside.”

If you’re facing joint replacement for the first time, you’re probably apprehensive, too. But arming yourself with knowledge can help put your fears to rest.

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Fear:

I wIll need to be off my feet for a long tIme after surgery. The idea that joint replacement surgery means weeks or months of bed rest is more than outdated. In fact, as your orthopedic surgeon will tell you, using your new joint soon after surgery is the best possible medicine. “Most patients will be up walking the day after the operation,” Rumble says. “The joints that are put in are able to carry weight immediately. At first, you’ll need a walker, but then you’ll get to the point of using a cane and then nothing at all. Usually, the third day after surgery you can walk independently.” Most patients can leave the hospital in three to five days. Physical therapy starts immediately. And while patients rehabilitate at different rates, most are back to their normal activities in four to six weeks.

Fear:

rehabIlItatIon wIll be too hard or tIme-consumIng. Yes, rehabilitation is hard work. Joint replacement is not a surgery you can just have and then recuperate from an easy chair. A personal commitment on the part of the patient is necessary for success. “With knee replacement, physiotherapy is essential,” Rumble says. “They will typically go two times a week. But the fact of the matter is, that’s time well spent. “If you want the knee to function well, you really do need to do the physiotherapy. When people don’t do their exercises, the knee remains stiffer and has less range of motion. Trust me, you’ll be happier if you do it.” McFarland is a big supporter of rehabilitation, having seen first-hand what a difference it makes. “It’s pretty minimal what you have to do,” she says. “Do the basics and keep active, and you’ll have a lot better result. You have to keep up your end; your doctor can’t do everything for you.”

Fear:

I won’t be able to do the thIngs I lIke to do. There may be some limitations in the activities you can do with your replacement joint. But if pain is keeping you from doing those things now, what will you be missing?

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photography by corbis

Kathy McFarland knows a thing or two about joint replacement. She should. A rare form of arthritis called calcium pyrophosphate deposition disease has led her to have six of them in the past 12 years. Although she says the first surgery scared her, they don’t anymore. “Now I’m totally fearless,” McFarland says. If you’re facing joint replacement for the first time, you’re probably apprehensive, too. And that’s natural. But arming yourself with knowledge can help put your fears to rest.

OnLIne photography by corbis

Returning Home Safely

Connect with Real Joint Replacement Patients

Get the inside scoop on what to expect from joint replacement surgery by talking with people who have done it. Visit orthoconnect.org to get connected today.

Patients who have hip or knee replacement surgery can usually be discharged home after the surgery. For some, however, returning home is delayed by post-operative complications or conditions that compromise the ability to live independently. For these patients, the inpatient musculoskeletal rehabilitation unit (MSK) at St. Joseph’s Parkwood Hospital may be an option if they meet the admission criteria. “Our patients need to learn new skills before they are ready to return home,” explains MSK resource nurse Lena Romeo. “Whether they need to regain their strength and balance, or learn to walk safely or how to navigate stairs, we tailor the care plan to their needs.” The MSK rehabilitation team includes physicians, nurses, physiotherapists, occupational therapists, social workers, and other health care professionals who work together to care for patients. Before a patient is discharged, an occupational therapist may visit the home to ensure safety features, such as grab bars in the bathtub, are in place so they can live independently. As well, patients are linked with community supports, such as the Community Care Access Centre, Meals on Wheels, ConnectCare or outpatient therapy at Parkwood’s Geriatric Rehabilitation Day Hospital to ensure a smooth transition back to their homes. In addition to hip and knee patients, the MSK unit also serves those who are deconditioned due to neuropathies, myopathies, cancer, burns, transplants, amputations and other health issues. Spri ng 2013

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“Activities increase enormously after surgery. You’ll be able to do far more things than before.”

“Most people who are candidates for joint replacement have advanced arthritis, so their activities are quite limited as it is,” Rumble says. “Activities increase enormously after surgery. You’ll be able to do far more things than before. Running and jumping are really the only activities we advise staying away from.” McFarland recommends being realistic about your new joint and being open to adapting your activities to it. “These are metal [and polyethylene] parts that don’t regenerate like your body does, and they do wear. So you probably shouldn’t do extreme sports or things with impact,” she says. “I go to the pool almost every day. Aqua jogging works for me. It may not be what you did before, but there’s always something you can do.”

Fear:

The joinT prosThesis will need To be replaced again in 10 years.

24

Fear:

i need To waiT as long as possible before having joinT replacemenT. Because in years past joint prostheses didn’t last as long, people used to wait until the last possible moment to have the surgery. Today, that philosophy has changed. Because the implants are lasting longer and because we know that the healthier you are when you have the surgery, the more successful it will likely be, people aren’t waiting as long in pain. “As a general rule, the earlier in the course of the disease you have the operation done, the better the results,” Rumble says. “If you’re having more pain than you’re willing to put up with or it’s limiting your abilities, then it’s time. It makes no sense to delay the inevitable if you are suffering.” McFarland also advocates talking to your doctor sooner than later. “There’s a concept out there that joint replacements are the treatments of last resort,” she says. “I know tons of people who wait until they’re in total agony, and I always tell them you don’t have to wait. My advice is that when it starts affecting your quality of life, go get it done. If you don’t wait until it’s so bad, you’ll have a better outcome.”

photography by corbis

Joint prostheses have come a long way since the first replacement surgeries in North America were performed in the 1960s and are much more durable. Implants are made of varying materials, depending on the joint being replaced and the condition of the surrounding bone. Common materials include metal, such as stainless steel or titanium, and polyethylene, a durable plastic. Some newer implants, particularly knees and hips, are made out of a special type of ceramic material

or oxidized zirconium, which are both smooth and durable. These new implants can last 20 to 25 years versus older implants with a 10- to 15-year life span. “With modern techniques and modern prostheses, joint replacements are lasting far longer than we ever expected they would,” Rumble says. “The question is no longer how long it will last; it’s will it last the rest of my life? And the answer to that is that about 95 per cent of replacements last people the rest of their lives.”

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Work By Amanda Myers

It!

Four steps

to having a healthier, less stressful workspace

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I

f you’re reading this at your desk, take a moment and look around. I’ll wait. Do you see clutter and chaos? Are stress-inducing to-do lists tacked up all over, reminding you in no uncertain terms that you have many, many things to do … ASAP?! Are your desk drawers hiding an emergency chocolate stash? (Yeah, mine too.) When you think about how the average Canadian spends 36.4 hours a week at work, you have to wonder why many of us aren’t treating our desks more like the Zen zones that they should be. Instead, we’re sitting down each day at a spot not necessarily designed to keep our minds and bodies in a healthy state—the kind of state that allows us to be productive and calm. Perhaps, then, it’s time for an office makeover. By creating a space that promotes health and serenity, you may find it’s a little easier to face the daily grind. Spri ng 2013

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STEP 1: Give Germs the Pink Slip You don’t even want to know how many germs are living on your desk. Just know that there are plenty—and on everything from your phone to your keyboard to that pen you sometimes put in your mouth and chew on anxiously. Germs from coughs and sneezes can live on surfaces for up to three days, so to avoid colds and the flu, make antibacterial wipes your friends. “Wipe off surfaces that are shared, like phones, a computer mouse and shared workstations,” says Dr. Nieca Goldberg, a cardiologist and the author of Dr. Nieca Goldberg’s Complete Guide to Women’s Health. And, though it seems common sense, Goldberg stresses, “people should stay home if they’re sick.” You may think you’re noble to trudge to work despite a nagging cough, but what you’re really doing is not so nicely sharing those germs. Finally, nix superfluous routes of cross-contamination. “If you have a bowl of jelly beans and everybody puts their hands in it, you’re going to get their germs,” Goldberg says. And, speaking of jelly beans …

STEP 2: Close the Candy Shop

26

ILLUSTRATIONS BY GREG CLARKE

Snacks are important to keep your energy up, but having them within arm’s reach at all times makes it too easy to graze the whole day long. This adds up to far more calories per day than your body requires. Instead, bring only the snacks you need for that day with you each morning. Pre-packed 100-calorie snacks help you stay on track with a healthy diet, as do baggies of fresh fruit slices or low-sugar cereal. Then there’s the office staple: the candy bowl. There’s one in every office and if it’s on your desk, give it the boot. “If you want to lose weight, keep the candy away,” Goldberg says. Consider that just three tiny, bite-sized candy bars load you up with as many as 225 calories, but an apple and a piece of string cheese are just under 140 calories. Plus, sugary snacks will cause a spike in your blood sugar, meaning you’re more likely to crash soon after. Sustaining your energy with healthy fibre, vitamins, minerals and protein will keep you alert until closing time. SP RI NG 2 013

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OnLinE

Strengthening Performance

Focusing on staff well-being and fostering a culture of care and service at St. Joseph’s Health Care London is just one component of the ongoing effort to strengthen performance. To view St. Joseph’s strategic plan, visit sjhc.london.on.ca/planningour-future/strengtheningour-performance/ our-people.

STEP 3:

Check Your Posture Back problems can plague people who spend the majority of their workday in an office chair. The reason: Many of us sit forward in our chairs, leaning toward the computer in front of us. “When you’re not sitting properly—straight up, abs in and with a good, strong core—there’s a lot of back strain,” Goldberg says. There shouldn’t be a space between your back and the back of the chair. Also, the doctor adds, keep your feet flat on the floor. Making these small changes can prevent orthopedic issues such as chronic back pain and pinched nerves. The benefits include improved flexibility, which helps prevent back injuries down the road. Additionally, check to make sure you haven’t glued yourself to your chair. “You should get up every hour, walk around the office, drop off a paper at someone’s desk,” Goldberg advises. These moments of movement will stretch your spine and the muscles of your back and legs, preventing stiffness and cramping.

STEP 4:

Find Your Happy Place Keeping a positive mental attitude can have real, tangible effects on your physical health. According to research from the Harvard School of Public Health, happy people were less likely to have risk factors for high blood pressure and high cholesterol levels and obesity. Make your workspace a happy space by surrounding yourself not with endless to-do lists, but instead, photographs or other trinkets that elicit positive memories, says Goldberg. “I have a letter from a friend of mine and I keep that in every desk I have. She was a nurse I worked with many years ago. It’s a very supportive note.” Put fresh flowers on your desk, which can be instant mood-lifters. If you can, incorporate natural light into your work area. You will feel sunny in no time. Do you want to actually strengthen your core or burn calories while you work? Ask your office to supply you with an exercise ball chair or a standing workstation, or invest in one yourself.

A Healthy Workplace

ILLUSTRATIONS BY GREG CLARKE

The Quality Workplace Committee (QWC) at St. Joseph’s Health Care London aims to raise awareness and foster a healthy workplace while promoting best practices among staff and physicians. “The QWC creates opportunities and provides resources for employees that will benefit their physical, mental and spiritual health,” explains committee co-chair Wendy Reed. “The ultimate goal is to support our staff to thrive in a healthy work environment so that our patients receive the best care possible. Happy, healthy staff and physicians contribute to increased staff engagement, retention, morale, decreased absenteeism and improved patient care.” One initiative of the QWC is a monthly “self-care sampler” featuring a monthly theme that promotes health and well-being for all St. Joseph’s employees through information, activities, courses and workshops. Monthly themes focus on topics such as physical health, nutrition, learning, time management, relaxation, leisure, gratitude and supporting your child to succeed in school. Each self-care sampler is intended to enhance awareness of activities that promote the importance of taking care of yourself while at work. SPRI NG 2013

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A

BY STEPHANIE PATERIK

Fresh OF

PHOTOGRAPHY BY VERA ANDERSON/GETTY

How Diane Keaton controls her asthma and lives life to the fullest

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n the movie

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PHOTOGRAPHY BY DIMITRIOS KAMBOURIS/GETTY

The Lemon Sisters, Diane Keaton plays a lovably kooky character with asthma who refuses to give up her menagerie of cats, even though they aggravate her condition. She puffs away on an inhaler as her furry companions strut around the house. It gets so bad she winds up in an emergency room, zipped inside an oxygen tent. At 67, the Oscar-winning actress has starred in nearly 50 films. But the role of an asthma sufferer is one she knows especially well. Keaton was plagued with asthma and related breathing problems as a young girl growing up in Los Angeles. In her 2011 memoir, Then Again, she recalls a lifethreatening bout with whooping cough. “I thought I was dying. I couldn’t breathe,” Keaton writes. “Asthma was bad enough, but this whoopingcough thing was way worse.” Treatment options were limited in the 1950s, so Keaton’s dad held her upside down to help her catch a breath. “When dad turned me upside down, I got my breath back almost instantaneously. It was like a miracle,” she writes. “Mom was so worried, she kept me out of school for two months of my fourthgrade year. Every day she spread Vicks VapoRub on my chest, and she gave me 7UP with ice hourly. Sometimes she’d even let me watch TV.” SP RI NG 2 013


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The star is breathing easier now—if her active lifestyle is any indication. She’s nabbing major movie roles, publishing books, flipping historic California homes and raising two kids, whom she adopted when she was 50, no less. Keaton is proof positive that people who have asthma can live full, joyful lives. The trick is finding the right medication, exercising wisely and keeping stress in check.

PHOTOGRAPHY BY DIMITRIOS KAMBOURIS/GETTY

FIND THE RIGHT MEDICATION ucky for Keaton—and 2.5 million Canadians who live with asthma—treatments have come a long way since the days of VapoRub and bed rest, says Dr. Francis Adams, a pulmonary specialist and author of The Asthma Sourcebook. “The way we treat asthma has changed tremendously,” he says. When Keaton was a kid, people raced to the ER for a shot of adrenalin under the arm during a severe attack. Since the advent of inhalers, people can treat the condition at home and vaporize attacks before they begin. There’s no cure for asthma, so the goal is to control it—that means staying out of the hospital and needing an inhaler no more than twice a week. Start by pinpointing the type of asthma you have and what triggers it, Adams says. Is it stoked by allergies, exercise or your workplace? Does it strike in the winter or hang around all year? Next, your doctor can tailor a treatment plan. That might include a preventive inhaler, a rescue inhaler, or anti-leukotriene medicine called montelukast (Singulair) that reduces inflammation in the lungs. Your doctor may even prescribe a combination drug to streamline your medications, not to mention your medicine cabinet! Newer treatments include omalizumab (Xolair), the so-called “asthma vaccine,” a monthly injection that eliminates breathing problems for many people who have allergy-related asthma. And for the most severe cases, surgeons can perform a bronchial thermoplasty, which uses heat to reduce constriction in the bronchial tubes and open air passages. Of course, the most important part of any treatment plan is to follow it. “No one likes to take medicine,” Adams says. “I’m a patient, too. I don’t like to take medicine, but you really have to commit to it when you have a chronic illness.”

EXERCISE WISELY or many with asthma, “exercise” is a scary word. After all, physical activity taxes your lungs. But Keaton seems to know that in the long run it helps her breathe easier. Photographers have spotted the actress stretching, running laps and doing yoga on a track in Santa Monica, Calif. And, being just as quirky in real life as she is on-screen, Keaton rehearses lines while jogging through her neighbourhood. “I don’t think I can keep trying to memorize my speech while jogging on the streets of Beverly Hills,” she confesses in her memoir. “The Starline Bus Tours unfailingly drive by while I’m in the middle of rehearsing the final section … when I sing a bit of ‘Seems Like Old Times.’ It’s awful. I feel like an idiot.” Embarrassment aside, she’s doing an excellent job of conditioning her lungs. And she’s pushing past

Allergy-Proof Your Home Diane Keaton’s home is her sanctuary. She’s known for lovingly renovating and decorating every house she owns. Asthmatic patients who suffer from allergies can make home a haven, too, by removing dust mites, mould and smoke. Follow this checklist from The Asthma Sourcebook by Dr. Francis Adams to allergy-proof your home and breathe easier. TO REDUCE DUST MITES: • Remove carpets, rugs and upholstered furniture. • Cover mattresses, pillows and box springs with zippered covers. • Wash bedding in hot water once a week. • Wash stuffed animals. • Use a HEPA air filter.

TO REDUCE MOULD: • Keep humidity levels at 30 to 50 per cent with a dehumidifier. • Use a mould-remover spray on bathroom walls, window sills, air conditioners, humidifiers and plant soil. TO REDUCE INDOOR POLLUTION: • Ban smoking from your home. • Avoid gas and wood stoves and fireplaces.

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the first eight minutes—the hardest part for someone with asthma. “She’s doing everything right,” Adams says. “That longer warm-up gets you through that initial tightness that comes to everyone with asthma when they start exercising. Then that second wind comes. In the long run, exercise is going to make you healthier and even decrease your asthma.” Take a cue from Keaton and warm up with stretches or a light jog. Incorporate yoga to regulate breath. And most importantly, exercise for 20 minutes three times a week to condition your body. “Studies actually have shown that if you’re in top shape, you have less need for medicine if you’re asthmatic, and you have fewer attacks,” Adams says. “This is definitely related to conditioning.” Some patients are sensitive to outdoor pollutants, allergens and cold air. If that’s your case, exercise indoors or wrap a scarf around your mouth to warm the air as you breathe.

impulses can trigger an asthma attack, much like a muscle twitch or cramp. Keaton is remarkably open about the stresses in her own life, from struggling with bulimia as a fledgling actress in New York to losing her mother to Alzheimer’s disease five years ago. Watching her mom fight to breathe at the end of her life struck a chord. “Having had asthma, I knew how hard it was to work for so little air,” Keaton writes. “Inhale, hold for thirty. Exhale. Inhale, hold for forty. Exhale.” Keaton turned to “talk therapy” in her 20s, a suggestion from then-boyfriend Woody Allen. Therapy

STRESS LESS, BREATHE MORE

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PHOTOGRAPHY BY RETNA IMAGES

n The Lemon Sisters, cats weren’t the only trigger for Keaton’s character. Stress pushed her over the edge. It’s a common scenario, Adams says. “Asthma at some points was looked upon as a hysterical reaction, and people were often dismissed that way, and obviously that was dead wrong,” he says. “But we do know stress can be as much of an asthma trigger as walking into a room with a cat if you’re allergic to cat dander.” Why are stress and asthma entwined? Picture the rich network of nerves running through your lungs and bronchial tubes. When you are stressed, nerve

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onLIne

Help Is Available

At St. Joseph’s Hospital in London, the full spectrum of care, with a focus on optimal function, wellness and prevention, is available for patients who have a respiratory disease. For more information, go to sjhc.london.on.ca/lunghealth.

PHOTOGRAPHY BY RETNA IMAGES

helped the Annie Hall star overcome bulimia, and it has been a cornerstone of her healthy lifestyle ever since. “All those disjointed words and half sentences, all those complaining, awkward phrases shaping incomplete monologues blurted out to a 65-year-old woman smoking a cigarette for fifty minutes five times a week, made the difference,” she writes. “It was the talking cure.” Adams encourages his patients to manage stress, anxiety and depression with talk therapy, incorporating breathing exercises to calm the body. Meditation and biofeedback help, too. “Stress is a tremendously important source of asthma, and it’s the hardest thing to treat,” he says. “I can prescribe lots of drugs to relax the bronchial tubes and reduce inflammation, but it’s not easy to say to someone, ‘You need to take care of your stress.’ “And we’re all stressed out,” he adds. “I will not hesitate to tell people that at a stressful time in my life, I went to see a psychiatrist, and I would recommend not trying to fight anxiety and depression without professional help.”

READY TO INHALE eaton breathes in life wherever she can find it. With a long-time passion for photography, architecture and performing, she is always immersed in a creative project. She enjoys shuttling her kids to swim practice in her bare feet, and peppering them with questions when they return from school. The Pacific Ocean, Sonoran Desert and Manhattan streets delight her equally.

Asthma in Athletes When top athletes are puzzled by a drop in their performance, the reason may surprise them. Studies show that up to 40 per cent of elite athletes, depending on their sport, suffer from symptoms of asthma, which is often difficult to diagnose in such fit individuals. Respirologist Dr. Jim Lewis, who treats many athletes at the Asthma Centre of St. Joseph’s Hospital, says competitive exercise and prolonged exposure to cold air, chlorine or air pollutants and pollens are believed to cause asthma in athletes. Most at risk are elite cross country skiers, hockey players, figure skaters, speed skaters, long distance runners and swimmers. “It’s key that athletes, or anyone with asthma, receive appropriate treatment as persistent symptoms can result in more severe disease,” says Dr. Lewis. “Yet the athlete often doesn’t want to take medication or is afraid to because of misconceptions about the medications used for asthma.” Asthma is treatable and reversible, Dr. Lewis points out. “Untreated, the consequences can lead to irreversible lung disease.”

“The best part is that I’m still here and, because the end is in sight, I treasure it all more,” she told AARP The Magazine in March 2012. “You have to live life all the way, you know? Take risks. Do things you can’t imagine. ’Cause, hey, why not, right?” Asthma reminds us to appreciate the little things, and that can drive us to greatness, Adams notes. “Martin Scorsese was asthmatic, and he attributes that to a lot of his interest in film, because he was always indoors and watching whatever medium he could watch.” Hollywood once portrayed asthma sufferers as weak-willed inhaler-toters, doomed to the sidelines of life. Then along came Keaton with her bolero hats and “la-de-da” charm, determined to defy every stereotype. SPRI NG 2013

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What Are the

N C E A S? H C Smoking, tanning, grilling your food—find out just how risky these behaviours are when it comes to cancer

I

B Y J I L L SC H I L DHOUS E 34


t seems as though everywhere you turn, you hear about another thing in your life that could cause you cancer. Deodorant. Cellphones. Plastic food containers. It all sounds a little ridiculous, doesn’t it? Believe it or not, the researchers behind the claims aren’t trying to scare you—or annoy you— to death. They’re trying to help you understand the risks so you can adequately protect yourself. But before you can go about protecting yourself, it’s important to understand exactly which objects and behaviours are actually harmful and which aren’t. Let’s explore some common behaviours, and determine which ones are most closely tied to cancer.

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3 More to Consider Artificial sweeteners: “For the most part, all research shows that there is no health risk of getting cancer from consuming artificial sweeteners,” says Robert Nuttall, Ph.D., senior health policy analyst for the Canadian Cancer Society. Still, the organization advises using sweeteners, such as aspartame and cyclamates, in moderation. Water fluoridation: After analyzing the existing evidence on cancer and drinking fluoridated water, the Canadian Cancer Society reports that a connection is unlikely. Cellphones: The jury is out on this one. Researchers have not found a consistent link to cancer, but studies continue as cellphone technology, and therefore radio frequency exposure, is changing rapidly, Nuttall says.

photography by getty images

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RISK LEVEL: 3 REASON: “We know that grilling certain types of meat, including red meat, can give off certain carcinogens,” says Robert Nuttall, Ph.D., senior health policy analyst for the Canadian Cancer Society. “And we know that diets high in red and processed meats can lead to an increased risk of colorectal cancer.” RECOMMENDATION: While the Canadian Cancer Society doesn’t discourage grilling, it does offer the following tips: • Cook at lower temperatures and turn meat frequently so you don’t burn it. If you do, don’t eat those areas. • Precook meats in the microwave or oven so they don’t need to be on the grill as long. Nuttall also suggests cutting back on red • meats in favour of seafood, poultry and vegetables.

SMOKING

RISK LEVEL: 5 REASON: “Smoking is the No. 1 cause of cancer,” Nuttall says. The Canadian Cancer Society estimates that 85 per cent of the country’s lung cancer cases are due to smoking. But you’re not necessarily in the clear if you aren’t a smoker. Each year, about 250 nonsmoking Canadian adults die of lung cancer related to the effects of second-hand smoke. RECOMMENDATION: If you’re a smoker, now is the time to quit. There are many tools to help

If you don’t smoke, weight is the next most important risk factor for cancer. 36

you succeed, and your physician can recommend medication or local support groups. Remember that only a small percentage of people are successful in quitting on their first attempt—it can take several tries. If you live with a smoker, ask him or her to smoke outside and never near children. And when choosing hotels and restaurants, select smoke-free options.

USING TANNING BEDS

RISK LEVEL: 4 REASON: Studies show that indoor tanning beds can emit five times more ultraviolet (UV) radiation than the sun, Nuttall says, greatly upping your risk of skin cancer. And if you start using tanning beds before age 35, you face an increased risk of melanoma, reports the International Agency for Research. RECOMMENDATION: “Avoid indoor tanning altogether,” Nuttall says. “We’re asking all jurisdictions across Canada to put legislation in place that protects everyone under 18 from indoor tanning.” And remember that it’s not just indoor tanning. The sun’s UV rays are harmful, too. When outside, wear sunscreen with an SPF of 15 or greater, sunglasses and a wide-brimmed hat.

USING ANTIPERSPIRANT

RISK LEVEL: 1 REASON: There is no strong evidence linking cancer risk and antiperspirant use, according to the Canadian Cancer Society. “The concern was that antiperspirants blocked sweat, meaning those toxins stayed inside the body and the bloodstream,” Nuttall says. “We know, based on the evidence, that whether a person used antiperspirant or not does not affect their risk of getting cancer or breast cancer.” RECOMMENDATION: Although the research is ongoing, Canadians should feel comfortable using antiperspirants and deodorants, Nuttall says.

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EATING GRILLED MEATS

Get help kicking the habit at smokershelpline.ca. Through this free online program, you can share your experience with others who are in the same boat, keep a cravings diary, sign up for encouraging emails and more.

TOOL

Ready to Quit Smoking?

Being overweight

RISK LEVEL: 5 REASON: “Maintaining a healthy weight is the No. 2 thing, after quitting smoking, people can do to lower cancer risk,” Nuttall says. Being obese, or having a body mass index (BMI) of 30 or higher, increases your risk for a variety of cancers, including breast, prostate and colon cancers, according to the Public Health Agency of Canada. RECOMMENDATION: Calculate your BMI (visit www.dietitians.ca/your-health and look under “Assess Yourself”), and take action if it’s 30 or greater. “Eat more fruits and vegetables and increase your activity levels. It’s not one thing—it’s many small things,” Nuttall says.


‘Butting Out’ Gets Surgery Patients Home Quicker St. Joseph’s Hospital in London has had some good success in encouraging surgery patients to “butt out.” A pilot project testing the effectiveness of a smoking cessation program compared a control group of patients who were simply advised to stop smoking before surgery to a treatment group that received a structured interview with one of the nurses, referral to Ontario’s Smokers Helpline, and a six-week supply of nicotine patches. On the day of surgery, 14.3 per cent of patients in the treatment group had stopped smoking compared with

3.6 per cent in the control group. At the 30-day follow-up, the difference had increased further to 28.6 per cent in the treatment group and 11 per cent in the control group. “These differences were statistically significant,” explains St. Joseph’s anesthesiologist Dr. Pat Morley-Forster. “As well, the treatment group was ready to be discharged from hospital after surgery earlier.” Findings of the study are being shared with various hospital departments in the city with a goal of working towards making smoking cessation a priority in London’s hospitals. Spri ng 2013

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Symptoms

Never to

PHOTOGRAPHY BY THINKSTOCK AND SUPERSTOCK

Ignore

FAINTING

NECK LUMP

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From incessant fatigue to unexplained weight loss, here are reasons to call your doctor—now BY LORI K. BAKER

SEEING SPOTS

“I simply don’t have time to get sick,” you mutter to yourself as you bolt out the door at 7 a.m. to head to work. Maybe you’ve been exhausted for weeks. Or you’ve had a constant, nagging backache. Or that swollen gland on your neck hasn’t gone away. Whatever it is, you say it’s nothing and convince yourself it will go away on its own. It’s easy to play the wait-and-see game when you’re preoccupied with so many other things. But when are simple aches and pains, lumps and bumps indicative of something more? Here are nine seemingly minor symptoms you should never ignore.

BLOOD IN URINE

FATIGUE

PHOTOGRAPHY BY THINKSTOCK AND SUPERSTOCK

NUMBNESS AND WEAKNESS IN HAND OR ARM

BACK PAIN

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12 FATIGUE

7 3

WHAT IT MIGHT MEAN: “It’s easy to pass off fatigue as due to stress, not sleeping or burning the candle at both ends,” says Dr. Dawn DeWitt, a professor of medicine at the University of British Columbia and co-author of Teaching in Your Office. “But if you are getting about eight hours of sleep each night and the fatigue is still overwhelming, it could be due to a medical condition— anemia, an underactive thyroid, heart disease, depression or hepatitis.” WHAT TO DO: If you’ve suffered from fatigue for more than two weeks, DeWitt recommends that you make an appointment with your primary care physician to find out its cause and how to treat it.

UNEXPLAINED WEIGHT LOSS

WHAT IT MIGHT MEAN: Stepping on the scale to discover you’ve lost five kilograms without even trying only sounds like a dream come true. If you haven’t changed your eating habits and you’ve lost a noticeable amount of weight, it can be a serious red flag. The list of suspects includes diabetes, an overactive thyroid gland and cancer, according to Drs. Neil Shulman and Jack Birge, co-authors of Your Body’s Red Light Warning Signals: Medical Tips That May Save Your Life. WHAT TO DO: “Go to your doctor,” Birge says. “This calls for a prompt investigation.”

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WHAT IT MIGHT MEAN: It might be something as simple as a sore throat. “But it also might mean a hidden malignancy or the first signs of Hodgkin disease,” Birge says. WHAT TO DO: Make an appointment to see your physician if the lump is larger than 2.5 centimetres wide or has lasted more than two weeks, Birge advises. Your physician will determine whether the lump is a discrete mass and may order a biopsy.

SEEING SPOTS

WHAT IT MIGHT MEAN: If you’re seeing specks or “floaters,” they may be more than annoying. They could be symptoms of retinal detachment, and you should see an eye-care professional immediately. WHAT CAN BE DONE: Small tears can be treated with laser surgery, during which tiny burns are made around the hole to “weld” the retina back into place. Another option is cryopexy, which freezes the area around the hole and helps reattach the retina. These procedures are usually performed in the doctor’s office. More complicated cases may require a hospital stay.

FAINTING

WHAT IT MIGHT MEAN: If you’ve fainted or felt extremely dizzy after quickly standing up, you may suffer from more than embarrassment. Called syncopy, it can be a symptom of internal hemorrhaging from an ulcer, high blood sugar levels in people who have diabetes, severe dehydration, anemia or serious heart irregularities such as arrhythmias, Birge says. WHAT CAN BE DONE: Your primary care physician may order tests to check your blood sugar level and blood count and to monitor your heart.

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BLOOD IN URINE

WHAT IT MIGHT MEAN: There are many causes of bleeding into the urinary tract, such as bladder infection, but “one of them is cancer, which may be in the kidney, ureter, bladder or prostate,” Shulman says. “At the time when they are still curable, these cancers often do not cause pain.” WHAT CAN BE DONE: In addition to a urinalysis, your physician may order an ultrasound of your kidneys or a cystoscopy to see the interior lining of the bladder. If a suspicious mass is found, a biopsy usually will be performed.


5

A NECK LUMP

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7 3 9 NUMBNESS AND WEAKNESS IN HAND OR ARM

WHAT IT MIGHT MEAN: You might pass it off as carpal tunnel syndrome. But it could be a transient ischemic attack, “a red light warning signal of a stroke,” Shulman says. Other warning signs include numbness on one side of your face, slurred speech and vertigo. WHAT TO DO: “Go to the emergency room,” Birge says. “We can now use a drug called tissue plasminogen activator to dissolve clots and restore blood flow to the brain.” But the drug must be given within three hours of the onset of symptoms to allow a chance for full recovery. And that doesn’t mean you can wait two hours and 45 minutes to get to the hospital. Given drive time and prep time, every minute counts. The best solution is to call 911 so the emergency response team can begin treating you in the ambulance and coordinate with the hospital for your arrival.

BACK PAIN

8

WHAT IT MIGHT MEAN: Everyday back sprains from heaving heavy boxes or picking up squirming toddlers don’t pose a big worry. But be on the lookout for back pain that’s constant and doesn’t change with movement, which can be a symptom of kidney disease, blood-borne infection or an aortic aneurysm, Birge says. WHAT TO DO: To help your doctor make the diagnosis, be sure to describe other symptoms you might be experiencing, such as paleness, a rapid pulse, chills, fever or flu-like signs.

LOWER LEG PAIN

WHAT IT MIGHT MEAN: If you suffer pain in the back of your calf after a long car trip, an airplane ride or a period of bed rest, it might be a symptom of a blood clot. It’s possible that a piece of the clot could break free and end up in your lungs, which can be fatal. If the pain occurs with walking and then is alleviated by rest, it could be peripheral vascular disease, a marker for heart disease. WHAT CAN BE DONE: Your doctor may order a venous ultrasound to detect a blood clot. Birge says blood clots can be treated with the prescription drugs heparin or warfarin. Peripheral vascular disease usually can be remedied with lifestyle changes— eating a heart-healthy diet and exercising at least 30 minutes a day three or more days per week. More severe cases may require medication, angioplasty, stent placement or bypass surgery.

CALL

Be Prudent During Pregnancy


Family physician Dr. Laura Lyons and senior resident Dr. Jean Chen at St. Joseph’s Family Medical and Dental Centre encourage patients to see their doctor if they have signs or symptoms of illness. It’s particularly important for pregnant women, who should see a physician when they have any of the following symptoms: • Vaginal bleeding: Depending on the stage of pregnancy, some spotting may be normal, but it can also represent serious placenta conditions. • Persistent cramps: If you have persistent contractions, talk to your doctor. It could be a sign of premature labour. • Loss of fluid: While mild vaginal discharge during pregnancy may be normal, a gush of fluid could be due to premature rupture of membranes. • Burning sensation with urination: While bladder infections in women are common, a urinary tract infection during pregnancy can be serious and should be treated. • Blurry vision: Vision changes, tingling and numbness in limbs, and intense headaches could be due to a serious condition called eclampsia.

Do You Have a Family Doctor?

If you have questions, contact your family physician, or call Telehealth Ontario at 1-866-7970000. If you need a family physician, visit Health Care Connect at health.gov.on.ca/ en/ms/healthcareconnect/ public/.

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Know the facts and myths about allergies and fight back

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By Stephanie R. ConneR

When Allergies Attack


Achoo! Sniffle. Blow. Achoo! Ah, the sounds of allergy season. • if you’re an allergy sufferer, you know the signs well—sneezing, runny nose, congestion and watery eyes are common symptoms. And if you’re an allergy sufferer, you’re far from alone. About 10 million Canadians say they suffer from allergies, according to a survey conducted by Johnson & Johnson. And 55 per cent of those people say that allergies affect their productivity. People who are allergic to pollen from particular plants, such as grass, trees or weeds, experience seasonal allergic rhinitis (or hay fever). Common indoor allergens like dust or pet dander can also trigger allergic rhinitis. Of course, if you’re allergic to these things, your allergy “season” is year-round.

Allergies explAined So, what’s happening when you have an allergy? An allergy is essentially a miscue in the body’s immune system, where it senses a substance—such as pollen or mould—as a harmful invader, and causes the body to produce immunoglobulin E antibodies. An initial allergy screening will often include a blood test for these antibodies, which travel to cells that release chemicals that cause an allergic reaction. There are steps you can take to minimize the symptoms of allergies, but perhaps the most important step is to first educate yourself. Here are a few common myths about allergies and what you should know.

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canadians say they

suffer from allergies. And

55 per cent say allergies affect their

productivity. Myth:

If you didn’t have allergies as a child, you don’t have to worry about them as an adult. Nope. “Allergies can develop at any age,” says Monika Gibson, spokeswoman and Ontario coordinator for the Allergy/Asthma Information Association, which receives one or two calls a day from adults who have recently developed an allergy. “That’s one of the biggest target audiences right now.” So, if that “cold” just won’t go away, it might be an adult-onset allergy. Talk to your doctor. Allergies tend to run in families, notes Dr. Stanley Fineman, a contributing editor for the publication Allergy Watch, so if your parents have allergies, that might be more indicative of your risk than whether you had them as a child.

Myth:

Moving to a dry climate will cure your allergies. “It depends on what you’re allergic to,” Gibson says. “If your issue is mould, it will certainly help. (Areas with) drier temperatures tend to have less mould spores in the air.” But desert climates still have plants, and those plants have pollen, Gibson adds. Fineman points out that people who have moved to drier climates, such as the desert Southwest in the U.S., brought plants with them, meaning a lot of dry climates have more than simple desert plants. In the end, you may simply find yourself trading one allergy for another.

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Myth:

To manage your allergies, stay away from brightly coloured flowers. Plants are pollinated in one of two ways—by wind or by bees. Brightly coloured flowers produce pollen that is too large and heavy to be spread by the wind. Bees fly from flower to flower to pollinate them. On the other hand, pollen from trees, grasses and weeds are smaller and spread by the wind. “The plants that don’t have flowers are the leading allergen,” Gibson explains. “They’re the ones putting out the spores and ragweed. They have way more irritants than any flowering plant could hope to.”

Myth:

To cure seasonal allergies, eat the local honey. If only it were so simple. “There have been studies that have shown that local honey is not medicinal for reducing an allergic predisposition,” Fineman says. “It’s not going to hurt you, but it’s not medicinal.”

Myth:

Short-haired pets don’t cause allergies. Sorry, Fido. “There’s no such thing as a hypoallergenic pet,” Gibson says. The issue is not the hair itself, but the dander—or flakes of skin—that hide out in fur or feathers. The amount of dander may be less in a small and short-haired pet than a large, long-haired one, but if pet dander is your kryptonite, you’re still likely to have a reaction around even the smallest pooch. Dander is found in mammals and birds, so if you happen to have a pet lizard or snake, you’re in the clear.

Myth:

Allergies are not life-threatening. Unfortunately, allergies are more than just a nuisance.

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photography by thinkstock

About 10 million

“Allergies can be life-threatening, and lifethreatening allergies can develop at any point in time,” Gibson says. “You need to take that very, very seriously.” Called anaphylaxis, these severe reactions require emergency care and are typically caused by food allergies or bee sting venom. People with allergies should carry an epinephrine autoinjector and know how to use it, Gibson advises.

Myth:

There’s nothing that can be done.


online

“Allergies are on the rise, but there are many things people can do should they develop allergies at any age,” Gibson says. The first step is to seek out the advice of an allergist and learn what you’re allergic to. “Allergies are not easy to diagnose,” Fineman adds. “And it does take experience, specialized training and the proper tools to really make an accurate diagnosis.” With that information, Gibson says, you can plan your lifestyle. In addition to simply avoiding the things you’re allergic to, your doctor may recommend an over-the-counter or prescription medication designed to alleviate symptoms. Another option for some patients, Fineman says, is allergy shots, which are typically recommended for people who have symptoms more than three months out of the year or have severe allergies. It’s not a cure, but rather a way to reduce your sensitivity to allergens. “Allergy shots are a very effective way of helping patients build tolerance,” he explains. “It’s really the only disease-modifying treatment we have.”

Advancing Allergy Care At St. Joseph’s Hospital in london, the allergy and immunology outpatient clinic provides comprehensive testing and management for a wide range of allergies. When it comes to insect stings, it’s the only hospital clinic in the region with a specialty in that allergy. A unique feature of the clinic is an on-site laboratory where customized allergy extracts are prepared and tailored for each patient, both for diagnosis and treatment. Many allergy problems can be diagnosed with skin-prick tests, explains allergist/immunologist Dr. William Moote. “This involves a very tiny quantity of allergy material being pressed into the skin with a tiny plastic pick. These are much less uncomfortable than the injections that were used previously.” once an allergy has been confirmed, the team works with the patient to review options for care and management. on the clinic’s website, helpful patient information for numerous allergies is readily available. Always looking to improve care and outcomes for patients, the expert team at St. Joseph’s has more than 30 years of experience in clinical research.

Helpful Information

The allergy and immunology program at St. Joseph’s Hospital offers an extensive array of helpful patient information on many different allergies. This information is easily accessible at sjhc.london. on.ca/allergyimmunology.

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VIRTUAL HEALTH BY CAREY ROSSI

4

to Follow for FOOD SAFETY

Food-borne illness is easily prevented, if you know where to look. Check out these four Twitter feeds to keep noshing without the nausea.

@ CFIA_Food WHAT THEY DO: A one-stop shop for news, tips, recalls and other food safety information from the Canadian Food Inspection Agency.

@ eartheats WHAT THEY DO: Tweet about food, food safety, policy, sustainable agriculture, international news and recipes to make the world a tastier place.

@ SustainOntario

SOCIAL MEDIA

WHAT THEY DO: This province-wide alliance promotes healthy food and farming.

WHAT HE DOES: This Twitter handle belongs to Doug Powell, a professor of diagnostic medicine and pathobiology at Kansas State University. He is passionate about reducing the burden of foodborne illness and compels others in the farm-tofork food safety system to adopt best practices.

Tune in To ST. JoSeph’S Watch What We Do

To watch St. Joseph’s in action, visit St. Joseph’s Health Care Foundation’s YouTube channel at youtube.com/user/ SJHCFoundation and St. Joseph’s Health Care London’s channel at youtube.com/ stjosephslondon.

Did you know that more than 800 million unique users visit YouTube each month? And they watch an astonishing four billion hours of video monthly. Contributing to these outstanding statistics are St. Joseph’s Health Care London and St. Joseph’s Health Care Foundation, both of which have their own YouTube channels. Visit these two sites and you will find special messages from Dr. Gillian Kernaghan, St. Joseph’s president and CEO, informative clips from our programs and services, and touching moments of our many events, including the foundation’s most recent video celebrating surgical innovation at St. Joseph’s. With nearly 25,000 views between the two channels, it’s clear that there is something worth watching at St. Joseph’s.


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Stress. Download. Relax. Breathe2Relax, a free app available for iPhone, iPad and Android devices, provides a guided way to diminish your response to a hairy situation. It shows you the effects of stress on the body and instructs you on how to do diaphragmatic breathing—a proven technique to lessen pressure and anxiety—to manage your stress. What’s more, Breathe2Relax was recently the subject of research at the Johns Hopkins School of Nursing examining whether apps could help people deal with stress. The small preliminary study found participants’ cortisol levels—a biological marker—decreased significantly after using the app for two weeks.

Misguided

MULTI-TASKING Doing more than one thing at a time may seem like the norm, but, according to research published in Computers in Human Behavior, the type of tasks done together might dictate the outcome. Specifically, doing two visual tasks at once, such as texting and driving, hurt performance much more than doing visual and audio tasks, such as talking on the phone and driving. (Of course, both these examples have proved to be highly dangerous and should not be done.) What seems to be most alarming is that the researchers found that the multi-taskers’ perception of their performance when engaging in two visual tasks simultaneously was overconfident—meaning the participants thought they nailed each task even though their performance was poor. In other words, even if you think you’re doing a great job of keeping your eyes on the road, make that your only job at the moment.

FEELING DIZZY? Watch YouTube


There’s no doubt YouTube can provide hours upon hours of mindless stimulation. But a do-it-yourself cure for dizziness? It may well do that, too! Research examining the social media site’s video selection about benign paroxysmal positional vertigo (BPPV)—an inner ear disorder that is a common cause of dizziness—suggests that watching a how-to clip and then completing an at-home treatment for

the disorder, the Epley manoeuvre, may be effective. A report in the journal Neurology found that healthcare providers are using the videos, such as the one at www.tinyurl.com/d687ysz, to help patients learn about the procedure. The researchers’ only complaint was that there wasn’t complementary information to explain what BPPV was (Editor’s note: BPPV is likely caused by loose calcium carbonate crystals that move in the sensing tubes of the inner ear. The Epley manoeuvre moves these crystals out and into another inner chamber of the ear, which does not cause dizziness). If watching a four-minute video helps ease your fear of treatment, why not check it out? SPRI NG 2013

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BRINGING SURGERY EXPERTISE TO THE

St. Joseph’s expands its reach through live broadcasts from the operating room

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BY KELSI BREAK fter 20 years of teaching the next generation of surgeons in London, Dr. John Denstedt hasn’t lost his enthusiasm for sharing his expertise. Now, through the magic of technology, the knowledge and skill of the acclaimed urologist are reaching farther than ever— around the world in fact. Through interactive, two-way audio-video broadcasts, Dr. Denstedt, chair/chief of surgery at St. Joseph’s Health Care London, has demonstrated live procedures to surgical audiences in Brazil and across China. “Personally and professionally it’s rewarding because you can see where you are making a difference,” says Dr. Denstedt, the author of more than 200 scientific articles and book chapters and a sought after guest professor in countries around the world. “Helping to train those 250 surgeons [in China] can translate to care for 100 million people in Sichuan Province alone. It’s an amazing ripple effect.”

BROADCASTING BETTER TECHNIQUES Audiences of the live broadcasts are provided with several views of the patient and the operating room, and internal views of the surgery itself through a camera scope, giving them a unique opportunity to learn cutting-edge techniques. They can also ask questions during the broadcast, adding to the real time training and collaboration. In recent months, Dr. Denstedt demonstrated two kidney stone removal procedures to 30 surgeons in Sao Paulo, Brazil. He also, along with fellow St. Joseph’s urologist Dr. Stephen Pautler, delivered lectures and live surgeries—a complex kidney stone case and a laparoscopic partial nephrectomy for kidney cancer—during a trip to West China Hospital in Chengdu, China.

Sharing knowledge with the world on this scale has benefits for everyone—experienced surgeons and students alike, explains Dr. Denstedt. “Because of China’s higher population they often have a mass volume of specific cases. When we apply our expertise to help treat these groups of patients, both sides gain knowledge on a larger scale then we could with the one or two cases of the same condition we would see here in Canada.”

In the operating room at St. Joseph’s Hospital in London, Dr. John Denstedt connects with surgeons in China during a broadcast of a urological surgical procedure.

NATIONWIDE REACH Dr. Denstedt, who was recently appointed special advisor on health globalization, internationalization and simulation for the Schulich School of Medicine & Dentistry at Western University, hopes to expand broadcast teaching and training opportunities. “It may be possible to broadcast such sessions across an entire country by linking and networking centres. This teaching platform enables experienced surgeons to mentor teams on new techniques and collaborate on complex cases while eliminating time, distance and cost barriers.” SPRI NG 2013

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‘A place where hope s The Wellness Centre plays an integral role in the care of patients at St. Joseph’s Regional Mental Health Care St. Thomas

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By Renee Sweeney 1. Zee utilizes the Wellness Centre’s fitness room at least five times a week and helps other patients with their workout routines. 2. Vince, left, jams with recreation therapist Bob Finlay in the music appreciation room. 3. Occupational therapist Maureen Ellis assists Robert in the gardening area. 4. Robin enjoys painting by numbers in the Wellness Centre’s creative expressions area while social worker Mary Ellen Ruddell looks on.

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ee knows he won’t be here forever. He knows one day he will go home—back out into the world that exists beyond the hospital walls. And he wants to be ready for that day in more ways than one. He knows that being an active participant in his own recovery means a greater chance of continued success in managing his mental illness, both upon discharge and throughout the course of his life. Zee is an inpatient on the forensic unit at St. Joseph’s Regional Mental Health Care (RMHC) St. Thomas, where a multidisciplinary group of staff spent months planning for, and bringing to life, the Wellness Centre. Zee uses the centre daily, accompanied by someone from his care team.

Vital SkillS and Support

Consisting of two main components that go hand-in-hand— group therapy and quality-of-life activity pods—the centre’s purpose is to offer opportunities for patients of the forensic program to take part in activities that support recovery through education, skill-building, and maintenance of a balanced and healthy daily routine.

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3. Therapeutic groups for patients include illness management and recovery, adventure-based counseling, spirituality, concurrent disorders management and smoking cessation. The quality-of-life pods are activity areas within the centre, such as a reflection room, creative expressions area, gardening centre, games and media area, resource room for

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pre-vocational work, kitchen for meal-planning and preparation, and a music appreciation room. “All of the quality-of-life pods were chosen because they are portable and affordable activities that patients can continue to participate in at home upon discharge,” says occupational therapist Maureen Ellis. “We teach patients skills in budgeting and responsibility for their own resources, and encourage something they can afford to do on their own budget. This is a place where hope starts to grow.” Zee works out in the fitness room at least five times a week. “It has really helped to keep me both physically and mentally fit,” he says in between sets. In addition to keeping in shape, Zee has discovered that the Wellness Centre has had many other positive benefits. He is working on kicking his smoking habit and has gained control over his eating disorder by learning to make healthier meal choices. He has also found a way to connect with other patients and provide positive peer support. “I’ve been able to work out with and train other patients to help them improve their physical fitness,” says Zee, smiling. He also enjoys playing Wii games with his friends in the games and media area and pondering the next phase of his life in the reflection room.

St. Thomas building and will be dedicated entirely to forensic mental health care.

Making ConneCTions —and Progress

Over in the expressions area, Robin enjoys painting by numbers, which has helped ignite her hope for the future. “When I’m with Robin in the Wellness Centre, she talks, not about painting by numbers, but about her life, her goals,” says social worker Mary Ellen Ruddell. “We are excited that the centre and all of its activity pods will come with us when we move into our new facility.”

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Banding TogeTher

Robert, meanwhile, relishes his time in the gardening area where all types of plants, flowers, vegetables and herbs are potted and tenderly attended to. In the warmer months some are moved to the courtyard, where patients continue to care for them outdoors and use them to prepare healthy meals. In the music appreciation room, where drums, a guitar, keyboards and vocal equipment are available to patients, Vince is rekindling his interest in playing the drums. The room even boasts the technology for patients to record their own tracks. Between beats, Vince, who often jams with recreation therapist Bob Finlay, recalls playing the drums as a kid and explains how music helps him with his personal recovery. “It’s an excellent way to release energy while at the same time produce a creative expression piece,” says the musician. Vince and Finlay hope to put together a forensic rock band with the goal of playing at the opening this spring of St. Joseph’s new mental health facility being built in Central Elgin. The new facility, to be called the Southwest Centre for Forensic Mental Health Care, will replace the existing RMHC

Stressing the importance of balance, structure and routine, Ruddell says the therapy sessions and activities provided by the Wellness Centre go a long way in helping patients move forward in their lives. “These are things that patients can do to take an active part in their own recovery and well-being. It is a rewarding experience to watch one of our patients light up when they connect with an activity that has meaning for them, or reminds them that they are good at something, such as gardening or painting,” explains Ruddell. “It’s like ‘I can still do this despite the fact that I have a mental illness and came into contact with the law. Be it a drummer or a good cook, a gardener or a musician I’m still the person I was before.’ ” Spri ng 2013

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CELEBRATING SURGICAL INNOVATION AT ST. JOSEPH’S

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BY JOHANNA MESJARIK

early 1,000 guests celebrated surgical innovation—past, present and future— at the annual Tribute Dinner hosted by St. Joseph’s Health Care Foundation on Sept. 13. This year’s event recognized the unique environment at St. Joseph’s Hospital which, over many decades, has nurtured discovery and innovation and has advanced surgical care around the world. The evening honoured talented medical leaders and teams whose vision and drive continue to inspire new approaches and techniques for better patient care. Also

recognized was London’s Callaghan family, which has been dedicated to St. Joseph’s for more than 80 years. The night was capped off by Naturally 7, who had guests dancing in the aisles. A photo gallery and inspirational video about St. Joseph’s surgical history and future are available at sjhcfoundation.org/events/past-foundation-events/ 2012-st-josephs-tribute-dinner. Proceeds from the Tribute Dinner support patient and resident care across St. Joseph’s Health Care London.

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George Zubick, left, and Bruce Zubick of John Zubick Limited, presenting sponsor for this year’s Tribute Dinner, enjoy the celebration.

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The Callaghan family, who were honoured for their commitment to St. Joseph’s, gathers for a family photo before dinner.

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Tribute Dinner chair Murray Faulkner kicks off the night by welcoming guests and thanking the many generous sponsors who make Tribute possible.

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From left, surgeons Dr. John Denstedt, Dr. James Roth, Dr. Douglas Bocking, Dr. Howard Cameron and Dr. Edwin Carroll were just some of the many past and present St. Joseph’s physicians who enjoyed the evening’s celebrations.

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Dr. Louis Ferreira, co-director of the Surgical Mechatronics Laboratory at St. Joseph’s Hand and Upper Limb Centre, is one of today’s pioneers. He shared the evening with his wife, Cheryl.

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Dr. Gillian Kernaghan, President and CEO of St. Joseph’s Health Care London, with Mayor Joe Fontana and Hon. Deb Matthews, Minister of Health and Long-Term Care and MPP, London North Centre.

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John Callaghan gives a touching speech on behalf of the Callaghan family, who were among the honourees of 2012 Tribute.

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MPP Chris Bentley, left, Elizabeth Cormer, Brenda Sarkany and Dr. Andrew Sarkany chat during the evening’s cocktail reception.

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Helen and Andy Spriet, Tribute sponsors, with Frank Longo, St. Joseph’s Health Care Foundation board member and Tribute sponsor.

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Major sponsors from The Marketing Department (TMD), Debbie and Randy Timmins, guest Paul Paolatto and Joe Farina, also from TMD, enjoy dinner.

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ONLINE

The evening concluded with an impressive performance by Naturally 7, which had guests dancing in the aisles.

Ways You Can Help

If you would like to help make a difference in the lives of patients and residents at St. Joseph’s, go to sjhcfoundation.org.

PHOTOS BY SUE BRADNAM

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IN YOUR OWN WORDS Every day, St. Joseph’s Health Care London receives words of appreciation and praise from grateful patients and their families. St. Joseph’s prides itself on serving with respect, excellence and compassion, which shows on our patient satisfaction scores—among the highest in the province. But don’t take our word for it …

PATIENCE AND KINDNESS On June 11, 2012, I had the necessity to have surgery. The surgeon was Dr. Brian Rotenberg, and I just wanted you to know what an outstanding surgeon you have at St. Joseph’s. He was kind, courteous and compassionate at every appointment. At the end of the surgery he took the time to speak to my wife to explain the entire process and the outcome of the surgery. He asked her if she had any questions and he answered each and every question with patience and kindness and in lay language. We both would like to thank Dr. Rotenberg and his team for their exceptional expertise and skill in making this whole experience as stress free as possible. Bob Picken, Dorchester, Ontario

GREAT SERVICE My daughter and I came to the Urgent Care Centre (UCC) as she had been ill with a sore throat and could not swallow. We got there

EMAIL

Your Story

If you would like to comment on the care you received at St. Joseph’s Health Care London, please email Dahlia Reich at dahlia.reich@ sjhc.london. on.ca.

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Dr. Brian Rotenberg is a surgeon with the otolaryngology - head and neck surgery program at St. Joseph’s Hospital.

at 7:45 am, had great care and were out of the UCC by 8:25 am, heading down to the pharmacy to get her prescription filled. I cannot tell you how many people stopped and asked if they could help us as we were looking at the signs since I am not familiar with St. Joseph’s Hospital. It was refreshing how many people wanted to help us. When

we noted that the pharmacy was not open until 9 a.m., a pharmacy tech was very kind to us and was even going to take my daughter’s script in earlier. But since my daughter had not been there before we needed to wait, which was fine. We headed to Tim Hortons, once again with many people offering to help us. When we returned to sit outside the pharmacy, the tech came out just before 9 a.m. to take her script and obtain the appropriate information. Her prescription was ready within 15 minutes. It was great service! Another experience at St. Joseph’s—I have had many visits to the breast screening department. I must say this is probably the best-run clinic I have experienced. … The caring attitude of all the staff I have come across is outstanding. The clinic seems to be always on time and running smoothly. I have had mammograms, ultrasounds and a biopsy, and I have yet to have a bad experience. We are lucky to have such a great clinic for London and the area. Thanks, The Bedards, London, Ontario

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Determined to Speak Up Olympian Clara Hughes will share her experience with depression at the Breakfast of Champions on April 30

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peed skater and cyclist Clara Hughes is a six-time Olympic medalist and the first Canadian to win a medal in both a summer and winter games. But for this remarkable athlete, there’s something more momentous than any of her Olympic feats. “Making my experience with depression public knowledge made me realize this sharing is perhaps more important than any of the medals I won,” says Hughes, whose humanitarian efforts have garnered as much recognition as her athleticism. The story that Hughes tells is resonating and the reaction has boosted her higher than the podium. “The response from Canadians from all walks of life has lifted me up and connected me to this very real struggle we as a nation have as reality,” she says.

Join Breakfast of Champions What: Presented in partnership by St. Joseph’s Health Care Foundation and the Canadian Mental Health Association, Breakfast of Champions raises awareness about and funds for mental health programs in the London community. When: April 30 at the London Convention Centre Keynote speaker: Clara Hughes, six-time Olympic medalist Tickets: $60 per person; $600 for a table of 10. To purchase, visit sjhcfoundation.org or call 519 646-6085.

TURNING STIGMA INTO SUPPORT Approximately one in five Canadians is affected by mental illness, and Hughes is committed to making a difference. It’s her actions off the playing field that define the success of this athlete, who feels being a champion is about more than winning. “I am determined not to just help break down the walls of stigma built to silence this struggle but to bust them down. Sharing this difficult period in my life has made me realize perhaps why I went through the depression in the first place: to have this story to share and to help others who struggle,” she says. As a designated spokesperson for Bell Canada’s Let’s Talk campaign, Hughes is working towards changing the dismal reality millions of Canadians face when it comes to support and treatment for mental health issues. For Hughes, healing began when she reached out for help from the national team doctor and faced mental illness head-on. She went on to win four more Olympic medals. Surrounded by educated and supportive individuals, Hughes has been able to manage and prevent depression from dragging her into darkness again. Using her voice, she hopes to help others do the same and eliminate some of the fear surrounding mental illness in Canada. “I look forward to making a difference in Canada the best I can in continuing advocacy for mental health and by walking the talk by living an active, healthy and balanced life.”

Olympic speed skater Clara Hughes is no stranger to depression, and has a winning determination to help others suffering from this illness.

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InspIred to Give

a team effort Motivated by personal experiences and a desire to help others, teams are quickly forming for Bust a Move for Breast Health By Douglas grant

F Baking is bringing in the bucks for The Rack Pack team at Jazz Aviation LP, which will be participating in Bust a Move for Breast Health in support of St. Joseph’s Breast Care Centre.

or Kathy Robinson, breast cancer has touched too many women in her life—her mother, a coworker, a close friend and her grandmother who died of breast cancer. But what all these experiences have done is inspire Robinson to get moving, and get grooving. She has joined the The Rack Pack team—one of dozens of teams that have already formed for Bust a Move for Breast Health™, being held April 6 at the London Convention Centre. Bust a Move is being brought to London by St. Joseph’s Health Care Foundation to raise vital funds for the Breast Care Centre at St. Joseph’s Hospital. The sixhour group fitness extravaganza is a non-competitive event designed to appeal to everyone, beginners and fitness buffs alike. “I think the impact cancer has had on me has only made me even more determined to raise as much money as possible for Bust a Move,” says Robinson. The Rack Pack team has nine members, all from Jazz Aviation LP. Their fundraising goal is $9,000, which they have been raising through BBQs, bake sales and even a “toonie toss” to win a turkey.

GroovinG for a Great Cause At St. Joseph’s Hospital, meanwhile, the team Fifty Shades of Pink can’t wait to “shake our groove,” says team member Andrea Wilkinson. The team was inspired by videos from similar events in other cities. “When we saw how much fun all the people were having exercising together, it looked like something we would like to do together as a team. We especially liked the idea of getting dressed up. The costumes make it!” Fifty Shades of Pink, which includes one male teammate, has an important message of its own to convey when it comes to breast cancer. “It’s important to get the word out that men can get breast cancer too,” Wilkinson explains. “My friend’s father passed away from this terrible disease, so I personally wanted to be able to share his story to make everyone aware that it’s not just women that this affects.” The Bust a Move teams set an inspiring example in London of creativity and passion, says foundation president and CEO Michelle Campbell. “The people who make up these teams demonstrate incredible heart as they work together to make life better for others in our community.”

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Get Your Groove On

To take part in Bust a Move for Breast Health, you can register as an individual or form a team. Your mission is to raise a minimum of $1,000 (per person) to support St. Joseph’s Breast Care Centre. For more information visit bustamove.ca.

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Like Mother, Like Daughter

She walks like you, talks like you—wants to be you. Give her a positive example to emulate,

and you’ll set her up for a lifetime of good health..

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St. Joseph’s Health Care Foundation 268 Grosvenor Street London, ON N6A 4V2 Please return Canadian Addresses to above address

Breakfast of Champions Featuring

Clara Hughes “Making my experience with depression public knowledge made me realize this sharing is perhaps more important than any of the medals I have won.”

PURCHASE YOUR TICKETS EARLY! $60 per person or $600 for a table of 10 (parking included)

For tickets, please visit sjhcfoundation.org or call 519 646-6085

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Speed skater and cyclist Clara Hughes is a six time Olympic medalist and the first Canadian to win a medal in both summer and winter games. But for this remarkable athlete, there’s something more momentous than any of her Olympic feats. Hughes is working towards changing the reality millions of Canadians face when it comes to public support and understanding of mental health issues.

APRIL 30, 2013 7:30 – 9:30 AM LONDON CONVENTION CENTRE LONDON, ONTARIO

Event includes a buffet breakfast and presentation of the CMHA London-Middlesex Champion of Mental Health Awards. To nominate a local ‘Mental Health Champion’ visit www.london.cmha.ca.

Proudly sponsored by

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