Summer 2012 - St. Joseph`s Health Care London

Transcription

vim&
SUMMER 2012
St. Joseph’s
Receives
Canada’s
First PET/MRI
GETTING LONG
LIFE OUT OF
NEW JOINTS
Technology
Transforms
Mental Health
Care
Firth
Impressions
BUST A
MOVE FOR
BREAST CARE
IS COMING
TO LONDON
page 55
Award-winning actor COLIN FIRTH
is making his 50s count. Learn
his secrets to great health
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Because of
St. Joseph’s...
Cindy and Paul
are embracing
the open road
of life.
And their legacy gift will help others do the same.
GRATEFUL for the thoughtful, personal and expert care they received at St. Joseph’s,
Cindy and Paul made a legacy gift. They want to ensure that others will experience
the same journey of care. You too can make a legacy gift. Through your will, life
insurance policy, RRSP or RRIF, you can help shape the future of health care.
To read more about Cindy and Paul, please visit sjhcfoundation.org/stories.
CARING FOR THE BODY, MIND & SPIRIT SINCE 1869
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
People Power
Individual accomplishments reflect excellence at St. Joseph’s
Prestigious Honour
A dedicated stroke rehabilitation
expert at St. Joseph’s Parkwood
Hospital has been named by
the Royal College of Physicians
and Surgeons of Canada as the
2012 McLaughlin-Gallie Visiting
Professor. Dr. Robert Teasell is the
medical director of the stroke rehaDr. Robert Teasell
bilitation program at Parkwood
and renowned for his work in stroke research. As
visiting professor, he will spend up to one week at
two Canadian faculties of medicine to participate in
undergraduate and postgraduate teaching, and in the
exchange of ideas with staff, researchers and students.
This year’s theme for the visiting professorship, for
which recipients are selected from any country in the
world, is pain medicine.
outstanding LeadersHiP
Three individuals who have made extraordinary
efforts to advance the roles and values of St. Joseph’s
Health Care London are the 2011 recipients of the
organization’s President’s Awards. The awards recognize leaders, both formal and informal, who have
made outstanding contributions to the mission, culture and performance of St. Joseph’s. Normally, there
are two awards but for 2011 a special citation was also
bestowed. The recipients are: Alison Evans, a clinical nurse specialist in specialized geriatric services at
Parkwood Hospital who received the Aspiring Leader
Award; Dr. Don Gutoski, a physician and interim
site chief in the Urgent Care Centre who received the
Leadership in Mission Award; and Father Michael
Prieur, a voice of wisdom at St. Joseph’s for more than
40 years who received the special citation—a Lifetime
Achievement Award for Leadership in Mission—for his
role on the St. Joseph’s Health Care Ethics Committee
of the Board. These awards and the people who receive
them exemplify St. Joseph’s commitment to excellence
in leadership.
a Boost for tHe Brain
An exciting consolidation of services under way at St.
Joseph’s Health Care London will strengthen care and
research for people with cognitive challenges, such
as memory loss and Alzheimer’s disease. The cognitive neurology clinics are moving from St. Joseph’s
Hospital to Parkwood Hospital, where they are joining forces with geriatric medicine. Bringing these
programs together is the first step in creating the
Centre for Cognitive Vitality, where experts will work
together to advance the diagnosis, treatment and continuity of care for people living with Alzheimer’s and
related dementia. While creation of the centre is still
in its infancy, it promises to have a profound impact
on patient care, says geriatrician Dr. Michael Borrie.
“St. Joseph’s is uniquely positioned to create this significant regional centre.”
transParency and
accountaBiLity
The Freedom of Information and Protection of Privacy
Act (FIPPA), which now encompasses Ontario’s hospitals, heralds a new era of transparency for St. Joseph’s
Health Care London. Visit the St. Joseph’s website at
sjhc.london.on.ca/fippa for a wide range of resources
and information about FIPPA.
Alison Evans
Dr. Don Gutoski
Father Michael
Prieur
Vim & Vigour • SUmm er 2012
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ConneCting with Our COmmunity
New Horizons
A
ST. JOSEPH’S
HEALTH CARE FOUNDATION
s the warm weather arrives
and new life unfolds around us,
St. Joseph’s too is stretching to
reach new heights and set our
sights on new horizons. While we continue
to rejuvenate St. Joseph’s Hospital, our newly
refreshed strategic plan reaches far beyond
bricks and mortar, laying out a clear road
map for care, teaching and research across
our organization for the next three years. We
can now reap the benefits of care environments created during earlier phases of conDr. Gillian Kernaghan, left, and Michelle
Campbell
struction. These specially designed spaces
are allowing our teams to develop innovative
synergies centred on patient care, discovery and the training of the next generation of care providers.
We see their successes every day. For example, in our new Breast Care Centre,
now the main hub of breast imaging and surgical services in London, wait times
for women most in need of care are being significantly reduced, consistent education and support are alleviating uncertainty and fear, and careful coordination of
appointments is smoothing the care journey for patients, from diagnosis through
treatment and follow-up care.
Across St. Joseph’s, in our labs, clinics and operating rooms, at the bedside and
in our rehabilitation and recreation programs, experts work together with a singular vision—to make a difference in the lives of patients and residents. In this
issue of Vim & Vigour, see this dedication in action for spinal cord injury patients
at Parkwood Hospital and long-term care residents at Mount Hope, and for those
living with mental illness.
At St. Joseph’s Hospital, meanwhile, the arrival of the first PET/MRI in Canada
is opening the door to new understanding of disease processes while at the Hand
and Upper Limb Centre leading-edge research aims at enriching the lives of active
baby boomers as they reach their senior years. In another exciting development,
St. Joseph’s Health Care Foundation is bringing Bust a Move™ to London. The
event, to be held March 2, 2013, is a high-energy fitness day that will raise critical
funds for the new Breast Care Centre and connect women locally to this important
resource. A first for the city, it’s a unique event you won’t want to miss.
As always, the support of the community fuels our success. Because of this generosity, St. Joseph’s is changing lives. And because of St. Joseph’s, people are living
their lives to the fullest. We welcome you along on our journey.
2011–2012 Board of Directors
Ron Martindale Jr. , Chair
Tim Brown
Michelle Campbell, President
Michael Dale
Sharon Doubt
Samira El-Hindi
Dianne Evans
Mark Farrow
Murray Faulkner
Faisal Joseph
Dr. Gillian Kernaghan
Gerald Killan
Brenda Lewis
Frank Longo
Jeff Macoun
Peter Mastorakos
Peter McMahon
Jim Mignault
Dr. Hassan Razvi
Dr. Walter Romano
Rick Spencer
Patrick Tremblay
ST. JOSEPH’S HEALTH CARE LONDON
2011–2012 Board of Directors
Marcella Grail, Chair
Dr. Pravin Batohi
John Callaghan
Kimberley Chesney
Jacquie Davison
Murray Faulkner
Phil Griffin
Dr. Gillian Kernaghan, President
Gerald Killan
Paul Kiteley
Gaétan Labbé
Dr. Ian McConachie
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, Sonya Gilpin, Amanda Jackman, Laura Janecka, Anne
Kay, Johanna Mesjarik, Jennifer Parraga, 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, Summer 2012, Volume 28, Number 2, 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
2
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
A Day
in the Life
4
DEPARTMENTS
1
St. Joseph’s
Notebook
Recognizing individuals
for their leadership
and contributions to
St. Joseph’s.
2 Connecting with
Our Community
St. Joseph’s is setting
its sights on new
horizons.
8 Faces of St. Joseph’s
The new chair/chief of
psychiatry reflects on
a transformative time
in mental health care.
46 Virtual Health Use
your smartphone
wisely by tapping
into our favourite
health-focused apps.
COVER PHOTO BY JIM WRIGHT
54 In Your Own Words
Grateful patients
share their St. Joseph’s
experiences.
56 Inspired to Give
Philanthropic teens
prove they don’t fit
the stereotype of
the “Me Generation.”
FEATURES
Improving
wellness and
quality of life
is an essential
aspect of care at
Mount Hope.
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7
10
14
18
21
24
34
Picture This
St. Joseph’s receives Canada’s first
PET/MRI scanner.
Going the Extra Mile
Dietitian Chris Fraser represents
St. Joseph’s Parkwood Hospital in
the Rick Hansen Anniversary Relay.
The Breakfast Club
Hop on the breakfast bandwagon
and find out why breakfast truly is
the most important meal of the day.
Arthritis Answers
From symptoms to treatments
to exercise, get answers to your
questions about osteoarthritis.
A TV Guide to Radiology
Brush up on your medical terminology
with this handy glossary.
Take Aim
While typically not life-threatening, a
mini-stroke is a warning. Take charge
and reduce your future risk.
It Might NOT Be Cancer
Don’t panic: Those breast lumps and
bumps could be a benign condition.
38
42
49
50
52
55
Step Up to the Plate
Reduce your children’s risk for
diabetes and score a home run for
their health with these expert tips.
Life After Cancer
Take a cue from these survivors:
There is life after cancer.
Get Dad to the Doc
When it comes to dodging the doctor,
Dad usually wins. Here’s your best game
plan for combatting his excuses.
Virtually Fit
Video conferencing is helping those
with spinal cord injury access exercise
and nutrition advice.
Giving Aging Joints New Life
Researchers at St. Joseph’s Hand and
Upper Limb Centre look to improve
joint replacement outcomes.
Taking Technology in Hand
An inside look at two exciting innovations in mental health care in the
London area.
Busting a Move
is bringing a fitness extravaganza to
London to help in the fight against
breast cancer.
28
ON THE COVER
At 51, Colin Firth shows us that being middle-aged
is nothing to fret. He’s as healthy and handsome as ever.
Learn Firth’s secrets to better living.
Vim & Vigour · SUMM ER 2012
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A DAY IN THE LIFE OF ST. JOSEPH’S
Supporting the Quest to Live Fully
Therapeutic recreation is an essential part of care for residents at Mount Hope
S
t. Joseph’s Mount Hope Centre for
Long Term Care is home to nearly
400 people. The youngest is 30, the
oldest 106. With a history of caring
dating back to 1869, the centre provides a
home-like environment and comprehensive
care for the elderly, technologically dependent individuals, and adults with mental or
physical challenges. With care tailored to
each resident, the goal is to maintain independence and choice and improve wellness
and quality of life.
Therapeutic recreation plays an essential role in this quest to live fully and Mount
Hope’s Wellness Centre and craft room are at
the heart of the highly specialized program.
From horticultural, art and music therapy,
to a computer centre, exercise equipment
1
and Snoezelen Room, therapeutic recreation
offers residents the opportunity to enjoy
long-time hobbies, pursue new interests, gain
skills and socialize. Programs are developed
for each resident and supported by a team of
therapeutic recreation specialists and assistants, physiotherapists, and an occupational
therapist. The following is a glimpse of therapeutic recreation, and the joy it brings, at
Mount Hope.
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The weekly baking program at Mount Hope
allows resident Dorothy Loucks to continue
a lifelong hobby. Each week, Dorothy, assisted
here by therapeutic recreation specialist Jennifer
McPhee, and other residents share stories, bake
treats and then enjoy them over tea.
2
Facebook, Twitter and the world of digital
communication have become mainstays
of today’s society, and at Mount Hope, it’s
never too late to jump aboard. Here, resident
Marianne Nuitjen works with Teresa Weicker,
therapeutic recreation specialist, to brush up on
computer skills so she can communicate with
family and friends.
3
Occupational therapist Sarah Trenker,
left, along with Christine Richardson,
rehabilitation assistant, assesses resident Edgar
Balcars for his ability to use a power wheelchair,
looking at endurance, coordination, range of
motion and other factors.
7
4
As a fun way to improve upper extremity
coordination, Nabil AbdulWahid, rehabilitation assistant, tosses a ball to Gladys Hubbs,
while Eldon Hawkins awaits his turn.
5
The horticulture program at Mount Hope
produces delicious vegetables over the
summer months, including pumpkins, squash
and gourds, which are shared with family and
friends and used for baking. Here, resident Carol
Kennedy turns some of the pumpkins into tarts
and pies.
8
6
The Wellness Centre features a Snoezelen
Room, a multisensory environment that
promotes stimulation and relaxation with the
use of colour, lighting effects, textures, motion,
sounds and music. At age 100, Lena Capirchio
enjoys a few minutes in the room with Rahima
Akhi, therapeutic recreation assistant.
7
Twice weekly, residents participate in group
exercise classes to improve range of motion,
strength and coordination. Led by rehabilitation
assistants Erica Hannan and Nabil AbdulWahid,
the class includes some fun stretching and the
lifting of small hand weights.
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9
10
Affectionately known as King of the
NuStep Bike, Gerry Forbes uses the special
equipment five times a week for a good work out.
The recumbent bike improves range of motion
and helps to build strength and endurance. It’s so
popular, residents line up to use it.
9
Rob Basra, a physiotherapy rehabilitation
assistant, helps resident Genoveva Liza with
the parallel bars used to help residents work on
standing and walking.
10
Mary Lou Rowe uses the standing frame
to help with weight-bearing exercises.
The frame helps to maintain the range of motion,
strength and balance required for transfers and
to reduce osteoporosis. The frame was funded
through St. Joseph’s Health Care Foundation and
is a great support for many residents.
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PICTURE THIS
St. Joseph’s receives Canada’s first PET/MRI scanner,
opening the door to early disease detection and superior
BY JULIA CAPALDI
patient care
I
magine being able to detect Alzheimer’s disease
at its earliest stage and prescribe medication to
halt its progress. Imagine being able to evaluate
the health of heart muscles and tissues after an
attack and accurately prescribe treatment to prevent
future heart failure. London is close to making these possibilities a reality with the installation of Canada’s first
whole-body PET/MRI scanner at St. Joseph’s Hospital,
part of St. Joseph’s Health
Care London.
The new hybrid imaging
scanner, which combines
magnetic resonance imaging (MRI) and positron
emission tomography (PET),
is an exciting acquisition
of the imaging program at
Lawson Health Research
Institute. The first of its kind
in Canada, the machine will
play a key role in Lawson’s
growing hybrid molecular
imaging program.
“PET/MRI scanners are
In February, Canada’s first PET/MRI scanner
among the most exciting and
was delivered to St. Joseph’s Hospital in
talked about developments
London. The 10-tonne machine was lifted by
crane and lowered into a hatch in the roof.
in radiology and nuclear
medicine and represent the
next generation of imaging technology,” explains Dr.
Frank Prato, leader of Lawson’s imaging program and
physicist chief at St. Joseph’s. “The applications for PET/
MRI are limitless. The scanner will be used by researchers to help improve diagnosis and treatment of Canada’s
major health challenges, such as cardiovascular disease,
neurological diseases, mental illness and cancer.”
A HISTORY OF FIRSTS
St. Joseph’s has long been a Canadian pioneer in bringing
the latest imaging technology to patients in Southwestern
Ontario. In 1981, for example, it was the first hospital in
Canada to perform bone mineral density imaging to detect
6
osteoporosis. In 2002, St. Joseph’s received the first PET/
CT in Canada, which has significantly advanced work in
cancer diagnostics.
“In 2012 we expect to do the first PET/MR images in
Canada on patients with dementia, cancer and heart disease,” says Dr. Gillian Kernaghan, St. Joseph’s president
and CEO. “I am proud of our tradition of medical imaging
research that makes a difference for our patients.”
The main mission of Lawson is research that directly
impacts the well-being of patients, says scientific director
Dr. David Hill. “This latest achievement of our imaging
research program epitomizes our core value of bench to
bedside.”
ADVANTAGES OF
HYBRID PET/MRI
IMAGING
• The high resolution and sensitivity of PET/MRI
captures minute details and produces superior
three-dimensional images.
• The simultaneous image capture of the PET
and MRI scans eliminates the potential imaging
problems caused by involuntary patient movement, such as breathing and muscle relaxation.
• When used for anatomical imaging, the radiation dose for patients is half that of the next
best technology.
• The combined scanner reduces the need for
patients to come for multiple visits.
• Patient diagnosis is faster because imaging
and overall information available from the scan
is better.
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Going the Extra Mile
Parkwood Hospital’s Chris Fraser—medal-bearer in the Rick
Hansen Anniversary Relay—is a source of inspiration for
many spinal cord injury patients BY ANNE KAY
Parkwood Hospital dietitian Chris Fraser is
surrounded by colleagues, family and friends as
she prepares for her section of the Rick Hansen
25th Anniversary Relay.
A
s the sun set on a chilly November evening you
could feel the excitement in the air. Chris Fraser
was about to embark on her section of the Rick
Hansen 25th Anniversary Relay. Surrounded
by cheering crowds, the Rick Hansen team, and the flashing lights of police escorts, Fraser wheeled down London’s
busy Wellington and Commissioners roads—during rush
hour, in the dark. It’s not the first challenging situation she
has overcome.
Fraser injured her spinal cord in 1988 when she was swept
off an ocean-side cliff by a rogue wave while traveling in
South Africa. After intensive rehabilitation at St. Joseph’s
Parkwood Hospital, she returned to university, completed a
degree in nutrition and came back to Parkwood, this time as
a registered dietitian, joining the same team that made her
recovery possible. “My role allows me to provide support
and mentorship to people who have recently had spinal cord
injury, as well as their families,” says Fraser.
THOUSANDS OF KILOMETRES
When Parkwood’s spinal cord injury rehabilitation program was approached by the Rick Hansen Institute to select
a medal-bearer for the relay, the staff didn’t hesitate to recommend Fraser, whose life is a beacon of hope for patients.
“Her determination, courage and integrity have inspired
many with a spinal cord injury to fully live their lives,” says
program coordinator Julie Gagliardi.
The relay is retracing the Canadian segment of the original
world tour, but this time one man in motion is being represented by about 7,000 participants from across Canada who
have made their own difference in the lives of others. The
relay will have travelled through more than 600 Canadian
communities and across 12,000 kilometres over nine months
before concluding in Vancouver on May 22. Focusing on
engaging Canadians to take up the challenge and become
catalysts for positive change, the relay features medal-bearers
who are running, walking, wheeling or biking to complete
their segments. Each passes along the singular Rick Hansen
Medal produced by the Royal Canadian Mint.
A tireless community advocate for promoting awareness
and prevention of spinal cord injury, Fraser spearheaded the
Possibilities Project that raises funds for equipment and medical supplies for people in the community who have a spinal
cord injury and need financial support. She is also an adapted
fitness instructor for the seated aerobics class at Parkwood’s
Fitness Centre for people with a disability.
IMPROVING WELLNESS
AND QUALITY OF LIFE
London is one of the foremost hubs of Rick Hansen Institutefunded projects. Fraser is a member of the team at Parkwood,
where researchers and clinicians work together to improve
wellness and quality of life for people with spinal cord injury
and disability.
An inspiration to patients and colleagues alike, Fraser says
“keeping a positive perspective on life and making the right
choices when confronted with obstacles make all the difference in the world to your quality of life.”
For more about Chris Fraser’s remarkable work with spinal cord
injury survivors, see page 49.
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Faces oF St. JoSeph’S
Advocacy, Academics
& Suicide Prevention
By Renee Sweeney
A talk with the new chair/chief of psychiatry as he takes over during
a transformative time in mental health care
Dr. Paul Links is the
new chair/chief of the
Department of Psychiatry
in the Schulich School of
Medicine & Dentistry and
its teaching hospitals—
St. Joseph’s Health Care
London and London
Health Sciences Centre.
Q
What drew you to psychiatry as a
career?
Q
What are your most significant
accomplishments as a professional?
My father was a physician, which stimulated
my interest. He was a surgeon, however, so
it wasn’t psychiatry I thought about initially.
When I did my clerkship in mental health, I
worked with exceptional supervisors; they
were so interested in their patients and took
time with them. I enjoyed discovering what
was behind behaviors and determining the
diagnosis so we could help them get better.
During the last 15 years I held a chair in suicide studies in Toronto, which was a fulfilling
experience because it was devoted to prevention. We did a lot of advocacy work and
were one of the voices crying for the barrier
around the Bloor Viaduct—a veil of iron rods
put in place to prevent people from jumping off the bridge. Another initiative found
us working closely with the Toronto Transit
Commission to prevent subway suicides—
facilitating a training program for staff to
recognize people who were distressed.
8
We were also involved with the Liberal
Party motion before the House of Commons
for a National Suicide Prevention Strategy
in Canada. This was significant because
Canada is one of the few developed nations
without one.
Q
What is one goal you wish to
achieve during your tenure?
I want to develop more research interest in
the area of suicide prevention.
Q
How will you improve mental health care education and
research?
I see the department moving forward
through involvement in training for subspecialty programs within child, geriatric
and forensic psychiatry … and in increasing
the number of psychiatrists who are trained
in those areas. I would also like to see the
department gain more prominence in its role
as a developer of new knowledge, increasing
the breadth of academic performance and
output. In terms of research, the department
has great strengths in certain areas and we
want to increase that scope. As a clinician
and a researcher I think it is important to
create more bridges between research, education and front-line care.
online
F
or 10 years as chair/chief of psychiatry for St. Joseph’s Health Care
London and London Health Sciences
Centre, Dr. Sandra Fisman guided
tremendous change that advanced care by leaps
and bounds for those living with mental illness.
In January, the dedicated psychiatrist handed the
reins to Dr. Paul Links, who takes on the role at a
critical juncture in the transformation of mental
health care as patients move closer to home and
two new mental health facilities take shape in
London and St. Thomas. Below, Dr. Links shares
a little bit about himself and his vision for the
mental health care over his five-year term.
Learn More
The full interview with Dr. Paul
Links is available on the St. Joseph’s
Health Care London website
at sjhc.london.on.ca/
psychiatrychair.
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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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THE
Breakfast C
cappuccino. The early morning calories can make you more alert and productive throughout the day.
And if you think skipping breakfast is your own little trick to weight loss,
think again. Studies show that breakfast can help you lose weight.
“I find that people who don’t have breakfast aren’t planning meals well,” says
Jessica Begg, a registered dietitian and member of the College of Dietitians of
Canada. “When they finally hit lunch, they are in a panic to eat and are
also too hungry to make healthy choices.”
Celebrity trainer Bob Harper of NBC’s The Biggest Loser agrees.
“I’ve been working with overweight people for many years
now, and there is one common thread that I see, and that is
overweight people hardly ever eat breakfast. That is the worst
thing you can do,” says Harper, who is also a “Quaker Coach”
with Quaker Oats. “Fueling your body with what it needs
will help to get your metabolism revved up, and when that
happens, you can burn fat.”
ON
THE
GO
10
BY AMANDA MYERS
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EGG PHOTOGRAPHY BY THINKSTOCK, BREAD BY DREAMSTIME
Eating breakfast Skip the most important meal of the day?
never do something like that, right?
means you will You’d
I mean, except for those days when the kids get up late and the morning
devolves into chaos. Oh, and those days when you’re due to give a speech at
make better food the board meeting and the thought of food before public speaking turns your
And wait, doesn’t a cup of coffee count as “breakfast” anyhow?
choices all day stomach.
Not exactly. Eating breakfast—actual food—can do more for you than that
t Club
“I’M NOT
HUNGRY IN
THE A.M.”
Convinced yet? If you’re just now hopping
on the breakfast bandwagon, here are some
options to choose from based on your breakfast
personality:
EGG PHOTOGRAPHY BY THINKSTOCK, BREAD BY DREAMSTIME
The On-the-Go Breakfast
When in a rush, you may be tempted to grab a
doughnut for the road, but sugary options like
pastries are high in calories and only give you
a short-lived burst of energy. You will be sleepy
again before you know it.
“What I do,” Harper says, “is keep a dozen hardboiled eggs in my fridge that I can grab and go.
I also have a serving of berries in a baggie in my
fridge that I can grab.”
Begg suggests a latte or tea with lots of milk (a
good source of protein and calcium) paired with
a granola bar and a piece of fruit to add whole
grains and essential vitamins to your quick
meal. Or look to a common lunch choice that also
works for breakfast. “A peanut butter sandwich
is something you can take with you,” Begg says.
Just make sure to choose a low-sugar peanut butter and whole-grain bread.
The ‘But I’m Not Hungry
in the Morning’ Breakfast
Skipping breakfast means you will be more
likely to overeat later, on account of being extra
hungry come lunchtime. If, however, you’ve
trained your body to skip breakfast, you might
feel queasy at the thought of a large meal right
after waking up.
“Oftentimes, people are not hungry in the
morning but should still try to eat something
within an hour of getting up,” Begg says. Eating
breakfast, quite literally, breaks your fast and
revs up your metabolism for the day ahead.
Begg suggests starting with a bowl of cereal
or a couple of pieces of whole-grain toast (lightly
buttered if you must). Whole grains are lower in
fat and have been linked to lowering the risk of
heart disease, diabetes and certain cancers.
Soon enough, your body should become accustomed to this morning meal. “Once the routine is
set, the body will get used to having breakfast,
and will get hungry,” Begg says.
11
2/9/12 7:19 AM
Food for Thought
The Kid-Friendly Breakfast
Help for Your Nutrition
Want to know if you are on the right track?
Dietitians of Canada offers a tool called eaTracker that
allows you to look into your food choices and access
healthy recipes, meal planners and exercise options,
as well as track progress. Visit eatracker.ca.
CEREAL PHOTOGRAPHY BY THINKSTOCK, PANCAKE BY CORBIS
This may come as a shock, but kids probably
aren’t eating everything you put in their lunch
box. That’s why it’s important to start the day
with a healthy meal.
“Getting a good breakfast, for kids especially,
is very important for their concentration at
school,” Begg says, adding that the rule of thumb
is to try to hit at least three of the four food groups
at every meal. She recommends peanut butter on
bread with sliced bananas, eggs with toast and
fruit, or cold cereals with berries.
Harper, not surprisingly, is an oatmeal advocate. “Instant [oatmeal] packages literally take
about two minutes,” he says. “They’ve made it so
easy.” Keep it fun by offering up topping options
for oatmeal, such as diced fresh fruit, cinnamon
or dried cranberries.
Online
KID
FRIENDLY
Ensuring patients at St. Joseph’s Regional Mental Health Care
(RMHC) eat a balanced and healthy breakfast is an important aspect
of care. RMHC dietitian Gurbir Rana explains that many medications
used in treating mental illness have the side effect of weight gain.
“Skipping breakfast makes you more susceptible to making poor
choices, especially if you are extremely hungry,” she says. “Eating
in the morning helps to avoid consuming larger portions at lunch,
extra snacks or choosing higher-fat foods, which can all lead to
weight gain. Breakfast is a key part of a structured, healthy eating
pattern that can contribute to weight management and maintaining
a healthy weight.”
The Relaxing
Weekend Breakfast
It’s Saturday morning and you actually have
time to make breakfast. What’s the best option?
French toast made from whole-grain bread
isn’t necessarily a bad call, Begg says. Up the
healthy factor by warming up frozen berries
to top it off. “It adds sweetness so that you need
just a bit of maple syrup,” she says. “The same
would go for pancakes.”
Try making your pancakes with whole-wheat
flour, then mixing in fruit such as blueberries
or diced apples. Fruit not only provides many
essential vitamins, but it’s also a good source
of fibre that can protect you from chronic
diseases, such as heart disease.
12
RELAXING
WEEKEND
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Changing the
Change
This isn’t your mother’s menopause. Relief from symptoms is
closer than ever. Talk to your doctor about your options.
vim&
DOWNLOAD
SIGN-OFF10
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3/26/12 10:47 AM
Arthritis
Answers
14
photography by dreamstime
iving with osteoarthritis (OA) can be like navigating a maze:
You’re going along in (seemingly) the right direction … then
you hit a dead end and are forced to take a different path. For
the more than three million Canadians who live with the complex and evolving condition, figuring out how best to traverse
this maze means getting answers. Does having arthritis in
your hand mean you will get it in your knees, too? What can
you do to slow its progression?
Vim & Vigour spoke with Dr. David G. Borenstein, a rheumatologist and author of several books on arthritis and back pain,
and Stanley Zimmerman, 77, who has lived well with arthritis
for 30 years.
Here, they tackle these and other arthritis questions from
their unique perspectives to help you get answers.
FdVVSU1200CND_14-17_Arthritis.indd 14
2/9/12 7:19 AM
A “joint” Q&A on
the ins and outs
of the condition
PHOTOGRAPHY BY DREAMSTIME
BY ALLISON
THOMAS
15
2/9/12 7:19 AM
DIAGNOSING OA
You really do
have a chance to
make an impact
even after your
diagnosis.
Dr. David G. Borenstein
DEFINING
OSTEOARTHRITIS
Q
What is arthritis?
Borenstein: There are
more than 100 types of arthritis, but
OA is the most common, and it’s essentially an inflammation inside the joint.
Q
If you have OA in one joint, does
that mean you’re more prone to
get it in another?
Borenstein: Once you have the disease, you
are more liable to get the problem in another
location than someone who does not have
any arthritis. But which joint and in what
time frame are not known.
Zimmerman: Mine started in my lower
body, but within the past two years, I’ve
begun having problems with my hands, too.
Q
What causes OA?
16
What are the signs and
symptoms?
Q
How is OA diagnosed?
Borenstein: Characteristically, this is a
slow onset problem. People may start noticing that they’re doing a certain activity and
their knee starts to bother them, or they use
their hand a certain way and it gets a little
stiff or achy.
Zimmerman: My first symptoms came
when I was jogging and I was having pain in
my knees and legs. My arthritis pain hasn’t
been debilitating, but it’s something I live
with daily. When I get up, my joints are stiff
until I get moving around. I have to work the
stiffness out, but once I do, I’m OK.
Borenstein: We look for characteristics such as joints that get worse as you use
them. Arthritic joints may also make noise,
grinding like sandpaper because cartilage
is no longer smooth, or there can be a bony
enlargement on the joint or fluid present.
X-rays can be helpful, but there’s more to it.
Pain is also a factor, and pain and joint change
can differ for each person.
TREATING OA
Q
What does OA treatment typically involve?
Q
When might joint surgery make
sense for someone who has OA?
Borenstein: Physical therapy can be helpful to improve function. But first, most
people need to have their pain addressed.
They generally start with acetaminophen
(Tylenol). Sometimes that’s adequate for
them to get around and feel that their joint
is doing better. Others may find nonsteroidal anti-inflammatory drugs, such as
ibuprofen (Advil), helpful. Rheumatologists
and internists can offer other non-steroidal
anti-inflammatories as well. Physical therapists can provide passive therapies like hot
packs, and, as the individual improves, he
or she can move to active therapy, working at
getting stronger.
Borenstein: If you have pain that keeps
photography by dreamstime
Borenstein: Understanding exactly
where OA comes from is a hot topic in the
rheumatology world right now, but the general thought is that it comes through wear
and tear, but not necessarily just age. OA is
a wearing away of the joint structures and
the body’s response to this. Obesity is a risk
factor for OA, particularly in women, as is
overuse of the joints and weakness of the
muscles that surround them.
Q
2/9/12 7:19 AM
you up at night, even though you’re taking medicine and trying other therapies, it
may indicate you’d be a candidate for surgical intervention. Marked instability in the
joint—in the hip or the knee—is also an indication. Hip replacement is probably the most
beneficial procedure for someone with OA in
regard to ability to function.
Zimmerman: My left hip started hurting
around 1998, and it got worse until one day
I was walking down the hallway with a cane
and I thought, “This isn’t right. I’m not living
like this.” So in 2000, I had a hip replacement.
I was in and out in 24 hours; the recovery was
pretty quick. My right hip aches a little now,
but my left hip is fine. I went back to playing
tennis and forgot about it.
LIVING WITH OA
Q
What can you do to slow the pace
of this degenerative condition?
Borenstein: Start by making sure your muscles are working. Exercise! This is particularly
important if you’re overweight. Get in shape
now, not 20 years from now.
Q
What’s the best way to exercise
so you don’t do more damage
than good?
online
Borenstein: If you run, run on softer surfaces
like a track as opposed to unforgiving concrete, with good supportive shoes. Swimming
is ideal, especially for those diagnosed with
OA who have knee or hip troubles. Or try a
stationary bicycle, with the height adjusted so
that the rotation of the pedals won’t irritate
the hip or the knee. You want to exercise to
the point where you’re at an ideal weight, but
don’t abuse your joints.
Resources
For more on the Rheumatology
Centre at St. Joseph’s Hospital,
go to sjhc.london.on.ca/
rheumatology. For an accurate
and reliable resource on arthritis, visit rheuminfo.com.
Making Education
Easy
For people with arthritis, understanding their various treatments and
medications is critical but the information is often complex. Dr. Andrew
Thompson, a leading Canadian rheumatologist at the Rheumatology
Centre at St. Joseph’s Hospital in London, is dedicated to making it as
easy as possible for patients to learn about their care. He is the creator of rheuminfo.com, a comprehensive collection of educational
resources and tools for both patients and physicians. It provides accurate
and reliable information on arthritis and musculoskeletal disorders and
the medications that treat them.
Dr. Thompson is currently researching literacy levels of arthritis
patients to find new ways to present information. “We want to find
the best ways to convey information to patients and improve recall
and understanding.”
Dr. Thompson is also the author of a quick reference guide
of rheumatic diseases and medications—a manual small enough
to fit into the pocket of a physician’s white coat and now used by
rheumatologists worldwide.
Zimmerman: I’m a big fan of the elliptical. It doesn’t hurt my joints at all, even for
30 minutes or more.
Q
What advice would you give
someone who is newly diagnosed
with OA?
Borenstein: The condition is not set in
stone. You really do have a chance to make
an impact even after your diagnosis. We’ve
learned from a variety of studies that if you
lose five to eight pounds, you can have a significant impact on OA of the lower leg, particularly the knee. We’re not talking about
losing 50 pounds here. We’re talking about
reachable goals.
Zimmerman: The most important thing
to realize is that this is something you can
manage.
Vim & Vigour • Summ er 2012
17
3/20/12 2:27 PM
2/21/12 6:57 AM
A TV Guide to
RADIOLOGY
PHOTOGRAPHY BY GETTY IMAGES, CORBIS
Become an armchair expert on the
language of medical imaging
with our handy glossary
FdVVSU1200CND_18-20_Radiology.indd 18
2/9/12 7:19 AM
T
he inside of a hospital seems almost familiar when you have
seen it dozens of times from the inside of your living room.
With the popularity of medical dramas, TV gives us regular
exposure to the world of medical treatment and testing. But
how close is what we see to reality?
“There must be an unwritten rule [of television] that if
you put up a chest X-ray, make sure it’s up backwards,” says
Dr. David M. Hovsepian, editor of RSNA News, a publication
of the Radiological Society of North America. Aside from
those kinds of blatant mistakes, “TV tends to abbreviate
most medical procedures and emphasize the dramatic elements,” Hovsepian says.
A three-hour test takes a minute or two, and TV doctors have the luxury of spending hours
with a single patient who has an unusual illness.
So, you might not want to take everything you see on the screen at face value. But being more
familiar with medical terminology can dial down the intimidation factor when it’s your turn to
be the patient. “If you already have some background knowledge of a procedure, it can be really
helpful,” says Dr. Linda Warren, clinical professor of radiology at the University of British
Columbia and a member of the Public Information Advisors Network for the Radiological
Society of North America.
These days, much diagnosing is done with the help of imaging tests. When people come to
the hospital with a problem, “almost everybody winds up in the radiology department at some
point to figure out what’s going on,” Hovsepian says. “Radiologists are really medical detectives.”
To help you know what to expect—or fact-check your favourite medical show—here’s a glossary of terms:
photography by getty images, Corbis
Radiology
The medical specialty that diagnoses and treats disease using imaging tools including X-ray,
CT, MRI, ultrasound and nuclear medicine.
Diagnostic radiology or diagnostic imaging: Uses imaging tests to answer questions about
what is going on in the body. “Imaging has gotten so good, you no longer need to open somebody up [surgically] to figure out what’s going on,” Hovsepian says.
Interventional radiology: Uses imaging-guided procedures to diagnose conditions and
perform medical intervention less invasively. “These procedures can replace more invasive,
open surgeries, saving tissue damage, eliminating the need for general anesthesia and shortening recovery time,” says Dr. J.S. Benseler, author of The Radiology Handbook: A Pocket Guide
to Medical Imaging.
By Teresa Caldwell Board
19
2/9/12 7:19 AM
For the past decade, St. Joseph’s Health Care London has been
a Canadian pioneer and leader in hybrid imaging—the merging
of two different sets of images to give specialists a whole new
three-dimensional assessment of the body’s organ systems.
Hybrid imaging started at St. Joseph’s in 2002 when the hospital
received the first PET/CT in Canada.
At St. Joseph’s, high-powered CT, which creates detailed anatomical images of the body, is combined with leading-edge PET
and SPECT imaging, which use radioactive materials to capture
how organs and cells function. When images from these two
scans are fused, crucial information about disease is uncovered
that once required multiple procedures, explains Dr. Jonathan
Romsa, chief/chair of nuclear medicine in London.
St. Joseph’s is once again breaking new ground with the installation in February of Canada’s first PET/MRI—the latest evolution
in hybrid imaging. This exciting development holds tremendous
promise for the assessment of many disease processes, particularly in the fields of neurology, oncology and cardiology. Read
more about this new wave in imaging at St. Joseph’s on page 6.
X-Ray
The oldest and most commonly used imaging test.
Creates an image by passing radiation through
the body, where the energy is absorbed at different
rates based on tissue density. Bones absorb the most
energy and show up in white; soft tissue is grey; and
air, which absorbs no energy, looks black.
ct scan (coMpUted
toMogRaphy)
A more sophisticated version of X-ray that produces
detailed cross-sectional images—like slices in a loaf of
bread—that combine to show a 3-D view. Faster than
MRI, and produces higher-definition images.
“The detail we can get for all soft tissues is absolutely exquisite,”
Warren says.
UltRasoUnd
A relatively inexpensive imaging technique that uses
no radiation. Instead, it uses “high-frequency sound
waves over a million cycles per second—a lot higher
frequency than we can hear,” Benseler says. “You’re
making a picture from the echoes of the sound that
bounce back.” Best at imaging fluid collections and
internal structures close to the surface of the body.
nUcleaR MedIcIne
Produces images of physiologic processes (the body
in action) using small amounts of radioactive material that stay in the body for a short time. To generate images, “instead of having X-rays or anything
else going into the body, the radiation in the form of
gamma rays comes out of the body from wherever it
accumulates,” Benseler says.
Radiopharmaceuticals: The radioactive materials
that are injected, swallowed or inhaled, then accumulate in a part of the body where they give off energy in
the form of gamma rays, allowing imaging equipment
to capture pictures.
PET (positron emission tomography) scan: One
way of recording the energy given off by radiopharmaceuticals. Often combined with CT scanning for a
clear look at both structure and function of organs,
tissue and other aspects of the body for more accurate
diagnoses.
Understand
Radiology Tests Better
Being empowered is about having
information. Read explanations of various
imaging tests and get answers to common
radiology questions at radiologyinfo.ca.
You can search by procedure (“scan”),
part of the body (“chest”) or type of test
(“MRI”) for complete information.
photography by thinkstock
20
Uses a powerful magnet and radio-frequency pulses
(instead of radiation) to send detailed images to a
computer. Excellent at imaging soft tissue. Takes longer than CT scanning (30 to 90 minutes compared
with 30 to 90 seconds), but “the greater scan time
can also provide a greater amount of information,”
Hovsepian says
online
The Next Frontier
MRI (MagnetIc
Resonance IMagIng)
3/20/12 2:27 PM
2/21/12 7:04 AM
BY AMY LYNN SMITH
PHOTOGRAPHY BY THINKSTOCK
TAKE AIM
After a
mini-stroke,
these 7 steps
can help keep
your health
on target
L
aurie Giles just knew something was wrong. In fact, she
admits she knew instinctively she was having some kind of
stroke. But she didn’t want to admit it to herself.
“I felt completely out of sorts, very dazed and disoriented,”
says Giles, whose attack happened about five years ago at age 45. “But
I kept telling myself it was just stress or something and kept on going.”
She even drove to her parents’ house about two miles away, where her
father said, “What’s wrong with your face? Part of it’s drooping.”
FdVVSU1200CND_21-23_Stroke.indd 21
21
2/9/12 7:20 AM
That’s when Giles knew she couldn’t wait any longer and went to the hospital. As
it turns out, her instinct that something was wrong was correct. Giles suffered a
transient ischemic attack (TIA), also known as a mini-stroke.
As with a stroke, a TIA causes blood flow to part of the brain to stop. But the symptoms typically go away within a couple of hours and there’s usually no permanent
damage afterward.
That doesn’t mean a TIA is nothing to worry about. A
TIA is a warning sign that you are at increased risk of
having a full-blown stroke, says Dr. Michael D. Hill,
a neurologist and spokesman for the Heart & Stroke
Foundation of Canada.
“A TIA not only puts you at risk of stroke, but it
turns out that risk is front-loaded,” he explains. “The
highest risk period is in the next few days to a couple
of weeks after a TIA.”
This is why prompt medical attention is essential.
Follow-up with a specialist is important, too. A doctor might prescribe blood thinners such as baby aspirin. Equally vital is making lifestyle changes right
away that can reduce the risk of stroke.
“Having a TIA isn’t debilitating, but it’s definitely
life-changing,” Giles says. “Even though I was in
great physical shape at the time, it was a real wakeup call for me that I could do better.”
Want to reduce your risk of stroke, especially if
you have had a TIA? Here are the key steps.
1
Know Your Family History
A good place to start making healthy
changes is evaluating your risk. If a close
relative has had a stroke—which Giles’
grandmother did—your odds of having one are
increased. Your doctor may want you to take extra
precautions to reduce your other risk factors.
“
22
Having a TIA
isn’t debilitating,
but it’s definitely
life-changing.”
2
Manage Your Blood Pressure
High blood pressure is the “most important”
risk factor for TIA (and stroke), Hill says,
but it’s also a treatable one. After a TIA, “we
aggressively treat high blood pressure,” he explains.
Most of the following steps can help keep blood
pressure at a healthy level, but regular monitoring of
blood pressure—by your doctor, at home or both—is
important. If lifestyle changes don’t help, your doctor
might prescribe medication.
3
Watch What You Eat
A diet low in fat, cholesterol and sodium
and rich in fruits, vegetables, whole grains
and lean protein can help reduce blood
pressure, Hill says.
He and many other experts recommend the Dietary
Approaches to Stop Hypertension (DASH) diet, which
focuses on these healthy basics and others, including
monitoring portion size and reducing sugar intake.
4
Get Moving
Exercise is another proven way to manage blood pressure. Hill says the generally
recommended guidelines of 30 minutes of
moderate activity most days of the week apply here.
Giles says she is much more consistent now about
exercise, walking more than a kilometre every day
and fitting in other activities during the week, such
as fitness DVDs and weight training.
5
Maintain a Healthy Weight.
See Steps 3 and 4. Eating right and exercising are the best ways to lose weight and
keep it off.
Giles admits she was carrying extra weight when
she had her TIA. Even though she wasn’t significantly overweight, Giles changed her eating habits to
lose the weight.
“I gave up junk food,” she says, in addition to
adopting a part-time vegetarian diet.
2/9/12 7:20 AM
An Event to Take Seriously
6
Manage Related
HealtH Conditions
High cholesterol, diabetes and atrial fibrillation (an irregular heart rhythm) all are
risk factors for TIA. Medication may be needed, but
high cholesterol and diabetes usually can be controlled through diet and exercise. Regular checkups
and screenings are important to stay on track.
Stress may be another factor in managing high
blood pressure. Researchers are debating the influence of stress, but Giles says she believes she needed
to better manage it to better manage her health. She
changed careers and says she puts less pressure on
herself than she did before.
7
Quit sMoking
“We tell people to stop smoking, but sometimes it takes a stroke event to get them to
stop,” Hill says.
There are many programs and strategies to help
you kick the habit, which is a smart move for every
aspect of your health.
Positive CHanges foR life
online
Other risk factors for stroke include being older than
55 and being of First Nations, African or South Asian
descent. You can’t change these facts or your family
history. But if you have had a TIA, you can take charge
of your life to reduce the risk factors you can influence.
“I’m in good health today,” Giles says. “I don’t have
to live my family history. It’s very empowering to
know that I can take proactive steps to take control of
my health and my future.”
Get the Whole Story
Read the full story of stroke survivor
Robert Truman and discover more about
the value of SMARTBoard technology
by visiting sjhcfoundation.org. To
learn more about stroke rehabilitation
expertise at Parkwood Hospital, go to
sjhc.london.on.ca/stroke.
From the Classroom
to the Clinic
Used in classrooms and boardrooms for years, SMARTBoards
are not new technology. But the way they’re being integrated
into rehabilitation is opening up a new world of recovery possibilities for stroke patients at St. Joseph’s Parkwood Hospital.
For Robert Truman, who suffered a massive stroke New
Year’s Day 2011, SMARTBoards have made a tremendous
difference. Among the serious health challenges caused by the
stroke was Truman’s loss of his ability to read. In Parkwood’s
cognitive communication therapy group, speech language
pathologist Penny Welch-West tackled the problem by coaching Truman using a SMARTBoard until he began reading single
words. He can now read entire paragraphs.
“SMARTBoards level the playing field for patients and
extend their potential far beyond the clinical elements,” says
Welch-West. She adds there are hundreds of active projects
that can be incorporated into SMARTBoards, which help with
deductive reasoning, cognitive communication activities, visual
tracking, reading, writing and math.
23
3/20/12 2:27 PM
2/21/12 7:06 AM
It Might
NOT
FEATURE BYLINE
Be Breast Cancer
Suspicious
lumps and
bumps
don’t always
mean cancer
H
ave you ever had “a scare”? Maybe you were doing a
breast self-exam or merely lotioning up after a shower.
Whatever you were doing, it was no less than a shock when
you felt a lump. • “Is that what I think it is?” • “How long has
it been there?” • “Oh my goodness, I have cancer.” • Because of effective breast cancer awareness campaigns—which have done wonders in helping increase mammogram
prevalence and breast cancer survival rates—when women feel changes in their breasts,
they may automatically assume it’s cancer. But that’s far from the reality. • “Most—about
95 per cent of lumps—are not cancer,” says Dr. Nancy Wadden, a radiologist, clinical image
reviewer and chair of the Mammography Accreditation Program for the Canadian Association
of Radiologists. “It depends on the age of the woman. The younger the person, the more likely it
isn’t cancer. But even in older women, it’s more likely it isn’t cancer.” • So if a lump isn’t cancer,
then what is it? First, it’s important to understand a little about the anatomy of the breast.
OUR CHANGING BREASTS
BY SHELLEY FLANNERY
24
PHOTOGRAPHY BY GETTY IMAGES
They may seem unchanging, but breasts are dynamic organs, Wadden says. “Breast tissue is never the same, any day, week or year.” • Blame it on hormones, says Dr. Shahla
Masood, president of the World Society for Breast Health. “The function of the breast
is to provide nutrition to children. The life cycle of breast tissue completes with
pregnancy, and the breasts are under continual change until menopause.”
Still, that doesn’t mean you should ignore breast symptoms. “We
don’t encourage women to do self-exams but just to be aware of
FdVVSU1200CND_24-27_BreastHealth2.indd 24
2/9/12 7:20 AM
Quicker
Access to
Care
online
The Breast Care Centre at St.
Joseph’s Hospital is streamlining
access to care and reducing wait
times for women most in need with
a new one-number central referral
process. With the new process, all
new referrals for breast assessment, which includes breast imaging and surgery consultation, are
faxed to one number at the centre.
Breast assessment is done when
a physician suspects, or screening
shows, there may be a problem. A
nurse practitioner reviews all new
referrals, triages them and books
the appropriate appointment. For
surgery consultations, there is an
option to book the first available
appointment or the patient’s surgeon of choice.
There is no change to the referral process for preventive (routine)
breast screening through the
Ontario Breast Screening Program
(OBSP). Patients who qualify continue to go through OBSP to book
appointments, even if choosing
the OBSP program at St. Joseph’s
Breast Care Centre.
Access Help
One-number central referral for breast assessment
in London is the latest improvement to breast care
made possible by the consolidation of breast imaging and surgery services at St. Joseph’s Hospital. Learn
more about St. Joseph’s Breast Care Centre at
sjhc.london.on.ca/breastcare.
25
3/20/12 2:27 PM
2/21/12 7:09 AM
It’s important
for a woman to
be familiar with
her breasts.
FIBROADENOMAS
WHO’S AFFECTED: Mostly young women ages 15 to 35.
WHAT THEY ARE: Fibroadenomas are well-defined
lumps that can feel rubbery or hard. They are benign
tumours that have no effect on breast cancer risk.
DETECTION: They are usually detected with mammography, Masood says.
TREATMENT: “None is necessary, so you may choose
to do nothing,” she says. “Removal with a minimally
invasive procedure is available, though, if the mass
bothers you.”
HYPERPLASIA
changes in their breasts,” Wadden says. “Women should
have regular mammographic screening. They should see
their family doctor to discuss.” Annual screenings should
begin at 50, according to the Canadian Cancer Society, or
earlier if you and your doctor decide that is best for you.
If you do find a lump or abnormality in your breast,
don’t worry. It likely will be one of the following benign
breast conditions.
CYSTS
26
INTRADUCTAL PAPILLOMAS
WHO’S AFFECTED: Mostly women between the ages of
30 and 50.
WHAT THEY ARE: Small lumps in the breast ducts.
They do not raise risk of breast cancer unless abnormal
cells are present.
WHO’S AFFECTED: Mostly premenopausal women,
although cysts can occur after menopause as well.
WHAT THEY ARE: Cysts are fluid-filled sacs that can
develop in many places in the body. Breast cysts are
almost always benign and are usually too small to feel.
Large cysts can be felt under the skin and are sometimes
painful. They have no effect on breast cancer risk.
DETECTION: No biopsy needed. Cysts can be diagnosed with breast ultrasound.
TREATMENT: Usually none is necessary, and often
cysts come and go on their own. If painful or large
enough to interfere with a physical breast exam, cysts
can be aspirated (the fluid removed) or removed entirely.
WHO’S AFFECTED: Undefined, although risk appears to
increase with age.
WHAT IT IS: Hyperplasia refers to an abnormal multiplication of cells. It is typically found in the lobules
(milk-producing glands) or in the milk ducts. There are
two types of breast hyperplasia: usual and atypical. Both
types raise the risk for breast cancer. Usual hyperplasia
can increase risk by two times and atypical by five times.
DETECTION: Hyperplasia is generally detected after
an abnormal mammogram or physical breast exam and
is diagnosed with biopsy.
TREATMENT: Usual hyperplasia is typically monitored closely, while atypical hyperplasia is generally
treated with surgery to remove the abnormal cells and
ensure there are no cancerous cells in the area. In either
case, your doctor may recommend earlier or more frequent breast cancer screenings.
2/9/12 7:20 AM
Detection: Intraductal papillomas are the most
common cause of nipple discharge from a single duct.
They are not easily seen on mammograms, if at all, but
may be felt by a physician during a physical breast exam.
Treatment: Intraductal papillomas can be removed
with surgery.
Fibrocystic Breast Condition, or
Fibrocystic Change
Who’s affected: “Fibrocystic change is a recurring
process that is very common,” Masood says. The condition affects more than half of all women. It most commonly begins in the 30s and goes away after menopause.
What it is: Fibrocystic breast condition describes
changes to the breast throughout the menstrual cycle
that cause the breasts to swell, feel lumpy and be painful.
Lumpy breasts are not the same as having breast lumps.
No cause has been detected, although some women have
reported that caffeine and diet may affect their symptoms.
Detection: Pain may come and go or may be present throughout your cycle. Breasts may feel thick or
lumpy, but the lumps will move when you push on them
as though they are not affixed to anything. Some women
have nipple discharge, although if it is clear, red or bloody,
see your doctor right away.
Treatment: No treatment is necessary. To reduce
pain, take an over-the-counter pain reliever, apply heat
or ice and wear a well-fitting bra.
Mastitis (Infection)
Who’s affected: Usually women who are breastfeeding.
What it is: Bacteria enter the breast through a crack
in the nipple, causing tissue to be inflamed. The swelling
causes pain and redness and puts pressure on the milk
ducts.
Detection: You may have a fever, pain and other
flu-like symptoms. One breast may be enlarged. Clogged
ducts cause the breast to be sore. You may notice small,
red lumps on the breast that are sore to the touch.
Treatment: Infections are treated with antibiotics.
Continue breastfeeding, and drain the breast as much as
possible. Beforehand, massage the breast, starting at the
outside and working your way in. Apply warm, moist
towels to the area several times a day. After a few days, if
the lumps do not go away or increase in size or redness,
or if you have severe pain, see your doctor.
Diabetic Mastopathy
Who’s affected: This rare breast condition affects
premenopausal women who have type 1 diabetes.
What it is: A condition in which small, hard masses
form in the ducts or lobules. Research is unclear, but it
appears not to affect breast cancer risk.
Detection: It may be detected through mammography or by feeling a lump. A biopsy may be ordered to rule
out other causes.
Treatment: No treatment necessary. When to Call Your Doctor
photography by Getty Images
Never hesitate to call your doctor about any breast symptoms,
the Canadian Cancer Society recommends. Be sure to make an
appointment if you have:
• A lump or swelling in your breast or armpit
• A change in size or shape of your breast
• Dimpling or puckering of the breast skin, which can
look like orange peel
• An inverted nipple
• Redness or increased warmth in the affected breast
• Crusting or scaling on the nipple
When you see your doctor, be prepared to answer the following questions:
• What are your symptoms?
• When did you first notice the change?
• Is it in one breast or both?
• Have there been changes since the symptoms appeared?
• When was your last period?
27
2/9/12 7:20 AM
Acting
His Age
How Colin Firth is making his 50s
phenomenal—and you can, too
E
ver the quintessential English
gentleman, the handsome and
articulate Colin Firth has been
capturing hearts—and catching
eyes—since his breakout role in Pride and
Prejudice (1995), a TV miniseries based on the
Jane Austen novel. Since then, he has continued to solidify his star status, and his adoring fan
base, with movies like Bridget Jones’s Diary, Love
Actually, The English Patient and Girl with a Pearl
Earring among others. But some of Firth’s finest
work has been in the past few years—as he neared
his 50th birthday. He received 10 awards and
even more nominations for his gut-wrenching
performance in A Single Man (2009), and in
2010, he received his first Academy Award as
well as a Golden Globe and Screen Actors
Guild Award, among others, for his inspiring
portrayal of the speech-challenged King
George VI in The King’s Speech (2010).
•
PHOTOGRAPHY BY JIM WRIGHT
•
By Alissa Edwards
28
FdVVSU1200CND_28-33_Firth_14.indd 28
2/9/12 7:20 AM
e
PHOTOGRAPHY BY JIM WRIGHT
2/9/12 7:20 AM
B
Better with Age
Hailed as one of the few Hollywood actors who have forgone
plastic surgery and other chemical procedures in favour of
aging naturally, Firth at 51 is a stellar example of how letting
nature take its course can be pleasant indeed.
Following in the footsteps of fellow 50-something
heartthrobs Denzel Washington, Pierce Brosnan, George
Clooney and Hugh Grant, Firth appears comfortable in his
older skin. And he is reaping the benefits of that attitude on
and off the stage.
“I don’t relish the idea of losing my faculties, but I do relish the idea of roles getting more interesting, which at the
moment is what seems to be happening,” Firth told London
journalist Simon Jablonski for his blog in 2010.
With an irresistible, self-deprecating charm, a face that
seems to grow more handsome with age, energy to spare
and more movies, this uncommonly gracious actor is making us look at our 50s in a new light.
Here, Dr. Henry S. Lodge, co-author of Younger Next Year:
Live Strong, Fit, and Sexy—Until You’re 80 and Beyond, shares
his insight into why Firth seems to be getting better with
age, and how you, too, can look and feel your best into your
50s and beyond.
30
1
Embrace
your age.
Make no mistake: Firth knows the effect the
years can have. But when it comes to the physical realities of getting older, he doesn’t sweat the
small stuff. In fact, he says, signs of aging may
have been a mild improvement.
“As a young actor I remember thinking I could
do with a wrinkle or two just to get something
interesting onto this face; I longed for a bit of texture. So a few lines worked quite well, as long as
I don’t fall apart completely,” Firth told Jablonski.
“There’s a cultural perception that aging is
about making the best of a bad situation, but the
reality is that people are steadily happier from
50 onward than they were in the earlier years
of their life,” Lodge says. “It turns out there’s far
more to embrace than we thought. But part of
embracing your age means accepting the reality
that you need to do things differently than you
did in your 30s.”
2
Take care
of yourself.
Being intentional about eating right and making
a genuine effort to be physically active on a regular basis are key to aging well naturally and to
living a long and healthy life.
“This is the time to take a good look at how
you’ve been treating your body over the last few
decades,” Lodge says. “Biologically, you have an
infinite number of second chances to do it right.
If you haven’t been making good choices, you can
start now.
“Being active at this point in your life is a nonnegotiable, not only for your physical health but
for your mental health as well,” Lodge continues.
“The risk of Alzheimer’s is 40 per cent lower in
people who exercise regularly compared to those
who are sedentary. I recommend doing cardio at
least four days a week and strength training at
least two days a week.”
For Firth, who found a new interest in the gym
at age 49, the inspiration came as he prepared for
his role in A Single Man in the form of writer and
2/9/12 7:20 AM
The
facTs
on Firth
A few things you may not
know about Colin Firth:
2011
“TIME 100” list
He made Time magazine’s
He has played a character
with the last name
Darcy
three times.
(First in the Pride and Prejudice miniseries,
and then in Bridget Jones’s Diary and
Bridget Jones: The Edge of Reason)
Neither his Italian wife,
Livia Giuggioli, nor her
family knew of his
cElEbrITy
sTaTus
when the two met.
His birthday
sEpT. 10, 1960,
is one day apart from fellow actor
and Englishman Hugh Grant
(Sept. 9, 1960)
He made People magazine’s
50 MosT
bEauTIful pEoplE
list in 2001, the year
Bridget Jones’s Diary
was released.
31
2/9/12 7:20 AM
‘
Exercise as
Medicine
online
In what researchers hope will become
a model for rural communities in
Canada, the Lawson Health Research
Institute has developed a program
to improve the health of individuals
in Huron County. In partnership with
the Huron community Family Health
Team, Lawson scientist Dr. Robert
Petrella has launched HealtheSteps,
a series of training modules based on
exercise and healthy lifestyle. Patient
progress is supported by an interactive website, group coaching and goal
setting, personalized exercise prescriptions, and online tracking tools.
HealtheSteps was initiated at the
request of Huron County participants
in a 2010 research project with Dr.
Petrella that prescribed exercise and
lifestyle changes to reduce the risks
of diabetes and cardiovascular disease. The 150 participants, who lost
a total of 500 pounds and reduced
their blood pressure significantly,
wanted the project to continue and
be available to others.
Learn More
For more information on the groundbreaking work of
scientists at Lawson Health Research Institute, go to
lawsonresearch.com.
32
3/20/12 2:27 PM
2/21/12 7:12 AM
‘‘
The present moment . . .
is something to be absolutely cherished.”
director Tom Ford. “He told me I looked good,
but I’d look better if I had a personal trainer,”
Firth told The New York Times.
In addition, take the time to schedule routine
checkups. “At this age, it’s more important than
ever to see your doctor,” Lodge says. “This is the
time to schedule those screenings and tests and
take your physician’s advice about losing weight
or taking medications seriously.”
3
Nurture your
relationships.
“Having an emotional connection to others is
more important than we realized,” Lodge says.
“Maintaining close relationships with people
who truly know and love you is good for your
body and soul.”
With a self-described happy, healthy 15-year
marriage to Italian director and producer Livia
Giuggioli and two young sons, Luca, 11, and
Matteo, 8, at home in West London, Firth seems
to be on the right track.
“We’re very committed on a daily basis to how
we deal with our family lives. But the real secret
is time—we have to make sure that we spend
enough time together,” Firth told Bang Showbiz.
“Every relationship in life you’re going to have to
take care of; there’s a marathon factor to it.”
The actor also maintains a close relationship
with his 21-year-old son, Will, from a previous relationship with Meg Tilly, as well as with
her two older children, Emily and David. And
experts say that’s a good thing.
“Individuals with a close support network
live longer, healthier lives, have fewer heart
attacks and recover more quickly and easily
from setbacks like stroke, surgery and cancer,”
Lodge says.
4
Make a
difference.
Though the humble Firth has never been one to
make a big deal of his charity work (or himself,
for that matter), the actor spends considerable
time working on behalf of refugees and supporting fair trade rights for tribal peoples.
He and Giuggioli developed www.brightwide.
com, a website that provides a platform for social
and political causes through online videos and
connects people with ways to get involved. The
couple also co-owns and operates Eco, a store
in London that offers earth-friendly, ethically
produced goods.
“It turns out that there is a biology of altruism,” Lodge says. “Giving of your time, talents
and/or resources to make a difference is hugely
beneficial to your health, especially at this age.
Firth is improving the lives of others and the
world around him, and giving himself a better
shot at living a longer, healthier life, too.”
Firth Rising
When it comes to getting older, having a grateful attitude and celebrating the little things in life
can make a difference.
Firth says that lesson became most poignant
for him during the filming of A Single Man. “[It’s]
given me a real sense of what I have to be grateful for in my own life. The present moment, for a
start, which is really all we have, is something to
be absolutely cherished,” Firth said on The Oprah
Winfrey Show in 2010.
With three movies coming out this year,
including Tinker, Tailor, Soldier, Spy; Gambit; and
a third installment in the Bridget Jones series,
the beloved 50-something and gorgeous-as-ever
Firth has no plans for retiring anytime soon.
And who’s complaining?
Regardless of what his acting future holds, the
uncommonly likeable actor seems certain to have a
healthy future and vibrant life ahead of him. And
if we take our cues from Firth, so can we.
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2/9/12 7:20 AM
FATHER/SON PHOTOGRAPHY BY GETTY IMAGES; PLATE PHOTOGRAPHY BY DREAMSTIME
2/9/12 7:20 AM
FdVVSU1200CND_34-37_Diabetes.indd 34
STEP UP
TO THE PLATE
5 ways parents can reduce their children’s risk for diabetes and
score a home run for their children’s health
››››››››››››››››››››››››››››››››››››››››››››››››
‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹
NO ONE SAID BEING A PARENT WAS EASY. From the first diaper to the day you drop your child off
at college, the parenting game is full of critical moments. Some days, you score; others, you strike out.
When it comes to your child’s health, every moment matters. Every meal is an opportunity to
give your child the nutrition he or she needs and a chance to instill healthy habits that will
last a lifetime. Healthy habits that will win big against diseases such as type 2 diabetes.
“More and more kids are getting it at a younger age, and it’s more severe,”
explains Dr. Wayne Andersen, who specializes in nutrition and is the
best-selling author of Dr. A’s Habits of Health. “The coupling of diabetes and obesity relates to the environment, daily choices, how
[kids] are moving and what they’re eating.” While being
overweight doesn’t guarantee a diabetes diagnosis, it does increase a child’s risk. According
to the Canadian Diabetes Association,
about 95 per cent of children
with type 2 diabetes are
overweight when
they receive
their
•
•
FATHER/SON PHOTOGRAPHY BY GETTY IMAGES; PLATE PHOTOGRAPHY BY DREAMSTIME
•
BY STEPHANIE R. CONNER
35
2/21/12 6:41 AM
diagnosis. And, the association reports, the proportion of
Canadian children who are overweight has tripled in the
past three decades.
“But the good news is that we can do something about
it,” Andersen says. “That’s the most important thing for
parents to realize.”
Here are five steps parents can take right now to step
up to the plate and reverse the trend by helping their children live healthier lives.
1
LEARN MORE
ABOUT DIABETES.
For parents, understanding diabetes is an
important first step.
Diabetes involves high blood glucose (sugar)
levels that result from the body’s inability to produce or
use insulin, a hormone that regulates glucose in the blood.
In those who have type 1, the body doesn’t produce
insulin. Among children 14 years or younger, Canada has
the sixth highest incidence rate of type 1 diabetes.
The most common form of the disease is type 2. The
body either doesn’t produce enough insulin or the cells
ignore it. This can lead to high blood glucose levels,
which, left unchecked, can cause serious complications
such as nerve disease, kidney disease, heart problems
and more.
The primary risk factor for type 2 diabetes is being
overweight. Other risk factors include inactivity and a
family history of the disease.
If you’re looking for symptoms of diabetes, you might
not see any. A few symptoms include frequent urination, unusual thirst or extreme hunger, unusual weight
loss, fatigue, frequent infections and blurred vision. If
you notice these symptoms or are concerned about your
child’s weight, talk to your child’s pediatrician about
testing for diabetes.
“Type 2 diabetes is one of the many problems that you can help your child prevent
with healthy eating habits, by being physically active and by keeping a healthy weight,” says Hope
Warshaw, a registered dietitian, a certified diabetes
educator and author of Diabetes Meal Planning Made Easy
and Real-Life Guide to Diabetes.
One of the best ways to encourage your children to do
this, Andersen suggests, is through your own healthy
behaviours.
“The parents are the role models,” he says. “The mom
holds the purse strings, and she buys the food that goes
in the house—not just from the standpoint of what they’re
feeding their kids, but also what they’re feeding themselves. … The parents can’t be eating fried chicken and
telling the kid to eat carrots.”
Warshaw, who is a mother, understands the challenges.
“You’re constantly modelling,” she says. “Raising
kids with healthy eating habits is a tough, endless job.
It requires daily vigilance. Parents give in a lot on food
because there are so many challenging situations. …
I encourage parents to hang tough.”
3
CREATE A HEALTHY
ENVIRONMENT.
“When the child is home, they can only eat
what’s in the house,” Andersen says.
If the pantry or fridge is stocked with
whole milk instead of skim or chips instead of apples,
kids don’t have much choice when they get the munchies.
“The modern world makes it very easy to out-eat exercise and nearly impossible to out-exercise overeating,”
Andersen notes. “The thing for parents is to focus on the
energy-in side of the equation.”
He offers this explanation: If a child goes on a moderately fast bike ride for an hour, he will burn 300 calories.
If he had been sitting at home for that hour, he would have
burned 60. So, the net loss is 240 calories. But an order of
french fries has 230 calories. The point, he says, is not to
rely on exercise to counter everything your child eats. By
focusing on what kids are consuming—from at-home meals
to making healthy lunches—parents can make a difference.
When you’re ready to create a healthy home environment, get a big plastic bag and throw away anything
that has more than 10 ingredients in it, Andersen says.
Then, replace those foods with whole, real foods like lean
meats, whole grains, fruits and vegetables.
2
MODEL HEALTHY
BEHAVIOURS.
2/14/12 1:39 PM
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‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹‹
Breaking Down Barriers
For those living with diabetes, education is the cornerstone of their care. For individuals with language barriers,
however, diabetes education can be a challenge. For example, Latin Canadians, who are three to four times more
likely to develop type 2 diabetes, often have difficulty accessing services where diabetes screening would usually
take place. To tackle this issue, the Primary Care Diabetes Support Program (PCDSP) of St. Joseph’s Health Care
London is partnering with Projenesis—a non-profit advocacy organization for Hispanic Canadians—to host diabetes
screening days for London’s Hispanic community. The first event was held last fall. About 120 people attended and
25 per cent of those were found to have high blood sugar levels.
“By providing accessible screening, we’re hoping we can start people down the path of good care, education and
prevention,” says Betty Harvey, PCDSP nurse practitioner.
Claudia Rosso of Projenesis says the organization looks forward to furthering its partnership with St. Joseph’s.
4
EAT TOGETHER,
BE ACTIVE TOGETHER.
Eating family meals at home, Warshaw
says, goes beyond the food. It’s also about
conversation and talking about your day.
Plus, she says, it’s beneficial to have your kids help with
preparing the meal. It’s an opportunity for you to teach,
and they’re more likely to enjoy something they had a
hand in.
And don’t assume kids just won’t eat certain foods.
“We think all kids eat is pizza, chicken nuggets and
hamburgers,” Warshaw says. “Don’t narrow your kids’
palates. Widen them.” Introduce them to more foods. You
might be surprised by what they like.
In addition to eating together, Warshaw suggests finding ways to be active together—exercising as a family,
rather than watching TV together.
It can be bowling, swimming at the community pool, taking a walk, riding bikes—whatever gets the family moving.
“All those activities can bring the family together,”
Andersen adds. “And everybody feels better.”
5
MAKE A LONG-TERM
COMMITMENT.
Warshaw doesn’t like the word “diet.” She
wants people to think beyond the short term.
“This is about healthy eating, healthy habits,” she says. “And you’ve got to start early, early, early.”
Then make it a lifelong commitment. Andersen adds
that once children become teenagers, they are likely to be
set in their patterns, so instilling healthy habits early on
and continuing to reinforce those patterns are essential.
“Diabetes is not a disease you get overnight,” Andersen
says. “We make choices day in and day out over time.”
Nobody said being a parent was easy. It’s not. But it’s
an important role, and by stepping up to the plate and
taking action, parents have the power to prevent obesity
and reverse the trend of diabetes in children.
“I do feel optimistic,” Warshaw says. “But people have
to be willing to dig in.”
And when we do, it’s the next generation that wins.
online
Have plenty of fruits and veggies on hand and make
them easy for kids to reach, and if it helps kids, cut the
fruits and veggies into bite-size pieces. Have water and
low-fat milk available, and ditch sodas, sports drinks and
high-calorie, sugary juices.
“Don’t bring foods into the house that you don’t want
your kids to be eating,” Warshaw says.
Help for Diabetes
St. Joseph’s Primary Care Diabetes Support
Program provides diabetes education and support for those without a family doctor or who
live with challenges that make managing diabetes
more difficult, such as poverty. Learn what the
program can do for you at sjhc.london.
on.ca/diabetesendocrinology.
37
3/20/12 2:27 PM
2/21/12 7:13 AM
Life After C
You’ve survived a life-threatening illness.
FdVVSU1200CND_38-41_Cancer_2.indd 38
2/9/12 7:20 AM
r Cancer
Now what?
B
eating cancer is no easy feat. Just ask Jim Drewitz. He
survived cancer not once but twice—first a cancer in
his upper throat and then lung cancer. And he’s grateful for each and every day.
“The fear is always that you’re never going to live as long as
you thought you should,” he says. “Be thankful for what has been
given to you and move on from there.”
That is easier said than done for most cancer survivors. Up until
now, you have had a clear goal—overcome cancer and thrive. Now
that treatment has ended and the time between doctor appointments has grown, you may find yourself struggling to figure out
what to do next. But there is life after cancer. Let our experts—and
real cancer survivors—show you the way.
BY COLLEEN RINGER
Weight gain is common
for breast cancer survivors.
Although no specific reason
has been pinpointed, studies have found strong links
to chemotherapy. With
weight gain, patients risk
further complications that
can affect long-term survival. At St. Joseph’s Breast
Care Centre, nutrition
counselling is an important
part of treatment. Dietitian
Celine Norrington provides
the following tips:
• Reduce your risks by consuming more fruits and vegetables. For females 14 years
and older, seven servings a
day is recommended.
• Incorporate beta-carotene
rich foods like carrots,
sweet potatoes and dark
leafy greens.
• Steam rather than
boil vegetables to maintain nutrients.
• Healthy weight loss is
gradual, involving diet and
physical activity. Losing two
to four pounds a month
is ideal.
oNLINe
.
Reducing
Risk
St. Joseph’s
Breast Care Centre
For more information on the Breast Care Centre
at St. Joseph’s Hospital in London, please visit
sjhc.london.on.ca/breastcare.
39
3/20/12 2:27 PM
2/21/12 7:16 AM
Establish a Follow-Up plan
When cancer treatment ends, it is critical that you
have a follow-up care plan already in place, says Janine
Giese-Davis, Ph.D., associate professor of oncology at
the University of Calgary. Late last year, Giese-Davis
was involved with the launch of a survivor network,
CancerBRIDGES, which is a collaboration between
Alberta Health Services and the university.
“One of the most common complaints for cancer survivors is that they’re not sure what they should be monitoring or what symptoms might be of late side effects,” she
says. But a care plan can solve that problem. What should
be in that plan? Regular medical checkups to test for
recurrence of cancer and to discuss any new symptoms,
and regular screenings, such as Pap tests, mammograms
and colonoscopies.
Your specific follow-up care plan will depend on the
cancer you have survived and the treatment you underwent. But as a guideline, for the first two or three years
after treatment, you can expect to see your oncologist
every three to four months, or, depending on your situation, you may see your primary care physician instead.
After that, appointments are scheduled once a year.
“In the beginning, I had PET scans every three months,”
says Adele Kolinsky, 73, a lung cancer survivor. “Now it’s
once a year. I’m not under the protective umbrella I used
to be under. There’s always that little thing in the back of
your head when you get a little pain. My initial thought is
always I wonder if it’s come back.”
This is often a survivor’s No. 1 fear, says Brenda Sabo,
R.N., Ph.D., president of the Canadian Association of
Nurses in Oncology (CANO), which is why keeping those
annual appointments is so crucial, as is establishing an
open relationship with your physician so you feel comfortable discussing your concerns.
Finding strEngth
in rElationships
62
PER CENT
40
In the past 10 years in
Canada, the survival rate
five years after diagnosis
has increased to 62 per
cent among all cancers.
Not all the aftershocks of cancer are drenched in worry
or concern. Some can be downright positive. For Sandra
Zacharias, 49, her breast cancer diagnosis gave her the
opportunity to make an already close relationship with
her two daughters even closer and teach them a little bit
about inner strength.
“I told my oldest daughter, ‘In life, we’re all going to go
through something. You have to be strong, and you have
to hold yourself together,’ ” she says. “The experience
is going to strengthen them throughout their lives—it
already has.” In fact, it did more than that for her oldest
daughter. It informed her future. After attending chemo
treatments with her mother and seeing the critical role
the nursing staff played, she is now studying to become
an oncology nurse.
Likewise, Kolinsky and brain cancer survivor John
Erickson, 56, both believe that their cancers brought
them closer to their spouses and helped them let go of the
little things. “So you put your toothbrush in the wrong
hole?” Erickson says. “That’s a small thing compared to
dying from a tumour or surgery.”
Kolinsky even went so far as to establish a local support
group, Living Life After Treatment, under the Gilda’s
Club Worldwide umbrella. (Gilda’s Club operates support
groups around the globe.) “As soon as I was able to get out
the door, I was going to the Gilda’s Club meetings because
I needed the support,” she says. “After treatment ended,
2/9/12 7:20 AM
I was in a different place, so I created a new group, and we
meet once a month.”
Now, instead of discussing treatment side effects, the
survivors talk about going back to work and returning to
a new normal.
Coping with Changes
Just as a fight with cancer may strengthen relationships,
it also can throw spousal roles and family dynamics for
a loop.
“When a patient experiences a disease, the family
experiences it together,” Sabo says. “A family member
may pick up a role they may not have had in the past. And
as a survivor, you may not be ready to step back into that
former role, but the family member is expecting you to,
so it could create tension.” The key, she says, is improved
communication and for everyone involved to discuss
emotions openly.
In addition, body image changes can affect both physical and emotional intimacy, putting further strain on a
relationship. A mastectomy, surgery to remove a breast,
can affect the way a woman feels about herself, and for
men, side effects of prostate cancer treatment can include
erectile dysfunction.
If sexual problems are creating a divide, don’t wait
until the situation seems insurmountable, Sabo stresses.
Speak to your healthcare provider. More than likely, he
or she can help with information, medication, medical
devices or some combination.
Know that you are not the only one experiencing these
physical changes and that help and support are available.
Managing Stress and Anxiety
Perhaps one of the toughest burdens survivors carry is
something that can’t be physically measured. It’s the intangible stress that comes the moment the diagnosis is delivered. “The real trick is managing your emotional response
to cancer and living with hope—doing things that improve
and preserve your quality of life,” Giese-Davis says. “It’s a
balance on that edge of fear and hope.”
Your physician may need to prescribe an antidepressant, or you may need to find new outlets for your stress,
such as a new hobby or form of exercise. A good social
worker also can provide guidance.
Drewitz says he believes that survivors should take
time each day to reflect and be thankful for life after cancer. “Once you get to this point, no matter what age, you
have to say, ‘I’ve been given a second opportunity,’ ” he
says. “A very important part of cancer recovery is to find
peace every day.” Aftereffects of
Cancer Treatment
You are probably familiar with the immediate
side effects of certain cancer treatments: the
hair loss and nausea that come with chemo or
the skin changes brought on by radiation. But
what cancer survivors need to be on the lookout
for are long-term, or late, side effects.
“Late side effects arise after completion of
your treatment,” says Brenda Sabo, R.N., Ph.D.,
president of the Canadian Association of Nurses
in Oncology. They may not show up until months
or years after active treatment has ended, and
they can be a result of one or all three main treatment options: chemotherapy, radiation and
surgery. Below are the most common late side
effects. Your doctor can tell you more about
those most likely for your specific therapy.
Chemotherapy
• Decreased heart function
• Altered brain function (chemo brain)
• Infertility
• Premature menopause
• Osteoporosis
• Risk of developing secondary cancers
Radiation (depending on the area targeted)
• Cavities and tooth decay
• Thyroid problems
• Lung issues
• Bladder, bowel or sexual problems
• Skin sensitivity
• Osteoporosis
• Decreased heart function
• Risk of developing secondary cancers
Surgery
• Lymphedema (swelling of an arm or leg)
41
2/9/12 7:20 AM
GET
DAD
DOC
TO THE
Forget dodge ball—men are masters at
dodging the doctor. Here are four common
excuses, and a game plan to counteract them
42
ILLUSTRATION BY JASON FORD
BY STEPHANIE PATERIK
FdVVSU1200CND_42-45_Men3.indd 42
2/9/12 7:20 AM
D
IllustratIon by Jason Ford
oes the man in your life avoid going to the doctor like, well, the
plague? It’s not uncommon for men to skip routine visits. But the
consequences of ignoring their health could be detrimental.
“Going to the doctor can’t guarantee you won’t get sick,” says
Dr. Steven Jonas, co-author of Help Your Man Get Healthy: An Essential Guide for Every
Caring Woman. “But it can guarantee a reduction in your risk of getting cancer, heart
disease, stroke, emphysema and pneumonia.”
Canadian men live five years fewer than women, with an average life expectancy of
79 versus 84. And the top causes of death for men are cancer and heart disease, which
often can be treated or prevented if caught early.
Chances are, you know a guy who refuses to see a physician. If “Dodge the Doc”
were a sport, men would be No. 1. They have a bevy of excuses in their gym bags. We
examine four common excuses, and suggest a game plan for getting Dad to the doctor.
43
2/9/12 7:20 AM
ExcusE: “I Feel FIne”
Some guys feel good on a day-to-day basis. They
see themselves as strong, capable and active, so
why bother with the doctor?
“In today’s society, men tend to be kind of
macho and feel like they are not vulnerable to
disease,” says Dr. Jeffry S. Life, a men’s fitness
expert and author of The Life Plan. “They don’t
always think at an early age about little things
they can do that will preserve quality of life and
prevent disease.”
Game plan :
When a warning light appears on your car’s dashboard, the damage is already done. Similarly,
by the time your body feels run down, it can be
difficult to fix.
Life-threatening conditions take root in a
man’s early years, so the sooner you pay attention
to your health, the better, Life says.
“Heart disease starts when people are in their
20s and teens. It starts early, and if it’s diagnosed early, it can be stopped and reversed,” he
says. “The key to preventing heart attack and
stroke is to diagnose it early on and [make] lifestyle changes that will reverse the progression of
the disease.”
Your physician can help you spot and prevent
many deadly diseases, including heart disease,
cancer, stroke, diabetes, respiratory problems,
pneumonia, depression and suicide. Simple
steps like getting flu shots, checking blood pressure and cholesterol levels, and monitoring your
weight can lengthen the life of your engine.
ExcusE:
“I don’t have tIme”
So, he knows he should see a doctor. The problem is he can’t find the time. After all, he may be
working and caring for young children in addition to elderly parents. To complicate matters, the
doctor’s office is far away.
Men skip the doctor because they just can’t
fit it into their schedule, according to Movember
Canada, a foundation that raises money and
awareness for men’s health.
Game plan :
First, it’s important to find a doctor’s office that is
convenient for you. Choose one close to work, for
example. And remember, the reward for carving
out a little time for your health now may be a lot
of time in the future, plus the energy to enjoy it.
“I’m 73 and physically better than I’ve ever
been,” says Life, who adopted a healthy routine after a sobering cardiologist appointment.
“Exercising, eating right and correcting hormone
deficiencies make such a difference in how I feel.
That’s the driving force for me and the driving
force for my patients.”
ExcusE: “I don’t
want to talk about It”
Women are more comfortable talking about their
health. They have been getting annual exams
since they were 18, they read health magazines,
they chat about personal issues with girlfriends—
it’s part of their culture, says Maria Regan,
co-author of Help Your Man Get Healthy.
“In contrast, men’s conversations tend to
revolve around face topics like work and sports,”
she says. “They don’t want to share anything that
makes them feel like they’re in a weaker position
or they have a problem.”
44
2/9/12 7:20 AM
ExcusE: “exams are
so uncomfortable”
No one enjoys disrobing to be poked and prodded
by a near-stranger. Plus, men are encouraged to
get prostate exams and colonoscopies at 50, and
that sounds unpleasant.
Game plan :
One of the most important things a man can do
is find a general practitioner whom he trusts and
feels comfortable with. This will put him at ease
and might lead to better medical outcomes.
“Prostate cancer is one of the most common
cancers in men,” Jonas says. A rectal exam at
your checkup can help find this disease, and
detecting cancer early is key to survival.
Advances in medical equipment have made
colonoscopies much more comfortable than
they used to be as well, Jonas adds. It’s important to talk with your doctor about when and
how often to get screened, because it varies for
each person.
And if something does make you uncomfortable, talk to your doctor about your concerns.
Prostate Health
Prostate cancer is the most common cancer among Canadian
men (excluding non-melanoma skin cancer). In 2011, it’s estimated that, on average, 70 Canadian men were diagnosed with
the disease each day. Annual testing is critical as the disease is
often without symptoms in its earliest, most curable stage.
Today, ultrasound imaging is playing an important role in
diagnosing prostate cancer. At the Diagnostic Imaging Centre
of St. Joseph’s Health Care London, more than 800 ultrasound
prostate exams are performed each year. The images help
urologists detect disorders within the prostate and determine
whether the prostate is enlarged or if there is an abnormal
growth within the gland.
Because ultrasound provides real-time images, it also can
be used to guide various procedures, such as needle biopsies.
Increasingly, St. Joseph’s is playing a key role in performing
ultrasound-guided prostate biopsies in which a needle is used
to take tissue from an abnormal area in the prostate for testing.
More than 450 prostate biopsies are now performed annually
at St. Joseph’s, and the need continues to grow.
online
Game plan :
It’s easier for a guy to avoid a problem if he doesn’t
talk about it, says Life, adding, “I think that’s definitely part of a male psyche—they’d rather not
know. It’s a tragic way of thinking.”
A physician will ask how often you smoke,
drink, eat vegetables and exercise, and about
your family’s medical history. Simply starting
this conversation usually can help you identify
positive goals. This leads to action, and action
leads to empowerment. That’s something even
the strong, silent type can appreciate.
Jonas says he experiences this when managing
his own health. When he suffers running injuries, the simple act of calling a doctor makes him
feel better because he knows recovery is in sight:
“I call it therapeutic appointment making.”
Learn More
To learn more about the urology and imaging expertise
at St. Joseph’s Hospital, visit sjhc.london.on.ca.
To find out more about men’s health, Health Canada
and the Public Health Agency of Canada have many
online resources. Go to hc-sc.gc.ca/hl-vs/jfy-spv/
men-hommes-eng.php#a2.
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3/20/12 2:27 PM
2/21/12 7:17 AM
Virtual HealtH
by Carey rossi
It’s Not Just a Game
L
ate last year, gamers snagged headlines. In a span of
three weeks, players mapped the structure of a protein
enzyme that plays a key role in how the AIDS virus
reproduces. In comparison, researchers have been
working on this project for more than a decade.
How did the gamers do it?
By playing Fold.it, an online game produced by the University
of Washington that presents complex puzzles that attempt to
unlock the protein structure of diseases and other substances.
Because proteins are a part of so many diseases, knowing their
structure can help develop drugs that target them better.
According to the game’s website, “Players can design brandnew proteins that could help prevent or treat important diseases.”
It works. Four scientific peer-reviewed papers list Fold.it gamers as authors, and this just may be the beginning. A number of
puzzles are left to be solved. Just think, your gaming abilities could
create the next big health headline.
Post Your
Progress
46
Change Is Good
When Facebook changes its layout, your news feed is wrought with
complaints. What’s the big deal?
Humans are creatures of habit by nature, and when things don’t go
as planned or as we predict, we view this as a threat. Apparently, we find
pleasure in our cocoon of predictability. According to a recent article
in Psychological Science, people who already knew the ending of a story
before reading it enjoyed the story more. This could explain our love of
television reruns and watching movies again and again. If, however, we
always gravitate toward the familiar, it can make us rigid and inflexible.
So go ahead, embrace your favourite website’s new look or check out
a new television show this summer.
App And GAmInG pHoToGrApHy by THInkSTock
If you’re having a hard time sticking
to your health goals, consider linking up with like-minded members of
Facebook, Twitter or Flickr or programs
such as Weight Watchers. According
to two studies published last year in
the Journal of Medical Internet Research,
people with health concerns who used
online programs were more likely to be
successful if those programs gave the
users confidence in their ability to make
healthy changes.
Both studies concluded that improving
social support, \outcome expectations
and self-regulation is what led to healthier habits.
FdVVSU1200CND_46-47_Virtualb.indd 46
2/9/12 7:21 AM
Finding the Words
Speech language pathologists (SLP) at St. Joseph’s Parkwood Hospital are finding innovative ways to use iPod and
iPad apps to help patients participate in therapy activities and express their thoughts. One iPod communication app
called “My Talk Tools” has been successful with a young woman with aphasia, a disorder that impairs the expression
or understanding of language. With this app, SLP Becky Orenczuk programmed phrases into the patient’s iPod such
as “I had a stroke. I can understand you but I can’t always say what I want to say—please be patient,” or “I’ll have a large
double double.” For extra therapy help, meanwhile, an app called “SmallTalk Aphasia” shows a video of lips moving
and making the shapes of sounds and words. This type of therapy app enables patients to practice their skills on their
own, complements the therapy from SLPs, and brings patients a new level of independence.
Apps a Plenty
S
Let’s face it. Your smartphone is a computer. It’s just
smaller and cooler. And application developers the world
over have found ways for it to help you be healthier.
Here are a few of our favourite apps:
naP26: Twenty-six minutes is the perfect amount of time to nap,
according to NASA. In fact, it could increase your alertness by
54 percent! This nap app will guide you through a perfect power
snooze based on this principle. NAP26 lulls you to sleep using
sound vibrations that match natural sleep patterns, and then
wakes you after 26 minutes. Available at www.nap26.com.
instant Heart rate: As your heart beats, it brings oxygenrich blood to the fingertips, which causes an almost imperceptible change in colour. The Instant Heart Rate app monitors these
colour changes to determine your overall heart rate by having
you hold your index finger lightly over the camera on your smartphone for 10 seconds. Available at www.instantheartrate.com.
OnLIne
App And GAminG photoGrAphy by thinkstock
Calorie Count: Food journalling can help you keep extra
weight off, but logging your meals can be a chore. With this app,
it’s easy with a database of more than 40,000 foods. Using a
simple calories-in, calories-out measure, a graphic balance scale
keeps you in check. Available at http://mobile.viaden.com/caloriecounter-free.html.
Get Moving
Celebrate your health and let your healthy feet
carry you across the finish line! Running (or walking) a 5K is a great way to exercise, spend time
with friends and even support a good cause.
Find one near you at eventsonline.ca.
FdVVSU1200CND_46-47_Virtualb.indd 47
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3/20/12 2:27 PM
2/21/12 7:19 AM
One size
fits all?
No way
Just like the men it affects, every case of prostate
cancer is different. And multiple treatments are available.
Ask your doctor about all of them before you decide which is best.
vim&
DOWNLOAD
SIGN-OFF
VV_
PSA_CAN_Prostate.indd
10
____la__ ART
___sf____EDIT
3/26/12 10:46 AM
By Anne KAy
Virtually Fit
Video conferencing at Parkwood Hospital is giving people
with a spinal cord injury an opportunity for exercise, nutrition
counselling and social interaction
T
ucked away in a research lab in St. Joseph’s
Parkwood Hospital, Chris Fraser is leading
seated aerobics classes for people in London
with a spinal cord injury (SCI). Fraser is there,
but the people aren’t. They’re exercising in the comfort of
their own homes.
Video conferencing exercise classes tailored for people
with quadriplegia or paraplegia is an innovative research
project under way with Lawson Health Research
Institute’s SCI group. Known as OPAN (Online Physical
Activity and Nutrition Counselling Project), the project promotes physical activity and provides one-on-one
nutrition counselling.
Fun and Motivating
Exercise has many benefits for those with a spinal cord
injury, including the prevention of secondary health complications and improved well-being. But obtaining these
benefits and overcoming barriers, such as distance and
access to fitness programs, can be difficult without the
right support. To address these issues, the SCI research
group is making in-home telehealth and ehealth one of its
priority research areas.
In the OPAN study, those with an SCI participate in
real-time seated aerobics classes using a webcam and
video conferencing from their home computers. “The
classes are interactive,” says instructor Fraser, a registered
dietitian at Parkwood and avid physical fitness instructor.
“The participants can talk to me and to each other during
the classes—we have fun and motivate each other.”
The classes are also a great opportunity for social interaction, with lots of discussion before and after the classes,
she adds. If participants want to discuss physical activity
or nutrition counselling, Fraser provides it through oneon-one video conferencing outside of class time.
Participants are closely monitored during the workout
through heart rate and blood pressure monitors provided
by the study.
At St. Joseph’s Parkwood Hospital, Chris Fraser, centre, leads a virtual fitness
class through teleconferencing while Bonnie Chapman, left, monitors the
music and Kelly Evoy, right, keeps an eye on the broadcast for technical issues.
Participants can be seen on the TV screen in the background.
For each segment of the project the classes are offered
twice a week for nine weeks. After the segment, participants receive a USB drive with a recording of the classes
so they can continue exercising on their own.
getting Results
Participants are surveyed regularly to determine if the
OPAN classes are increasing their physical activity outside of the classes.
“I love having accessibility to a program like this—it
makes me exercise more,” says one participant. Another
has commented that “it’s very encouraging how these
classes are increasing my stamina.”
The SCI research group developed the OPAN study
in collaboration with SCI Action Canada and with funding from the Rick Hansen Institute. Once the feasibility
of OPAN is determined, the SCI group hopes to offer the
program more broadly to those with an SCI injury.
Vim & Vigour • SUmm er 2012
FdVVSU1286_49_virtually fit.indd 49
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GIVING AGING J
Researchers at St. Joseph’s Hand and Upper Limb Centre have
embarked on exciting work in mechatronics to improve joint
replacement outcomes for patients.
BY KELSI BREAK
A
s baby boomers enter their senior years and feel
the effects of aging, so too do their tired shoulders, wrists and elbows. In fact, worn out joints
of active baby boomers are fuelling a giant
wave of joint replacement surgeries, along with research to
improve how those new joints perform. At the leading edge
of this work is the Hand and Upper Limb Centre (HULC) at
St. Joseph’s Hospital in London, where experts are breaking
new ground to ensure patients can enjoy many fit and healthy
years ahead.
Although highly successful, joint replacement surgeries
are technically challenging, requiring expert precision. For
example, shoulder and elbow implants can quickly wear out
if not perfectly aligned with the axis of the joint. With wear,
particles can be ground off the implant and cause degenerative or rheumatoid arthritis, requiring patients to undergo
more surgery to repair damage.
At HULC, researchers have set their sights on developing new technologies that will improve a surgeon’s accuracy
when performing procedures like joint replacements. A new,
state-of-the-art surgical mechatronics laboratory is bringing
together engineering and medicine to advance leading-edge
work in robotics and surgical simulation.
ENHANCING PATIENT CARE
Mechatronics is an evolving science that allows for less
invasive, more accurate procedures and better outcomes for
patients, explains HULC director Dr. Jim Roth. “Robotic technology through medical mechatronics has many advantages
but its purpose is to enhance patient care,” he says. “This
includes reducing recovery times, decreasing patients’ length
of stay in hospital, less pain post-surgery, smaller incisions,
and extended longevity of joint implants.”
Use of these advanced technologies in surgery can also
mean less rehabilitation for patients “and ultimately a speedier return to normal life and the workforce,” adds Dr. Louis
Ferreira, co-director of HULC’s bioengineering research lab
and surgical mechatronics lab.
50
Dr. Louis Ferreira, co-director of both the surgical mechatronics
and bioengineering research labs at the Hand and Upper Limb
Centre at St. Joseph’s Hospital, uses an apparatus that simulates
the motion of a shoulder. The equipment helps to evaluate the
effects of surgical procedures.
FdVVSU1286_50-51_mechatronics2.indd 50
3/20/12 2:27 PM
G Joints New Life
s
s
This conceptual illustration is of a computer-assisted
shoulder replacement procedure, just one minimally
invasive technique that will be perfected at the surgical
mechatronics laboratory in the Hand and Upper Limb
Centre at St. Joseph’s Hospital.
Global Reach
Founded in 1992 as an innovative collaboration between
orthopedic and plastic surgery, HULC is an acclaimed training ground for surgeons around the world—a tradition that
will reach new heights with the surgical mechatronics lab.
online
Research done in the surgical mechatronics lab will
include: design of advanced, three-dimensional computer
navigation equipment for use in surgery; designs for surgical simulation systems; and development and testing of
smart implant devices that can take readings of the body
and relay information back to a computer.
The simulators will virtually reproduce surgeries
while tracking the motion of the surgeon’s hands and can
be used to practice techniques on cadavers before surgeons
perform those surgeries on patients in the operating room,
says Dr. Ferreira.
“There is an urgent need for simulators designed specifically for the challenges of orthopedic surgery and,
in particular, for systems able to duplicate the experience of cutting and drilling into bone,” says Dr. Ferreira.
“Engineers will be partnered with surgical residents to
include both perspectives on each project.”
Engineering students, surgical residents and graduate
students, along with seasoned surgeons, will have access
to tracking system equipment, surgical simulators and
mid-sized robotic arms.
In the future, Dr. Ferreira, in collaboration with Dr.
James Johnson, co-director of the HULC bioengineering
lab, hopes to develop devices that can be used in operating rooms around the globe.
“Research like this is paramount to the evolving world
of health care and health care technology. There are
many technologies and procedures that are currently
being used in other areas of surgery such as cardiac and
neurosurgery that could be modified for use in orthopedics. What we develop in the surgical mechatronics
lab and apply to patients at HULC may ultimately help
surgeons in smaller centres that don’t have access to
advanced equipment.”
This exciting work at St. Joseph’s complements a
broad focus in London on surgical simulation and
medical device development that is attracting attention
around the world.
Learn More
Every year at the Hand and Upper Limb Centre
(HULC) of St. Joseph’s Health Care London,
more than 30,000 patient visits are made to
the clinic, there are 14,000 visits for therapy,
and 3,800 surgical cases are performed in
operating rooms and the clinic. For more
information on the work of surgeons, therapists and scientists at HULC, please visit
sjhc.london.on.ca/hulc.
Vim & Vigour • SUmm Er 2012
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3/20/12 2:27 PM
TAKING
TECHNOLOGY
IN HAND
Innovations in mental health care in the London area are
propelling rehabilitation in new directions. On these pages, read
about two exciting projects under way.
Getting ‘Smart’
BY SONYA GILPIN
F
or mental health care patients living in the
community, accessing ongoing care can be challenging. Home is where the heart is, but it’s not a
hospital. With a “smart” new strategy, however,
Lawson Health Research Institute’s Dr. Cheryl Forchuk
hopes to better connect patients with the support
they need.
OVERCOMING
THE BIGGEST LIMITATIONS
The acclaimed researcher is partnering with TELUS
Health Solutions in the Mental Health Engagement
Network (MHEN) project that uses smartphones and
Web services to connect patients to their health team no
matter where they are.
“Some of the biggest limitations to community mental
health care are time and travel,” Dr. Forchuk explains. “It
can be difficult for patients to put their entire day on hold
for a checkup. This means many people don’t seek help
until they’re already in crisis.”
Through the MHEN project, each patient will receive a
smartphone and a TELUS “Health Space” personal health
record (PHR). Unlike traditional paper records, the PHR
is loaded with interactive tips and tools to help patients
manage their daily needs. Prompts and reminders are
built in to reflect each individual care plan. Medication
schedules and instructions are updated dynamically to
keep patients on track. When it’s time for a prescription
refill, the PHR sends a friendly reminder.
1
52
As well, mood monitor
tools provide daily “checkups.” If a patient’s mood
starts to waver, the PHR triggers a personalized reminder
to boost the individual’s spirits. This could be anything
from taking a walk to phoning a friend.
Patients are also linked
directly to their care providDr. Cheryl Forchuk’s project will use
smartphones and Internet technology
ers, who are each equipped
to help patients access mental health
with a tablet to monitor
services.
progress remotely. They can
send text messages back and
forth, and share health status updates. “This project does
a lot of things we’re already doing, but improves them by
taking advantage of the technology now available to us,”
explains Dr. Forchuk.
A MODEL FOR OTHER COMMUNITIES
Over the next year, Dr. Forchuk and her team will follow
400 patients and 50 care providers from St. Joseph’s
Health Care London, London Health Sciences Centre
and community agencies.
By providing virtual access to health care information,
Dr. Forchuk hopes to empower patients to take control
of their health. If successful, the MHEN project could
become a model in communities across the country.
FdVVSU1286_52-53_mentalhealth2.indd 52
3/20/12 2:27 PM
Making
Connections
2
BY RENEE SWEENEY
A
s she pushes the button to turn on the new
laptop, Suzanne becomes visibly engaged.
Her face lights up, her posture straightens,
she moves her chair closer and prepares to
enter cyberspace.
A resident at the Steele Street group home in St.
Thomas, part of St. Joseph’s Regional Mental Health
Care, Suzanne is one of nine people receiving mental
health rehabilitation therapy in the residence, and she
can’t wait to read today’s latest news on the Internet. It’s
all part of her journey to recovery.
Wireless Internet access, a laptop, a desktop computer, and various mobile devices such as an iPod, an
iPad, and a cellphone are all part of an innovative project that is integrating technology into recovery plans for
Steele Street residents. The research project is the brainchild of Jackie McAdams, an occupational therapist at
St. Joseph’s Regional Mental Health Care. It was given
the green light, and a $5,000 grant, through St. Joseph’s
President’s Grants for Innovation, a program that invites
staff to apply for funding for innovative ideas that will
improve quality of care.
TREMENDOUS IMPACT
In McAdams’ project, residents are given the opportunity to learn to use a piece of technology that can assist
them with their goals and recovery. For example, tablets
that can provide cooking instructions and easy-to-locate
recipes, or iPod applications that remind patients when
it’s time to take medication, can be valuable tools for individuals with mental illness.
“In today’s world, basic technology and computer skills
are life skills,” explains McAdams. “Individuals who
are learning to cope with mental illness should have the
opportunity to develop these aptitudes, allowing them
to connect with and participate in the wider community,
optimize functioning and maximize independence.”
The impact as the residents are exposed to technology
has been tremendous, she adds. “We’ve seen residents
who were previously afraid to leave the house due to anxiety now able to venture out because they have learned
Nina Caughill, a nurse at the Steele Street rehabilitation group home
in St. Thomas, part of St. Joseph’s Regional Mental Health Care, assists
resident Suzanne as she learns to navigate the Internet.
how to use a cellphone and know that a member of their
care team is just a text or phone call away.”
AN ACTIVE ROLE
Marxy is another Steele Street resident who, through
learning how to use social media, reconnected with long
lost friends and relatives. Originally from Honduras,
Marxy moved to Canada with his family in 1992. When
admitted to hospital in 2008 for mental health treatment,
he lost contact with his family members, who were not
supportive of his illness and recovery.
Today, as his rehabilitation progresses, he is able to
take an active role in his own recovery. Learning how
to download Spanish music and communicate online
with others who speak his language has allowed Marxy
to once again experience a connection to his culture
and community. Through the Internet, he is also able to
research ways to reduce his anxiety and panic attacks,
sharing what he learns with his care team.
Most significant to his recovery, says Marxy, was
being able to connect with his estranged father through
Facebook, a relationship he hopes to rebuild as he continues on his journey of rehabilitation.
Experiences like Marxy’s are just the tip of the iceberg, says McAdams. “The use of technology is integral
in the future of mental health care. The opportunities
are endless.”
FdVVSU1286_52-53_mentalhealth2.indd 53
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3/20/12 2:27 PM
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 …
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.
54
an ImPressIve HosPItal
Andy Morton, hand therapist in the Hand and
Upper Limb Centre at St. Joseph’s Hospital
Kudos a’Plenty
I’d like to kudo and compliment the following
St. Joseph’s staff:
• Dr. Ruby Grewal and the surgical team in
the Hand and Upper Limb Centre for their
superb efforts on and after my August 22,
2011, right-elbow repair. I truly appreciate both their excellent technical skills and
warm, empathetic support.
• Linda, Dr. Grewal’s “girl Friday,” who has
been invaluable in helping me with various
follow-up appointments. She’s always been
so very cheerful, polite, patient and helpful.
• Also, max-kudos go out to various nurses
on Dr. Grewal’s team for their TLC treatment
and quality of care given to me.
Finally, one last set of max-kudos go out
to hand therapist Andy Morton in the hand
therapy clinic. Andy was always full of
encouragement, technical feedback, clinical
advice and emotional support to me during
my recovery process. I greatly admire his
technical skills, warm persona and abiding
commitment to my overall care.
Cheers and sinceres,
Thomas E. F. Testa
London, Ontario
I recently accompanied my father-in-law for
his eye surgery at St. Joseph’s Hospital. This
was my first visit to your facility. I must say
that I have never been so impressed with a
hospital. Here are a few reasons why:
• The staff and volunteers were so friendly
and helpful.
• We stayed two nights at the housing you
offer and it was so affordable and handy.
This is a great service to offer.
• The hospital was so clean and modern
looking even though it is an old facility. You
have done a great job renovating.
• The patient safety protocols are obvious,
thorough and consistently followed by everyone. You obviously did a great job developing
them and training the staff.
• The wait times were so manageable. Each
step in the process required the minimum
amount of waiting.
Thanks for your efforts to create and
maintain such a great facility.
Steve Taylor
Burlington, Ontario
The state-of-the art Ivey Eye Institute at St. Joseph’s
Hospital is among many new spaces being enjoyed
by patients, visitors, staff, physicians, researchers and
students.
Vim & Vigour • S u m m e R 2 0 1 2
FdVVSU1286_54_patient letters.indd 54
3/20/12 2:29 PM
BUSTING a Move
A fitness extravaganza becomes part of the fight
against breast cancer at St. Joseph’s Hospital
BY JENNIFER PARRAGA
F
Participants get into
the groove at Bust a
Move in Halifax. The
event is coming to
London in March 2013.
EVENT
or six hours, on one day, 700 people will
take part in an experience of a lifetime.
They will be part of a movement that is
helping to change the way women facing a
diagnosis of breast cancer receive care.
They will be “busting a move” for breast health.
On March 2, 2013, St. Joseph’s Health Care
Foundation will launch its first-ever Bust a Move™
for breast health event to raise more than $500,000
in support of St. Joseph’s new Breast Care Centre.
The fitness extravaganza
is a first for London and
will be pivotal in the fight
against breast cancer for
women, and men, across
the region.
Just how will Bust a
Move work? It’s a team
event during which participants will get their
groove on by taking part in six hours of energy-filled
and fabulous fitness sessions. With breaks scheduled between each session there is plenty of time to
eat a snack, refill water bottles, take in exhibits at
the event, and enjoy time with team members or fellow participants.
There will be prizes, healthy snacks, refreshments
and lunch, volunteers to look after participants’ every
need, massage therapy and first aid to ensure safety.
“We are so excited to be presenting Bust a Move for
breast health,” says Michelle Campbell, foundation
president and CEO. “It is an exhilarating event that
empowers the community to make a difference and
really enjoy themselves at the same time. We can’t
wait for event day.”
If you like to dance, groove or just “Bust a Move,”
join in!
Get Your Groove On
It’s easy to register for Bust a Move. Simply visit the
St. Joseph’s Health Care Foundation website and, over
the next five months, raise a minimum of $1,000
(per person). Then gear up for an exciting day full of fun,
fitness and inspirational moments.
When: March 2, 2013.
Opening ceremonies begin at 9 a.m.
Where: Western Fair District, Agriplex Centre,
845 Florence St. in London
For more information: To view the Bust a Move
video, register for the event or learn more about volunteer opportunities, visit sjhcfoundation.org.
FdVVSU1286_55_Bust_a_Move_for_breast_health_pg.indd 55
55
3/20/12 2:29 PM
INSPIRED TO GIVE
Teens in Action
BY JENNIFER PARRAGA
AND JOHANNA MESJARIK
Two special donations to St. Joseph’s touch many
CALL
You Can
Help
Find out how you
can make a difference to health
care in the London
region. Visit sjhc
foundation.org
or contact Kathleen
Mendelin at 519
646-6085.
Teacher Rebecca McDonald,
left, and students Shelby
Mackenzie and Chelsea Read
of Medway High School
present a cheque to Anne
Marie McIlmoyl, director
of perioperative services
at St. Joseph’s Health Care
London. The donation will
go to St. Joseph’s Breast
Care Centre.
56
T
hey may be part of the “Me Generation”
but three London area teens are
proving they don’t fit the stereotype
of being self-absorbed or socially
unaware. Motivated for different reasons and
important people in their lives, all three recently
turned their minds and hearts to helping people
struggling with illness and injury. Inspiring
many along the way, they have made very special
donations to St. Joseph’s Health Care London.
Here are their stories:
CLASS PROJECT GOES BIG
The loss of a beloved teacher inspired Shelby
Mackenzie and Chelsea Read, two Grade 11 students from Medway High School in Arva, to
take their leadership class project to a whole new
level—raising more than $2,500 for St. Joseph’s
new Breast Care Centre.
As part of their original class project, the
students were asked to find a school or community endeavour that would showcase their own
leadership ability. Mackenzie and Read chose to
participate in a local run in support of breast cancer awareness. They then raised funds by organizing a “Pink Ribbon Day” during which they
went class-to-class sharing information about
breast cancer, distributing 1,200 pink ribbons
they crafted with the help of their classmates and
collecting donations.
Jordann Campbell with her dad, Steve, at St. Joseph’s
Parkwood Hospital.
Going one step further, the girls went on to
sell more than 620 pairs of pink breast cancer
mittens to classmates, teachers and a local primary school.
“We never dreamed of doing something to
this scale,” says Read. “We never thought it
was possible.”
A DAUGHTER’S LOVE
This past year, Jordann Campbell decided to
give up birthday presents. Invitations to her 13th
birthday pool party came with a special request.
She asked each of her guests to forgo a gift for her
and instead make a donation in support of spinal
cord research at St. Joseph’s Parkwood Hospital.
What would inspire such a selfless act? For
Campbell it was the love of her father, Steve.
The devoted dad has a spinal cord injury.
During a family holiday, Steve was enjoying
mountain biking with his son when he performed a manoeuvre on an apparatus at a bike
park. The bike flipped over and he landed on his
head. Unable to move, he was airlifted to hospital
in London and would eventually spend five arduous months in Parkwood’s spinal cord injury
rehabilitation program.
Having seen first-hand the benefits of research
at work as her father recovered, Campbell is
committed to helping people living with a spinal cord injury. Her birthday party raised more
than $330 for St. Joseph’s, and she’s not stopping
there. Already, the generous teen is planning her
next fundraising event.
FdVVSU1286_56_Inspired.indd 56
3/20/12 2:30 PM
Because 1 in 9
women will be affected...
...and support St. Joseph’s
new Breast Care Centre!
On 1 day, for 6 hours, 700 women and
men will bust-a-move – and change
the lives of thousands in the process.
Register a team, support a friend, or
make a donation – get all the details at
sjhcfoundation.org
March 2, 2013 | Agriplex, Western Fair District, London
CARING FOR THE BODY,
MIND & SPIRIT SINCE 1869
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.
FdVVSU1286_C3_Bust-A-Move_Ad.indd 3
sjhcfoundation.org
3/20/12 2:30 PM
268 Grosvenor Street
London, ON
N6A 4V2
Please return Canadian Addresses to above address
2.125” AREA FOR PRINTING
OF MAILING INFO
2012 ST. JOSEPH’S TRIBUTE DINNER
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SUR VATION
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DAY 2
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TICKET
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519 64 ndation.org
sjhcfou
A SPECIAL PERFORMANCE BY NATURALLY 7
FdVVSU1286_C4_ad.indd 4
3/26/12 9:55 AM
CLIENT
JOB DESCRIPTION
DATE
TIME
DESIGNER
ACCOUNT REP

Summer 2012 - St. Joseph`s Health Care London

Transcription

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