Ray Sanchez, Chief Operating Officer, Victoria Hospital

June is Men’s Health Month, and Victoria Hospital is committed to the men of Fort Richmond.  You are our friends, neighbours, husbands, fathers, brothers, and staff members.  Because we value you, we want you to be healthy.  This will, however, require some action on your part!

Stereotypically men are resistant to seeing doctors and dismissive of healthy lifestyles. According to researchers, the cause is partly because of gender scripts – it is not “macho” to attend to health matters.  It’s 2023. Let’s flip the script and help you get the most out of life.

The leading cause of death in Manitoba men is cancer, and three types in particular:  lung, prostate, and colorectal.  The second leading cause of death is heart disease.  Fortunately, you can take many steps to prevent these diseases or catch them early enough to improve outcomes.  We’ve got 10 tips for you.  Are you already doing them? Bravo!  If not, please consider them.  Every step you take improves your odds.

1. Eat a healthy diet low in processed food and charred meat, and high in vegetables and fruit. Aim for 5-8 servings of fruit and vegetables daily.
2. 2.5 hours of exercise weekly reduces the likelihood of cancer and heart disease. Try 5 days/week for 30 minutes.
3. Maintain a healthy weight.  If you are over your ideal weight, note that even a modest weight loss (5% of your weight) significantly reduces your health risks.
4. If you are a smoker, get help to quit.  Smoking doesn’t just cause lung cancer; it is also linked to prostate and colorectal cancers.
5. Test your house for radon, which can cause lung cancer.  It is easy: just do a web search for “radon testing in Manitoba.”
6. Have a family doctor or nurse practitioner.  See them regularly for prostate screening.  They will also check your blood pressure, cholesterol, and blood sugar for silent signs of heart disease and diabetes.  How often should you go?  Go once and ask them.
7. Drink less alcohol.  According to Canadian researchers, the ideal quantity is two drinks per week or less, and risk rises beyond that.  But they also note that any reduction results in lower risk.
8. Make sleep a priority.  Less than 7-8 hours nightly increases your risk of heart disease, colorectal cancer, and diabetes. 
9. If you are between 50 and 74, sign up for the ColonCheck program through CancerCare Manitoba.  Every two years they will screen for blood in your stool.  This simple test reduces deaths from colorectal cancer by 25%.
10. Care for your mental health.  Stress impacts many aspects of health including your cardiovascular system. Historically men are less likely to seek mental health care (again, gender stereotypes) but we can change this. Not ready to talk? A great place to start is the HeadsUpGuys.org website from British Columbia.

Invest in yourself and your future.  Do it for you, and for the folks who love you. Pick one idea and get started this month!    

Doris Dong, Director of Mental Health
Victoria Hospital

You probably do specific things to care for your physical health: regular check-ups, vaccines, exercise, and healthy eating are common steps we take to feel good, enjoy life, and live longer.  We put in the effort because the research and our experience tell us these things work. But don’t stop there!  We should also take steps to protect our mental health.  Here are several ways to care for our mental well-being:

1. Get regular exercise:  We think of exercise as a way of managing our weight and keeping our heart healthy, but exercise also prevents anxiety and depression. 
   
2.  Get your sleep:  Insufficient sleep also creates a risk for anxiety and depression.  Getting enough sleep gives your brain time to rest and stay healthy. Different folks need different amounts of sleep, but most adults need 7 to 9 hours per night.
   
3. Develop strategies for stressful times. We all experience stressful times, and failure to manage that stress can lead to both physical and mental illnesses.  There are many ways to manage stress – some healthy and some not so healthy.  We recommend trying a wide variety of healthy strategies to find your favourites.  Common strategies include meditation, spending time in nature, journalling, aromatherapy, yoga, and spending time doing hobbies.
   
4. Find a friend.  Friendships promote good mental health in many ways: they boost happiness and self-confidence, provide support during difficult times, increase feelings of security, and help put problems into context.  If you are lucky enough to have trusted friends, nourish those relationships.  If you haven’t found your friends yet, make a concerted effort to establish relationships with people who bring you happiness. Remember that positive, healthy friendships are good for you, but relationships full of conflict, hostility and inequity can impact you negatively.
   
5. Try volunteering. When you volunteer, someone else benefits.  But volunteering also makes us happier! It seems this happiness comes from knowing we’ve made a valuable contribution, but also from the social connections that develop.  Try it!
   
6. Set reasonable expectations. Setting unreasonable expectations, then failing to meet them, causes unhappiness.  We don’t need to be perfect, so focus on achievable goals.  As Jane Fonda said: The challenge is not to be perfect – it is to be whole.” Treat yourself with kindness, patience, and compassion.
   
7. Get help if your strategies aren’t working. Remember that seeking help is a sign of strength.  If you are struggling, please reach out to your family doctor or one of the provincially funded mental health agencies (found here: https://www.gov.mb.ca/mh/mh/crisis.html).  A little help from the right resources is often just what you need to restore good mental health.

Every one of us deserves to enjoy good mental health, but sometimes it takes a little work.  The effort is worth it when the quality of your life improves. Give these strategies a try and see if you can maximize your enjoyment of life!

Sources:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1470658/

https://www.columbiapsychiatry.org/news/how-sleep-deprivation-affects-your-mental-health

https://www.nhlbi.nih.gov/health/sleep-deprivation/health-effects

https://www.educba.com/stress-management-strategies/

https://www.webmd.com/mental-health/psychological-benefits-of-friendship

https://commons.und.edu/cgi/viewcontent.cgi?article=1019&context=psych-fac

https://greatergood.berkeley.edu/article/item/how_volunteering_can_help_your_mental_health

https://www.webmd.com/mental-health/mental-benefits-of-volunteering

Overview of the Research

There has been a surge in research publications lately about our favourite morning beverages, and the findings suggest that tea and coffee may help us live longer, healthier lives.  Here is a quick overview:

• An article published in Annals of Internal Medicine in May 2022, found that people who drink coffee (either unsweetened, or sweetened with sugar) were likely to live longer than those who didn’t drink coffee, or drank coffee with artificial sweetener. The protective effects were most evident in people who drank 2-4 cups per day.  
• A study published in PLoS Medicine in November 2021 found a link between tea and coffee consumption and a reduction in strokes and dementia.  Compared to those who did not drink tea or coffee, drinking 2-3 cups of coffee, and 2-3 cups of tea per day was associated with a 32% lower risk of stroke, and a 28% lower risk of dementia. 
• A study published in Annals of Internal Medicine in September 2022 found that people who drink 2 or more cups of black tea daily lived longer and were less likely to die from cardiovascular disease. 
• A study published in the Journal of Preventive Cardiology in September 2022 found that people who drink 2-3 cups of coffee daily had significant reductions in the incidence of cardiovascular disease.
• Other studies have suggested that coffee may be good for your liver, may lower your risk of Parkinson’s Disease, and reduce your chances of getting Type 2 Diabetes. 

Before We Get Too Excited

These results might have you plugging in the kettle, but not so fast.  Researchers and physicians are not quite ready to prescribe caffeinated beverages, and here is why:

• There are limitations to the research.  The beverage intake was based on self-reporting, which can be inaccurate.  Most of these studies were based on subjects who are predominantly Caucasian, and the findings may not be applicable to populations of other ethnicities.  And perhaps most importantly, despite their efforts to clean the data, it is possible that other dietary or lifestyle factors were impacting the results.
• While researchers have documented these correlations between coffee and tea and good outcomes, they don’t yet have evidence of why this is occurring.  The theory is that the benefits come from the antioxidants, and not the caffeine, but more research is needed.
  

The Dark Side of Coffee & Tea

Despite these potential benefits, caffeine consumption brings some risks:

• It can cause insomnia, nervousness, irritability, accelerated heart rates, and muscle tremors.
• Caffeine is addictive; abruptly stopping caffeine consumption can lead to withdrawal symptoms like extreme tiredness and headaches.
• Caffeine can interact poorly with several medications including over-the-counter remedies and herbs.  Checking with a doctor or pharmacist can be helpful.

So now what?

Most experts recommend limiting caffeine to 400 mg/day (roughly 4 cups of coffee).  If you are drinking a moderate amount of caffeine, if it doesn’t interact with your medications or make you feel unwell, keep enjoying it.  But stay tuned for more research; this is an area of increasing activity, perhaps because we all love our morning beverages so much!

For more reading:

Gunnars, Kris. “Why Is Coffee Good for You? Here Are 7 Reasons.” Healthline, Healthline Media, 30 Apr. 2018, https://www.healthline.com/nutrition/why-is-coffee-good-for-you .

Inoue-Choi, Maki, et al. “Tea Consumption and All-Cause and Cause-Specific Mortality in the UK Biobank: A Prospective Cohort Study: Annals of Internal Medicine: Vol 175, No 9.” Annals of Internal Medicine, Sept. 2022, https://pubmed.ncbi.nlm.nih.gov/36037472/

Pass, Will. “Coffee Drinkers – Even Those with a Sweet Tooth – Live Longer.” Medscape, Medscape, 1 June 2022, https://wb.md/3CyiMYX  

Sharon Worcester, MA. “Drinking Black Tea Linked to Lower Risk of Dying from CVD.” Medscape, Medscape, 31 Aug. 2022, https://wb.md/3RviXIE   Zhang, Yuan, et al. “Consumption of Coffee and Tea and Risk of Developing Stroke, Dementia, and Poststroke Dementia: A Cohort Study in the UK Biobank.” PLOS Medicine, Public Library of Science, 16 Nov. 2021, https://pubmed.ncbi.nlm.nih.gov/34784347/

Tara Carpenter-Kellett

Our staff are incredibly kind, well-educated, and dedicated to providing excellent healthcare, but being human, occasionally they make mistakes.  Accordingly, we try to design fool-proof systems – preventive maintenance, narcotics double-checks, automated systems, – and still, we aren’t perfect yet.  While we continue to strive to become error-free, there are many ways that patients and families can contribute to this work. 

When you or your family member becomes a patient

These are things that every patient should know:

• If you have specific expectations or needs, please share them with your care team.
• Educate yourself about your health conditions and treatments.  Your active participate in your own care can catch errors before they happen.
• Feel comfortable asking questions whenever you don’t understand things. It should always be safe to ask questions.  If for some reason you feel unsafe, speak to another member of the care team, the manager, or the Patient Relations Officer.
• Be especially vigilant at times of transitions (such as changing units, hospitals, or care providers, at shift changes, and when being discharged) as these are statistically higher-risk times.
• Follow instructions (such as finishing prescriptions, booking follow-ups, doing dressing changes, etc.)

If things don’t go as expected

If you or your family member experience harm:

• Speak-up and ask questions about what happened and why.
• Ask how the incident will be reported.  We review and learn from these reports, so they are very important. Staff can complete an “incident report”. Anyone can trigger a review by writing to the hospital with concerns. Similarly, anyone can trigger a formal review of a serious and harmful event using this link:  https://wrha.mb.ca/quality-improvement/patient-safety/reporting-a-critical-incident/
• Expect an apology and to be informed about next steps.
• If you need it, ask for practical or emotional support to cope with the incident; if you feel you need more support than the unit staff can provide, speak to the Patient Relations Officer.
• Share ideas, concerns, and suggestions; you have a unique and valuable perspective.

Other ways you can help to improve patient safety:

Even if you’ve had an uneventful or a positive experience, you can still help to make the system stronger:

• Participate in training the next generation of care providers.  If your team asks to include a student in your appointment, welcome them and speak openly about your experience and feelings so they can learn from you.
• Give us feedback by completing patient surveys if you receive one.
• Reach out to the hospital with both compliments and constructive suggestions.
• Volunteer to act as a patient representative on quality projects or the Patient Voice Committee.
• Attend town halls when they are offered.

We remain committed to excellence.  We chose to work in healthcare because we wanted to help people.  As we work toward perfection, we warmly welcome our patients and families as important partners in making care safer. 

With files from https://www.healthcareexcellence.ca/

If you have been diagnosed with arthritis, welcome to a large club; 20% of Canadians have arthritis, and it is Canada’s most common chronic disease.  Technically though, arthritis isn’t one disease.  The term “arthritis” comes from Latin and translates as “inflammation of the joint”.  Arthritis is a symptom in over 100 different illnesses, and often comes with swelling, pain, stiffness, and a reduced range of motion.  Osteoarthritis, rheumatoid arthritis, lupus, gout, and fibromyalgia are some the most common types of arthritis.  Symptoms vary by type of disease, and can include fever, fatigue, eye problems, feeling flu-like, and emotional distress.  It is important to understand what kind of arthritis you have, what symptoms you can expect, and how to treat them; your healthcare provider can point you to reliable information.  

These 5 things will help all arthritis conditions:

1. Get regular exercise.  You might think that you should avoid exercise, but it is a critical part of staying healthy.  Regular exercise strengthens the muscles around the joints and supports your sleep and energy levels.  Without some exercise your joints will actually become more stiff and painful.  You may need to adjust your exercise to ensure it is meeting your goals and not causing too much pain; a physiotherapist is a great resource to help set up an exercise program. 
   
2. Get your sleep.  Pain and sleep can easily create a vicious circle:  people with pain find it hard to sleep, but people without enough sleep tend to experience greater pain.  Review general recommendations on good sleep habits (i.e., have a regular bedtime, avoid stimulants like tea and coffee after noon, create a comfortable bedroom just for sleeping etc.)  Some folks find it helpful to take a hot shower before bed, do some gentle stretching, or use an electric blanket. Whatever you do, don’t skimp on sleep!
   
3. Manage your stress. Everyone has stress but the addition of a chronic disease can add an extra layer of stress.  Unfortunately, stress isn’t good for arthritis.  It causes muscle tension which can increase the pain.  Stress can even trigger an episode of arthritis.  If you haven’t found skills to manage your stress yet, it is time to try some new strategies.  Meditation, yoga, therapy, journalling, and guided relaxation are all worth trying. You may have to learn how to prioritize your workload, how to ask for help, and how to say no to things that add to your stress level.
   
4.  Let your food be medicine. Researchers have proven that many foods have “anti-inflammatory” properties, which make them helpful to arthritis sufferers.  Green tea, berries, and fish high in Omega-3 are all considered anti-inflammatory, and so are several vegetables (like broccoli, cauliflower, Brussels sprouts and mushrooms). Olive oil is a great cooking oil, and ginger and turmeric are anti-inflammatory spices.   You can research anti-inflammatory diets, or you might start with the most famous one, the Mediterranean diet.
   
5. Work with your doctor to develop a plan for flares.  A “flare” is an episode where you experience a worsening of symptoms, and they are to be expected.  By keeping a record of your flares you may be able to figure out what triggers them in hopes of avoiding them over time.  When flares happen, you must be gentle with yourself.  Get lots of rest and ask for help if you need it.  Some people find heat helps reduce the pain, and cold packs may reduce swelling and inflammation.  Work with your healthcare provider to see how medication fits into your plan for flares.

In addition, there are two things to stop:

1. Quit smoking.  If you’ve been looking for a reason to quit, you just found it.  Smoking is detrimental to your bones and joints, and this damage can make your arthritis worse.
   
2. Skip “high impact” activities if they cause joint pain.  You’ll get to know your own limitations, but you may need to replace running and jumping with lower impact exercise like biking, walking, or using an elliptical trainer. Again, a physiotherapist can help.

Adjusting to arthritis can take time, particularly as you learn how your body responds to your type of arthritis.  Be patient with yourself, ask for help if you need it, and educate yourself on arthritis management techniques. 

For more reading on this topic:

“How Do Exercise and Arthritis Fit Together?” Mayo Clinic, Mayo Foundation for Medical Education and Research, 1 Dec. 2020, https://www.mayoclinic.org/diseases-conditions/arthritis/in-depth/arthritis/art-20047971

“Arthritis Pain and Sleep.” WebMD, WebMD, https://www.webmd.com/osteoarthritis/features/arthritis-pain-sleep. 

. Elizabeth Scott, PhD. “18 Highly Effective Stress Relievers.” Verywell Mind, https://www.verywellmind.com/tips-to-reduce-stress-3145195. 

  Bone, Muscle and Joint Team. “10 Foods That Help Ease Your Arthritis Pain.” Cleveland Clinic, Cleveland Clinic, 11 Feb. 2021, https://health.clevelandclinic.org/top-10-foods-power-ease-arthritis-pain/.

  “Managing an Arthritis Flare: Arthritis NSW.” Arthritis New South Wales, 25 Feb. 2020, https://www.arthritisnsw.org.au/managing-an-arthritis-flare/#:~:text=Managing%20an%20Arthritis%20Flare%201%20Plan%20Ahead.%20Plan,variety%20of%20options%20available%20for%20support%20and%20information.  

“Daily Living – Smoking and Arthritis.” Home, https://arthritis.ca/support-education/online-learning/daily-living/smoking-and-arthritis.  

“Managing Arthritis Pain.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 6 Aug. 2022, https://www.mayoclinic.org/diseases-conditions/arthritis/in-depth/arthritis/art-20046440.   

As much as we love our beautiful Manitoba summer days, they can become dangerous when the air fills with smoke from forest fires.  It is hard to believe that smoke can travel hundreds, even thousands, of kilometers and still be a risk to our health, but in recent years we have experienced it many times.

Wildfire smoke can be annoying, but it can also create health emergencies.  The smoke particles make it harder for your lungs to get oxygen into your blood. Additionally, the smoke particles in your lungs can be irritating and can cause inflammation.

People respond differently to the smoke depending on factors like their age and health status. Folks with respiratory conditions (like asthma and COPD), the young and the elderly, pregnant people and anyone with pre-existing health conditions are at higher risk. People who work outdoors, and those who don’t have access to air conditioning, are also at greater risk. Fortunately, we’ve got tips for everyone on how to manage the dangers.

Before smoke arrives:

1. Become familiar with the Air Quality Health Index.  It is an indicator of the air quality in your city and helps you determine your risk.  Here is the link for Winnipeg, and from there you can navigate to other Canadian cities as well:  https://weather.gc.ca/airquality/pages/mbaq-001_e.html
2. Consider the purchase of a certified HEPA air purifier to improve the air quality in your home and keep replacement filters on hand.
3. Determine if there is one room in your home that you can close off to outside air and keep the air purifier in that room.  Make sure windows and doors can be securely closed.
4. Keep 3 to 5 days of supplies on hand (including medication, like inhalers) so you can limit your trips outside.
5. Change the air filters on your air conditioner and furnace according to the manufacturer’s recommendations and keep replacement filters on hand.

When the smoke arrives:

6. Listen to your body! If you are experiencing symptoms, pay attention to how you are reacting to the smoke.  Don’t just push through it; take whatever actions you can to keep yourself well.
7. Limit your time outside, especially time spent doing strenuous activity.  Move your physical activity inside. 
8. If you must be outside, use strategies to stay cool such as staying in the shade, staying hydrated, using cool packs, and reducing your level of exertion. Try to avoid exercises that make you sweat or breathe heavily.
9. Try wearing a mask when you go outside; as we learned with COVID-19, the best protection comes from a properly fitted N95 mask, but most masks will provide some protection against the microscopic smoke particles.
10. Drink more water than usual; it helps your body deal with the smoke.
11. Limit actions that reduce indoor air quality:  these include indoor smoking, burning candles or incense, frying or broiling foods, vacuuming, using wood stoves, using products in aerosol cans, and using cleaning products or paints that emit high levels of volatile organic compounds (VOCs).
12. Limit the use of exhaust fans in kitchens and bathrooms, and keep windows closed.
13. If possible, have the settings on your heating and air conditioning systems set to “recirculation”, to limit the intake of smoky air.  Try to keep the humidity levels low (below 50%).
14. Keep car windows closed, with air handling on “recirculate”.
15. Keep an eye on pets; seek help from a veterinarian if they show signs of trouble breathing, fatigue, weakness, or loss of appetite or thirst.
16. Check in frequently with children, the elderly, and anyone who might not realize the impact of smoke on their health.
17. Keep an eye on the Air Quality Health Index; sometimes there can be periods of reduced smokiness – use that time to air out your house.
18. Pay attention to notices from the City of Winnipeg, health advisories, and Environment Canada.
19. If you don’t have good air quality at home, give yourself breaks by going to places like libraries and shopping malls.
20. Consider evacuation if the impacts become too much for you to handle.

The United Nations believes that wildfires are linked to climate change and land use changes, and it predicts that wildfires will continue to become more common and more intense.  As we work to address those issues globally, Manitobans are wise to prepare for air quality challenges each summer.

References and Further Reading:

https://winnipeg.ca/emergencypreparedness/hazards/air-quality.stm

https://www.canada.ca/en/environment-climate-change/services/air-quality-health-index/wildfire-smoke/wildfire-smoke-health.html

https://www.cdc.gov/disasters/wildfires/duringfire.html

https://beyond.ubc.ca/wildfire-smoke/

https://www.unep.org/news-and-stories/press-release/number-wildfires-rise-50-2100-and-governments-are-not-prepared

Recently the Winnipeg Free Press reported preliminary data from the Manitoba Chief Medical Examiner’s office, and the findings were stunning:  there were 407 drug-related deaths in 2021, more than double the historical average.  While federal and provincial governments work to reduce overdose deaths there are steps we can all take to help.  Here are 5 actions to consider:

1. Clean out your medicine cabinet

Many of us have leftover drugs at home – maybe Tylenol 3s from a dental surgery, or medications belonging a family member who passed away.  It happens. However, sources estimate that between 40 and 70 percent of opioid dependence begins with leftover drugs in the medicine cabinet.  Let’s get rid of them!  Simply return them to the pharmacy; they offer free and environmentally safe disposal.

2. Ditch the stigma

Historically we used harsh language like “druggies”, and “junkies” to describe individuals with drug addictions. Now we know that drug addiction can happen to anyone – it may begin with recreational use, a prescription, or a well-meaning friend sharing their pain medication.  Addiction can happen quickly, and it changes the brain in ways that make it difficult to stop using.  With that knowledge, we now use the phrase “substance use disorder”, which aligns with mental health and the hope of recovery.  This term may help to lessen the stigma associated with addiction and support our shared goal of encouraging those battling addiction to seek help.  Try your best to remain non-judgmental in all of your conversations; you may well have family, friends, or colleagues battling addiction without your knowledge.

3. Stay connected to those who are struggling

Professionals who treat addictions have a saying:  the opposite of addiction is connection. While healthy, trusting, and supportive relationships are only one piece of the addiction puzzle, research has proven that these relationships can be protective, and can make recovery easier.  If you’ve got friends, family, or even acquaintances who are lonely, isolated, and vulnerable – take a few minutes to reach out.  You might make the difference.

4. Be aware of addiction resources and recommend them to those in need

Here are two of the best places to get help:

• Your primary care provider (your family doctor or nurse practitioner) is trained in managing addictions.

• Addictions Foundation of Manitoba is a great resource.  They have an Addictions Helpline (1-855-662-6605) and are online at https://afm.mb.ca/

5. Consider Naloxone

Naloxone is a very safe drug that temporarily reverses the effects of an opioid overdose.  It comes either as a nasal spray or an injection that can be given in any muscle.  If you or a loved one are at risk of an opioid overdose, please keep naloxone on hand.  There are two ways to get a naloxone kit.

• Contact Street Connections, a community outreach organization.  Drop into their office at 496 Hargrave Street (Main Floor) Monday to Friday, 8:30am to 4:00pm, and ask about the naloxone program. No appointment is necessary. The staff will train you to recognize an overdose and how to give naloxone and will give you a free take-home naloxone kit. The visit should take less than 1 hour. The Street Connections website is here: https://streetconnections.ca/
• Alternatively, naloxone kits are available for purchase throughout the province.  For a list of vendors, and some great training videos, check out: https://streetconnections.ca//content.php?navigation_id=2294 

Our thoughts are with everyone who has lost a friend or loved one due to overdose. These deaths are shocking and painful.  Loving someone with a substance use disorder is a hard road, and we recommend getting support such as the Family Program run by the Addictions Foundation of Manitoba.  Substance use is a complicated problem, but we can all take these 5 steps toward reducing as many untimely deaths as possible.

References:

Canada, H. (2014, May 6). Safe Disposal of Prescription Drugs. Government of Canada. Canada.ca. https://www.canada.ca/en/health-canada/services/safe-disposal-prescription-drugs.html#s1a  

Malone, K. G. (2022, April 9). Manitoba marks 407 overdose deaths in 2021. The Free Press. https://www.winnipegfreepress.com/breakingnews/everybodys-responsibility-surging-number-of-deadly-overdoses-in-manitoba-576379322.html  

National clean out your medicine cabinet day – disposerx®. DisposeRx® – Solving the Problem of Drug Disposal. (n.d.). https://bit.ly/3uwcHbf

National Study: Teen Misuse and abuse of prescription drugs up 33 percent since 2008, stimulants contributing to sustained rx epidemic. Partnership to End Addiction. (2020, March 20). https://drugfree.org/newsroom/news-item/national-study-teen-misuse-and-abuse-of-prescription-drugs-up-33-percent-since-2008-stimulants-contributing-to-sustained-rx-epidemic/  

Sussex Publishers. (n.d.). The opposite of addiction is connection. Psychology Today. https://www.psychologytoday.com/us/blog/love-and-sex-in-the-digital-age/201509/the-opposite-addiction-is-connection  Take-home naloxone distribution program. Province of Manitoba – Health. (n.d.). https://www.gov.mb.ca/health/publichealth/naloxone.html

Take-home naloxone distribution program. Province of Manitoba – Health. (n.d.). https://www.gov.mb.ca/health/publichealth/naloxone.html  

Years ago, we believed everything we read in the newspaper. We took expert advice at face value.  Conspiracy theories were not a significant part of our culture.  But today we are much less likely to trust our sources.  Many people report wanting to do their own research before making decisions.  And bringing our own critical thinking skills to decision making is a great idea because we are being exposed to more hoaxes, scams, and fraudsters than ever.  But, and this is a big “but”, we need to educate ourselves on how to do that research.

You may already be aware of the website snopes.com because it is the oldest and largest on-line fact-checking site.  Did astronaut Buzz Aldrin really admit that the moon landing was faked? Snopes will tell you no, that isn’t true.  They will also explain how the rumour developed and why it isn’t true.  Snopes is considered a reliable site because they have a long history of factual reporting, and because they are completely transparent about who they are and how they are funded. (They can be found at https://www.snopes.com/)

If Snopes doesn’t have the answer, and we still want to do our own research, we need to begin with reliable sources. We must resist the risk of being swayed by fascinating or compelling news stories; we must methodically ask all kinds of tough questions.

Here is a quick example.  A gynecologist in Mexico reports that COVID vaccines are responsible for producing a strain of “transhuman” babies with all black eyeballs who are capable of walking at two months of age.  Keeping an open mind, these are questions we would want to ask:

• Is this individual known as a reputable physician? Can we independently confirm this individual’s education and experience?
• Specifically, what data has been collected to support these claims? (How many babies are allegedly involved, where and when were they born, over what time, etc.)
• Has the data been collected according to established clinical practice guidelines?  Can we see these guidelines?
• Can we review the data ourselves, as well as any other clinical evidence?
• Has the evidence been verified by others, and are they reputable? (If there is video evidence of the walking newborns, how will we know the video hasn’t been tampered with?)
• If there is undeniable proof the problem exists, what alternative theories have been explored? A good research paper will acknowledge all other possible explanations.
• Has the research been reviewed by the doctor’s peers to validate the methodology and findings? Has it been published in a reputable medical journal?
• Are credible news sources picking up this story?

Being able to answer these tough questions is crucial, especially if we are making decisions about our own health.  Ideally, everyone would take a research methodology course to learn how to capably evaluate the evidence.  Be aware of your own knowledge gaps, and if you feel like you are in over your head, consider starting your research with peer-reviewed publications by scientists associated with accredited universities, published in mainstream journals.

Interested in learning more? The News Literacy Project is a non-partisan, non-profit organization designed to teach us how to be smart consumers of news and information.  They are concerned that even sophisticated audiences can have difficult separating reliable, legitimate information from information that has been created to mislead them.  On their site (https://newslit.org/) you’ll find all kinds of resources to help you become a savvy critical thinker, able to make informed decisions.  If you are going to do your own research, more power to you.  Just take the time to fully educate yourself on how to assess information.  Be mindful of your own biases and knowledge gaps. Validate your sources. Ask a lot of hard questions. Here’s to being smart information consumers! 

Stephen Covey, a distinguished businessman, author, and educator, gave us this advice: “Begin with the end in mind.”  He recommends taking time to think about how you want the future to look.  Working backwards from that vision you can more easily see the necessary steps to get there. It is a great tool that can be used in many situations.

Let’s take a few minutes to think about how it applies to our health.  25 years from now, how old will you be?  And just how healthy do you want to be at that age?  Do you hope to be well and active, strong, fit and enjoying life? How do you imagine your flexibility, energy, joint pain, and memory? Does the future look bright? And are you on the right track to get there?

Many researchers have proven that the health decisions we make now, and over the next 25 years, can impact our future wellbeing.  If you plan to have a healthy future, here are seven steps you should start taking now to help reach your goal.  Even small steps can make a big difference over time.

1. Exercise for your heart:
   Heart attacks and strokes will definitely get in the way of your future health goals.  To help prevent them, research shows that the best thing you can do is move in a way that increases your pulse to your “target heart rate”.  Exercise (like walking, skiing, dancing, rowing, biking etc.) is recommended at least 30 minutes, 5 times a week.  This 150 minutes per week also benefits your weight and your mental health and reduces your chances of type 2 diabetes.  Don’t skip this strategy!
   
   
2. Weight lift for your bones:
    If your long-term health plan includes being strong and moving easily, include some regular resistance training.  You don’t need to become an Olympic weightlifter; you can achieve a lot with hand weights, resistance bands, and even using the resistance of your own body weight.  Resistance training not only keeps your muscles strong, but it keeps your bones strong as well.  Looking to avoid osteoporosis and broken bones?  This is a great approach, and it also improves your mood.
   
   
3. Make sleep a priority: 
   Researchers have identified a relationship between inadequate sleep and an early death.  Most adults need at least 7 hours per night and getting an adequate amount will also improve your mental health.
   
   
4. Nourish your body: 
   Making healthy food choices will almost certainly pay off, and in particular get those fruits and vegetables into your diet!  Some researchers have found that eating at least 5 servings per day is associated with less chronic disease and a longer life, while others recommend up to 9 or 13.  Always aim for at least three servings of vegetables and two servings of fruit per day.
   
   
5. Alcohol in moderation: 
   If you enjoy alcohol, be sure to keep it in moderation.  Too much alcohol causes risks to your organs and increases your risk of cancer.  While some researchers conclude that no amount of alcohol is safe, for those folks who want to continue to imbibe some interesting research from Japan now recommends “liver rest days” for heavy drinkers (skipping alcohol 2 or 3 days per week) as a strategy to help improve their lifespan.
   
   
6. Stop smoking:
   Smokers simply have more cardiovascular disease and cancer than non-smokers.  Vaping has been promoted as a safer alternative, but in fact we don’t yet have good long-term data on the risks associated with it. See if you can become smoke-free.
   
   
7. Manage your stress: 
   We now know that stress can have a big impact on your health.  It can cause headaches, low mood, and sleep disturbances, and it can impact your cardiovascular health and create a compromised immune system.  Use relaxation techniques (like deep breathing and meditation) and schedule fun breaks.  Nurture healthy relationships with friends and family, because this has shown to impact both health and life span.  If you need it, get professional help for a little while.
   
   

Are you already doing these things, or do you need to invest a little more effort in your future health?  If you are off track, and it feels overwhelming, take just one area, and make some changes – when those changes become a habit, tackle another area.  Anything you do will benefit your health, and your future self will thank you!

References:

Boone, J. (2003, May). Evaluating the impact of stress on systemic disease: The most protocol in primary care. The Journal of the American Osteopathic Association.   https://pubmed.ncbi.nlm.nih.gov/12776765/ 

Covey, S. R. (2020). The 7 Habits of Highly Effective People: Powerful Lessons in Personal Change. Simon & Schuster.

Gallicchio, A., & Kaleson, B. (2009, Jun). Sleep duration and mortality: A systematic review and meta-analysis. Journal of Sleep Research. https://pubmed.ncbi.nlm.nih.gov/19645960/  

Gardner, B., Lally, P., & Wardle, J. (2012, December). Making health habitual: The psychology of ‘habit-formation’ and general practice. The British Journal of General Practice: the Journal of the Royal College of General Practitioners.   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3505409/ 

GBD 2016 Alcohol Collaborators . (2018, August 23). Alcohol use and burden for 195 countries and territories. The Lancet.   https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31310-2/fulltext 

Health Canada. (2021, September 3). Health Risks of Alcohol. Canada.ca.   https://www.canada.ca/en/health-canada/services/substance-use/alcohol.html

Holt-Lundstad, J. (2010, July 27). Social Relationships and Mortality Risk. PLOS Medicine.   https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1000316 

Laucks, P., & Salzman, G. A. (2020). The dangers of vaping. Missouri Medicine.   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7144697/ 

Liu, R. H. (2013, June). Dietary bioactive compounds and their health implications. Journal of Food Science.   https://pubmed.ncbi.nlm.nih.gov/23789932 

Liu, R. H. (2013, May). Health-promoting components of fruits and vegetables in the Diet. Advances in nutrition (Bethesda, Md.). https://pubmed.ncbi.nlm.nih.gov/23674808/ 

Marugame , T. (2007, May 1). Patterns of alcohol drinking and all-cause mortality: Results from a large-scale population-based cohort study in Japan. American Journal of Epidemiology. https://pubmed.ncbi.nlm.nih.gov/17344205/ 

Mons, U., et al (2015, April 20). Impact of smoking and smoking cessation on cardiovascular events and mortality among older adults: Meta-analysis of individual participant data from prospective cohort studies of the chances consortium. The BMJ. https://www.bmj.com/content/350/bmj.h1551#:~:text=Smokers%20had%20twofold%20hazards%20of%20cardiovascular%20mortality%20compared,was%20also%20twofold%2C%20and%201.5-fold%20for%20stroke%20events 

Rasulo, D., Christensen, K., & Tomassini, C. (2005, October 1). Influence of social relations on mortality in later life: A study on elderly Danish twins. OUP Academic.   https://academic.oup.com/gerontologist/article/45/5/601/6525746 

Sleep Foundation. (2021, December 9). Why do we need sleep? https://www.sleepfoundation.org/how-sleep-works/why-do-we-need-sleep#:~:text=One%20of%20the%20vital%20roles%20of%20sleep%20is,many%20of%20these%20steps%20happen%20while%20we%20sleep

Tian, D., & Meng, J. (2019, April 9). Exercise for prevention and relief of cardiovascular disease: Prognoses, mechanisms, and approaches. Oxidative medicine and cellular longevity.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6481017/ 

Wang, D. D. (2021, Apr 27.). Fruit and vegetable intake and mortality: Results from 2 prospective cohort studies of US men and women and a meta-analysis of 26 cohort studies. Circulation.   https://pubmed.ncbi.nlm.nih.gov/33641343/  

 Westcot, Wayne L. (2012, Jul-Aug). Resistance training is medicine: Effects of strength training on health. Current Sports Medicine Reports.   https://pubmed.ncbi.nlm.nih.gov/22777332   Worley, S. L. (2018, December). The extraordinary importance of sleep: The detrimental effects of inadequate sleep on health and public safety drive an explosion of sleep research. Pharmacy & Therapeutics   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6281147/

Dr. Donatus Onwurah, Psychiatrist, Victoria Hospital

When a psychiatrist, psychologist, or family physician shares the news that you have a mental health disorder, it is normal to feel many emotions.  You may be relieved that there is a reason for the symptoms you’ve been experiencing.  You may feel uncomfortable or embarrassed. You might even feel overwhelmed.  These feelings are normal and common.  Remember that mental health disorders are also very common!  We see them all the time, and help is available.

Feeling Comfortable with the Diagnosis

The good news is you are now starting a journey where you will be supported as you become healthier.  Just like some physical illnesses, some mental health diagnoses will stay with you for a long time, but you can manage them and have an improved quality of life. If it bothers you, don’t dwell on the diagnosis itself.  Instead, stay focused on working with your caregiver towards becoming healthier.

Sharing the News

How widely should you share your diagnosis?  This is a great topic to discuss with your caregiver, but we recommend you consider sharing the news with one, or a few, trusted family members. We often encourage these family members meet your care providers because family can be very supportive and may have helpful insight.  

Getting Up to Speed

Finding out more about your diagnosis is helpful; you can learn coping strategies, what to avoid, and what to expect.  Your care provider will probably provide you with educational information such as pamphlets or links to reputable websites.  If you don’t get this information, be sure to ask. 

Support Can Make a Difference

We have excellent support groups in Manitoba, and some wonderful groups online too.  Ask your care provider which groups they recommend.  Attending a support group might feel intimidating to start, but it is a terrific place to learn more about your diagnosis, connect with people having similar struggles, become motivated, and of course, feel support as you progress. 

Take It One Day at a Time

Tackling a mental health diagnosis is rarely a quick fix.  Discuss reasonable expectations with your care provider and talk about reasons for having hope.  Stick to your treatment plan; it is very important!  Taking life just 24 hours at a time can make things much more manageable. 

Providing Support for a Family Member

If your loved one receives a new diagnosis, know that your support is very valuable.  If possible, consider meeting with the care provider to get tips on helping. Try a family support group; ask the care provider for recommendations. Finally, be sure to care for yourself during this challenging time and monitor your own mental health.

Remember that the diagnosis of a mental health disorder is the start of a new chapter.  Stay focused on your recovery, not your diagnosis.  Get support, get informed, and take it one day at a time.   Be well!