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Hiring A Personal Trainer – What A Great Idea!

I can’t believe I hired my own Personal Trainer.  Doesn’t it seem like the height of self indulgence?  I’ve always associated personal trainers with movie stars – certainly not ordinary people and definitely not little old me.

Then it struck me.  What’s more important than my health?!  I need to lose a huge amount of weight.  That means eating better food in better portions and it means EXERCISE.  I don’t just want to look better, I want to feel better.  I want to be stronger, more limber and suffer less pain as a result of my osteo arthritis.  (I have had one total knee replacement (in ‘07) and am scheduled to have the second knee done this spring.)

I realized I needed help.  Like most of us my financial resources are limited so I had to make a choice.  Would I spend my money getting help with my eating or my exercising?

After a life time of reading books on nutrition I actually know how to eat healthy.  But I realized I didn’t know how to workout safely and effectively.  When I tried exercising in the past I either worked too hard and injured myself or didn’t work hard enough and therefore didn’t see results.  Plus, I find wandering around the unfamiliar environment of a gym to be a scary and lonely experience.  I believed that if I could figure out how to exercise regularly that would motivate me to stick to a healthy eating plan.  Therefore, I decided to monitor my own food intake and spend my money on getting fit (instead of paying for Jenny Craig or Nutrisystem, etc.)  For me, hiring a personal trainer is a shrewd investment in my own health and longevity.

I found my personal trainer on staff at a small, reputable gym that offers physiotherapy, massage therapy and athletic therapy.  Like all the personal trainers employed by this gym he has a university degree in Exercise Science/ Kinesiology.  He’s a very pleasant young man who is incredibly fit but not at all ‘jock-ish’.  I’m old enough to be his Mom and he treats me kindly and gently, while at the same time ensuring every workout we share is super effective.  Sometimes he pushes me harder than I realized I could go.  (I was happily surprised to learn my upper body strength is pretty good considering my lifelong aversion to regular exercise.)  Other times he holds me back so that I don’t hurt myself.

Sometimes I workout at the gym with my trainer, while other times I workout at home by myself.  When I work out by myself I am following my trainer’s plan and I keep a fitness log so he can give me feedback on what I’m doing at home. Knowing there’s someone to guide me in my workouts so that they’re both safe and effective really means the world to me.  Knowing there’s someone who will meet me at the gym = automatic motivation for me.  I’ve been working out with my trainer for three weeks now and I plan to continue indefinitely.  Yes, it costs money but I’ve decided to make my health a priority.

The Dreaded "Before" Picture!

The Dreaded "Before" Picture!

If this seems selfish consider the following:  you can’t take care of anyone else unless you first take care of yourself.   I’ll keep you posted on my progress as time goes on.  I’ve also bravely included the dreaded “before” picture so you know that despite my super organized health record keeping, I too struggle with health challenges.  That’s OK because what defines us is not the challenges we face but how we choose to face them.  Wish me luck!

Lazy Eye Blindness – Early Diagnosis is Crucial

Have Eyes Examined Before Age 3

Have Eyes Examined Before Age 3

A friend’s child was just diagnosed with Lazy Eye Blindness (more scientifically known as “Amblyopia”).  The little fellow is receiving treatment and he’ll be fine.  This condition was caught in time because (fortunately) my friend followed the recommended practice of taking her son for an opthamologist exam prior to his 3rd birthday. Frighteningly, she learned that if this condition had been allowed to go on without treatment it could have permanently affected his vision!

Apparently between birth and 6 months of age babies see the world through their peripheral vision because the centre of their retina is not yet developed.  However, at 6 months of age they begin to see the world the way adults do, with binocular vision.  (Seeing one image with two eyes.)  However, some children have one eye that is stronger than the other.  Or, one of their eyes may turns inward or outward (even an inward or outward cant that is imperceptible to the naked eye can cause problems).  In both of these situations the result is that the child’s brain receives two different pictures.  To avoid confusion, the brain ignores the weaker image.  The weaker or out of kilter eye just stops working.  This is Lazy Eye Blindness.

My friend’s son has been fitted with an eye patch (he will wear it for a few months).  The patch covers the stronger eye and forces the brain to rely on the weaker eye.  As the weaker eye becomes stronger the imbalance issue may be resolved and the problem is cured.  Normal vision is restored.  However, if this problem had been missed or ignored, it would have gotten progressively worse.  Sometimes special glasses or surgery are required.

Considering how precious vision is it only makes sense to guard children against this condition.  It cannot be over emphasized:  EARLY DETECTION OF THIS PROBLEM IS VITAL.  Ignoring the problem will not make it go away.  Old wives tales suggested that children could just ‘grow out of it’.  Old wives tales are dead wrong when it comes to Lazy Eye Blindness.

There are things parents can watch out for, but before I list them please be aware that some children who have this condition may not exhibit these symptoms.  The ONLY way to be sure your child’s vision is developing normally is to take them in for an opthalmologist’s check up no later than their 3rd birthday.

Visual problems in children sometimes trigger these symptoms:

* Needing to sit close to the TV,

* Not being interested in picture books,

* Squinting,

* Habitually closing one eye,

* Tilting the head or thrusting it forward when looking at things,

* Tripping over small things on the floor.

How to set up an opthalmologist appointment?  An opthalmologist is a specialist medical doctor so some provinces insist that your family doctor refer you to the specialist.  Others allow you to contact the opthalmologist’s office directly.  If you already are a patient of a opthalmologist, I suggest you just call their office and ask if they will see your child for a 3rd year check up?

Let’s keep our little folks healthy and happy!

No Name ‘Flu Is No Fun

Fever!

Fever!

Wow!  This is my first symptom-free day since I came down with a ‘flu that lacked a specific name but packed a powerful punch.  I was bed ridden for 7 days with a high fever, headaches, chills, a slight cough, acid stomach, vomiting, diarrhea and a general feeling of ‘Please take me now Lord!’.

Because I’ve had the H1N1 vaccine I at least had the comfort of knowing it probably wasn’t THAT flu.  This may seem like a minor point, except that my reaction to feeling so profoundly awful so suddenly was that I started to imagine doom and gloom scenarios.  Being able to rule out H1N1 at least meant I knew what my malady was NOT, even if I didn’t know exactly what it was.   (What can I say?  May as well admit that a high fever increases fear and decreases clear thinking.)

Why, you may ask, didn’t I call my doctor and try to obtain the Tamiflu medication that is supposed to somewhat lighten the effects of the flu?  Probably because I didn’t think of it until it was the weekend and by then my doctor was unavailable.  I believe non-emergency cases shouldn’t clog hospital Emergency Rooms so I was loathe to try that route.  Besides, I didn’t have the strength to sit in a waiting room anyway!

When I first got back to my email I wrote to colleagues and friends to explain why my husband had to cancel my business meetings and social lunches all last week.  Several people responded that they understood completely because either they or people in their circles had caught the same flu.  Apparently this flu doesn’t discriminate.  My exceedingly unscientific survey found that the large number of people in my area who contracted this flu included children, seniors and middle aged adults.

Here’s how I coped (would you believe ’survived’?) my flu: constant application of a super cold washcloth on hot skin, regularly taking Tylenol or Motrin, avoiding any nourishment I couldn’t see through and whimpering softly to my wonderful husband who frequently visited me during my stay on Pain Island.

An important thing to remember:  after the flu replace your toothbrush to avoid re-infecting yourself!

I fervently hope that none of you get this flu and extend my sincere sympathies if you do.

If you have any coping strategies that work for you PLEASE consider sharing them with us at the Comments section.  I know we’d all appreciate it.

Cheers,

Virginia

Welcome To My Health Blog!

Virginia Menzie

Virginia Menzie

Hi and welcome to my health blog! This blog is based on my belief that we play an essential role in our own health care.

Doctors are medical experts.  We are “me” experts.  When your doctor’s knowledge is combined with your information and insights about your own health the result is informed medical care.

As informed patients we track our medical history and communicate it clearly to our doctors.  This helps them avoid common medication errors and assists in diagnosis when new problems arise.

Fortunately, learning about how to care for ourselves and our loved ones can be really interesting!  There’s a huge amount of health information on the Internet.  In this blog I sift through this info and identify sources of credible, relevant health data.

I sometimes write about conditions that my friends, family members or I have experienced.  In those cases I share personal experiences that I hope will help you if you’re going through similar events.

This is as much YOUR blog as it is mine, so if you’d like to share your experiences or request an article on a specific topic please send me a ‘comment’ – I love hearing from you!  Please join my readers and me on our quest for Better Health Based on Better Information.

Virginia

Avoiding Medication Errors in Hospital

It’s amazing that more medication errors don’t occur.  Think about what happens every time a doctor in a hospital setting prescribes medication:

Avoid Medication Errors in the Hospital

Avoid Medication Errors in the Hospital

1.  Doctor prescribes medication,

2.  Nurse transcribes prescription to access medication from hospital pharmacy,

3.  Pharmacist dispenses medication,

4.  Nurse administers medication

When everything goes well the correct patient receives the right dose of the right drug at the right time and it is administered properly.

For example, a needle given to the correct patient, loaded with the proper dose of the right medicine, given at the correct time still can fail if it is injected into the bloodstream when it should be injected into the muscle.

(College of Nurses of Ontario, “Medication Practice Standard: Medication Errorshttp://cno.org 2008.)

Fortunately, this is a subject about which doctors and nurses are keenly aware.  They constantly try to improve their systems in many different ways in order to decrease medication errors.

AS A PATIENT YOU HAVE A CRUCIAL ROLE TO PLAY IN AVOIDING MEDICATION ERRORS

Many medication errors are caused by unexpected drug interactions. As a patient, you can help your doctor avoid this type of medication error by keeping an up-to-date list of all your medications in your health journal.

Remember to list both prescription and over-the-counter medications.  Don’t forget eye drops, asthma inhalers, topical creams, herbal medications and vitamin/mineral supplements.  Ideally, your medication list also should show who prescribed the drug, when and for what condition.

Keeping your own health journal makes you more aware of your medications and helps you to confirm what medications you receive whenever the nurse delivers it to you in the hospital.  99% of the time the conversation will go like this:

Nurse:  “Time for your meds Mr. Doe.”

Mr. Doe: “Great.  Which medicine is this?”

Nurse: “Your penicillin tablet.”

Mr. Doe:  “OK.”

However, sometimes the conversation goes differently:

Nurse:  “Time for your afternoon pills.”

Mr. Doe:  “Funny, I don’t usally take pills in the afternoon.”

Nurse:  “Doctor just prescribed these for you Mr. Smith.”

Mr. Doe:  “Mr. Smith is the patient in the next bed Nurse.”

It is a good practice to always confirm what the medicine is and what it is for.  Your nurse will appreciate your awareness because it is one more safeguard to help him or her avoid making an error.  So be proactive – it could save your life.

Credible Medical Websites – How To Find Them

Librarians Help Find Digital Information

Librarians Help Find Digital Information

Type the word “health” into Google and you’ll find 172 Million sites (!) .  How can you tell which sites are credible and which are not?  With more and more people finding their health information on the Web, this is a crucial question.

In the traditional world of paper books and journals stacked on shelves people called LIBRARIANS helped us find good sources of information.  Fortunately, librarians still exist and their expertise in evaluating information and pointing us in the right direction is still available despite our migration to the digital age.

The Medical Library Association’s website  http://www.mlanet.org/resources/userguide.html offers Content Evaluation Guidelines and a  sample of medical websites that they believe are worth visiting regarding specific health isses.

In a world where too many people use the Internet to expound on unproven medical theories or to exploit our health concerns to make a sale it is great to have objective recommendations.   And these librarians don’t say, “SHHH…!”

Low Testosterone Level Can Devastate Men’s Health and Sense of Self

Don't Give Up On Feeling Better

Don't Give Up On Feeling Better

“Aging gracefully” shouldn’t rob a man of his sex drive, energy level and sense of humor.  If it does, it’s time to check with the doctor.  Aging can’t be reversed but the effects of a low testosterone level definitely can.

Testosterone is an essential male hormone.  Men with low testosterone levels (hypogonadism) may experience symptoms that are guaranteed to turn anyone into a ‘grumpy old man’:

  • Fatigue
  • Depression
  • Loss of muscle tissue/ strength
  • Increased body fat
  • Irritability
  • Inability to concentrate
  • Erectile dysfunction or decreased sex drive.

If the condition continues for a long time it can lead to loss of bone mass (osteoporosis), loss of hair and an increase in a man’s risk for heart disease.

Between 40 and 55 men’s testosterone levels normally decrease gradually.  This is the male version of menopause called andropause.  If this decrease results in a too-low level of testosterone it causes hypogonadism.

In one man’s case, a youthful case of mumps lowered his testosterone level for the rest of his life, but did not trigger hypogonadism.  However, the hormone decrease associated with andropause did.  But because the problematic changes occurred at the same time as he found his first grey hair he mistakenly assumed the symptoms were just an inevitable part of aging.

Fortunately, his doctor realized that when a middle-aged man with no history of depression or fatigue reports these symptoms, it’s probably time to order a simple blood test that checks for low testosterone levels.  Doctors have been aware of hypogonadism since the 1940’s.  It used to be difficult to diagnose because the symptoms can be caused by more than one medical condition.  More recently, blood tests have been developed that assist in identifying a low testosterone level.

Hypogonadism can be very successfully treated with Hormone Replacement Therapy.  Once treated, men report a welcome boost to their energy level, strength, mood and sex drive.  Some men discard their erectile dysfunction medication because it’s no longer necessary (although it can be used in conjunction with HRT).

Caution: Men who have had prostate or breast cancer should never use HRT. (Yes,  men can get breast cancer!  See: http://www.healthsystem.virginia.edu/uvahealth/adult_men/brstcan.cfm)

So don’t resign yourself to being (or living with) the stereotypical “grumpy old man.”  Ask your doctor to do a testosterone level test.  If the test comes back ‘normal’ then you’ve established a baseline reading for your body.  If it shows you have this condition then you’re one step closer to feeling a whole lot better!

For more information here’s a (non-commercial) article on the Ontario Government website: http://www.healthyontario.com/ConditionDetails.aspx?disease_id=300

Mammograms: Best Sandwiched Between 50 and 74?

Deciding for Yourself

Deciding for Yourself

I have a mammogram every two years because my mother is a breast cancer survivor.  However, there may be good news for women who don’t have breast cancer risk factors such as family history or gene mutations.

On November 16, 2009 the U.S. Preventive Services Task Force announced new advice based on a recent medical study. (http://www.ahrq.gov/clinic/uspstf/uspsbrca.htm)

This advice applies to women who do NOT have breast cancer risk factors.  The study found that this group of women:

* Do not benefit from routine mammograms performed in their 40’s, and

* Should get a mammogram every other year between 50 and 74.

(The study also found that the risks and benefits of mammograms are unknown for women 75 and over.)

The phrase ‘risks and benefits’ is crucial.  Medicine doesn’t lend itself to simplistic, Yes/No answers.  Doctors and patients constantly weigh risks against benefits because most medical tests, treatments and medications offer both.

The doctors who conducted the study concluded that the risks of unnecessary mammograms (false positives, unnecessary breast biopsies, worry and expense) did not outweigh the benefits (catching the comparatively small number of breast cancer cases that occur in women in their 40’s who did not have risk factors).

However each woman must balance the risks and benefits for herself.  Two things to consider are:

  1. The American Cancer Society disagrees with this study’s conclusions and advises women in their 40’s to continue getting routine mammograms.
  2. There probably are about 100 different tests that your doctor theoretically could run on you tomorrow.  Would you really want him/her to order any (or all) of these tests without a clear indication that the benefits of those test results would outweigh the associated risks of undergoing the tests?

Whether to have a mammogram if you’re in your 40’s without risk factors isn’t a simple decision.  Nor is it a decision someone else can make for you.  Ask your doctor for information and advice – then decide what you want to do.

H1N1 – My Kids Are MY Priority

I’m not a bad person.  I don’t want any little children under 5 to die.  But I also don’t want MY children to die.  They’re 19 and 22.  I must confess that I’m also quite fond of my husband.  I’d like him to continue in what Stephen Colbert calls, “This long, dreary parade of sorrows we call life.”  However, according to the current priority list for the H1N1 vaccine, I’m the only person in my family who qualifies for a vaccine shot!

Young People Vulnerable to H1N1

Young People Vulnerable to H1N1

The Rational Me knows there are valid medical reasons for having a priority list.  People who are considered most vulnerable to the H1N1 flu should be the first to be vaccinated.  We’ll all get a turn, eventually.  However, I don’t understand why people over the age of 65 are deemed a priority while teenagers are not?  We’ve heard reports of otherwise healthy teenagers dying of H1N1 flu.  Happily, we haven’t heard one report of any Canadians over the age of 65 suffering the same fate.

The Not-So-Rational Me is the animal who exists in all human beings.  Her primary concern is protecting her children and her mate.  Other people are important to me, but not as important as my family.  This is evolutionary biology and an important survival mechanism.

I wrote the other day about how proud I was of the very civilized, ‘we’re-all-in-this-together’ way everyone behaved in the very long line up for the flu vaccine clinic.  I meant it then and I still mean it.  But upon further reflection I realized that this was something to be proud of because it represented a huge victory over the “me and mine first” instinct that exists in all of us.

Consider, though, what would have happened if someone had suddenly stepped out of the clinic and announced that there were only 50 shots left for the 200 people standing in line?  Anyone with a lick of sense knows that mothers pushing baby strollers only appear to be sweet and nurturing.  They’re actually quite dangerous if anyone threatens their offspring.

Bizarre as it may seem it’s medieval writer, Machiavelli, who reassures me that this entire situation will turn out OK.  Centuries ago he stated that the priority of all politicians must be to retain political power.  I have faith that “every Canadian who wants a flu vaccine will get one [eventually]” because I think governments are every bit as aware of people’s animal instincts as I am.  They know that a fast way to lose political power is to preside over chaos.  Therefore, their self-preservation instincts will ensure that the vaccine keeps rolling off the production lines in a relatively timely manner.

In the meantime, don’t feel guilty because you’re worried about your 15-year old child and want him or her to get the vaccine immediately.  This doesn’t make you a bad person, just a good parent.  Anyone who expects you to feel otherwise is unrealistic.

Lucentis vs. Avastin – Want To SEE Your House Or OWN It?

A few months ago my mother was diagnosed with wet macular degeneration.  This is a condition that gradually erodes vision to the point of blindness.  Fortunately there are treatments available for this cruel condition.  Treatment can’t reverse damage that’s already occurred, but it may stop future damage to the eye and prevent blindness.

My mother’s ophthalmologist explained that there are two drugs that treat this condition:  Lucentis and Avastin.  Lucentis was designed and approved to treat wet macular degeneration.  Avastin was designed and approved to treat colo-rectal cancer.  However, the two drugs are so similar at the molecular level that doctors realized Avastin could be used to do the same thing as Lucentis.Eye exam photo

The one dramatic difference between the two drugs is their price.  Lucentis is $2,000/dose and Avastin is $100/dose. Because the doctor prescribed a course of 10 treatment for my mother this would mean a final price tag of $20,000 for Lucentis.  Obviously she opted for the Avastin which will cost her a total of $1,000.  Unfortunately Manitoba Health doesn’t cover the cost of either drug so she has to bear the cost.  (This varies amongst different provinces.)  But at least a $1,000 price tag is achievable whereas $20,000 would be impossible.

The group most affected by wet macular degeneration is seniors.  How many seniors can afford to pay an unexpected bill of $20,000?  And how cruel is it to tell someone they have to choose between going blind or selling their house (assuming they own one)?

To add insult to injury Genentech, the drug company that produces both Lucentis and Avastin reportedly has refused to submit Avastin for trials as a wet macular degeneration treatment.  This flys in the face of the argument drug companies have always made, somewhat convincingly, that they must charge high prices in order to pay for research into new medicines.  However, by Genentech’s own calculations, they are able to provide Avastin for a fraction of the price of Lucentis.

If Avastin is not formally approved as a wet macular degeneration treatment then Canadian authorities, fearing liability issues, are unlikely to agree to fund it.  Clearly if Manitoba Health ever decides to cover wet macular degeneration treatments then Genentech would prefer to sell them Lucentis at $2,000/dose instead of Avastin at $100/dose.  Small wonder that health costs, which all of us pay for via our taxes, are constantly on the rise.

Here’s an excellent article, dated Oct 27, 2009, on this subject:  http://www.amdsupport.ca/2009/10/27/avastin-as-effective-as-lucentis-for-macular-degeneration/