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Gastroenteritis

Leah Sarich | posted Tuesday, May 17th, 2016

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More and more Fort McMurray evacuees in evacuation centres across the province are coming down with an intestinal illness called Viral Gastroenteritis or viral gastro. The latest numbers of those infected can be found here from Alberta Health Services.  This is a viral infection that can be caused by several kinds of viruses… norovirus (the one often associated with cruise ships and daycares,) rota virus, adeno virus and more. These are viruses that are in the community at all times. But Dr. Raj Bhardwaj, an acute care physician, explains the viruses are highly contagious and easily spread through confined spaces like schools and evacuation centres. He says the virus particles can live on hard surfaces for up to two weeks if not cleaned off.

The viruses cause unpleasant symptoms like vomiting and diarrhea, stomach pain and nausea. While unpleasant, the infection usually only lasts about 2-3 days. But because it is so highly contagious, Dr. Bhardwaj says the best defence is good hand hygiene. He says washing hands with soap and water for 15 to 30 seconds, then drying hands with a paper towel and using that paper towel to turn off the taps and open the door is the best practice. It’s critical not to reinfect yourself leaving the bathroom by touching any surfaces. Hand sanitizers are less helpful because they’re often not used properly. Dr. Bhardwaj says with an alcohol based sanitizer, people must wet their entire hands including between fingers and under fingernails and then they must rub hands together until they’re dry. It’s also necessary for patients to isolate themselves as best as they can. They must also not prepare food for others.

And as for treating this infection, do not expect antibiotics. Dr. Bhardwaj explains viral gastro is a viral illness so antibiotics won’t work. The best thing to do is support the body while it clears the infection itself and that means staying hydrated. While it can be a challenge to keep water down, particularly in little kids, Dr. Bhardwaj says aim for just 1 tablespoon of water every 5 to 10 minutes. This is all the hydration the body needs to fight the infection on its own.

For more information on this illness read this fact sheet from AHS.

 

Lupus

Leah Sarich | posted Friday, May 13th, 2016

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Lupus affects one in two thousand individuals, 90 percent of them are women. The disease is most commonly diagnosed between the ages of 15 and 45 so this age group presents unique challenges. But first off what is lupus? Dr. Ann Clarke who has started a new Lupus Clinic at the University of Calgary explains lupus is an autoimmune disease where the patient’s own antibodies attack their own tissues. Numerous organs and tissues can be affected but many patients present with a skin rash, arthritis or kidney involvement. So the disease can be tricky to diagnose, hence the nickname “the disease of a thousand faces.”

Typically a family doctor will suspect lupus in a patient and then refer them to a rheumatologist. That doctor will then do a full patient history to try and put together a symptom profile, they’ll do an exam and order blood work where they’ll be looking for specific antibodies related to lupus. Like with many diseases, lupus is easier to treat if it is caught early. Treatments usually involve immune suppressing drugs from steroids to biologics. The goal of treatment is to get the patient into a prolonged state of remission.

And with this group of patients family planning is a huge issue, says Dr. Clarke. Fertility can be affected and the fetus can also be adversely affected by lupus medications. Furthermore, the mom’s condition can become worse in pregnancy so patients who want to become pregnant must come up with a plan with their doctor in order to do so safely.

The good news is Dr. Clarke’s lupus clinic is accepting new patients with lupus. This clinic will provide optimal care for lupus patients. Dr. Clarke has established relationships with other specialists like nephrologists or kidney doctors and a dermatologist with a special interest in lupus. The clinic will also allow for patients to participate in clinical trials for new medications.

For more information on lupus visit this site, for more information on Dr. Clarke go here.

 

Kids & Headaches

Leah Sarich | posted Wednesday, May 11th, 2016

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Headaches in children are more common than most of us realize. By the age of 15, three out of four kids has experienced a significant headache.  These headaches occur for many reasons… and tension headaches are most common, but migraine headaches are right up there explains Pediatric Neurologist Dr. Thilinie Rajapakse from the Headache Clinic at the Alberta Children’s Hospital.

In fact, at the ACH they have three thousand children with chronic migraines that get these headaches 15 times or more a month. These headaches are very disabling says Dr. Rajapakse and usually start with vague symptoms like yawning, carb cravings and moodiness which is then followed by a pounding headache, nausea and vomiting as well as a sensitivity to light and sound. A third of these kids will also experience an aura which is a wave of electricity that move across the brain from the back to the front that causes dramatic symptoms like seeing flashes of light, difficulty speaking and losing the ability to feel one side of the body. While these symptoms are very scary for parents, Dr. Rajapakse says they’re very common and usually subside within an hour and are then followed by that pounding headache. These migraines can last for one hour or up to three days.

Dr. Rajapakse says treatment usually begins with lifestyle changes like drinking more water, getting better sleep and then painkillers like ibuprofen and acetaminophen. If the child is not getting enough relief there are several medications that can help including preventative medicines that can be used that work on reducing the nerve excitability in the brain. These drugs do have side effects that include sedation and changes in appetite, but Dr. Rajapakse says these medicines work quite well and only need to be taken for a short time and that any side effects can usually be well managed. Other vitamin and herbal therapies are also used to help.

The good news is exciting new treatment options are being researched right now. Dr. Rajapakse says they’re looking into injections into the brain like nerve blockers and they’re also exploring brain stimulation to help with these headaches.

For more information on children and headaches visit this website. 

Reconstructing Ears

Leah Sarich | posted Friday, May 6th, 2016

About one in every three thousand babies is born without an ear. And one in 1500 is born without an ear because of syndrome like the one 13 year old Alassandro Manzoni was born with. Alassandro’s syndrome affects five parts of his face including his ear. His case is one of the worst his reconstructive surgeon Dr. Ryan Frank has ever seen. But Dr. Frank has made great progress making Alassandro a new ear. The process began a couple of years ago. And it’s a big one. To create a new ear, Dr. Frank says it usually takes three surgeries over a year and a half.

The first surgery is the biggest one. Dr. Frank says this surgery is usually six to eight hours in the operating room. Children typically undergo this surgery after the age of 6 when the good ear is 90 percent formed. Dr. Frank makes a model of the good ear, reverses it then uses it as a model for the new ear. He then takes part of the rib cartilage out of the child, bends it and forms it to match the model ear using tiny wires to hold the pieces of cartilage together. He then implants the cartilage ear under the skin and lets the child recover. A month or so later, with the second surgery, Dr. Frank will lift that cartilage ear to give it some projection and make it look more like the good ear. The third surgery usually involves inserting fat into the new ear to make it look as natural as possible.

Dr. Frank says the best results occur when using the child’s own tissue. He says there is a better chance the ear will get a blood supply and less of a chance of infection or of the body rejecting the ear.

Alassandro likely has a couple more surgeries to go before his ear is completed. But he’s already very pleased with the results. He says his new ear is “cool and pretty awesome.” He explains it’s much better “than everyone staring at me.” And that’s what it’s all about says Dr. Frank. Creating the ear is not about helping the child hear better, they can hear well with one ear and with the help of a hearing aid. It’s a cosmetic procedure to help the child look and feel as normal as possible.

For more information on microtia or small ear defect visit this site.

Kids and Drugs

Leah Sarich | posted Wednesday, May 4th, 2016

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Last year in Alberta there were 272 overdose deaths involving the drug fentanyl. Now we know there is a street drug in Alberta called W-18 that is 100 times stronger than fentanyl. That’s why parents are very concerned right now about these drugs and their children. David Hodgins, Head of the Department of Psychology at the University of Calgary who specializes in addictions, says it’s a terrifying time for parents.

He suggests parents talk to their kids right now about drugs. He says it’s not one conversation but it’s several conversations that establish an open line of communication between parent and child. He says using a news story about fentanyl or W-18 would be a great springboard for a conversation. And parents must be prepared to listen without judgement to try and get an understanding of where their child is coming from. Hodgins also suggests parents educate themselves about what’s out there, so in this case, about fentanyl and W-18. And these conversations need to happen sooner rather than later. Hodgins says research shows children as young as age 11, 12 and 13 have the opportunity to access drugs and that the average age of initiation is 15, so the earlier the better to talk about drug use.

Hodgins says there are many reasons why kids choose NOT to do drugs, but one of the main reasons is because drugs are not compatible with what the child might be doing or want to do. For example if the child is a hockey player or a dancer, being on drugs won’t allow them to do that successfully. This is a point parents should articulate clearly to their kids.

And if parents are concerned their child is already using drugs, parents need to step in and not take a relaxed approach. Hodgins says a child is not going to ask a parent about drug counselling or treatment. These options need to be suggested by the parent.

The good news is once most parents have the conversation about drugs with their kid, they’re often reassured that their child will make safe choices.

For more information about fentanyl and W-18 visit this website, for more information on talking to your kids about drugs visit this site.

 

 

Standing Desks

Leah Sarich | posted Thursday, Apr 28th, 2016

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Sitting is the new smoking. It’s a phrase we’ve heard a lot lately but Assistant Professor of Community Health Sciences at the University of Calgary, Nishan Sharma, really likes the analogy. He and his research team are looking into standing desks as an option for for those in the workplace looking to break up their day.

Sharma says prolonged sitting, where one doesn’t engage the big muscle groups for a 2 to 3 hour period, increases the risk of serious chronic diseases like obesity, heart disease, diabetes and cancer. One of the best ways to combat this sedentary time is to stand at a desk. Sharma and his team tried a pilot project where people were first given boxes to prop up their computers, then they were given standing desks. Sharma says no one wanted to go back to their sitting desks and everyone reported more energy through the day as well as more alertness particularly around that lull period of the day at 2 in the afternoon.

This positive feedback has encouraged Sharma and his team to do another study on standing desks that will start this summer. This study will measure the cognitive effects of using a standing desk as well as the physiological effects.

Sharma says to be clear, people cannot stand all day long either… that there’s a balance to strike. But Sharma has found in his preliminary research that everyone likes the option of being able to stand at their desk. And there are many standing desks to try out. From the simple boxes, to standing desks that can accommodate a treadmill underneath, Sharma hopes standing desks are a standard feature in the office of the future.

For more information on how important it is to break up your sedentary behaviour and how best to do that visit this website. 

Adult ADHD

Leah Sarich | posted Tuesday, Apr 26th, 2016

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Six to seven percent of children have ADHD – or Attention Deficit Hyperactivity Disorder. And these kids are growing up and not growing out of their ADHD.

Consulting Psychiatrist Dr. Carl Adrian says about 4-5 percent of the adult population has ADHD and the bulk are undiagnosed and untreated. He jokes, “why do you think there are so many coffee shops on every corner?” Caffeine is a stimulant and stimulants help with ADHD.

ADHD is composed  of three parts: inattention, impulsivity and hyperactivity. You do not have to have all three. In fact, many children with ADHD grow out of the hyperactivity part and then the inattention part dominates the picture. ADHD affects the prefrontal cortex of the brain, the part that is in charge of ‘executive function.’ Executive function refers to several things including organizing, planning and emotional control. And Dr. Adrian explains adults with ADHD do not have a problem with focus, they have a problem shifting focus. So for adults with ADHD, interpersonal relationships can be a real challenge.

Dr. Adrian says what often happens is an adult with ADHD has trouble staying focused on what their partner might be saying because they’re constantly shifting their focus to the next thought that pops into their head. Their partner experiences this inattention as not being heard or listened to. Adults with ADHD also struggle with putting themselves in someone else’s shoes. These characteristics can be very damaging in relationships.

In the workplace, adults with ADHD can also struggle because they have difficulty organizing, planning and sequencing. For example, Dr. Adrian says an adult with ADHD may make an appointment with someone but get the time wrong, or they may get so wrapped up in one project they forget about a scheduled meeting.

However, Dr. Adrian says there are good treatment options for adults with ADHD. Dr. Adrian says the first line of medications used are stimulants. He says there is a 70-80 percent response rate. He says stimulants in the treatment of ADHD are “the closest thing to pharmacological magic” he gets to use in his practice. For example, if an adult with ADHD has the right dosage and right medication for about 3 months, that’s when their partner starts to say things like “you’re a much better listener now, I feel much more connected to you.” The other big part of ADHD treatment in adults is skills development. These adults need to learn skills that can help them to better organize their lives and manage their workload like using a digital watch that has reminders or using their smartphone alarm to tell them to move on to the next task.

The ADHD brain is an amazing thing, says Dr. Adrian. These people are highly creative and very interesting. He suggests some of the biggest gifts to humanity have likely been designed by an ADHD brain.

For more information on adult ADHD, Dr. Adrian suggests talking to your family doctor about an assessment and referral. He also suggests reading this book and this book.

For more information on ADHD you can also visit this site.

 

 

 

Organ and Tissue Donation

Leah Sarich | posted Tuesday, Apr 19th, 2016

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It’s National Organ and Tissue Donation Awareness Week. Last year, 383 organs were transplanted in Alberta. But there are more than 600 Albertans waiting for life-saving organs and many more waiting for life enhancing tissues.

Dr. Debra Isaac, the Director of the Cardiac Transplant Clinic at Foothills Hospital says on average a patient in heart failure will wait for a year for a heart transplant. In that time, 25 percent of patients are taken off the list because they’ve either become too sick or they’ve died. So the need for donation continues to be a concern, and not just for hearts.

Many organs and tissues can be donated says Dr. Isaac, everything from a cornea, heart, lung, liver, kidney, pancreas, small bowel and in terms of tissues one can donate skin, bone, valves, tendons and more. One donation can save 8 lives and improve the quality of life for up to 75 people.

And Dr. Isaac says once most people understand what’s involved when it comes to donation, they’re happy to make that decision. However, many people don’t realize it’s not enough just to register online, or sign the back of  their health card or get the symbol on a driver’s license. Everyone must talk to their family about their organ donation wishes. Dr. Isaac says even if the donor has made their wishes clear, a family member must still sign off on the donation.

Dr. Isaac wants everyone to know that donors are treated with the utmost respect in both the operating room and after because doctors recognize the donor is giving the gift of life to many people. For example, if the family is planning an open casket funeral, their loved one will be just the same.

Dr. Isaac encourages all of us to consider being an organ donor, she saves it’s often a way to find comfort in a tragic situation.

For more information visit this site  or this site  or this site and to register online go here. 

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