healthier you fall 2015

Healthier You

Interview Provincial Health Officer Dr. Perry Kendall on flu shots p. 6

The childhoodobesiTy

epidemicWhy it matters

and how to prevent it

health appsPage 25

2015Fall

6 handy numbers for seniors

the falls guru

is your child overweight?

A young woman tells her story of childhood obesity

managing chronic pain

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Flu sHOt, yes Or nO? ................................ Page 6Provincial Health Officer Dr. Perry Kendall talks about what went wrong with last years flu vaccine, challenges with landing the perfect vaccine and why the flu shot is still your best bet.

By Shannon Henderson

WHO ya gOnna call? ................................ Page 96 must-have numbers every senior needs on their fridge

By Bonnie Irving

HannaHs cHallenge ..............................Page 20How one 11-year-old Surrey student challenged Surrey Memorial Hospital staff members to commit to one positive change for health as part of Change Day BC coming October 15

By Diane Wild

DyI HealtH ...............................................Page 25Apps to help you manage some of your chronic health concerns

Compiled by Lisa Thibault

tHe Falls guru ......................................Page 26Want fresh ideas about reducing injuries from falls among seniors? Ask Fraser Healths Fabio Feldman.

By Tasleem Juma

nO MagIc PIll .........................................Page 30Imagine what your life would be like if you were in pain 24 hours a day, seven days a week. One man shares his personal story of chronic pain, the effect its had on his life and how hes learned to take his life back.

By Wendy Young

My HealtH cOacH Sleep your way to a healthy weightBy Cathryn Smith

The Childhood obesiTy epidemiCObesity is likely to overtake smoking as the number one preventable public health concern. Experts say the solution lies with treating, and preventing, the condition in childhood.By Jake Adrian

Volume 1, Issue 3

p.12

coverstory

inside

2015Fall

OtHer stOrIes Why obesity matters Is your child overweight? Prevention is the key

p.35

lOOK at Me nOW My journey from unhealthy obesity to good health and happiness.

By Sierra, as told to Jake Adrian

Fall 2015 Healthier You 3

Healthier You

Fraser Health

editors / Bonnie Irving, Tasleem Juma

content advisor / Samantha TongPopulation and Public Health

contributors / Jake Adrian, Shannon Henderson, Hannah, Cathie Heritage, Tasleem

Juma, Sierra, Cathryn Smith, Lisa Thibault, Diane

Wild, Wendy Young.

www.glaciermedia.ca

By Michael Marchbank, President and CEO

Fraser Health

In doctors offices, walk-in clinics, pharmacies and other community settings, we will be waiting there too keeping you company, and sharing stories and insight into health-related issues that matter to you.

Where can you find Healthier You?

CEOmessage

Volume 1, Issue 3 Fall 2015

published by:

PUBLISHED BY FRASER HEALTH & GLACIER MEDIACopyright 2015. All rights reserved. Reproduction of articles permitted with credit.

glacier Media group

sales & Marketing Kevin Dergez Director of Special Projects

[email protected]

Ellyn Schriber Newsmedia Features Manager BC [email protected]

Keshav Sharma Manager Specialty Publications [email protected]

creative Director / Eric Pinfold

Advertisements in this magazine are coordinated by Glacier Media. Fraser Health does not endorse products or services. Any errors, omissions or opinions found in this magazine should not be attributed to the publisher. The authors, the publisher and the collaborating organizations will not assume any responsibility for commercial loss due to business decisions made based on the information contained in this magazine. Speak with your doctor before acting on any health information contained in this magazine. No part of this publication may be reproduced or transmitted without crediting Fraser Health and Glacier Media. Printed in Canada. Please recycle.

FSC

Good Health, Long Lives

This is our third issue of Healthier You. And from all reports you are finding the articles engaging and useful.

Our goal with this magazine is simple to promote healthy living. While our hospitals may be the first thing you think of when you hear the words Fraser Health, our role extends far beyond illness and the hospital.

One of the biggest challenges our health care system faces is how to encourage the behaviours we know can prevent chronic disease particularly cancer, diabetes, heart disease, chronic obstructive pulmonary disorder (COPD) and depression. One in three of us lives with one or more of these five diseases. If we could prevent them from starting in the first place, or prevent them from worsening for those already affected, we could eliminate much needless suffering. We could also save BC taxpayers many billions of dollars a year.

Fraser Health wants to promote the kind of healthy living that will reduce the incidence of these diseases. Scientists can tell us what factors contribute to the onset of these diseases lifestyle (no exercise, alcohol use); smoking; obesity; genetics; and poor nutrition but it will take more than just naming them to get us to change.

We use a variety of methods to talk prevention. This magazine is one of them as are our activities on Facebook and Twitter. We have built formal and informal partnerships with municipal councils, non-profit community organizations and groups of family doctors to support and promote activities that support healthy living in our communities.

Prevention, of course, really needs to start with our children. When we reach out to moms, dads and grandparents, we hope we are encouraging them not only to modify their own behaviours, but also to set their children on the path to good health and long lives.

As always, please let our editorial team know what you liked about this issue, and what you would like to see in coming issues at [email protected].

Connect with us:

www.fraserhealth.ca

4 Healthier You Fall 2015

Flu shoT,

yes or no?PROvInCIAL HEALTH OFFICER DR. PERRY KEnDALL

TALKS ABOUT wHAT wEnT wROnG wITH LAST YEARS FLU vACCInE, CHALLEnGES wITH LAnDInG THE PERFECT vACCInE AnD wHY THE FLU SHOT

IS STILL YOUR BEST BET.

Finding your perfect match isnt easy, especially if youre a flu vaccine.

While last years flu vaccine was effective in protecting us against two types of flu viruses, it was rejected by the circulating H3N2 virus the one virus that was giving us the most trouble.

In Fraser Health alone, there were nearly 60 flu outbreaks in long-term care facilities the most since tracking began in 2007. While some of this increase was likely due to better reporting, it is also an

indicator that the reduced protection resulted in more at-risk people, like seniors, becoming ill with the flu.

This mismatch, along with studies that questioned the impact of getting vaccinated every year, has led some people to question the value of getting the flu shot.

As the provincial health care system gears up for the 2015-2016 flu season this fall, Healthier You connected with Provincial Health Officer Dr. Perry Kendall to get his take on what all this means to you.

By Shannon Henderson


last year we kept hearing about what a bad match the vaccine was to the circulating strain of flu. how bad was the match, really?

Flu vaccines used in BC contain three flu strains, or types two flu A strains and one flu B strain. Last year, one of the A strains (H1N1), as well as the B strain, were a good match to circulating viruses. But the second flu A (H3N2) was not. In fact, it had the lowest vaccine effectiveness in Canada since we started measuring in 2005. While the H3N2 mismatch led to a significant number of illnesses in older people, the H1N1 and B components provided very good protection. This years vaccine has been changed to match the H3N2 strain that is predicted to circulate later this year.

how are flu vaccines determined each year? Are there opportunities to adjust the vaccine mid-season if there are indications you havent got a good match?

The most common way flu vaccines are made is by using a chicken egg-based manufacturing process. Eggs are injected with the types of flu viruses scientists at the World Health Organization (WHO) predict will be the most prevalent in the upcoming year. The eggs are incubated for several days to allow the viruses to reproduce. The virus-containing fluid is harvested from the eggs. For flu shots, the flu viruses for the vaccine are then inactivated (killed), and the virus antigen is purified and tested. For the nasal spray vaccine, the viruses are weakened rather than killed and go through a slightly different production process.

When given to a person, the killed or weakened viruses will stimulate an immune response without actually causing the flu. That resulting immunity is our protection from the live viruses we will encounter.

The manufacturing process takes about six months if all goes well. Therefore, its not possible to adjust the vaccine in mid-season if the best guesses from WHO scientists are wrong. Additionally, flu viruses change form constantly and rapidly. Because of these factors, there is always the possibility of a poor match between the vaccine and the types of viruses that are circulating that year.

so, if the scientists guess wrong about which strain of h3N2 to include in this years vaccine, theres nothing that can be done?

Thats correct. The lengthy time it takes to develop a vaccine means that we cannot develop a new vaccine in that flu season. However, staying healthy, practicing hand and respiratory hygiene and staying home when ill are additional measures to help protect oneself and others against a range of viruses, including flu.

how bad is it if you get the flu, really? It can be deadly for older people and can send others with

underlying illnesses, like asthma, to hospital. For otherwise healthy people, it can be a miserable illness marked by severe muscle and joint aches, headaches, fatigue and a cough that can last for up to two weeks. It also forces you to miss out on winter fun like that sunny beach vacation you booked, parties, family get-togethers and the ski season.

have you seen an increase in the past five to 10 years in the number of people who get their flu shot? if so, what do you think is generating the increase?

Fortunately, we have. Over the years, people have seen how serious and even deadly the flu can be, especially for older people. Increasingly, people are more conscious of the role they play in not only protecting themselves, but also others who are vulnerable to illness.

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What are the common misunderstandings that prevent people from getting the flu vaccine?

There are so many reasons people will give for not getting the flu shot. They range from Im healthy and dont need it to the flu shot will give me the flu. The reality is that between 10-20% of the population does get the flu every year, healthy people included. As to whether the flu shot actually gives you the flu, the vaccine contains either killed virus or weakened virus. These are like paper targets your body can practice shooting at. To say that you can get the flu from the flu shot is like saying paper targets can shoot back at you. Thats impossible. Yes, your bodys practice reaction can make your arm sore for a day or two, and sometimes even cause a fever, but its not the flu. Trust me, when you get the flu, youll know it.

Some people report that they received their flu shot and still got the flu, and there are a few reasons for this: one is that the overall vaccine effectiveness is about 60% on average, which is still very good in terms of population protection; two, is that they may have been incubating the flu at the time they got their flu shot; and three, that it wasnt the flu they got but another respiratory bug, instead.

public health officials talk about how at-risk populations, like seniors or pregnant women, should get the flu shot. do you think that gives the rest of the population that doesnt identify itself as at risk an excuse not to get vaccinated?

I dont believe focusing on those most at risk has discouraged people from getting vaccinated. Rather the reverse as they get vaccinated to protect those at risk and provide what we call herd or community immunity. Its that herd immunity that is so important in protecting the population as a whole from potential widespread disease.

Recent studies from the bC Centre for disease Control show that people who receive flu vaccines year after year can sometimes show reduced protection. Researchers in several countries have shown similar puzzling results. What do you make of these findings?

These studies have provided important insights into the factors influencing flu vaccine protection. To date, these studies overall have shown that people who receive the flu vaccine are better protected against seasonal flu than those who are not vaccinated. But among those who are vaccinated each year, the amount of protection may be reduced over time. The reasons for this require better understanding. None of the effectiveness studies to date have shown that receiving the flu vaccine increases the risk of serious flu illness. Since these studies show that vaccinated people are better off than unvaccinated people, it is important that people continue to get their annual flu vaccine.

is there a better solution on the horizon as to how flu vaccines are determined?

Research is ongoing for a better, longer-lasting, flu vaccine. A vaccine that covers off all flu strains would be good, so then we wouldnt be worried about changes in the viruses and matching vaccine to circulating strains.

Given everything we know about flu and vaccines, whats your best advice for people?

Exercise, eat healthy, dont smoke, get enough sleep, wash your hands frequently, stay home if you are sick and GET YOUR FLU SHOT.

To find out where you can get your flu shot, visit fraserhealth.ca/flushot

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1647

5 0

9.15

Epidemic

The Childhood

Obesity

OBESITY IS LIKELY TO OvERTAKE SMOKInG

AS THE nUMBER OnE PREvEnTABLE

PUBLIC HEALTH COnCERn.

ExPERTS SAY THE SOLUTIOn

LIES wITH TREATInG, AnD PREvEnTInG,

THE COnDITIOn In CHILDHOOD.

specialfeature

By Jake Adrian


Canada, like many nations, is in the midst of an epidemic of obesity and excess weight. And

according to the Childhood Obesity Foundation in Vancouver, childrens eating and exercise habits

are a big part of the problem. According to the 2009-2011 Canadian Health Measures Survey, close to one-third (31.5) of children between

five and 17, an estimated 1.6 million, were overweight or obese. Only a few years earlier, a similar survey showed that only about one-quarter of children between two and 17 were overweight or obese. The upward trend is worrisome.

Why does it matter?

Because being overweight or obese is dangerous for a childs health.

Recent societal trends have encouraged unhealthy eating and inactive lifestyles which result in excess fat accumulation. Obese children are more likely to develop a range of health problems, including Type 2 Diabetes, heart disease, liver disease, bone and joint problems to name only a few of the potential physical problems. As well, emotional problems include low self-esteem and negative body image, depression and the emotional fallout from feeling judged and being teased and bullied.

Most adolescents do not outgrow this problem and, in fact, many continue to gain excess weight. As a result of obesity, says the foundation, it is possible that for the first time in history our children may have a shorter lifespan than their parents.

In addition to the toll being overweight and obese can take on an individual including dying up to three to seven years earlier than counterparts with a healthy weight there are also financial costs to society. In 2013, the total in health care costs caused by obesity to Canadians was $23 billion.

This is 25% higher than costs caused by tobacco smoking ($23.3 vs. $18.7 billion). From 1998 to

2008 the costs associated with smoking decreased while the costs of excess weight increased. According

to the Canadian Journal of Public Health, the economic burden attributable to smoking decreased

to $18.4 billion from $21.3 billion (-13.4%). On the other hand, the economic burden attributable to excess

weight and physical inactivity increased to $21.3 billion from $19 billion (11.7%) and to $10.6 billion from $10

billion (6.3%) respectively.

Obesity is difficult to reverse. But it can be done. Healthier You asked one young woman to share her journey from obesity

to health.

Continued on next page >


i would tell other kids who are struggling with

weight issues, you arent alone. There are people and places you can go to for help. And

its okay to ask for help.

Now!Look at me

MY jOURnEY FROM UnHEALTHY OBESITY

TO GOOD HEALTH AnD HAPPInESS

My name is Sierra and Im 15 years old. Ive been overweight for most of my life.

I cant remember not being overweight. I was chubby as a child and just gained more and more weight as I got older. Because of my weight, I was always being bullied and made fun of at school. This started when I was in kindergarten and went on all through elementary school. In the younger grades kids would say things like Youre fat or People fat like you are dumb. They drew pictures of me as a large round circle with

By Sierra as told to Jake AdrianPhotos Jerald Walliser


a tiny head. Kids pushed me down in the playground and laughed at me. I also have dyslexia, a learning disability, so kids teased me about that too. These were kids in my class and I thought they were my friends. Then my mom would tell me No, theyre not your friends theyre treating you badly. You just havent realized it. I guess the teasing had become normal to me. I grew up with it and didnt know any different, but I didnt like it at all. When I got older, kids were less physical, but bugged

me more with name calling and swearing. My parents talked to my teachers several times. They didnt see the bullying though and didnt seem to know anything about it. They would often write it off saying Kids will be kids. Some teachers were helpful and tried moving me away from the problem kids. That just made them pick on me more. Kids would go out of their way to tease me.

Just going to school made me feel sick to my stomach. Every day I felt like throwing up because of how nervous I was. I didnt feel safe at school at all. Id come home and cry. It made me really sad so Id just stay in my room eating and watching television to feel better.

To try to help, my parents had me change schools. One school had a special education program I was asked to participate in, but that just led to more teasing. Its like when someone has a flaw or is obviously different in some way were automatically picked on and laughed at. After two years, I changed schools again. I went to three different schools in six years, never lasting more than two years at one school because the name calling followed me and happened again and again at the different schools. But every day I showed up and faked a smile pretending that everything was A-okay.

My eating habits were terrible. I only wanted to eat lasagna, chips and iced cappuccinos. These were foods that made me feel good. I didnt like vegetables or anything green. My parents tried to get me to eat better, but I didnt want to listen to them. I was picky and moody.

By the time I was 12, I was really large way over the 97th percentile for my age, weight and height. I was gaining more and more weight and just couldnt stop eating. I didnt like the way I looked at all. I wished I


could just cut off my stomach to make it flat. I wanted to get rid of the weight so bad I started skipping meals. Then Id be so hungry Id break down and eat a bag of chips.

After a checkup at my pediatricians office she told me my cholesterol and fasting insulin levels were really high, which could lead to heart disease and Type 2 Diabetes, and recommended I enter the Shapedown BC Program at Langley Memorial Hospital.

At first I didnt want to go. I thought it was going to be a lot of work like school and didnt want that. The hardest part was admitting to myself that I needed it that I needed help. My parents didnt give me a choice. They said I needed to give it a try.

The first few times were really hard. Then I got to know other kids like me struggling with their weight and I started to feel more comfortable. My parents and I attended group twice weekly. We went once a week together for classes and then once on the weekend for family fitness. During the week, they would be with the other parents learning things like how to plan healthy meals, how to read food labelling and trying different healthy recipes like quinoa salads.

I went with the other kids and learned things like how much food is in a single serving or that a meat serving should be the size of your palm. I didnt need to eat everything on my plate if I was full. I learned to tell the difference between heart hunger eating when youre sad and stomach hunger when youre actually physically hungry.

Now when I eat I chew slowly and take breaks in between bites of food. When I get hungry I can check in with myself and ask if I am really hungry. Ill wait and see if my stomach is growling, then Ill know I am. I want to keep my weight off so Ive learned to like fruits and vegetables and eat them a lot more.

Continued on page 18 >

I didnt feel safe at school at all. Id come home and cry. It made me really sad so Id just stay in my room eating and watching television to feel better.

Sierra

Why obesity mattersObese children are more likely to develop a range of health problems, including:

physiCAl: Type 2 Diabetes high blood pressure and

elevated blood cholesterol heart disease liver disease bone and joint problems respiratory problems and

sleep disorders such as difficulty breathing while asleep (sleep apnea)

earlier than normal puberty or menstruation

eating disorders such as anorexia or bulimia

skin infections due to moisture from sweat being trapped in skin folds

fatigue

emoTioNAl: low self-esteem and negative

body image depression feeling judged being teased or bullied bullying others being more socially isolated poorer social skills high stress and anxiety behaviour and/or learning

problems as a result of psychological difficulties related to childhood obesity

When I see a picture of myself from before, Im glad I got help and am not like that anymore.

I wasnt happy. I want to be healthy and stay this way.


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Continued from page 16 >

We got a six-month membership to the Tong Louie YMCA as part of the program. On Saturdays wed meet with the other kids and a fitness coach and go swim, play soccer or other games where we were exercising, but it was made fun. I was too young at first to use the weight machines the stationary bikes, weights and elliptical machines but learned to use them later once I was old enough.

I also learned to set realistic exercise goals. The first time I set an exercise goal it was to take four long walks in a week. I walked so much that I got really tired and didnt want to do it anymore. Now I know how to be realistic. I watch TV less and spend more time taking my dogs for walks or even going walking with my friends. I work out twice a week and do sit-ups, pushups and the plank.

Another thing that really helped me was in one of the classes they showed us how women in magazine pictures are made to look perfect; how theyve had so much editing and airbrushing done to make them look that way. Learning these things helped me to start feeling better about myself. I was starting to lose weight and because I saw a result my confidence grew too. I thought, This program isnt so bad I can lose more weight.

When I finished the program I was invited to come back. Because I was losing weight, I wanted to continue and ended up taking the program three times. Now Im at a healthy weight. The bullying has stopped. I have more friends and I feel a lot better about myself.

My family used to eat a lot of packaged food or takeout because we were so busy and we thought it was quick and easy. Now we make our own pizzas rather than takeout and we eat a lot more salads.

Id like to tell people who used to tease me look at me now. Bullying people because they may be overweight really hurts, even if youre just joking it doesnt feel that way. I would tell other kids who are struggling with weight issues, You arent alone. There are people and places you can go to for help. And its okay to ask for help.

When I see a picture of myself from before, Im glad I got help and am not like that anymore. I wasnt happy. I want to be healthy and stay this way. The best thing of all is that now when I smile it isnt faked anymore.

Is your child overweight?The Childhood Obesity Foundation defines a healthy weight as a body composition that positively contributes to an individuals overall health, well-being and quality of life over their lifespan. Healthy weights in children vary by age, sex and height. It is important to remember that weight is only one marker of health and a healthy weight is different for each individual child.

The Body Mass Index (BMI) is one tool doctors use to assess if a child is overweight. It is defined as a persons weight in kilograms divided by the square of his height in metres. According to the World Health Organization (WHO) after BMI is calculated for children and teens, it is expressed as a percentile which can be obtained from either a graph or a percentile calculator at the link here: dietitians.ca/your-health/assess-yourself/assess-your-bmi/bmi-children.aspx

overweight: 85th to less than the 97th percentile obese: Equal to or greater than the 97th percentile

If you are concerned that your child is above a healthy weight, visit your family doctor for an assessment.

the best thing of all is that now

when I smile it isnt faked

anymore.


Prevention is the keyMaintaining good health throughout ones life begins in childhood. Learning proper eating and exercise habits needs to start early to prevent unhealthy weight gain or disease.

Canadas Food Guide suggests eating well and being active every day. Help your child develop healthy eating and exercise habits with:

Plenty of vegetables, fruits and whole-grain products

Low-fat or non-fat milk or dairy products Lean meats, poultry, fish, lentils and beans

for protein Reasonably-sized portions Lots of water Less sugar and saturated fat Brisk walking Playing tag Jumping rope Riding a bike Playing soccer Swimming Dancing

Source: cdc.gov/healthyweight/children/

Live 5210 live5210.caMaintaining good health throughout ones life begins in childhood. A great rule of thumb is the 5-2-1-0 rule:

5 or more veggies and fruit per day2 no more than two hours of screen

time a day

1 hour of physical activity or more per day

0 no sugar drinksSource: Childhood Obesity Foundation childhoodobesityfoundation.ca/scope/

For more info on tips for healthy eating and exercise:

dietitians.ca healthyfamiliesbc.ca participaction.com physicalactivityline.com healthycanadians.gc.ca/eating-nutrition healthlinkbc.ca/healthyeating Shapedown BC childhoodobesityfoundation.ca


HOW ONE 11-yEAR-OLD CHALLEnGED SURREY MEMORIAL HOSPITAL STAFF MEMBERS TO COMMIT TO OnE POSITIvE CHAnGE FOR HEALTH AS PART OF CHAnGE DAY BC

When Fraser Healths quality improvement consultant Catherine ODonnell came home from work last May, she told her daughter Hannah about a new project shed taken on: encouraging Fraser Health employees to commit to a positive change for health, for Octobers Change Day BC. She knew where shed like to start and was excited to share her enthusiasm.

Turns out, she got off to a massive start through that chat with Hannah.

I decided right away I wanted to pledge to promote the day and get 100 pledges, says the 11-year-old Surrey student.

Inspired by a movement that started in England, Change Day BC encourages people who work in health or social care to commit to an act of change that will improve care for patients or the system they work in. It also encourages members of the community to commit to a change that would improve their health.

Hannahs first convert on the way to blowing that goal out of the water was her friend Christina, who pledged to talk to her grandparents in Chinese about pledging to make a change for better health. Both girls walked around their cul de sac to get more pledges, and Hannah made posters for her neighbourhood. She also met with her principal and vice principal at Woodland Park Elementary, both of whom embraced the idea.

The two friends goal was to get everyone in their school to make pledges related to healthy living. But Hannah didnt stop there. After an email exchange with Surrey Memorial Hospitals executive director Cathie Heritage, she challenged the hospital to match her schools pledges.

hannahs Challenge

aBOve

three change-makers: Pals chanteya and Hannah team up with Fraser Healths catherine ODonnell.

By Diane Wild


Hannah: I would be more than happy to challenge your staff to try and get more pledges than me. The thing is theyre going to have to keep up Im on a roll! If your staff have more pledges than me, Ill hand out a $25 gift voucher from my birthday money (which is a lot of money for a fifth grader), and Ive convinced my mom to give a $50 gift voucher as well. She says thats a lot of money for a Scottish person.

Cathie: I accept your challenge on behalf of Surrey Memorial Hospital. If you win I will personally contribute $250 to your school for a healthy living project. What do you think? I would also be happy to speak to your principal if you want. Maybe I could come to your school and meet with you both. I think it might be exciting to bring you and a few of your classmates on a tour of Surrey Memorial Hospital. We could take some pictures and you could take them back to a school assembly. I think it is really important that the community understands how important healthy living is. We need your help to keep our community fit, healthy and happy!

Hannah: I love your offer and I bet my school will too. Now we are extra motivated to make this pledge happen. I just feel sad about taking that $250 away from you.

With a goal of 5,000 pledges across the province, Hannah and Cathie teamed up to rally their entire community to commit to a change. The challenge went beyond the school and hospital as Hannah and one of her classmates, Chanteya, presented their plan to the senior leadership of Fraser Health to spur each community in the region to try to get more pledges than Surrey.

Hannah alone racked up over 300 pledges from her circles within a month of starting her efforts, making her one of the top 10 contributors to Change Day BC amid a field that includes large health care organizations.

Cathie: We want this challenge to extend beyond our hospitals doors because we recognize the importance of prevention, and staying healthy. Much of Fraser Healths work is about trying to keep people out of the hospital and getting the support they need in their communities instead.

Hannah: Its everyones chance to fix something in their lives and in the health care system. For example, like wearing a helmet, making healthy food choices and exercising daily. I want peoples health to be better. You cant stop accidents, but you can prevent lots of them.

Cathie: Just start doing it! It doesnt need to be complicated, and it shouldnt be. It can be something simple about your own health. Sometimes we create unrealistic expectations of ourselves. Even small changes can make a huge difference. Maybe its packing your lunch, or taking 15 minutes a day to just rest and relax.

Hannah: People can make changes for themselves or for a better system.

Cathie: I was a nurse but it has been a long time since I cared directly for patients. About eight months ago, I spent an entire day on a hospital ward to better understand the challenges our frontline staff, like nurses and doctors, face today, especially at the patients bedside. It was really a positive learning experience for me.

Cathie calls Hannah an amazing young woman, saying she and her mother Catherine are equally inspiring.

Change Day BC is October 15, too late for the results of the Hannah-Cathie competition to be reported in this issue of the magazine. But were betting that win or lose both competitors will feel like winners.

Says Cathie Heritage: Any opportunity for Surrey Memorial Hospital to engage with our community is great. Children have so much influence with mom and dad and the choices the family makes. Its very powerful to have kids involved, making active choices about their own health.

Hannah herself makes the inspiring and challenging -- case for change: If you make a pledge for healthier living, you can make the world a better place. More importantly, you dont want to be beaten by an 11-year-old.

any opportunity for surrey Memorial Hospital to engage with our community is great... Its very powerful to have kids involved, making active choices about their own health. cathie Heritage, executive Director

I pledge to...

I pledge to...

I pledge to...

... wear my helmet when riding my bike... walk to school or ride my bike... walk 3 times a week for 20-30 minutes... recycle to save the environment... eat more fruits and veggies... use internet only when my parents can monitor

Woodland Park Elementary pledges

I pledge to...

I pledge to...

I pledge to...

... smile at everyone I meet

passing in hallways

... run twice a week for 30 minutes

... clean out my closets and donate

to those in need

... walk on my lunch break

... be more like my pup: live in the

moment

... catch people doing good and

acknowledge them immediately

Surrey Memorial

Hospital pledges


Good for your heart.Good for your brain. Health Canada recommends 2 x 75gservings of oily fish, such as salmon,per week.

Salmon is high in Omega-3s, which helpsprevent heart disease and stroke twoof the leading causes of death in Canada.

80% of premature heart diseaseand stroke is preventable.

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For the brine: 2 L Cold Water 125 ml Kosher Salt 125 ml Brown Sugar 4 8 oz Salmon Filets or 1 32oz Salmon Side

For the glaze: 15 ml Chopped Chipotle in Adobe Sauce 30 ml Fresh Lime Juice 45 ml Maple Syrup Salt and Pepper to taste 4 Small or 1 Large Cedar Plank

Directions1) Combine brine ingredients in a casserole dish.2) Submerge salmon in the brine and refrigerate 30 45

minutes.3) While salmon is soaking, combine all glaze ingredients. 4) Just before you are ready to start cooking, place cedar planks

over direct heat to heat them up.5) Remove salmon from the brine, pat dry and place on heated

cedar planks.6) Place salmon on the grill using indirect heat. 7) Glaze with half of the chipotle maple mixture, close lid and

cook at 400F for 5 minutes. 8) Open the lid, glaze again and cook another 5 minutes.

Continue to cook until desired oneness is reached.9) Serve with our Brussel sprout and cranberry slaw and roasted

B.C. Potatoes.

Note: Brining your salmon will not only help it taste better, but it will also assist with avoiding the unattractive, white albumin from seeping out.

Maple Chipotle Salmon Recipe(Yield: 4 servings)

Salmon is one of natures superfoods

sponsored content

Creating Healthy Delicious Dishes

As the Chef for the B.C. Agriculture in the Classroom Foundation and the Chef Instructor at Maple Ridge Secondary School, I am committed to creating delicious, healthy dishes that not only celebrate B.C.s agriculture, but are also very easy to prepare. The Cedar Planked Maple-Chipotle Salmon is no exception. By rounding off the sweetness and the heat with a splash of fresh lime juice, this twist on a B.C. classic is sure to be a hit at your next dinner party or weekday family dinner. When choosing to cook with B.C. products, you are setting your meal up for success not only will those fresh ingredients make the dish come alive, but you are also supporting local farmers at the same time. Give this a try and let us know how you enjoyed Taking a Bite of B.C.

Take a Bite of BC was developed by BC Agriculture in the Classroom Foundation in partnership with the BC Culinary Arts Association, BC agricultural commodity groups and

BC producers. The program started in 2009 with 14 schools participating. Take a Bite of BC is now in 30 schools in the Fraser Valley and Okanagan. For more information on AITC, their programs and recipes, please visit www.aitc.ca/bc.

Culinary creation by Chef Trevor Randle.

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Apps To help yoU mANAGe some of yoUR ChRoNiC heAlTh CoNCeRNs

WebMD Allergy

After you enter the allergies you have, the WebMD Allergy app for iPhone and Android will help you manage each day with a personalized allergy and weather forecast for your location. The app also includes a library of tips that can be customized for your allergy. you can track how you feel each day, your symptoms, and treatments to track your allergies and any potential triggers info you can share with your doctor.

The app includes:

Allergy forecast with up-to-date allergen levels based on your location. you can also look up data for other communities if you are travelling

Seasonal allergy map

Library and tips to help you manage your allergies

Symptom tracker

BC Health Service Locator App healthlinkbc.ca

If, despite your best efforts to keep healthy, you need medical help, heres a good local app. It helps you find walk-in clinics, hospitals, emergency rooms, immunization locations, after-hours pharmacies, and laboratory services near you. You can search for health services by city or keyword. you can also call 8-1-1 and view the latest health alerts.

WebMD Pain Coach

Pain Coach tracks symptoms and goals in order to help you better manage your chronic pain condition. This highly personalized app allows you to select the symptoms, treatments and goals you wish to track for your particular experience with chronic pain. Over time you will be able to review patterns that help you understand your pain triggers and set goals and lifestyle choices you can share with your family doctor.

The app includes:

A journal to easily record how you feel each day, your pain experience, symptoms, triggers, treatments and notes

Tool to help you select goals from five categories related to your pain conditions

Library and tips to help you manage your chronic pain

MyMedRec Developed with input from several Canadian health care associations, this is a fantastic little app that lets you track your health care record so you can share it with your health care provider, pharmacist or family whenever you need to. The app lets you track medications, allergies, blood pressure, immunizations and other information for you and members of your family.

Track the following in MyMedRec:

Medications and natural products, immunizations, blood pressure, cholesterol, allergies, health care providers, notes

Other features:

Dose reminders for medications. Multiple profiles to keep track of family members. Add entries to your calendar for medication refills, appointments and immunizations. Email parts of your record to your health provider.

The Canadian Red Cross First Aid app provides lifesaving first aid information in the palm of your hand. It includes information on preparing for emergency situations and quizzes to test your knowledge. Great resource if youve ever wondered what to do when faced with a medical emergency.

The Canadian Red Cross First Aid App

Compiled by Lisa Thibault


wAnT FRESH IDEAS ABOUT REDUCInG InjURIES FROM FALLS AMOnG SEnIORS? ASK FRASER

HEALTHS FABIO FELDMAn.

Fabio Feldman, manager of Fraser Healths seniors falls and injury prevention program, never thought he would turn out to be so passionate about falls. But his love for translating research into practical applications naturally led him into a field in which he was eventually able to turn all conventional wisdom about seniors falls on its head.

Falls among seniors over 65 are, unfortunately, common, with one in three falling at least once a year. This rate goes up to one in two for those over 80. Falls cost the Canadian health care system over $1 billion a year money that

could be diverted to other pressing needs.

When Feldman first got involved in the field of injury prevention, it was ripe for change and ready for people like him who were hungry to ask their own questions and find their own answers. After arriving in Canada from Brazil, where he was a professional football player, in 1996 Feldman attended Simon Fraser University (SFU) to study kinesiology, eventually completing his masters and a PhD. As a young researcher at SFU, Feldman was part of a team that challenged and ultimately dislodged much of the accepted wisdom about falls and injury prevention. He has been putting that research into action over the last 10 years, ultimately improving the quality of life of seniors and saving millions in our health care system.

For Feldman, it means constantly questioning the validity of other peoples work and putting their conclusions to the test. He worked closely in those early days with his revered mentor and PhD supervisor, Dr. Stephen Robinovitch, then the Canada Research Chair in Injury Prevention and Mobility Biomechanics. After Feldman was hired by Fraser Health, the two developed a strong partnership that has greatly improved Fraser Health and SFUs research

By Tasleem Juma

The Falls

Guru


capacity, netting them both over $5 million in grants from the Canadian Institute for Health Research and other agencies.

What really attracted me to seniors and falls and injury prevention is that its such a big problem its costly and there are personal issues, pain and suffering, and theres so much being done, yet we know so little about the problem, says Feldman.

From the beginning of his graduate studies, Feldman focused his work on injury prevention as opposed to falls prevention. His collaboration with fellow researchers has led him to pursue several theories aimed at reducing injuries, including stick-on hip protectors and bouncy floors.

As an adjunct professor in the department of biomedical physiology and kinesiology at SFU and the manager of injury prevention at Fraser Health, Feldman is ideally positioned to combine research with cutting-edge technology.

Stick it to it!

Feldman has come to see the many benefits of hip protectors through his research over the past seven years. But he has also seen how the design of todays hip protectors presents a real barrier to their use by some.

Traditional hip protectors are special garments (underwear, shorts or pants) containing soft pads inserted into pockets covering the hip area. The underwear-style model poses many challenges in hospitals: it needs to be laundered often to reduce the spread of germs; many different sizes are necessary; and they are difficult to use on seniors with mobility issues, especially when they need to use the washroom.

Through collaboration with colleagues from SFU, Feldman has developed a disposable stick-on hip protector that capitalizes on a special tape developed by 3M that can be reused several times. Unlike its garment counterpart, once its placed directly on the skin covering the hip, the stick-on pad doesnt move until removed. And it can be reused over and over again cutting down costs

while providing equal, if not better, protection than traditional hip protectors that are currently available.

Prototypes have been developed for a clinical trial, beginning with a pilot project at Surrey Memorial Hospital, to make sure people are comfortable using the stick-ons, that the tape is effective, and that it is resistant to wear and tear.

For the bounce of it

Feldman and his team at SFU have also discovered a unique energy-absorbing floor produced by Satech Inc. in Washington state. The flooring cushions falls and prevents injuries when installed in indoor areas.

Testing revealed that the bouncy floor could reduce 40% of the impact force to the hip and 70% to the head enough to dramatically reduce injuries due to falls. Feldman has been known to demonstrate the floors injury-prevention qualities by repeatedly dropping an egg on it

without breaking it.

The special flooring is currently being evaluated in a large clinical trial led by Feldman and Dawn Mackey, an assistant professor at SFU. The researchers hypothesized that the flooring should reduce fractures and head injuries by at least 50%. Results from the trial, expected in 2017, may change the way residential care facilities are designed to prevent injuries due to falls.

Taking the show on the road

Feldman has also led the establishment of Fraser Healths falls prevention mobile clinic. The clinics model was developed to improve access to risk screening, assessment tools and interventions for seniors by bringing experts

What attracted me to seniors and falls and injury prevention is that its such a big problem its costly and there are personal issues, pain and suffering, yet we know so little about the problem. Fabio Feldman

PHOtO: Jerald Walliser

Why they fallMajor predictors of falls injuries: dizziness, hypotension, balance, gait disturbances, syncope, confusion, frequent urination, use of assistive devices, dementia or cognitive impairment, increased gait and mobility impairment, staffing and environmental issues.


from various fields together to help prevent falls and fall-related injuries. This is the first of its kind in the world.

The most unique feature of this clinic is that it goes to seniors rather than vice versa. It takes falls assessment and interventions to community locations where seniors typically meet, like recreation centres and seniors centres. It also operates at a relatively low cost due to contributions from community, government and private partners. Each session of the clinic provides services to a large number of seniors and can be adapted to different ethnic groups. Similar clinics are now being offered across Canada.

The clinics have proven to be so successful that the BC Ministry of Health recently awarded Feldman and his team $400,000 through the Centre for Hip Health and Mobility to increase the availability of Fraser Healths falls clinics and to support other BC health authorities to implement the same model in their regions.

The beauty of these clinics is that they are a cost-effective way to provide falls and injury prevention to the community through partnerships with community organizations and other health care professionals. The model can even be used to address chronic diseases, says Feldman.

New Directions

Feldmans research success has led to new opportunities to improve seniors health. He has started to focus on dementia and delirium in seniors and is leading a research project at Royal Columbian Hospital to examine whether exposure to a digital skylight above a patients bed in the emergency room reduces the incidence of severe confusion or delirium.

He and his team have also developed the Safety Superheroes Program (safetysuperheroes.com) that promotes an intergenerational approach to fall prevention. Launched in 2010, the program includes a picture book, Safety Superheroes: Preventing Grandparents from Falling and related print activities to help children ages five to 10 and their families learn ways to prevent falls at home. This is the first and only childrens book in the world to address this issue and it is now being utilized in over 30 communities across North America.

In spite of all the attention and focus Feldman receives, he is quick to stress the cooperative nature of his work and credits his team for their support. The quintessential team player, Feldman will continue to lead Fraser Health in new, innovative directions in the pursuit of preventing falls and injuries for some of the most vulnerable members of our communities.

Staying Upright4 key things that can prevent falls:

Have a doctor or pharmacist review your medications Make your home safer Start a regular exercise program to improve balance

and strength Have your vision checked at least once a year

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When critical care matters, the regionrelies on Royal Columbian Hospital.

Your donation is meaningful. Your care is critical.

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IMAGInE wHAT YOUR LIFE wOULD BE LIKE IF yOu WERE IN PAIN 24 HOuRS A DAy,

SEvEn DAYS A wEEK. OnE MAn SHARES HIS PERSOnAL STORY OF CHROnIC PAIn, THE

EFFECT ITS HAD On HIS LIFE AnD HOw HES LEARnED TO TAKE HIS LIFE BACK.

By Wendy Young

With his skates, pads and large sports bag over his shoulder, 13-year-old Justin rushed out of the house, slamming the door behind him. His mother was waiting in the car to take him to his weekly early-morning hockey practice. Justin had been playing hockey since he was five and was the goaltender on his AAA rep-level team. He had hopes of playing for a college league and eventually maybe even the NHL.

That dream was shattered one day during a physical education class at school when he suffered a minor neck injury, which led to the discovery of a very rare disorder that forced him to stop playing all sports, including his beloved hockey.

The diagnosis: Klippel-Feil syndrome a congenital deformity in which two or more bones of the spinal

column are fused together. The most common signs are

a short neck and restricted mobility of the upper spine.

Countless questions and concerns raced through Justins

mothers mind. What does this mean? How will this impact

his life? A very uncommon condition, the doctor didnt have

a lot of information to offer except that it was a degenerative

condition with no cure. Justin and his mother left with more

questions than answers.

Over the years, Justin managed the resulting headaches and

stiff necks with Tylenol #3 and ibuprofen. He enrolled in

horticulture science at Kwantlen Polytechnic University while

managing a garden supply store. Then, while developing his

green thumb, Justin developed cabin fever and cured it with

a bite from the travel bug. Over the next three years, he took

breaks in between his studies to travel to Australia and Asia.

Shortly after his return home in 2006, Justins neck pain

got progressively worse and the medications were losing

their effectiveness. Then one day, after a long day at work

managing a hydroponic store, he suffered extreme neck pain

to the point where he could no longer move. An MRI and CT

scan both confirmed that his condition was deteriorating.

no magic

Pill


The long slide into despairHis doctor advised him to stop all physical activity,

including his work. That day, when he was only 26 years old, marked the start of a downward spiral of suffering that would eventually rob Justin of his work, school, friends, independence and enjoyment of life.

Despite the lack of activity and the stronger prescription pain medication, every day was a gamble. Justin would not know whether he would make it through the day or if his pain would return and derail his plans. Ultimately, he had to drop out of university due to the pain and the medication which affected his memory and left his mind in a constant fog.

Justins pain had overwhelmed him. Isolated in his room and confined to his bed, he spent his days mindlessly watching television programs and movies, and playing video games. He was forced to stop driving because he would lose sensation in his hands and legs. And he was unable to participate in regular social activities. Justin developed severe chronic depression, relying on prescribed narcotics and medical marijuana to numb the pain and escape the reality of his life. It seemed pointless. Id often cross the street and not bother to look for oncoming traffic, he admits.

But there was hope.

In 2008, Justins mom who was a former nurse introduced him to Ruth Ringland, a nurse practitioner at Surrey Memorial Hospital with advanced education in pain management.

Ringland could see that pain had become part of every aspect of Justins life. He had lost his job, had no income and was socially isolated. The resulting emotional roller coaster made his underlying problem worse. Justin had become another patient struggling to deal with chronic pain which was devastating his life.

What is chronic pain?Persistent chronic pain is not a symptom, but rather a

disease that is quite different from acute pain, for example after surgery or as a result of an accident. But left untreated, the neurological processes that transmit acute pain messages to the brain create ingrained pathways and actually result in physiological changes to cells. Like a scratched music CD gets stuck playing the same few sounds over and over again, nerve endings fire the pain message endlessly. Ruth Ringland gives the insidious example of phantom limb pain, where pain seems to emanate from an appendage that no longer exists.

Medication and interventions can help some people but they are usually not the only answer to managing pain. Medications are often initially effective but the effectiveness often wears off over time, especially with opioids such as morphine.

There are a host of factors that are interacting in patients with chronic pain. Its not just about skin, bones and tissues. Anxiety, depression, neurotransmitters and the immune system all affect the way nerve signals are transmitted, and its a very individual thing.

The goal of chronic pain management is not to cure it; its about improving the persons quality of life. How much an individual suffers from their pain is not always related to

how severe the pain is. Its not that severe pain does not cause suffering. It does. But an individual may be suffering because the pain has affected all aspects of their life psychological, physical, social, financial and spiritual. Managing pain is about shifting the mind to re-define those aspects and find options to cope with the change.

Pain experts say that there are skills and behaviours that can help chronic pain sufferers live well with their condition. They refer to this ability to influence their pain as self-management. It doesnt replace physical therapies, medication and psychological support, but its a big part of feeling better. To start controlling the effect of the pain first requires acceptance from the sufferer that they have the power to effect a change.

When nurse practitioner Ruth Ringland met Justin, she herself had wanted to better understand how to help patients like him manage their own pain when other avenues failed. She enrolled in a self-management pain workshop with Justin and five other patients. They attended the weekly workshops to learn practical skills and behavioural approaches to better manage their symptoms and day-to-day life. Topics included dealing with stress and depression, appropriate exercise, relationships, nutrition and pacing daily activities.

Despite learning some self-management techniques, Justin continued to struggle with his pain and its crushing impact. It was another three years before Justin and Ringland would meet again.

An intervention offers hopeBy 2011, Fraser Health had opened a specialized pain clinic

at the Jim Pattison Outpatient Care and Surgery Centre in Surrey. The Pain Clinic provided access to advanced techniques and specialized equipment to treat pain. Ringland and pain specialist Dr. David Twist identified Justin as a possible candidate for the Radio Frequency Lesioning (RFL) treatment. RFL treats certain types of chronic pain by interrupting or blocking nerve signals on a semi-permanent basis, usually for six to nine months.

There was only one problem: Justins needle phobia. In fact, the sight of needles scared him so much that his heart rate and blood pressure would suddenly drop and he would faint. Julie Carlson, the social worker at the Pain Clinic, worked

Justin and the team who helped him get his life back: (l to r) Dr. David Twist,

Ruth Ringland, julie Carlson.


with Justin over several counselling sessions using a variety of therapeutic approaches to help him overcome his phobia as well as find coping strategies to live with his pain.

Carlson emphasizes mind-body strategies to manage stress and anxiety. These therapies and practices balance self-regulation strategies and mindfulness meditation with using ones mind (thoughts, feelings, beliefs and attitudes) to positively affect ones physical health.

Patients with needle phobias often have an overwhelmed nervous system including thought patterns that increase their anxiety before they even enter the treatment room, explains Carlson. I focus on self-regulation strategies and mindfulness techniques to help patients calm the mind and body before and during the medical procedure.

Mindfulness meditation trains the mind to focus on the present without any judgment. The goal is to not get lost in the past or worry about the future; its just to be curious and open to the present experience. For Justin, practicing the strategies he had learned encouraged him to respond to his daily pain in a positive manner.

Following Carlsons counselling, Justin was determined to go through with the RFL treatment and overcome his fear. With the guidance of Ringland and Carlson he developed a system that helped him to remain calm. Hed plug in his headphones, close his eyes and let the streams of classical music calm his mind. Hed picture roots from his feet grounding him into the floor and rub a smooth rock in the palm of his hand while concentrating on his slow, rhythmic breathing just as he had practiced.

His first treatment was a success, and he suffered only a minor anxiety attack fostering positive results. It was like night and day, describes Justin. The RFL treatments were effectively minimizing his pain. Justin returned every six months for the procedure, and each time it would get a little easier.

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7 principles of self-management Use knowledge about chronic pain to validate your

experience, understand treatment options and empower you to be your own best advocate.

optimize your sleep it may improve energy levels, pain coping and mood.

lifestyle changes. Eat well, quit smoking and use appropriate alternative and complementary medicine.

Cognitive-based psychotherapy cannot alter pain but many people find it dramatically alters how much they suffer from their pain. Get help with anxiety, depression, anger and fear.

Getting the right kind of support from your spouse and from others who have chronic pain can reduce the burden of chronic pain and offer alternative perspectives. Look into community resources, subsidies and help with employment and disability.

Use gentle exercise and progressively increase activity to optimize weight, reduce stress and to improve tolerance, fatigue and sleep.

mindfulness, yoga, and breathing exercises will reduce your pain, calm your nervous system, reduce stress and improve your sleep.

Source: Pain BC Pain Toolbox


The glass is half fullThe tides were slowly turning as Justin chose to see life more

positively. I was miserable before, very negative. But now I try to avoid the negativity because it only makes the pain worse, he says. He also quit smoking medical marijuana as it created more health issues, namely chronic obstructive pulmonary disease (COPD), rather than providing any real relief. Justin joined a yoga class offered at the Pain Clinic designed for those living with chronic pain, which taught them to understand their own bodies limits and boundaries. It offered relaxation, safe stretches and a positive connection with the body for a change.

With the coupled success of the RFL treatments and mind-body strategies, Justin, now 35, has gained the confidence and strength necessary to take back his life. He renewed his drivers license and started connecting with friends again. He made travel plans for Mexico, Las Vegas and Arizona. He also went back to part-time work as an actor in background roles in films and television. Earlier this year, Justin was on set with David Duchovny for the filming of The X-Files revival series premiering in January 2016.

There is no cure, surgery or magic pill that will take away my pain forever, says Justin. I could keep taking drugs and more drugs until I was a vegetable in a wheelchair but I didnt want that. He has learned to manage his condition by pacing his activities. Whether it is doing the laundry or emptying the dishwasher, he takes his time and doesnt push himself too hard. Its not worth it. If I go too hard, the pain can set me back for weeks.

Without his willingness, tenacity and enthusiasm, he wouldnt be where he is today, says Ringland. The road to get there wasnt easy but Justins journey offers hope to other chronic pain sufferers that they too can take back their lives.

More info: Fraser Health: fraserhealth.ca/pain Pain BC: painbc.ca Canadian Pain Coalition: prc.canadianpaincoalition.ca Self-Management BC free pain workshops:

selfmanagementbc.ca yoga: yogadirectorycanada.com (check your local

community recreation centres for restorative yoga classes) The Mindfulness App by MindApps Catch My Pain app (pain diary and community) youTube - understanding Pain: What to do about

it in less than five minutes www.youtube.com/watch?v=RWMKucuejIs

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sleep your way to a healthy weight

Are you still fighting the battle of the abdominal bulge despite being active and eating healthily? Ongoing research suggests that, besides exercise and diet, two other factors may also play a large role in how many pounds you carry and where you carry them: sleep and stress. So lets look at how these two factors play a role.

More than 35% of Canadians have trouble sleeping or staying asleep, about 10% get less than six hours of sleep regularly and 30% dont feel refreshed after sleep, according to Dr. Cameron Mustard, a scientist and president at the Institute for Work & Health (IWH). Missing out on both the quantity and the quality of sleep sets biological and behavioural processes in motion that lead to increased food intake, fat storage and physical inactivity. Dr. Jean-Philippe Chaput, assistant professor of pediatrics at the University of Ottawa, states that sleep deprivation affects hormones, increasing ghrelin, which tells you when to eat, and decreasing leptin, which tells you when to stop. More ghrelin and less leptin equals weight gain.

Lack of sleep is a stressor, says Chaput, which leads to elevated [levels of the hormone] cortisol short sleepers have higher levels of cortisol at the end of the day. You can blame that cortisol for depositing fat in your abdomen and increasing your risk for Type 2 Diabetes. Inadequate sleep also leads to feeling fatigued, making you less likely to be active, decreases the immune response, increases the risk of injury and interferes with mood, memory and clarity of thought.

Each time youre stressed, whether the stress is something like not sleeping eight hours a night or being stuck in traffic, your adrenal glands release the stress hormones cortisol, adrenaline and noradrenalin. Regardless of what the stress is, these hormones help you either to fight the stress or to run from it the so-called fight-or-flight response. They increase heart rate and blood pressure, divert blood and nerve supply from the gut to the limbs, heighten the immune response, slow down weight loss and metabolism and inhibit any form of relaxation and deep sleep.

So lets get this straight: stress can cause lack of sleep, and not getting adequate sleep is a stressor. A shift in hormones due to poor

sleep and/or excess stress can cause weight gain. Excess weight is one of the risk factors for obstructive sleep apnea, which interrupts your sleep, which leads to more stress you get the picture. Its a bit of a vicious cycle, for sure.

How to Break the CyclePay attention to patterns

Keep a daily journal for a week or two. Track how you feel when you wake up, your activity level, your energy level, your nutrition and fluids for the day, how you are feeling emotionally. Note whether there is anything in your life causing an increase in stress and how you respond. This can help you become aware of any areas in your life where you may need to make some changes and perhaps seek out some assistance from a health care professional.

Slow things down

Try to cut back 10%. Walk 10% more slowly, drive 10% more slowly, talk 10% more slowly, decrease your commitments by 10%.

Dont over-exercise

With exercise, you can get too much of a good thing, especially if you are feeling chronically stressed or sleep deprived. Research published in the journal Hormone Research found that long distance running like that done by endurance runners causes a sustained increase in cortisol which can make weight loss more difficult. In other words, overtraining when you are already tired or feeling stressed can have the exact opposite effect that you are looking for. Try something gentle like a walk outside or a yoga class until your energy level improves. Its about finding the right balance for your body.

Here are a few more tips to help improve the quality of your sleep.

Improve your sleep

Have a consistent, fixed wake-up time every day as this is one of the most important factors in building a consistent sleep pattern

Avoid caffeine after noon or so. Caffeine has a half-life of five hours. If you drink a cup of coffee at noon, at 5 pm only half of the caffeine will be out of your system

Remember that alcohol even one drink can interfere with the quality of sleep

Keep the bedroom dark and cool and have a routine that helps you unwind before sleep

If you are a shift worker, it is important to decrease light when the shift is complete (using blackout blinds and/or an eye mask ) and increase light when it is time to go to work (opening blinds and using a light box may help).

By Cathryn Smith

If you sleep less than five hours a night, you have a 50% likelihood of being obese. Russell Foster, neuroscientist

More info:Ted Talk by circadian neuroscientist Russell Fosterted.com/talks/russell_foster_why_do_we_sleep?language=en


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Thats why, Revera would like to invite you and a guest for your choice of a complimentary lunch or dinner and tour. Take the opportunity to explore our vibrant communities and speak with residents about what its like to live at Revera. See why they tell us they should have done this years ago.

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HomeChallengesI havedifficultymoving.

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ParentChallengesIm worriedabout mymom.

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Were stressedby illness.

Life Can BeChallenging.

What is obstructive sleep apnea?OSA is caused by narrowing or complete blockage of the airway during sleep, this can occur multiple times during the night.

What are some symptoms of OSA? Snoring, gasping during the night Fatigue and daytime sleepiness Feeling unrefreshed in the morning Morning headaches

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What will happen if I dont treat it?Increased risk of: High blood pressure Stroke and heart attacks Type 2 diabetes

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The independence you want with the services you needLive Life to the Fullest649 - 8th Ave., New Westminster, B.C.SeniorS retirement community

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For information or to bookan appointment please call:

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Six days

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