- Hepatitis A, Hepatitis B, Rabies, Typhoid, Dukoral,
- Meningitis, Anti-Malarrhial medication, Traveller’s
- Diarrhea medication
Article written by Seema Prihar – Pharmacist
Believed to be caused by inflammation of the facial nerve (7th cranial nerve), the paralysis results in distortion of the face and interferes with normal functions such as eating, smiling and closing the eyes. The progress from onset of symptoms to maximal weakness usually occurs within three days and almost always within one week.
- Disappearance of facial creases and nasolabial fold
- Drooping of saliva from the corner of the mouth
- Sagging of the lower eyelids and inability to close the eyelids; when patient tries to close the eye, there’s upward rolling movement of the eye (Bell’s phenomenon)
- Impaired speech
- Pain around the jaw or behind the ear on the affected side
Acupuncture as a Treatment
In conventional Chinese medicine, Bell’s palsy is known as Zhong Feng which translates as “Wind Attack”. This condition was thought to be associated with an invasion of “wind” that causes an imbalance in the “Qi”, which is the essential substance of the body, and stagnation of blood. The principle of acupuncture treatment is to expel this wind and enhance the movement of Qi and blood circulation. A number of Chinese studies had supported the therapeutic effect of acupuncture which was found to be beneficial in the management of Bell’s palsy. Reports had shown a minimum cure rate of 37 percent and a highest cure rate of 100 percent, with an average of 81 percent.
Acupuncture is often very successful in relieving the facial paralysis especially when treatment is begun within the first two weeks of diagnosis. This form of treatment uses natural pressure points on the body and is believed to relieve pain by limiting swelling and inflammation. The acupuncturist inserts small, thin needles into the skin in a number of main pulse points throughout the face and body. Some of the key point insertions will be in the stomach, liver, gall bladder, spleen, large intestine, forehead and hands. The side of the face that is used varies from patient to patient. There is no harmful side effect to this treatment.
Learn more about the Ministry of Health’s Primary and Community Care Strategy for BC.
” It is expected the BC population will grow at an annual rate of 1.3% per year to 5,229,463 by 2022. After which time population growth is projected to slow to just below one percent towards the end of the projection period reaching 6,057,948 persons in 2036.”
“Primary and community care is a major component of the British Columbia (BC) health system, delivering over thirty million health care services each year to BC’s 4.5 million residents, with a total expenditure of approximately $5.4 billion. Nearly every British Columbian has contact with this part of the health care system each year.”
Read more: primary-and-community-care-policy-paper
8-1-1 is a free-of-charge health information and advice phone line available in British Columbia. The 8-1-1 phone line is operated by HealthLink BC, which is part of the Ministry of Health. By calling 8-1-1, you can speak to a health services representative, who can help you find health information and services; or connect you directly with a registered nurse, a registered dietitian or a pharmacist. Any one of these healthcare professionals will help you get the information you need to manage your health concerns, or those of your family.
Nurses
At any time of the day or night, every day of the year, you can call 8-1-1 to ask a registered nurse your health questions. Our nurses are available to help you with non-emergency health concerns, to discuss symptoms and procedures and recommend whether you should see a health care provider in person.
Pharmacists
You can call 8-1-1 to talk to a pharmacist about your medication questions. Our pharmacists are on call at 8-1-1when your community pharmacist may be unavailable – every night from 5 pm to 9 am.
Dietitians
Registered dietitians are available to answer your healthy eating and nutrition questions by phone at 8-1-1, or you can Email a HealthLinkBC Dietitian. Our dietitians are available from 9am to 5pm Monday to Friday.
Health Services Representatives
When you call 8-1-1, you will speak to a health services representative who will direct your call to the HealthLink BC service that fits your needs. Our health services representatives can also help you find your way in the B.C. health care system. Whether you are looking for the closest walk-in clinic, travel clinic, or want to know where to take your child for immunizations, the Navigation Services team at HealthLink BC will direct you to the services you need, closest to where you live.
Our health services representative can also answer your questions about the B.C. Smoking Cessation Program, and register you for Nicotine Replacement Therapy (NRT). For more information, call 8-1-1 or visit our B.C. Smoking Cessation program web page.
Translation Services
8-1-1 provides translation services on request in more than 130 languages.
Plantar Fasciitis
- Pain on the plantar surface of the heel.
- Heel pain that radiates to the toes.
- Stiffness of the plantar aspect of the foot.
- Pain early in the morning with initial steps or pain with walking after prolonged sitting.
- Pain is alleviated with activity but quickly returns.
When one thinks of this condition, it sounds like only one group of tissues is involved. In actuality, plantar fasciitis can have a number of possible etiologies. There are three specific structures in the plantar aspect of the foot that are most commonly diagnosed as plantar fasciitis: the muscles of flexor digitorum brevis, and the quadratus plantae along with the plantar aponeurosis. This grouping of tissues lies more centrally in the foot, whereas the plantar fascia actually lies medial and lateral. Occasionally, the muscle abductor digiti minimi can be indicated due to it’s calcaneal origin and the fact that the quadratus plantae lie just beneath it. Similarly, the abductor hallucis lies ontop of the medial plantar fascia and any adhesion of these two muscles can create symptoms like plantar fasciitis. Less frequently, the hallicus brevis is involved. This deep, strong muscle can be differentiated by testing gait mechanics and looking for hyperpronation during push off.
Plantar Fasciitis is also closely related to the working order of the lower leg, more specifically, gastrocnemius, soleus, flexor hallicus longus, and the achillies tendon. Trauma in this are can easily refer to the foot. The best way I have found to ensure that there are no fascia adhesions or nerve entrapments ( medial plantar nerve) in this area is through combined treatments of Active Release Technique® (ART) and acupuncture. Through ART the muscle condition and gate mechanics of the injury area can be assessed for tissue texture, tension, movement, and function. There are easily two dozen specific protocols for treating the foot alone. This should be done by someone that is ART® certified. Some massage therapists or PT’s may claim to ‘know some’ ART® but do not actually know the protocols and techniques.
So what can be done through acupuncture and to alleviate the symptoms of plantar fasciitis? Usually the standard measures of acute care are applied such as: RICE protocol, anti-inflammatories, and stretching. Acupuncture treatments should be twice a week for at least three weeks. Treatments should focus on Kidney and Bladder meridian pathologies due to the location of the pain. Systemically there is likely qi and blood stagnation with the possibility of heat. Work to nourish blood, move qi and clear any local heat.
Whitfield Reaves has spent a lifetime applying classical acupuncture theory along with western pathology and kinesiology to create applicable protocols for injuries like plantar fasciitis. I have found that in combination with ART® and acupuncture, plantar fasciitis can be resolved with a high amount of success and longevity. Here are some classical protocols from Mr. Reaves that I have found useful in practice.
The plantar fascia is the long muscle that runs along the sole of the foot. Plantar fasciitis is an inflammation of this muscle that can make walking painful. Treatment plans include physical therapy, stretching, using shoe inserts, acupuncture and also lifestyle changes. One study published in 2006 in “Medical Acupuncture” showed an improvement in pain reduction in 9 of 11 people who had painful plantar fasciitis.
The founder of Hasu eCounselling and addiction therapist, Greg Rennie, talks about enabling and codependence in addiction, and how to recognize and avoid enabling behaviour with loved ones.
A family member is impacted by the disease of chemical dependence (addiction) just as much as the person with the dependence and more often than not, harder hit. Family members seldom get professional help because it is thought that the problem is alcohol, drugs or gambling and if the person simply stops, things would be back to normal. This is a common misconception. Often, the families need support once the individual is in recovery.
Supporting family members impacted by someone’s chemical dependency, I’m often asked about enabling. Unfortunately, the true meaning of the word is often distorted by the media. Merriam-Webster Dictionary defines enabling as a verb, “to provide with the means or opportunity or to make possible, practical, or easy.” Unfortunately in the media, the family member is seen as someone who has caused the person to drink or use drugs. No one is the cause of someone’s dependence on a substance or behaviour such as gambling. Chemical dependence is a brain disease. I have worked with many family members and have yet to meet someone who is the cause of someone’s chemical dependence.
Often a parent or spouse will get resistance from the individual if the use of their drug of choice is interfered with or blocked. If you are a family member of an alcoholic or addict, you already know what I’m referring to. The individual’s behaviour is highly persuasive and manipulative. Their actions encourage a reaction that makes it possible or easy to continue using.
In the following examples, the individuals are at risk of experiencing a negative consequence as a result of their chemical dependence. Unknowingly, the family members in these examples have enabled them to continue using and experience the consequence.
In the first example, a son is at risk of being charged with possession of a controlled substance. His mother finds a large amount of marijuana in his bedroom and is worried that if he uses it in public, he will be charged although she does not want him smoking it in the house either. Telling him this will certainly result in resistance. He yells at the parent and starts an argument and perhaps brings up the fact that the parent used to smoke when she was younger or that Dad likes to have a couple glasses of wine at dinner and an argument starts.
It is much easier for the parent to give in or negotiate than stand her ground. Her reaction to his behaviour can unknowingly lead to providing him the opportunity to continue using. The son’s behaviour has put the wheels in motion. The mother agrees that he can continue using marijuana but only in the garage. At school the next day, they find a large quantity of marijuana in his backpack and he is charged with possession.
In the next example, a husband with dependency on alcohol is at risk of losing his job. His wife wakes up in the morning to realize he spent the night in the basement drinking, is intoxicated and not able to go to work. He was previously warned by his employer that if he is drunk at work one more time, he would lose his job. Concerned that he will be fired, she calls his boss and tells him that her husband is in the hospital and won’t be at work. The next day he goes back to work and is found drinking on the job and is fired.
In an effort to protect someone from negative consequences, a family member often reacts by intervening. It makes perfect sense to protect a loved one but working with individuals with chemical dependence, I’ve realized none of them would have sought out help if it wasn’t for some type of consequence in their lives. If their lives are not in an immediate danger, don’t intervene, even if it may result in a criminal charge or loss of the job. It may be the moment of clarity they need.
Often, families seek help for the individual but not for themselves. Commonly, the focus is on the person with chemical dependence and when they get well and are in recovery the expectation is that everything will be fine. Yet years of reactionary behaviour can have an impact on the family member. Roles change in the family dynamic when the person is in early recovery. It can be difficult to cope with change especially if the enabling behaviour has gone on for a number of years.
Issues discussed with the family member in counselling are enabling, codependency, issues of trust, control and fears of relapse. It takes time for a family member to understand chemical dependence. Educating yourself is the first step. There are a lot of great resources on the internet for family members. I recommend the Centre for Addiction and Mental Health in Toronto, Ontario at www.camh.net or in the United States, the National Institute on Drug Abuse at www.drugabuse.gov.
In my experience, many family members recover from the impact of chemical dependence. If you have any questions regarding enabling or if you are interested in talking with an addiction therapist, go to our website at https://www.hasuecounselling.ca or contact us at 1-844-669-4278.
Do compression socks help?
Compression socks or stockings can be found on the legs of a wide swath of the population, from flight travellers, runners, and nurses to pregnant women, people recovering from surgery, and people otherwise at risk for blood clots in their legs.
They make our legs feel refreshed and energized, almost like they’re getting a mini-massage. How do they do it? By increasing the blood flow from our legs to our heart and raising our blood oxygen level.
Compression socks are fully graduated, meaning they start out with a greater amount of compression at the ankle and gradually get looser up the calf. This graduation is meant to help promote blood flow back towards the heart and thus help promote faster recovery.
But compression socks do more than just make our legs feel great. They minimize leg pain and cramping and reduce swelling in our ankles and feet. Wearing compression socks can also help keep our legs healthy, by delaying the onset of varicose and spider veins. Most importantly, they can help prevent a DVT (deep vein thrombosis)— a life-threatening blood clot that can show up in our legs.
If you struggle with lower leg pain or have a hard time recovering from activity, they could be worth a try!
Lowell Jordan
Certified Pedorthist
Viva Care Medical Clinic – Burnaby
As we approach the winter months, we can look forward to shorter days and less sunlight. Sunshine is important because it helps our bodies produce Vitamin D when it interacts with our skin. Vitamin D plays numerous roles in our bodies including that facilitation of Calcium absorption which helps us to strengthen our bones. As we age, our bones lose mass and deteriorate increasing the risk of fractures. This condition is known as osteoporosis.
According to Osteoporosis Canada, experts recommend that all Canadians supplement their diets with Calcium and Vitamin D. Healthy adults between the ages of 19 and 50 require 1000 mg of Calcium and 400 IU – 1000 IU of Vitamin D every day. This increases for adults over 50 to 1200 mg of Calcium and 800 IU to 2000 IU of Vitamin D.
For a list of food sources rich in Calcium and Vitamin D, visit https://osteoporosis.ca/bone-health-osteoporosis/calcium-and-vitamin-d/. However, obtaining enough Calcium and Vitamin D through diet alone can be challenging. Supplementing with both of these is critical to reduce the risk of bone fractures and many other conditions. Please speak with your physician before starting any new supplements.
If you’re interested in learning more about Calcium and Vitamin D, please call me at Grove Pharmacy at 778 298 1000 or visit the pharmacy. Grove Pharmacy is conveniently located across the street from Chartwell Green on the corner of 88 Ave and 212 Street next to the Viva Care Medical Clinic.
Sameer Premji, BSc (Pharm), MBA
Pharmacy Owner/Manager
Grove Pharmacy
Do you have that 3pm slump where you are completely zapped of energy? What depletes your energy? Whatever the cause, here are some simple solutions that will help you fight fatigue and boost your energy so you can tackle whatever your schedule calls for.
Six supplements that I recommend people take to boost their energy are:
- The first thing to make sure that you have as part of your daily regimen is a high quality multivitamin/mineral complex. It should have a broad range of B vitamins because these really help the body not only handle stress better but also produce more energy. B5, or panthothenic acid and B12 or cobalamin are particularly important.
- Vitamin C is also another important vitamin which helps to keep our immune system strong. During periods of stress our adrenal gland needs more vitamin C to make the proper stress hormones which is very important to make sure that our energy stays consistent during the entire day
- Spirulina is a blue green algae. It’s a complete protein that has excellent energy enhancing properties. It comes in a powdered form so you can add it to water or your favorite drink.
- L carnitine is an amino acid and is naturally found in protein food sources like red meat, chicken, turkey, and lamb. What L-carnitine does is help to boost metabolism by transporting fat into our cells where it is burned to make energy.
- Omega 3 fish oil is essential to brain development and function so it helps your ability to focus and helps to improve your concentration.
- Green Tea taken as a supplement or simply as a drink is great for that extra boost of energy not simply because it contains caffeine but more importantly it has a nutrient called EGCG (epigallocatechin gallate) which not only is a powerful antioxidant but it helps to increase and improve our metabolism.
GENERAL MEASURES TO HELP FIGHT FATIGUE
The big categories in our life that really help with improving our energy are food, sleep and environment. Eating the right foods is just as important as getting enough sleep. Here are some tips that will help boost your energy:
FOOD
- Avoid sugar, and any “white” foods. By that I mean, white flour foods like muffins, donuts, white pasta, white rice, because these will give you an energy burst initially but you will simply crash an hour later and this is the reason a lot of people feel sleepy after they’ve eaten such foods. So instead focus on a good balance of protein, brown carbohydrates which are your complex carbohydrates or whole grains and vegetables as well as good quality fats.
- Don’t skip breakfast. I’m sure you’ve heard this tip a number of times but it is an important one because many people still are rushing out the door in the mornings and don’t have time for breakfast and pay for it by eating filling up the “white” foods that I had mentioned for lunch which will lead to fatigue a few hours after. A quick breakfast that is nutritious and simple to make is a protein shake and what I recommend and we now carry at Pharmasave is the Vega One all in one nutritional shake that has 50% of your daily intake of vitamins and minerals in one serving. Or pumpkin seed butter is a great source of protein and omega 3 fats and you can spread that on whole grain toast.
- Keep your body hydrated by drinking 8 glasses of water a day. This is important especially as we enter the summer months as dehydration is one of the main reasons that people are fatigued. Water helps transport energy giving nutrients and helps oxygenate the blood so if you take one tip away from this, it would be to increase your water intake and you should see a boost in your energy.
SLEEP
Everyone should aim to get between 7-9 hours of sleep a night if you want to keep your body, your immune system healthy. In fact, at this range of sleep, you can expect to manage stress better, and even help to improve memory and concentration. Three quick tips I can recommend to ensure that you can make this happen would be:
- Thirty minutes before bed, clear your mind, turn off all electronic devices, and get your body ready to fall asleep.
- Keep your room dark and quiet and don’t bring any work and papers into your bedroom. You need the darkness in order for our sleep hormone, melatonin to be released and we need melatonin in order to get a good restful sleep so this is really important.
- Routine is really important so try and go to bed at the same time each day and wake up at the same time. Even on the weekends, try and wake up and sleep within an hour or two of the schedule you keep on the weekdays and this will really help you overall with fighting that fatigue.
ENVIRONMENT
Just by modifying a few things in your environments, you can really boost your energy. Whether it’s at your desk at work, or at home, or if you spend a lot of time in your car, you may be really surprised at the enormously energizing effect of modifying your environment. Here are three tips:
- Surround yourself with warm colors like yellow, orange and red as these send impulses to the brain to boost your energy. Apparently, the electromagnetic waves of yellow are the most energizing so you could add a plant with yellow flowers, a painting, pottery, or a poster with warm colors and that should really spike your energy.
- Scents are another thing in your environment that you can modify to help stimulate wakefulness. Pleasant scents stimulate a nerve in the body that triggers this wakefulness so you can keep a basket of oranges or lemons or a mint plant and breathe in its aroma.
- Wear headphones and listen to energizing music of your choice. This is a great way to eliminate energy sapping sounds in your environment. Listen to music with gentle rhythms like that of the piano or flute, without lyrics or loud drums.
QUICK TIPS
Here are some suggestions that you can do right at 3pm when you are feeling that energy dip and need an instant “pick me up”:
- Get some sun – vitamin D really helps to boost your energy.
- A lot of people feel more energetic after taking a hot bath or shower.
- Take a brisk 10 minute walk as this can energize you for 2 hours. It’s recommended to take a total of three of these brief walks a day to keep your energy levels constant. Exercise really helps to refill your body’s fuel tank and oxygenate your blood cells. If you are really depleted, then start with an exercise routine that includes yoga or tai chi and then gradually build up your energy and your aerobic exercise capacity.
- A brief 60 second moment for yourself where you close your eyes and breathe deeply can help.
ENERGY DRINKS – IS IT WORTH CONSUMING THESE?
Energy drinks are formulated and recommended for people who are looking for that additional mental and physical stimulation for short periods of time and they claim to restore energy and alertness. It’s very important to read the label, because it’s here that you’ll find the recommended use, and dosage and who the energy drink is intended for, what the cautions are and the list of medicinal and non medical ingredients. However, even with this information, it’s easy to get confused so the key facts are this:
- Energy drinks contain, among the vitamins and minerals, herbals and amino acids, two key ingredients which are sugar and caffeine. They contain caffeine ranging in the amount of 50-200mg per can which is about two cups of coffee. To give you an idea a cup of roasted coffee is 180mg, an iced cap is 100mg, tea is about 50mg and a cola drink is 30mg.
- Teens are the largest group that use energy drinks.
- Children and adolescents are found to be the most at risk of exceeding the recommended maximum daily intake for caffeine.
- The maximum number of cans that a person should consume of an energy drink is 2 cans a day.
- Energy drinks are not recommended for children and teens, pregnant and breastfeeding women and people who are sensitive to caffeine.
- Energy drinks acutally have hidden sources of caffeine listed as some herbal ingredients like green tea extract or guarana, which is actually 40mg of caffeine. It is listed simply as an ingredient but not with its corresponding caffeine content.
- Side effects of too much caffeine include lack of concentration, vomiting, shaking, trouble sleeping, muscle cramps, headache, irregular heart beat, nervousness and dehydration.
- Energy drinks shouldn’t be confused with sports drinks such as Gatorade or Powerade. These drinks actually rehydrate the body and replenish electrolytes as well as provide sugars which the body burned in order to create energy. So use sports drinks before, during and after exercise but when it comes to energy drinks, these really shouldn’t be used before or during exercise as the safety of caffeine in combination with the herbal supplements prior to or during exercise still needs to be established.
- The herbal products in energy drinks claim to individually do a lot of different things such as improve endurance, increase energy, enhance physical performance, promote weight loss, but there is still insufficient evidence as to whether the actual herb is performing the action or it is due to the caffeine content and that is contributing to the action.
- Energy drinks should not be mixed with alcohol as they reduce the depressant effect of alcohol like fatigue and enhance the feel good buzz which can cause individuals to overlook the debilitating effects of intoxication because they have this sensation of being alert. Also, both caffeine and alcohol act as diuretics which can lead to dehydration and adverse cardiovascular events.
All in all, as long as you are not a child, teen, pregnant or breast feeding or sensitive to caffeine, and you stay within the two can a day limit, and you do not mix them with alcohol, energy drinks can be used in moderation but there are a whole host of better options to try to boost your energy before you reach for an energy drink.
Article written by Shabita Teja, Pharmacist.
Chronic pain can be one of the most challenging and frustrating presentations in primary care; it is rarely treated to the full satisfaction of either provider or patient. The process is much more likely to be successful if it has included a good diagnostic workup and therapeutic trials; however, reframing the classic expectation in the doctor-patient relationship of patients ‘seeking a cure’ and providers ‘having a cure’ is key to management of chronic pain. Over time, it is important – both for patients and for providers –to aim for a degree of acceptance of chronic pain as a relapsing-and-remitting problem and that goals of treatment should be towards improving function and reducing pain to a manageable degree, rather than removing it, from their lives. Consider counselling them as you would a smoker –– identify their stage of change and deliver the right intervention for the stage they are at.