Mental Health: How to recognize depression and what to do about it

By Dr. Yvette Lu.

This week is Canadian Mental Health Week and it’s the perfect opportunity to talk about mental health and mental illness. Talking about mental illness normalizes and reduces shame around it, making it more likely that people will seek help if they experience symptoms.

Check out my video from Breakfast Television on Mental Health. In it, we discuss the signs of depression, what to do about it, why you need to seek help, and resources in BC (other provinces and areas should have similar resources). I will also discuss this information in more detail below.


This year, the theme of Mental Health Week is #GetLoud! During mental health week, we encourage people to reflect on their attitudes towards mental health. It’s important to reduce discrimination and stigma so that people don’t feel shame about mental illness and don’t wait to seek help.

People with mental health issues often feel like they need to suffer silently. Part of the illness is that you feel like your voice and feelings are not important, so if you have mental illness, find someone you feel safe talking to and share how you feel. If someone opens up to you about their feelings and mental health, do your best to listen without judgment and help in whatever way you can.

Most people know that symptoms of depression include feeling sad or having a low mood. However, there are other symptoms that you may not be aware of that can also be signs of depression. These include:

    • anhedonia – no interest or pleasure in doing things you usually like to do
    • irritability and anger
    • poor sleep or sleeping too much
    • poor appetite or overeating, weight gain or weight loss
    • fatigue or low energy
    • feelings of guilt, that you are a failure or that you have let yourself or others down
    • poor concentration or attention
    • feeling really restless or, the opposite, feeling sluggish and slow
    • feeling very sensitive to rejection, to the point that it affects relationships

If you notice these symptoms, you should seek help. You can talk to your family doctor, who can connect you to resources and services in the community, and who can make sure your symptoms aren’t caused by another medical condition, like thyroid disease. You can also contact your local mental health center if you don’t have a doctor. It’s best to seek help early as mental illness is easier to treat when it’s caught early. Parents, I recommend looking for these symptoms in your children and teens as well.

There are many online and community resources available. Many of them are free and don’t require a doctor’s referral:

      • Bounce back: a free, evidence based program for adults and youth who are experiencing mild to moderate depression/anxiety, low mood, or stress. You can do the course online or through a telephone coaching program. It’s available in English, French, Cantonese or Punjabi. The telephone coaching version of the course requires a referral from your family doctor.
      • Confident Parents, Thriving Kids: A family focused, telephone based service for parents and caregivers that helps reduce mild to moderate behavioural challenges and promotes healthy child development in children ages 3-12. The course requires a referral from your family doctor.
      • Living Life to the Full: A mental health promotion course designed to help people deal with low mood, anxiety, stress, and everyday life challenges.
      • MindShift App: A free app from AnxietyBC to help cope with anxiety, originally developed for teens and young adults. I recommend it to all ages.
      • BC Crisis Center: A free Mental Health Support Line: 310-6789 in BC (no area code). You can call for information on local services or if you need emotional support. Workers have advanced training in mental health issues and services. They also have a suicide hotline 1-800-SUICIDE (1-800-784-2433) and a Seniors Distress Line: 604-872-1234. As well, an online chat is available for youth and adults.
      • Kelty Mental Health: Provides peer support to children, youth and their families, and to people with eating disorders.
      • Here to Help BC: An online resource to help people manage mental health and substance use problems.

These are only a few of the resources available online. Please check out the sites listed above for more info.

For more info about mental health week, visit www.mentalhealthweek.ca.

On another note, a show about caregivers that I made is currently in a competition for funding! If we win, we can make five more episodes! Please vote for “Who Cares with Dr Yvette Lu” at www.storiesforcaregivers.com.

Thank you!!

 

 

Healthy Sleeping Tips and How the Time Change Can Affect Your Health

By Dr. Yvette Lu.

The time change can affect your sleep for as long as a week after the switch. Find out how it can impact your body and learn some ways to help improve your sleep!

 

 

For more info on the health effects of the time change, check out this post:

Fall Back Tips by Dr Yvette Lu on mybackyard.press

 

Preventing infections and other travel health tips

By Dr. Yvette Lu.

We’re into the second month of winter, and a lot of people are talking about escaping to sunny climates. When planning a trip or holiday, it’s important to take health considerations into account and to plan for any infections that you might be exposed to on your journey.

In the video and my detailed article below, I discuss some of the diseases you may encounter while travelling and how to protect against them.

 

 

Travelling exposes us to new places and new experiences, but along with that may come exposure to diseases and infections that are not present in our home country. With some basic precautions and forethought, we can reduce our risk of contracting travel-related illnesses. Especially when going to tropical areas, it is important to find out if there are any vaccinations that you need to get prior to the trip or any medications that you should be bringing with you. You want to start this process as soon as you start planning your trip. Many vaccines require time to take effect, so you want to talk to your doctor or go to a travel clinic at least 6-8 weeks before your trip.

 

Vaccinations

You want to start by making sure you have all your basic vaccinations, including vaccinations against tetanus and diphtheria (booster required every ten years), measles, mumps, rubella, polio, and pertussis; the yearly influenza vaccine; the HPV vaccine for young women and men; and the pneumonia vaccine for people over the age of 65. Other optional basic vaccines include the chicken pox or shingles vaccines, meningitis vaccines, and hepatitis A/B vaccines.

The Hepatitis A and B vaccines are frequently recommended to people who travel, and also to everyone as basic vaccinations, even if they are not travelling. The Hepatitis B vaccine is covered in British Columbia for children and people at high risk. The Hepatitis A vaccine is covered for people at high risk. Hepatitis is an infection of the liver that can cause liver failure, and in the case of Hepatitis B, chronic liver disease and cancer. Hepatitis A and B are transmitted by blood and body fluid contact, and Hepatitis A can also be transmitted by contaminated food and water. If you’re traveling to a country where these diseases are more common, it’s important to get these vaccinations.

Side note: Here is a video explaining Hepatitis B from Immunize BC in which I play a nurse!

 

Vaccine recommendations differ by province and country. Here are links to the immunization schedules recommended by British Columbia, the rest of Canada, and the Center for Disease Control in the US.

When travelling, it’s important to look at what country you’re visiting, which area of the country you’re visiting, and what kinds of activities you will be doing. People visiting rural areas and families will often have different recommendations from people staying in large cities or resort areas. The CDC website is an excellent resource. You can look up the health and vaccination recommendations based on the country that you’re visiting.

Most of the countries in warm areas, Mexico, the Caribbean, South America, Africa, Asia, and particularly less developed countries tend to have more vaccination recommendations. Immunizations that may be recommended include vaccines against Typhoid, Yellow Fever, Cholera, and Meningitis.

If you plan to do adventure travel and will be spending time in nature, doing caving or other activities where you may be in contact with wild animals, or if you’re staying in more rural areas, or will be working with animals, then you want to consider getting the Rabies vaccination and if you’re going to Asia, the Japanese Encephalitis vaccination.

 

Mosquito-borne illnesses

The other major consideration is exposure to mosquito-borne illnesses. We’ve already mentioned two viral infections that are spread by mosquitoes – Yellow Fever and Japanese Encephalitis. Another important mosquito-borne illness is Malaria.

Malaria prevention is very important if you are traveling to an area where malaria is common. Malaria is a serious illness caused by a parasite. It lives in blood cells and can cause serious illness that can lead to complications and death. If you’ve come back from a country that has malaria and have a flu-like illness that is not going away, it’s important to be checked for malaria.

Malaria is found in warmer climates such as Central and South America, Africa, and Asia. Your risk level is determined by where in the country you will be travelling, Tourist areas, large cities, and higher elevations tend to have less mosquitoes, so the risk is lower. Fortunately, malaria is preventable by taking medications, so it’s important to talk to your doctor beforehand and to find out if these are necessary.

Three other mosquito borne illnesses are Chikungunya, Dengue, West Nile Virus and Zika. These viruses are all transmitted by mosquitoes and the only way to prevent them is to avoid mosquito bites. It’s important to find out how common these viruses are in the locations that you will be travelling, so you can prepare and bring mosquito repellent, mosquito netting, and long sleeved clothing. Staying indoors at the times of day when mosquitoes are most active is also helpful.

The Zika Virus is a mosquito-borne virus that is known to cause birth defects. Women who are pregnant are recommended to avoid travel to Zika-affected areas. If a woman is thinking of getting pregnant, she should wait at least 8 weeks after travel to a Zika-affected area before trying to conceive.

Zika can also be transmitted via sexual activity and men can continue to transmit the virus for six months after a Zika infection. Couples wanting to have a baby should wait six months after travel to a Zika-affected area before trying to conceive.

Because you can have a Zika infection that is asymptomatic, it is important to follow the waiting period guidelines even if you haven’t had symptoms of an infection during or after your trip.

For women who are already pregnant, they should avoid sexual contact for 6 months if their partner has been in a Zika-affected area. Proper condom use may also be protective if used consistently and correctly for all forms of sexual contact.

For people who aren’t pregnant or wanting to conceive in the near future, Zika is usually a mild illness. There’s a small chance of a neurologic disease that can cause paralysis called Guillain-Barre Syndrome, but it seems to be infrequent. For this reason, and also due to the other mosquito-borne diseases that you can encounter, it’s important to prevent against mosquito bites. Like with malaria and other mosquito borne illnesses, your risk level will be determined by where in a country you are travelling and whether or not there are infected mosquitoes there.

 

Traveller’s Diarrhea prevention

Traveller’s Diarrhea is another common infection that can be acquired through travel. It’s usually acquired through food and water, so it’s important to take proper precautions like washing hands, only eating food that is well cooked and served hot, avoiding raw/undercooked food, peeling or cooking fruits/vegetables, avoiding food from street vendors, drinking water only if it has been boiled/disinfected or if it is in a commercially sealed bottle, brushing your teeth using purified or bottled water, and avoiding unpasteurized dairy products/fruit juices.

There is an oral vaccine available for traveller’s diarrhea. How useful and effective it is will depend on where you are travelling. Talk to your doctor about whether or not it would be appropriate. Another strategy is to bring a short course of antibiotics. Mild cases of traveller’s diarrhea can be treated with rehydration and symptom management with over-the-counter medications. More serious cases with fever and bloody diarrhea would benefit from antibiotic management and/or a visit to a doctor.

 

Other travel recommendations

  • Check the Health Canada and CDC websites for travel alerts before you go.
  • Prepare a travel health kit with basic medications and first aid supplies. These might not be readily available at your destination. I reviewed travel first aid kits in a previous article.
  • Consider buying travel insurance.
  • Consider registering your trip with the Registration of Canadians Abroad service – a free service that allows the Government of Canada to notify you in case of an emergency abroad or a personal emergency at home. It also allows the traveller to receive information before or during a natural disaster or civil unrest. Americans have a similar service called the Smart Traveler Enrollment Program.

 

And most importantly, have a great trip!

 

 

Health Resolutions From the Doctor’s Office

Set your health resolutions for the new year!

By Dr. Yvette Lu.

Take charge of your health for the new year!

Cancer, heart disease, and stroke are the leading causes of death in Canada. Fortunately, we have screening tests to reduce our risk from these diseases.

Have you done all the recommended medical screening tests for your age and risk level? Check out my talk and blog for an overview of what screening tests you should be talking to your doctor about plus some tips on setting health resolutions for the 2017.

Happy New Year!

 

    • Lifestyle changes
      • quit smoking
      • exercise regularly
      • eat healthy foods, more fruits and vegetables, and smaller portions
      • maintain a healthy body weight
      • get adequate sleep
  • Keys to success:
    • set a small goal that is achievable
    • find a goal that motivates you!
    • get help – talk to your doctor or call 811 to get help from a nurse or dietician to achieve your health goals
    • set your goals with a friend so you will be accountable to someone
    • write your goals down and make them specific
    • examples of small goals:
        • Take the stairs instead of the elevator
        • Park farther away at the office or supermarket so you have to walk
        • Add 10 minutes of exercise to your week
        • Don’t go shopping hungry
        • Start reading labels and counting calories to become food aware
        • Call the dietician line 811in BC
        • Add a vegetable or fruit to your diet every day
        • Substitute water for one of your usual drinks
        • Use smaller plates to decrease portion size
        • Reduce the size of the treats that you have
        • Eat whole wheat bread instead of white bread

 

Links:

Healthlink BC

BC Cancer Screening Website

It’s my life: Canadian Cancer Society website on assessing your cancer risk

 

Are you taking too much Tylenol? Tips on how to use acetaminophen (Tylenol) and other over-the-counter medications safely.

By Dr. Yvette Lu.

Recently Health Canada issued new guidelines for manufacturers of medications containing acetaminophen, a common medication used for pain relief and the control of fevers. Acetaminophen (Tylenol) is a leading cause of liver failure in Canada. Liver failure, in serious cases, can require a liver transplant or even lead to death.

Check out my five minute chat on Roundhouse Radio on acetaminophen and the use of other over-the-counter pain medications, or read my detailed notes below.

Make sure you’re taking Tylenol and these other pain medications correctly.

Roundhouse Radio: Dr Yvette Lu on acetaminophen use

 

***

Q&A on acetaminophen use:

1. Is Acetominphen is still safe to use?

  • Acetaminophen (Tylenol) is a widely used drug for pain control and relief of fevers
  • It is safe if used properly

2. What are the new labelling guidelines for?

  • Health Canada has recommended new labelling guidelines because acetaminophen is the most common cause of liver injury in Canada
  • Liver injury occurs when a person takes too much acetaminophen
  • This causes toxic byproducts to be produced, which damages cells
  • People can inadvertently ingest too much acetaminophen when they don’t follow the dosing guidelines on the bottle (Eg. take too many or take them too frequently) or when they are taking multiple medications that have acetaminophen and don’t realize it
  • Acetaminophen is found in over 700 over the counter products including combination cough and cold medications and night time medications

3. How much acetaminophen is safe?

  • Adults should follow the directions on the bottle, maximum 1000mg per dose, every 4-6 hours, no more than 4000mg per day
  • Children should be dosed by age and weight
  • People at higher risk include people with liver disease, people who drink 3 or more alcoholic drinks per day, people who take acetaminophen long term (3200mg per day maximum for long term use, 2400mg per day maximum for people with liver injury)

4. What are the signs and symptoms of acetaminophen overdose?

  • Aceteminophen is the most common cause of liver injury in Canada
  • Overdose symptoms can range from vomiting, to abdominal pain, to jaundice, to liver failure and death
  • Symptoms may not start for 24-72 hours so if you’ve taken too much acetaminophen, you should go to the hospital even if you don’t feel any symptoms yet

5. What can I do to stay safe?

  • All drugs have risks and benefits and should be taken with caution
  • Be aware of how many pills you can take with each dose and how often
  • Be careful about how many pills you take, write down how much medication you’ve taken and what time you’ve taken them
  • Read labels and avoid using multiple products with acetaminophen at once
  • If you use multiple medications, check with pharmacist or doctor first so you know what the safe limit is for the number of pills you can take per dose and per day
  • Don’t take acetaminophen long term without medical supervision
  • If you are high risk for liver injury, talk to your doctor before taking acetaminophen
  • If you need acetaminophen for more than a week, see your doctor because the underlying problem needs to be diagnosed and treated

 

Additional links:

Health Canada website: acetaminophen

Sun Safety Myths: What’s true and what’s not.

By Dr. Yvette Lu.

Summer is FINALLY here, and it’s time to discuss Sun Safety. I review some common beliefs about sunscreen and sun safety in my 4 minute video and more extensively in my blog below.

Please enjoy the video and the lovely freeze frame that accompanies it as the video preview!

 

 

 

Below, I will go over sunscreen and sun safety myths in more detail.

 

MYTH: The higher the SPF the better

There are two types of Ultraviolet (UV) radiation that we worry about, UVA and UVB. SPF refers to the ability of sunscreen to protect against UVB rays. UVA rays age your skin causing wrinkles and age spots, and can pass through glass. UVB rays cause sunburns (B for burn!) and are blocked by window glass. Both UVA and UVB cause skin cancer.

Sunscreens are products that reflect or absorb radiation so that it can’t damage our skin. SPF (Sun Protection Factor) refers to the ability of the product to protect against UVB rays. The numbers aren’t logical (the relationship is not linear), i.e. SPF 30 is not double the protection of SPF 15. SPF 15 protects against 93% of the UVB radiation that hits your skin, SPF 30 protects against 97% of the UVB radiation, and SPF 50 blocks out 98% of the UVB radiation. If you use products with SPF >50 you will get a negligible increase in protection from UVB radiation. Buy a sunscreen that is at least SPF 30, but don’t bother spending extra money on SPF greater than 50, because you won’t get much additional benefit.

SPF

Source: https://www.beyondcoastal.com/page/sun-protection

It’s also important to make sure that your sunscreen protects against both UVA and UVB radiation. Look on the bottle to make sure it says “broad spectrum” protection against UVA and UVB.

This is a striking photo from the New England Journal of Medicine of a man with extensive UVA damage to the left side of his face from sun exposure while driving a truck for 28 years. You can see how the left side of his face is thickened and filled with wrinkles from photodamage.

UVA Sun Damage
UVA Sun Damage

Source: http://www.nejm.org/doi/full/10.1056/NEJMicm1104059

 

MYTH: You don’t need that much sunscreen to be protected.

The Shotglass Rule for Sunscreen.
The Shotglass Rule for Sunscreen. (Image Source: http://biohormonesinc.com/anti-aging/get-the-facts-on-sunscreen-use-anti-aging/)

The amount of sunscreen researchers use when they study the product is 2mg of sunscreen for each square centimeter of exposed skin. Think about that for a second… that’s a lot of sunscreen! Most people apply only 25-50% of the recommended amount of sunscreen. A good rule of thumb is the shotglass rule. The amount of sunscreen that fills a shotglass (one ounce, or 30mL) is how much you need to cover exposed areas of the body for an adult. Since most bottles of sunscreen are 90-150mL, they should be used up after 3-5 applications of sunscreen. If you put on less sunscreen, you will still get some protection, but you won’t get the full SPF protection that is labeled on the bottle. Sunscreens should last for at least three years – however, if you are using it properly, you shouldn’t have to worry about the expiry date because you will have consumed your bottle before then.

 

MYTH: I don’t need sunscreen on cloudy days.

UV rays are present on cloudy days and winter days, and up to 80% of UV rays can still penetrate the skin when it’s cloudy. A better indication of whether or not you need sun protection is to look at the UV index on your local weather report. The UV index looks at how much radiation we are receiving from the sun. A UV index greater than 3 indicates a moderate risk of harm from sun exposure. If the UV index is 3 or greater, put on sunscreen and stay out of the sun during the peak times of 11am to 4pm, when the UV rays are the strongest. Plan your outdoor activities before 11am and after 4pm if possible.

 

MYTH: If I put on sunscreen, I can safely sit in the sunshine.

Sunscreen is meant to provide protection during periods of sun exposure. It shouldn’t be used as a way to increase the amount of time you can spend in the sun. Even if you put on sunscreen, you should still wear a hat, stay in the shade, wear protective clothing, and take breaks from the sun. Apply sunscreen early, about 20-30 minutes before sun exposure to allow the product to form a protective film on your skin. Reapply every couple of hours or after swimming and sweating – even if it’s labelled water resistant!

There are two ways that sunscreens work – via physical block or chemical block. Physical block sunscreens work by reflecting or blocking UV rays. Chemical sunscreens work by absorbing UV rays so that they can’t damage your cells.

Sunscreen mechanisms of action
Sunscreen mechanisms of action. (Image source: http://www.acne.org/spf-sunscreen.html)

Don’t forget your ears, nose and neck when applying sunscreen. A lip product with sunscreen and sunglasses to protect your eyes are also important. Sun exposure can cause cataracts in the eyes.

Do not use sunscreen and insect repellent combination products. Sunscreen is meant to be used amply and reapplied every few hours. Insect repellent is meant to be used sparingly.

Babies can use sunscreen after the age of 6 months. Do a test patch on the baby’s inner arm first to check for reactions. All babies should be kept out of direct sunlight.

 

MYTH: Spray on sunscreens are the same as regular sunscreens.

There are two main concerns with spray on sunscreens: accidentally breathing in the products and adequate protection. When we spray sunscreen, the particles are aerosolized and we can breathe them in. We do not have enough data on whether or not these particles are safe, especially in children. It is possible that they could trigger asthma attacks or allergic reactions. Some organizations recommend avoiding spray on sunscreen in children (unless no other product is available) due to the lack of safety data.

The other concern about spray on sunscreens is that it is difficult to tell if you’ve put on enough, possibly resulting in less protection compared to the cream form. How you spray on the sunscreen and environmental factors like the wind can also affect how much sunscreen gets on your skin. If you decide to use spray on sunscreen, avoid inhaling it as much as possible. Don’t spray it in enclosed areas, and be aware around open flames (BBQs, candles) because some sprays are flammable. It is best to spray the product onto your hands and then rub it onto your skin, particularly when applying to your face. This reduces inhalation and provides better coverage. Apply lots, because it’s harder to assess coverage with sprays.

 

MYTH: Some sun is good for me.

The biggest risk factor for developing skin cancer is exposure to UV radiation.

There is no safe way to tan. Every time you tan, you damage your skin.

It is easy to get Vitamin D in your diet, and ambient sunlight will also provide you with Vitamin D.

We know that UV radiation from the sun causes skin cancer. It is a known carcinogen. Protect yourself!

 

Here is an informative slideshow on the different ways that UV radiation from the sun can damage skin:

http://www.webmd.boots.com/melanoma-skin-cancer/ss/slideshow-sun-damaged-skin

 

Here are some other good websites:

BC Cancer’s Sun Safety website: suntips.ca

Healthlink BC: Protecting Your Skin From the Sun

Canadian Dermatology Association http://www.dermatology.ca/

You are at risk of hearing loss. How to prevent it.

By Dr. Yvette Lu.

May is speech and hearing awareness month, making it the perfect time to discuss how to prevent hearing loss! When I started researching this topic, I was surprised to find that 47% of adults aged 60-79 have hearing loss. Even more interesting is that out of the people who have hearing loss, 70% of adults and 83% of children are unaware of their condition.

For a quick overview of how to prevent hearing loss, check out my recent chat on Breakfast Television. For more detailed information and some fun charts, keep reading!

 


Who is at risk of hearing loss?

Hearing loss is a problem that we often experience, for example during an airplane flight, after going to a loud concert, or maybe during an ear infection. Usually, these are temporary problems. More concerning is permanent hearing loss.

Age-related hearing loss is the most common cause of permanent hearing loss. We will all get age-related hearing loss eventually if we live long enough. We can’t do much about that… But we can prevent another common form of hearing loss, noise-induced hearing loss. Exposure to excessive noise can also permanently damage hearing.

Permanent hearing loss is an important health concern that is often unrecognized and untreated. It can have many emotional and social consequences including social isolation, mood disorders, safety issues, mobility limitations, reduced income and employment opportunities, and poor quality of life. In children, it can affect academic performance, language development, and learning. A hearing test is one of the first things I order when a child comes into my office with delayed language development.

 

How to prevent hearing loss?

The best way to prevent hearing loss is to protect yourself from loud noises. Repeated exposure to excessive noise for long periods of time can cause permanent hearing damage. A single exposure to an intense sound (like a gun shot) can also cause permanent hearing loss. Loud noises can also worsen age-related hearing loss. Until recently, noise-induced hearing loss was usually caused by excessive noise in the workplace. Now with stricter regulations, recreational and everyday activities are more frequently the cause of hearing loss, especially in young people. Loud mp3 players, concerts, nightclubs, and garden tools are a few of the culprits.

As a general rule, if you have to shout to make yourself heard to someone two meters away, then the ambient noise is too loud. If you have ringing in your ear or dull hearing after exposure to noise, then that noise has been too loud. The key number is 85dB, which is the volume of a lawn mower or loud traffic. Continued exposure to noise above the level of 85dB can cause hearing loss.

Here’s a chart that looks at how long you can be exposed to a noise level before you risk damaging your hearing.

For every 3 dBAs over 85dBA, the exposure time before possible damage can occur is cut in half.

Decibel Exposure Time Guidelines

Source: Dangerous Decibels

Dangerous decibels is a great website with information about hearing loss prevention, particularly in children.

And here’s a chart from WSJ which gives you an idea of what those decibel levels mean in everyday life:

howloudistooloud

Source: Wall Street Journal: Behind the Music: IPods and Hearing Loss

To assess your daily risk, you have to consider all the noise you’re exposed to on a given day – you may have two activities that separately don’t put you at increased risk, but because they both happen on the same day, then your exposure would cross the risk threshold for that day.

Tips for prevention:

  • Don’t have your TV, radio, or music on too loud, particularly if there are young children in the house, as their ears are more sensitive. If you need to raise your voice to be heard above the TV, turn it down.
  • If you can’t hear external sounds when you have your headphones on, or if the person next to you can hear the music, it’s too loud.
  • 60:60 rule – listen to your music at 60% of the maximum volume for no more than 60 minutes per day. Take breaks from your headphones to give your ears a rest. Also be careful in the car, because you are listening to music in a confined space.
  • Use headphones that block out outside noise, rather than turning up the volume.
  • Use ear protection equipment when you work in noisy environments – eg a pub, nightclub, garage workshop or building site, or when using noisy equipment – eg. power tools, yard equipment, riding a motorcycle/snowmobile, using firearms.
  • People worry about not being able to hear properly with ear protection on, but just as sunglasses help vision in bright light, hearing protectors can enhance speech understanding in noisy places.
  • For people with damaged hearing, hearing protection may reduce the ability to understand normal conversation, but protection must be worn to prevent further damage.
  • Use ear protection at loud concerts and other events that have high noise levels like motor races. You can get specially designed musician earplugs if you frequently go to concerts, and sound quality is important to you. At these events, stand away from the speakers and use the chill-out zones, which give you a break from the loudest areas.
  • Give yourself recovery time. You need at least 16-48 hours of rest for your ears away from loud noises after spending 2 hours in 100 dB sound, eg. in a nightclub. Reducing recovery time increases risk of permanent hearing loss.
  • Particularly in children, vaccinations are important to prevent illnesses that can cause permanent hearing loss (eg. measles, chicken pox, mumps, rubella).

 

When to get your hearing tested?

See your doctor if you have any signs and symptoms of hearing loss, for example:

  • asking people to repeat things or speak louder
  • having difficulty understanding or following conversations
  • having to concentrate to understand what people say
  • a feeling that your ear is plugged
  • listening to the TV or radio at a higher volume than in the past
  • ringing, roaring or buzzing in the ear (tinnitus)
  • a feeling that you or your surroundings are spinning (vertigo)
  • ear pain, itching, irritation of the ear, or fluid leaking from the ear

Your doctor will start by looking for reversible and medical causes of hearing loss.

For permanent hearing loss, hearing amplification (eg. getting a hearing aid) can help improve communication and quality of life. Hearing amplification won’t restore hearing completely. It usually improves hearing by only one half of the loss, which is all the more reason to do what you can to prevent hearing loss before it occurs!

I hope this post inspires you to protect your hearing! Please share and comment below.

 

What you need to know before you travel

by Dr. Yvette Lu.

With Spring Break and Easter Holidays this weekend, and summer holidays coming up, a lot of people are making travel plans. What are the health considerations that we need to think about before travelling? Check out my Breakfast Television chat and my tips below!

 


In my blog below, I will look at

  • what needs to be done before travel
  • what goes in a travel health kit
  • what precautions to take while travelling abroad
  • what to think about when travelling with children

 

What needs to be done before travel?

Here are some basic things to do and think about before you travel. Start thinking about these things early! I have so many people who come into my office a few days before their trip asking about whether or not they need vaccinations. Some of the vaccinations and medications that are required for travel require several weeks lead time before they start taking effect. I tell my patients, book an appointment in the office as soon as you book your plane tickets to discuss your vaccinations!

More “Before You Go” tips:

  • consult a health care provider or travel clinic, preferably at least six weeks before travel to review vaccinations
  • make sure your basic vaccinations up to date – eg. tetanus/diphtheria (every 10 years), measles, mumps, rubella, pertussis, varicella (chicken pox), polio.
  • For certain places, additional vaccinations may be recommended – eg. yellow fever, typhoid, traveller’s diarrhea, hepatitis A.
  • When travelling to warmer areas, you may need protection against malaria (it involves taking antimalarial medication).
  • Check the Health Canada and CDC websites for any travel alerts to the areas you will be visiting.
  • Consider registering your trip with the Registration of Canadians Abroad Service – a free service that allows the Government of Canada to notify you in case of an emergency abroad or a personal emergency at home. It also allows the traveller to receive information before or during a natural disaster or civil unrest. Americans have a similar service called the Smart Traveler Enrollment Program. Many people don’t know about these programs, so spread the word.
  • Buy travel insurance – highly recommended! Health care costs can add up VERY quickly in a foreign country. We are lucky here in Canada, because we have good health insurance, but that is not the case in other countries.
  • Prepare a travel health kit (see next section).

 

What should be in a travel health kit?

It’s important to carry a basic travel health kit with you. First aid supplies and medications may not be easily available in other countries or may be different from those available here. A good travel health kit contains supplies to prevent illness, handle minor injuries and illnesses, and manage pre-existing medical conditions.

Here’s what to put in your travel medical kit:

  • Basic first aid items: eg. bandages, adhesive tape, hand sanitizer, antiseptic wound cleanser, blister pads or moleskin, disposable gloves, gauze, safety pins and scissors, tensor bandage, thermometer, tweezers for removing ticks/splinters, oral rehydration salts.
  • Basic medications: allergy medication, antidiarrheal medication, medication for motion sickness, 1% hydrocortisone cream for minor skin irritation (bug bites, poison ivy), antibacterial and antifungal ointments, cold and flu medications (decongestants, cough suppressants, throat lozenges), pain and fever medication, stomach and intestinal medication.
  • Prescription medication: bring more than enough medication to last your entire trip, at least an extra week. Carry a list or prescription of your medications from your health care provider. If you use needles or syringes, carry a medical certificate from your health care provider explaining that they are for medical use. Bring extra medications. Pack all medications in your carry-on baggage in their original, labelled containers to facilitate airport security and customs screening. Prescription medication is usually exempted from the liquid restrictions but must be presented to the screening officer separately from your carry-on baggage. More information about travelling with medications and with medical devices can be found on the Health Canada Website.
  • Destination specific medication: antimalarial pills, medication for altitude sickness.
  • Be aware that some over-the-counter medications, dietary supplements and herbal and homeopathic products are illegal for import and use in other countries or may require a prescription.
  • Other useful items: moisturizer, eye drops, ear plugs, extra glasses/contacts, sunscreen, water purification tablets or filter.
  • Emergency Contact card – with name and number of emergency contact, health care provider, address and phone number of accommodation at destination. You can also include information about hospitals/clinics at destination, number for your country’s embassy/consulate.
  • Proof of insurance coverage and emergency contact number for travel insurance.
  • Immunization record and proof of immunization — especially if going to a country that requires specific vaccinations (eg. yellow fever).

 

Precautions to take while travelling abroad

When travelling abroad, you don’t want illness and a hospital visit to ruin your trip. Here are some simple precautions that you can take to ensure that you stay healthy while away from home.

  • Prevent insect bites – many travel related diseases are spread by diseased insects like mosquitoes, ticks, fleas, flies. Be aware of insects at your destination that cause disease, make sure you have the appropriate preventive vaccines/medications, and take protective measures to avoid bites.
  • Eat and drink safely – the most common illnesses among travellers are generally from eating food or drinking beverages that are contaminated by bacteria, parasites, or viruses. Precautions include washing hands, only eating food that is well-cooked and served hot, avoiding raw/undercooked food, peeling or cooking fruits/vegetables, avoiding food from street vendors, drinking water only if it has been boiled/disinfected or if it is in a commercially sealed bottle, brushing your teeth using purified or bottled water, avoiding unpasturized dairy products/fruit juices. I know… it seems like sort of a drag since doing some of these things are part of getting a “local” travel experience… but when you think about the consequences (i.e. getting sick with traveller’s diarrhea or worse), it’s worth taking the precautions. Make decisions based on your location of travel and the local health and safety standards.
  • Be careful when swimming and bathing – water (pools, lakes, ocean, hot tubs etc.) may look clean but could be contaminated or inadequately treated. There are also water-based parasites that live in certain countries. Be aware of water safety when doing water based activities (eg. motorized water vehicles, safety of equipment).

 

Travelling with children

Travelling with children can present certain challenges. Here are some tips to make your trip run more smoothly!

  • In children, there is a higher risk for most vaccine-preventable diseases when travelling abroad and these diseases tend to be more severe in children than in adults. Make sure all immunizations are up to date! Some immunizations can be given early or on an accelerated schedule if necessary. Talk to your doctor for more details.
  • Ear pain due to changes in pressure during airplane travel (especially during take off and landing) is more common in children than in adults. To lessen the pain, infants can bottle or breast feed. Older children can chew gum, swallow or yawn.
  • Children can be more sensitive to jet lag and motion sickness. Avoid reading in moving vehicles. Sleeping or focusing on the horizon can also help with motion sickness. An anti-nauseant medication may also be helpful. Make sure you follow the age-appropriate dosing instructions.
  • Travellers’ diarrhea in children can be concerning because they become dehydrated more quickly than adults. Make sure children stay hydrated and consider using an oral rehydration solution.
  • Unfamiliar environments and a change in routine may cause stress for children. For older children, familiarize them in advance with the food, customs, and language of the destination and involve them in developing the travel itinerary. For younger children, a favourite toy or special snacks may help them adjust to a new environment.
  • Traffic laws differ around the world. Even if the use of safety devices like car seats, seat belts, and bike helmets is not required in the destination country, caregivers should follow the practices recommended in Canada as closely as possible. Remember to bring your age-appropriate car or booster seats from home as availability abroad may be limited.

 

Want more information? Check out these links:

http://travel.gc.ca/

http://www.cdc.gov/travel

 

How To Set Health Goals That Work

By Dr. Yvette Lu.

25% of people give up on their New Year’s Resolutions after one week.
36% give up after one month.
By six months, only 46% of people are still working on their New Year’s Resolutions.
Clearly, we have a problem!

The leading causes of death in Canada are heart disease, stroke, and cancer, particularly lung cancer. You can prevent and reduce your risk for these diseases by making lifestyle changes. It’s easy to say you’re going to change, but how to set a goal that will actually work to help you achieve lasting change?

Check out our chat on how to set goals that work. Let’s troubleshoot those New Year’s Resolutions!

 

 

 

Two additional troubleshooting points that we didn’t have a chance to cover in the video:

  • Make sure your goal is something you actually want to do.
    • If you’re having trouble with your health goals, it may be because you’re not ready to make change. It’s very hard to make change if you’re not ready and motivated. Perhaps you’ve only set the goal because somebody else is pressuring you! Go back and look at your goal, and ask yourself, what would I like to change about my life. You are more likely to be successful at your resolution if you truly want to achieve it and are motivated internally.
  • Get help.
    • If you find that you’re still not able to achieve your goal, then you want to go and talk to your doctor and get help. A lot of habits like smoking and overeating are self reinforcing. Our brain gets a chemical reward when we do those activities, so it makes it hard to quit. For example, when we overeat or eat sugary foods, our bodies release endorphins, chemicals which make us feel happy. Your doctor can help with behavioural strategies, and in some cases medications. There are some medications that are available to help reduce cravings, especially for smokers. Some people may also have an underlying disease like depression or anxiety that may be causing them to smoke, overeat, or drink too much alcohol. It’s important to treat the underlying illness, as those habits will be very tough to break without treating the underlying problem that’s causing those behaviours.

 

Troubleshooting summary for setting health goals:

  1. Set specific goals.
  2. Make sure your goal is achievable.
  3. Don’t exhaust your willpower by working on too many goals at once.
  4. Make sure your goal is internally motivated.
  5. Get help!

 

Now, go out there and set yourself some goals! Good luck!

Facts you need to know about HIV

By Dr. Yvette Lu.

Today is World AIDS Day.

36.9 million people have HIV worldwide.

About 75,000 people had HIV in Canada at the end of 2014.

About 21% of HIV positive people in Canada are unaware that they have HIV. That’s about 16,200 people in Canada who DO NOT KNOW that they have HIV.

It is estimated that 7 Canadians are infected with HIV every day.

HIV is a virus that attacks the immune system. Without treatment, HIV wears down the immune system to the point where it can no longer fight infections and cancer. When this happens, we say that a person has AIDS. Not everyone who has HIV will develop AIDS.

With the treatment we have today, HIV is a chronic illness and with early and regular treatment, people with HIV may not develop AIDS and can expect to live into their early 70s.

The key to living a healthy life with HIV is early diagnosis and early treatment, so get tested! It’s better to know. Then you can get treatment.

More details on HIV testing in our 4 minute video. Check it out!

 

 

More information on HIV Prevention:

  • Most of HIV in Canada is spread through unprotected sexual contact
  • You can NOT get HIV from casual contact like shaking hands, hugging, or sharing dishes/drinking glasses
  • Some ways to reduce your risk of exposure to HIV:
    • Choose less risky sexual behaviours
    • Use protection consistently and correctly (condoms)
    • Reduce exposure by having fewer sexual partners
    • Get tested regularly for sexually transmitted infections including HIV
    • Ask your partner to get tested before sexual contact
  • If you have ongoing high risk of exposure to HIV, there are medications that you can take to lower transmission rates. This is called pre-exposure prophylaxis. The medications help keep the virus from taking hold in the body, but must be taken regularly to work. (Note: This is not currently funded in British Columbia, but may be funded by private medical insurance.)
  • If you think you have been exposed to HIV, there are medications that can help prevent your body from becoming infected with the virus. This is called post-exposure prophylaxis. You need to see the doctor as soon as possible after the exposure (within 3 days), and take the medications daily for a month for the medications to work properly and reduce your chance of getting HIV.

 

More information at:

AIDS.gov: U.S. Government HIV/AIDS information.

CATIE: Canadian Information about AIDS and Hepatitis C

Smart Sex Resource: a website by the BC Centre for Disease Control

BC Centre for Excellence for HIV/AIDS

 

 
How Can I Prevent HIV Transmission?

 
 

Facts about HIV in Canada