Health and Wellness in the Glebe
This month, we feature articles by Dr Sharin Mithani about the effects of cholesterol to your health; Michelle Lahey gives us tips on navigating the Ontario healthcare system; Tracey Tong tells us the inspiring story of Ottawa couple, Roberta Driscoll and John Tawn; and James Morden gives us the scoop on upcoming fundraisers in support of the annual Glebe Collegiate Institute CHEO Drive.
Cholesterol and your health
By Dr. Sharin Mithani
High cholesterol, or hypercholesterolemia, is defined as higher than normal levels of cholesterol in the blood. Cholesterol travels through the blood while bound to proteins and is subsequently known as a lipoprotein. There are different types of cholesterol, with the two main types being: low-density lipoproteins (LDL) and high-density lipoproteins (HDL). LDL cholesterol is known as the “bad cholesterol” as it has a tendency to be deposited within the walls of blood vessels, reducing blood flow. HDL cholesterol is known as the “good cholesterol” as it moves cholesterol out of the blood and into the liver. Typically, LDL levels exceeding 5.18 mmol/L are considered high, although this threshold may vary depending on individual risk factors. Accordingly, your family physician is the best authority to diagnose and manage high cholesterol (Anderson et al, 2012).
FUNCTIONS IN THE BODY
Cholesterol has important functions in the body, so a basal level in the blood is essential. For instance, cholesterol is used to produce steroid hormones such as estrogen, progesterone and testosterone. Cholesterol is also used to produce the stress hormone cortisol and a salt-and-water regulating hormone known as aldosterone. Cholesterol is also a precursor to bile, a substance made by the liver and stored in the gallbladder, that is subsequently released into the gut to aid in digesting fatty foods. Furthermore, bile is also necessary to absorb fat-soluble vitamins A, D, E and K from the gut. Cholesterol has absolutely critical roles in the healthy functioning of our bodies; fortunately, we are able to produce a sufficient quantity of cholesterol to perform these vital functions (Javitt,1994).
Elevated cholesterol levels can cause cardiovascular disease among other systemic ailments. “Bad” LDL can cause atherosclerosis, or fatty plaques, to develop within blood vessels. These plaques can grow and eventually rupture, causing a complete blockage of the blood vessel. Depending on the location of the blockage, the organ downstream of the blockage is deprived of vital oxygen carried by blood cells; this leads to cell death of the organ and whole organ damage. Some organs that can be affected include the heart, the brain, both eyes and the kidneys. When damage is inflicted on the heart, it is termed myocardial infarction, or heart attack, whereas damage endured by the brain is termed a cerebrovascular accident, or stroke. Additional risk factors for cardiovascular disease stemming from high cholesterol levels include having diabetes or hypertension, being overweight, smoking, living a sedentary lifestyle, alcohol use and a family history of cardiovascular disease (Ross, 1993).
Lifestyle modifications reduce the risk of cardiovascular disease from hypertension, diabetes and high cholesterol. Such modifications include exercise, a healthy diet and smoking cessation. An effective weekly goal for adults is moderate to vigorous aerobic exercise of 150 minutes, at least 10 minutes at a time. Additionally, strength training at least two days per week has been shown to be beneficial. Weight loss in people who are overweight is also critical in reducing cardiovascular disease. Diet modifications include reducing the consumption of foods high in saturated fats and cholesterol such as butter, whole milk products, baked goods and high fat meats. On the other hand, increasing the consumption of high-fibre foods such as fruit, vegetables, legumes, nuts and whole grains help prevent excessive absorption of cholesterol. Cholesterol intake should be limited to less than 200 milligrams per day. The recommended daily fibre intake is approximately 25 grams for women and 38 grams for men. Finally, quitting smoking is among the most important and influential lifestyle changes linked to decreasing the risk of cardiovascular disease (Anderson et al, 2012).
Medications may also be used effectively to lower cholesterol. LDL level targets differ, based on one’s cardiovascular risk. For most individuals, the LDL target is less than 3.4 mmol/L; however, in those with more risk factors for cardiovascular disease, the LDL target is more stringent at less than 2.6 mmol/L. First-line treatment drugs are known as statins and they work by blocking an enzyme in the body that synthesizes cholesterol, which helps counteract the excessive amount consumed through one’s diet. Furthermore, the anti-inflammatory effect of statins on plaques in blood vessels significantly reduces cardiovascular risk. Your family physician is best able to determine whether you would benefit from a statin for hypercholesterolemia based on LDL cholesterol levels and your own unique risk factors for heart disease. Hypercholesterolemia typically has no symptoms associated with it, so it is important to continue therapeutic, diet and exercise regimens as recommended by your family physician, even though you may feel fine (Rosenson, 2004).
Javitt NB. (December 1994). “Bile acid synthesis from cholesterol: regulatory and auxiliary pathways,” FASEB J. 8 (15): 1308–11.
Ross R. “The pathogenesis of atherosclerosis: a perspective for the 1990s,” Nature 1993; 362:801.
Anderson et al. (2012). “2012 Update of the Canadian Cardiovascular Society Guidelines for the Diagnosis and Treatment of Dyslipidemia for the Prevention of Cardiovascular Disease in the Adult.” Retrieved from Canadian Journal of Cardiology: http://www.onlinecjc.ca/article/S0828-282X(12)01510-3/fulltext#sec1
Rosenson RS. “Statins in atherosclerosis: lipid-lowering agents with antioxidant capabilities,” Atherosclerosis 2004; 173:1.
Dr. Sharin Mithani is a resident in family medicine at the University of Ottawa. She practises at The Ottawa Hospital and Bruyère Continuing Care.
Tips for navigating the healthcare system
By Michelle Lahey
Do you feel overwhelmed when dealing with the healthcare system? Does going to see your doctor or specialist stress you out because you don’t know what to ask or you don’t understand everything they tell you? If so, you are not alone. Every day Canadians are stressed because of the challenges they face when trying to navigate the healthcare system.
Here are five tips that can help you deal with some of those challenges.
Write down questions that you want to ask before you go to your appointment.
If seeing a specialist, ask your family practitioner for a copy of the referral letter, pertinent lab reports etc. that the specialist will need. There is nothing worse than getting to a specialist’s office and discovering they don’t have the information they need to be able to help you.
Bring a list of all your medications to each medical appointment as well as to the emergency department. You can get this from your pharmacy.
Know why you are at an appointment. If the specialist hasn’t received the “consult letter” from your family practitioner and you aren’t exactly sure why you are there, you won’t get the answers you need. This will result in a visit that leaves you frustrated and no further ahead in your treatment plan.
If you were told that you would be called for follow-up and you haven’t heard anything in a month, call back to make sure that your information hasn’t been forgotten or misplaced.
No news does not always mean good news. No news is, quite simply, no news.
For example if you have a blood test and don’t hear back from your practitioner about the result, don’t assume that everything is OK. Of course, if your practitioner sees that you have an abnormal result, they will call you to discuss this. However, sometimes things may be missed or overlooked. The result could mistakenly go into the wrong file, or it may be filed without your practitioner seeing it. There are steps in place to prevent these errors, but things can fall through the cracks and, if they do, it could be your health that is affected. Follow up and you can prevent this from happening to you.
Ask if there is a cancellation list. If so, put your name on that list. Make sure the person booking the appointments has the best contact information for you. If you need to cancel an appointment, don’t wait until the last minute. No-shows and last-minute cancellations waste hours of appointment times per week, thereby making wait lists even longer. Some people don’t want to have surgery at certain times such as summer or Christmas. If you are available during these times, you may be seen sooner.
TAKE SOMEBODY TO YOUR APPOINTMENT WITH YOU
Taking somebody with a medical background would be ideal, but taking anybody you trust is better than going alone. Having somebody with you can make the situation less stressful.
Ask him or her to take notes so that you can review what was said after you leave your appointment.
HAVE A PLAN IN PLACE BEFORE YOU LEAVE YOUR APPOINTMENT
Are there changes in your treatment? Are there changes in your medications?
Do you need a follow-up appointment? Who will book that appointment? When?
If you are in the hospital and need to see a specialist, can you see them before discharge? If you are being discharged from hospital, do you need home care? Do you need special equipment?
Having a plan in place keeps you informed and makes you an active participant in your healthcare. Using these tips when faced with the challenges of navigating the healthcare system can alleviate some of the stress at an already difficult time, making, one hopes, for a more pleasant healthcare experience.
Michelle Lahey is the founder and owner of Help with Healthcare: Advocacy Services for Canadians Inc. She has more than 25 years’ experience in healthcare, having worked 10 years as a critical care nurse and more than 10 years as a primary health care nurse practitioner. She can be reached at 613-222-9996 or email@example.com. Consult her website at www.helpwithhealthcare.ca
Ottawa couple’s glass still ‘half full’
By Tracey Tong
John Tawn noticed the first signs that something was wrong while working in his kitchen. A talented cook, the 43-year-old Glebe resident noticed that he was having trouble with a chef’s knife. He spent a couple of days in the hospital for diagnostic tests including an MRI. It was a “total shock” when Tawn was diagnosed with Parkinson’s disease, said his wife, Roberta Driscoll. It was 1990 and “there was not the access to information that there is now, which made the diagnosis more intimidating.”
The couple decided to take it in stride. “The symptoms were not that noticeable,” Driscoll said. “We’ve been really fortunate because onset has been slow.” A sales manager at the Subaru dealership in Westboro, Tawn continued to work for another 15 years before retiring.
Thanks to regular physiotherapy and the extraordinary care from his doctors at The Ottawa Hospital, Tawn’s Parkinson’s has been well managed and his medication has controlled most symptoms. “People don’t really notice that he has Parkinson’s. We’ve been able to manage the disease as it progressed.” Now 66, the father and grandfather is enjoying retirement. He still cooks, is an avid reader and a stamp collector. “Parkinson’s is part of our life together,” said Driscoll without a hint of regret.
In 2009, Driscoll, an investment advisor, joined forces with her RBC Dominion Securities colleagues, Richard Shantz and Andrew Frank, along with other professionals in the investment industry, to form Partners Investing in Parkinson Research (PIPR). Over the past six years, the group has raised more than $750,000 for research done at The Ottawa Hospital (TOH). PIPR has also engaged the support of TOH’s Parkinson’s doctors, including Dr. Michael Schlossmacher, Dr. David Grimes and Dr. David Park, who will be walking and running alongside members of PIPR to raise funds during Ottawa Race Weekend (May 24-25).
This year, Driscoll and Kim Teron, whose husband, Ross, has also been afflicted with Parkinson’s, have stepped up as the group’s new co-chairs. Their goal for 2014 is to hit the $1-million fundraising mark and to reach out to Parkinson’s patients in Ottawa.
In the meantime, life (very happily) goes on at the Tawn-Driscoll household. “Our quality of life is still great,” Driscoll said. “Many people have been impacted much more dramatically than we have, so we are fortunate. The glass is still half full.”
Tracey Tong is the media relations and marketing officer for The Ottawa Hospital Foundation.
Editor’s note: According to the Parkinson Society of Canada, over 100,000 Canadians are living with Parkinson’s disease, a progressive neurodegenerative disease that is associated with insufficient production of dopamine, a neurotransmitter that controls movement. For more information, contact the Parkinson Society Eastern Ontario at 613-722-9238 or firstname.lastname@example.org or www.parkinsons.ca
Glebe Collegiate ‘Kids 4 Kids’ CHEO drive
by James Morden
It’s that time of year again. The days are longer, the air is warmer, and the atmosphere is electric. Why? Because Glebe Collegiate students will be all over Ottawa on May 29 for the annual Children’s Hospital of Eastern Ontario (CHEO) drive. Legions of high-school students will set out across the city collecting donations for the hospital. All funds raised during this incredible event will be donated directly to CHEO during its yearly telethon.
This “Kids 4 Kids” CHEO drive spans all of downtown Ottawa, raising money and awareness for Ottawa’s very own children’s hospital. Over 500 students will take part in fun after-school activities, a barbeque, and then go on to canvass with their peers. This year’s CHEO drive is made possible by the numerous local businesses sponsoring the students. This allows Glebe Collegiate to raise as much money as possible for CHEO. On the night of the event itself, CHEZ 106 will be at Glebe CI to help promote the drive to Ottawa residents, and will have a tent set up to play music for participating students. Other sponsors include David’s Tea, Britton’s, Scotiabank and Menchie’s on Merivale.
STUDENT CANVASSERS MAY 29
Students who are canvassing on May 29 will be wearing Glebe CI attire, a CHEO pin, and a “Kids 4 Kids” sticker. Glebe Collegiate is asking residents of the Glebe for any sort of cash or cheque donation to this cause. Donors will be asked to write their name, address and total amount donated on the sheets that the students will be carrying. Tax receipts will be issued to those who identify themselves on the sheet and who donate $10 or more.
If individuals prefer, online donations can be made through the Glebe Collegiate CHEO donation page. The link to Glebe’s CHEO Foundation donation page is accessible through our website: glebe.ocdsb.ca. We appreciate all donations, as each one will help Glebe reach our goal of $20,000.
To attain this ambitious goal, Glebe Students’ Council – @GCIstudsco on Twitter or Glebe Students’ Council on Facebook – has scheduled various pre-events to raise awareness about the drive:
Students and staff attended an informative assembly with several guest speakers on April 25 to launch the event.
During the “Month of Music in May for CHEO,” staff and students can also “purchase” music to play over the announcement system before the daily announcements and post-lunch period – $3 for 5 minutes worth of music. Students’ Council will then purchase the songs to be played.
Glebe Students’ Council’s Oscars Night on May 15 will also benefit CHEO.
Glebe Collegiate is thrilled to bring the “Kids 4 Kids” CHEO drive back to Ottawa for its fourth year. Glebe is honoured and excited to be a part of a campaign to raise funds for such an amazing cause. With your help, we hope to attain, perhaps even surpass, our ambitious goal. See you on Thursday, May 29!
If you have any questions, please feel free to contact our teacher advisors: Janice Bernstein at 613-239-2424 x 2134 email@example.com and Katherine Caldwell at 613-239-2424 x 2089 firstname.lastname@example.org
James Morden is a Grade 11 student at Glebe CI. He is a member of Glebe Students’ Council and is leading this year’s CHEO drive and media campaign.