concert audience

Does loud music damage hearing?

Although attending concerts is a great social activity, it is wise to be aware of the impact on your hearing. Audiologist Susan Whiteside explains the risks of loud noise and how to protect yourself from permanent hearing damage.

How loud is too loud?

Construction workers have to wear hearing protection because the noise they’re exposed to could damage their ears, yet there are no requirements for concert goers.

Here’s a comparison of sound decibels:

  • Volume of a conversation from a distance of 1 metre is approximately 65 decibels.
  • A vacuum cleaner from 3 metres away is approximately 75 decibels.
  • At 80 decibels, the Ontario Ministry of Labour recommends hearing protection if exposed to for 8 hours.
  • A jackhammer from 15 metres away is approximately 95 decibels.
  • The volume at a typical concert and nightclub reaches 120 decibels. Recommended maximum exposure is only 15 minutes with no protection.

Sensations of fullness, numbness and ringing is a sign of temporary hearing loss. Short term, your ears might be able to recover. Repeated exposure can result in long term hearing loss. Musician style ear plugs are a great option to protect your hearing. They lower the decibels but retain the quality of the music. To measure how loud your environment is and how long you can be there before it’s dangerous to your hearing, try the Starkey – Sound Check app.

Remember: try standing further away from the speakers, take breaks from the sound and bring some ear plugs with you.

Protect your ears and enjoy your concert safely!


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Protecting young ears

A baby wearing a black and red helmet

Treating flat head syndrome with a helmet

You’ve probably noticed a baby wearing a helmet at some point in your life. There are a variety of reasons for this, but the most common is to correct a misshapen head. The condition is known as flat head syndrome or plagiocephaly. While it isn’t rare, most people know very little about it.

Hamilton Health Sciences’ Prosthetics & Orthotics Program is one of Canada’s largest providers of treatment for this condition. This team creates custom helmets to help remold the skill skull when it has grown unevenly. Certified Orthotist, Michael Hall, specializes in assessing and correcting plagiocephaly. He shares answers to some of the most common questions he receives.

What causes babies to develop a flat spot on their heads?

We started to notice an increase in flat spots on infants’ heads in the early 90s when the “Back to Sleep” program was first introduced. It encourages parents to have their children sleep on their backs on a very firm mattress to help reduce the risk of SIDS (sudden infant death syndrome). Infants’ heads are still very soft and easily influenced by prolonged pressure in one area. Back sleeping has contributed to some of the misshapen heads that we are seeing. Some babies don’t adjust their position during sleep, and the part of their head that’s in contact with the mattress becomes flattened.

A what point might child need a helmet?

Infants who have developed a significantly misshapen head may benefit from the use of a helmet to correct the shape.

Infants with a very mild to moderate misshape can benefit from conservative treatments like repositioning of the head from left to right during sleep, using a repositioning pillow, and increasing tummy time. If your infant has moderate to severe misshape, you should consider possible treatment with a helmet. Your healthcare provider can help you determine the degree of misshape your baby has developed.

How do they work?

These custom helmets are shaped to limit growth on the side of the skull that is overdeveloped and encourage growth on the side of the skull that is underdeveloped. As the brain grows, the skull will expand into the flattened areas to fill out the space in the helmet. The lining of the helmet is also designed to better distribute pressure along the bones of the skull.

Scroll down to see before and after scans!

When is the best time to start exploring a helmet as an option?

The best time to begin treatment with a corrective helmet is once a child has developed good head control. This normally occurs round the age of 4 months.  We recommend this age because the head grows quickly between the ages of 4 months to 7 months, and this is when we see the best correction occurring with the use of a helmet.

It is always best to start asking questions early. I have sadly had to tell some families that it is too late for a helmet to reshape their child’s head because they waited too long to be referred for assessment. This is very hard news to deliver, so we recommend parents inquire with their family doctor when they start to notice a problem, and request a referral to a certified orthotist as early as possible.

baby's head is measured using calipers


What should I expect once we’ve decided to have a helmet made?

Once a decision has been made to treat with a helmet the following steps will occur:

  1. A scan of your child’s head shape will be captured using a special digital scanner. This is quick and absolutely painless. The scan gives us a better idea of your child’s head shape, and will be used to develop the helmet. You can even choose a custom design and colour for the helmet!
  2. Two weeks after the scan you’ll attend a fitting appointment. At this appointment the new helmet will be fitted to your child and you’ll receive information for how to use and care for the helmet. We will also answer any additional questions you may have.
  3. After a short break in-period of a couple of days the child will – wear the helmet full time. This ensures the best possible correction.
  4. Every two weeks, you’ll come in for a follow-up appointment to review progress. If needed, slight changes will be made to the helmet to continue reshaping the head.
  5. Your child will remain in treatment until the desired head shape has been achieved and there is no longer any risk of the flat spot returning, or until about twelve months of age.

Orthotist Mike Hall shapes the lining of a baby helmet



Will the use of the helmet affect the brain’s neurological development in any way? Does the helmet hurt?

The helmet does not affect the brain’s neurological development in any way. The helmet does not hurt.  While an infant may fuss or cry when they are first fitted with the helmet, they soon settle down and the helmet becomes familiar and more comfortable.

What happens if we don’t do the helmet?

This is always a difficult question to answer.  We do have some parents who decide not to treat with a helmet, however since we never see the child again for any follow-up, it is difficult to know if the child’s head shape improved or just remained the same.

Generally, if a baby’s head is moderately to severely misshapen, a helmet is the best way to correct it.

How much does it cost for treatment? Does insurance cover this?

This treatment is not currently covered by OHIP or the Assistive Devices Program (ADP). The complete cost for the treatment, including follow-up visits is $2,888. Most insurance carriers will provide some form of coverage for this treatment. The level of coverage depends on your insurance plan.

A parent’s perspective

Parents Lyndsay and Steve started to notice a difference in their daughter Anastasia’s head shape when she was only a couple months old. They tried to correct it by repositioning her and increasing tummy time, but her head continued to grow unevenly. When she was four months old, they were referred to Prosthetics & Orthotics at Hamilton Health Sciences where Mike Hall assessed Anastasia. When he measured her head there was a 18mm difference between the right and left side.

“It was severe,” says Mike. “Anything over 15mm is considered severe and the most severely involved case we have seen was a child with a 29 mm discrepancy.”

“It’s been a really positive experience.”

Lyndsay and Steve opted to have a helmet created for Anastasia. They were pleasantly surprised by how quickly she adapted to it, and how positively strangers reacted when they saw her.

“We’ve been stopped in public by parents who are exploring it for their kids and want to know more,” says Steve.

Lyndsay chose a Harley Quinn design for Anastasia’s helmet, since she and Steve are big superhero fans. Anastasia got used to the helmet quickly, and it didn’t dampen her cheerful spirit.

“It’s been a really positive experience,” says Lyndsay. “Mike is great with her.”

Anastasia’s treatment has led to great results. After wearing her helmet for six months, her head shape corrected by 13mm.

Before and after

The scan on the left was taken at the start of Anastasia’s treatment, and the one on the right was taken when it was complete.

scans showing a 13mm reduction in discrepancy in the shape of a baby's skull


Physical activity and mental health in children

At long last, the warmer weather is just around the corner which means more opportunities for the whole family to get outside and get active. The change in seasons is a great opportunity to take stock of your family’s physical and mental health – an important connection to be mindful of in raising healthy and happy kids.

The risks of an inactive lifestyle for children

Are your children as active as they should be? It’s a question we should ask ourselves often since an inactive lifestyle can have negative effects on children. Obesity is one concern, but mental health is also greatly affected by inactivity. It can lead to depression and anxiety.

A study from the Centre for Disease Control found obesity rates in Canadian children age three to 19 have more than doubled since the 1970s. As of 2013, 13 per cent of Canadian children were obese. This trend is concerning as these kids can experience physical and mental health concerns as a result of their obesity.

Kids aren’t moving enough

Canadian 24-Hour Movement Guidelines for Children and Youth recommend at least an hour of vigorous physical activity each day, along with several hours of light physical activity. Dr. Kim Edwards, a clinical and health psychologist who works in McMaster Children’s Hospital’s Pediatric Chronic Pain program says “the majority of youth are not meeting these recommendations. And we know a contributing factor is screen time,” she says. “Based on studies in Canada, youth between the ages of 8-18 spend on average 6+ hours a day on screens.”

“Youth between the ages of 8 – 18 spend on average 6+ hours a day on screens”

Dr. Edwards sees many patients who have become inactive as a result of their pain, and says they often experience further psychological effects due to that inactivity. Those effects include anxiety, depression, trouble sleeping, and social problems.

Brooke Biggs, a physiotherapist in the program, says physical issues, including muscle weakness, decreased stamina and flexibility, obesity, and low energy often arise as well. Both agree that these concerns can affect all children regardless of the reason for their inactivity.

Slow and steady treatment approach

Brooke recommends a gradual approach for any child struggling with an inactive lifestyle. “We take it slow and steady in our program, and would recommend that for all kids who need to increase their physical activity,” says Brooke. “We don’t tell them to run a marathon. It’s about gradual introduction of exercise and movement, incorporating lots of breaks.”

Brooke and Dr. Edwards say that it’s important to encourage kids to take part in physical activities that are enjoyable and meaningful to them. “We want them to be engaged and committed to their progress so they can stick with it long-term and be active for life,” says Brooke. “And if kids understand the benefits of physical activity and participate in setting meaningful activity goals, we see more buy-in and commitment,” Brooke shares.

“Exercise…is like taking an antidepressant”

Dr. Edwards notes that it can be difficult to start, but says even kids will see the mental health benefits once they are more active. “Exercise has been likened to having the same impact as taking an antidepressant,” she says. “It’s remarkable, youth who are active tend to report less anxiety and depression, display greater confidence, improved thinking skills, and overall, have a better outlook on life.”

Both Dr. Edwards and Brooke assert, “Kids are able to feel good when they engage in exercise.”

What you can do

So where do you start? Time and money are popular fallback excuses but your family doesn’t have to spend endless hours a day exercising or invest in a fancy gym membership. Start small, set realistic goals, and make sure your child enjoys the physical activity you choose.

You can start with simple measures like going for regular walks with the family pet, or get creative and have a dance party in your living room…just get moving! Getting outdoors and immersing yourself in nature has a whole other host of benefits on your family’s mental health. Some other ideas to consider:

  • – Connect with your child’s school for after-school activities and sports teams
  • – Explore the trails and hiking routes in your region
  • – Check out your local YMCA for various programs, open gym and swim times

Dr. Edwards emphasizes the importance of getting your kids physically active and engaged early on in life. “You build health habits as a child which sets the stage for your whole life.” She and Brooke recommend looking at the Canadian 24-Hour Movement Guidelines to guide you and your family on the ideal amount of movement per day.

Dr. Edwards especially challenges parents to look at their own health habits to provide the best example for their kids when it comes to physical activity and mental well-being.

Reducing screen time goes hand in hand with increasing physical activity. Check out our related article on tips for improving your family’s digital health.

a person is lying face down in bed with their feet poking out from the covers

Pain and Insomnia – breaking a vicious cycle

By Dr. Laura Katz, Psychologist, Hamilton Health Sciences’  Michael G. DeGroote Pain Clinic

The link between chronic pain and lack of sleep is widely understood among insomniacs. Lack of sleep can aggravate physical ailments, including pain, and in return, pain can make it difficult to sleep. The relationship creates a cycle with one feeding into the other. In fact, over 40 per cent of people with chronic pain also have insomnia compared to just 10 per cent of the general population.

There are many reasons for the relationship between chronic pain and poor sleep:

  • Chronic pain changes the way the brain works
  • Negative emotions, stress, and anxiety that accompany chronic pain can make it hard to “shut off” your brain
  • Pain can lead people to be less active, which can lead to poor sleep
  • Inconsistent sleep patterns can cause a cycle of trouble sleeping—poor sleep can make you need a nap, which makes it harder to fall asleep at night, and so on
  • Pain can make it hard to find a comfortable sleeping position, or can wake you up during the night

The Effects of Poor Sleep

We can all agree that we feel pretty miserable when we have a bad night’s rest. Combining that with chronic pain can make daily life seem unmanageable at times. I like to say that sleep “debt” or lack of sleep charges interest. Over time, the impact snowballs, affecting both ability to sleep, and increasing the amount of pain you experience. It is common for patients with chronic pain to experience issues falling and staying asleep due to their pain. This tends to increase their experience of pain, tension, and symptoms throughout the day. In turn, patients feel more emotional, irritable, and distressed, and they will often feel like they have less patience because of their pain. Patients often describe feeling frustrated with themselves and those around them, potentially lashing out at their loved ones. Resulting relationship issues can again negatively affect sleep, leading to further issues with pain and mood. As you can see, it’s all part of a vicious cycle.

Sleep “debt” or lack of sleep charges interest

So, how do we break that cycle? Many strategies involved in treatment require behavior changes and are based on Cognitive Behavioural Therapy for Insomnia (CBT-I). Change can, of course, be difficult for a lot of people. Brief interventions, such as only going to bed when sleepy and re-associating the bed with sleep, can be very effective for patients to start getting better sleep. To maintain these improvements, patients need to be motivated to change their habits and behavior in order to improve their sleep.

Tips for Improving Sleep Quality

1. Reduce time in bed and only go to bed when sleepy. This helps to re-associate the bed with sleep. Use your bed only for sleep.
2. Turn off all electronics, and unplug from screens at least 30 minutes before bed.
3. Go to bed and wake up at the same time every day. Our bodies like routine, and this helps to set our biological clock.
4. Avoid day-time napping. If you need a nap because of fatigue or pain, nap between 1-3 PM for less than an hour.
5. Let your body be tired. Engage in exercise and activities out of the house throughout the day.
6. Avoid big meals before bed.
7. Reduce substances such as alcohol, nicotine, and caffeine. All substances alter your sleep, and can lead to less restorative sleep.
8. Manage your anxieties, worries, and stress before you go to bed. In the early evening (several hours before bedtime), try “clearing your head” by writing down what’s on your mind, categorizing your thoughts (e.g., finances, to do’s, shopping lists), and/or finding possible solutions.

If sleep or insomnia is an issue for you, be sure to discuss it with your family physician.

blurred photo of a patient in a wheelchair

Preventing delirium in the hospital

By: Alexandra Curkovic,  clinical nurse specialist, Hospital Elder Life Program 

Have you ever heard of delirium? This disorder isn’t commonly understood, but it is a common concern among older adults in the hospital (it can also affect kids).

It’s an acute disorder, which means it usually appears suddenly and doesn’t typically last too long. It can develop in as little as a few hours and symptoms tend to fluctuate in severity throughout the day. People with delirium have problems in attention and awareness. It is most common in older patients who are hospitalized, but the symptoms are not always easy to identify.

A patient with delirium may have difficulty following a conversation and may get confused about their environment to the point that they don’t recognize they are in the hospital. Changes to the patient’s physical environment—like moving a patient to a new room—may make symptoms worse.

What does hospital delirium look like?

People with delirium can act confused and may:

• have trouble paying attention
• be forgetful
• be restless and upset
• have trouble concentrating
• startle easily to any sound or touch
• slur their speech
• ramble and jump from topic to topic
• not know where they are
• have trouble staying awake
• see and hear imaginary things
• mix up days and nights
• act confused for a short period of time during the day and then be suddenly okay
• drift into sleep during conversation

Delirium can have serious, negative effects on a person’s ability to function independently and can affect their quality of life long term. It can also increase a person’s likelihood of developing dementia.

A patient’s perspective on delirium

John Vlainic, a former Hamilton Health Sciences employee, experienced delirium while he was in the hospital being treated for a serious infection. He describes the experience as completely disorienting.

“I remember being adamant there were men on the roof”

“I remember being adamant there were men on the roof outside my hospital room window,” he says, recalling one of the visions he imagined. “I also became convinced the machine warming my oxygen was dangerous. I decided I would unplug it in the middle of the night.”

John’s wife Ruth says it was concerning seeing her husband in this state. They were glad when his delirium started to lift after a couple days.

What’s the difference between dementia and delirium?

Dementia develops over months, with a slow progression of cognitive decline over years. On the other hand, delirium occurs abruptly over a few days or weeks, and symptoms can come and go during the day. A person with dementia is much more likely to develop delirium when hospitalized.

The main difference separating delirium from dementia is inattention and level of alertness. The individual with delirium simply cannot focus on one idea or task. This inattention is usually present in later stages of dementia.

Level of consciousness for patients with delirium may fluctuate from very tired to very easily startled state whereas patients with dementia are normally alert unless they are in the later stage. .

a pair of glasses sit on a patients bedside table

Risk factors for hospital delirium

There are several risk factors that can make a person more likely to develop delirium. The tips below will help you to reduce these risk factors in the hospital:

1. Cognitive impairment: People with existing dementia or mild cognitive impairment are more likely to develop delirium. Look out for signs of changes in thinking like memory loss or difficulty with daily tasks.

How to help: If someone has cognitive impairment, keep their mind active while they’re in the hospital. Ask questions about current season, holidays, past hobbies and family members. Bring familiar items, like board games or books to their room to help occupy them.

2. Sensory impairment: Hearing or vision loss can make it more difficult for someone to assess their surroundings and can contribute to delirium.

How to help: Bring their sensory aids with you to the hospital and label them. If they typically wear hearing aids or glasses, make sure they wear them during their hospital stay.

3. Loss of mobility: Lack of movement can make someone more likely to develop delirium. A patient who walked independently before hospitalization may feel unsteady during their illness or after an operation, and need assistance with a walker or other mobility device.

How to help: Advocate for removal of tethers such as IVs and oxygen tubes, and urinary catheters. Encourage the patient to move throughout the day to keep their muscles strong. Family members can help!

4. Dehydration: When people get dehydrated, they are significantly more likely to develop delirium.

How to help: Watch out for physical indicators of dehydration like muscle weakness, speech difficulty, dry mouth and a pale lining inside of the mouth. Encourage drinking throughout the day. Talk to the care team to make sure your loved can safely drink.

5. Recently added medications: New medications can increase someone’s risk of delirium. The medications most often associated with delirium are benzodiazepines and anticholinergics.

How to help: Discuss alternative medications with the care team to reduce risk.

a patient with delirium uses a colouring book

If delirium develops while your loved one is in hospital

• Tell the staff right away if you see a change in thinking.
• Develop a plan of care with the staff to help with the confusion.
• Try to redirect to current season, date and place. Explain why they are in the hospital. You may need to repeat this many times. Do not argue if they see things differently.
• Continue to ensure glasses and hearing aids are worn if needed.
• Continue to ensure your loved one is eating and drinking well. Ask your nurse if it is okay to feed your love one.
• Continue to encourage walking.

a staff member reads to a patient with delirium

Hamilton Health Sciences has a Hospital Elder Life Program (HELP) service available for patients over 75 who are in select clinical areas at Hamilton General or Juravinski hospitals. If your loved one develops delirium, ask if these services are available on their unit. Click here for more information about the HELP Program.

This helpful handout provides more information for patients and families can learn more about preventing delirium while in the hospital.

the figure from the supposed "momo challenge"

More than Momo: Online safety should be a constant conversation

By Dr. Tony DeBono, child psychologist

By now, you’ve probably heard of at least one of the numerous internet challenges that have reportedly targeted our youth. The Momo Challenge is the latest to enter the picture, and though debunked as a hoax, it has raised fair concern among parents. The Blue Whale Challenge, Tide Pod Challenge, and others like them have sparked similar fears about what’s lurking within our children’s tablets. Unfortunately, the concern usually fades before we can establish healthier online habits within our families. Let’s make this time different.

Blurred lines between virtual and reality

There’s no doubt the internet can be a risky place for unsupervised kids. Even with parental controls on, our kids can be exposed to content that affects their mental health.

Their two worlds are seamlessly integrated

Because most kids spend a lot of their time on devices, it’s important for parents to be aware of what their children are seeing online, and keep the lines of communication open. If you grew up pre-smartphone, it’s hard to imagine just how much the online experience affects kids. But Gen Z doesn’t distinguish between “real life” and social media in the same way we do. Their two worlds are seamlessly integrated, and what they see online can affect them as much, or more than face-to-face interactions.

Why does this content keep popping up?

Social media clout is big business. Even people who aren’t profiting from their posts get a thrill from going viral. Why? “Success,” measured by likes, views, and retweets, plays into the positive feedback loop that revs up our brain’s pleasure centres. When we get a positive response, we feel good, and that makes us want to repeat the action.

When we share viral challenges, even as a warning, we are to some degree feeding into this cycle. The old adage that “there is no such thing as bad publicity” often rings true for people behind these concerning challenges.

The young brain’s pleasure centre

This positive feedback loop also exists in developing brains, and participating in these challenges can play into the same emotions in kids as they do in the individuals who start these trends.

Talk to your child about using social media for validation. Remind them that while likes and views may be very important to them, the trade-off to achieve them isn’t always worth it. These can be big and difficult conversations. Try to incorporate them into regular chats so your kids become comfortable with the topic.

Many kids worry their social media privileges will be revoked if they raise a concern with you. If that happens, they’ll become less likely to talk to you about what they see. When you see something that worries you, try to become more involved rather than limiting your child’s access. It will build trust and make them more likely to turn to you in the future.

Practical tips for parents

• Inform and empower yourself by reading service agreements so you know what your kids are signing up for

• Use parental controls, but also be aware of their limitations

• Talk to your child regularly about what they’re seeing online. Keeping communication lines open will make them more likely to come to you with their concerns.

• Set limits around social media use, and stick to them.

• Encourage your kids to look for validation offline in accomplishments such as mastering a new skill, or doing a good deed for a neighbour.

• If you suspect your child is having significant difficulties because of their online interactions, talk to your primary care provider


More tips for improving your family’s technology use:

Tips for staying well on vacation

So you’re going on vacation. Lucky you!

It may be easy to get wrapped up in visions of beaches and buffets, but before you hit the road, there are some important things to take into consideration. When you travel, the health care resources you’re used to at home may not be readily available. There are also different risks and infections that you can be exposed to away from home. Follow these recommendations for a safe and healthy vacation.

Before you go

1. Check travel health notices

Check to see if there are any travel advisories for the place you’re visiting. The Centers for Disease Control and Prevention (CDC) outlines three types of notices: Watch Level 1 (practice usual precaution), Alert Level 2 (practice enhanced precautions) and Warning Level 3 (avoid nonessential travel). Search by country to see if there is anything to be concerned about:

2. Make sure vaccinations are up-to-date

On the same CDC website, you can check the required and recommended vaccinations by country:

Ensure your routine vaccinations are up to date and consult a health care professional to see if any additional vaccinations are required or recommended based on where you are travelling to and the types of activities you have planned (for example, if you may come in contact with malaria or rabies).

Routine vaccinations include measles-mumps-rubella (MMR) vaccine, diphtheria-tetanus-pertussis vaccine, varicella (chickenpox) vaccine, polio vaccine, and your yearly flu shot. Sometimes, your doctor may recommend a Hepatitis A, Hepatitis B, or Rabies shot (only if you’re at risk for bug or animal bites, travelling in remote areas or working with wildlife).

View out the airplane window

3. Purchase travel insurance

The thought of something going wrong on vacation is the last thing you want to consider during travel planning. But it’s better to be safe than sorry. If you’re travelling outside of Canada, purchase comprehensive health insurance that covers medical procedures in other countries and/or the cost of getting you home if needed for peace of mind. Make sure you keep this documentation on your person while travelling.

4. Book an appointment with a travel health clinic

If you’re travelling outside Canada and the U.S., you may want to learn about the specific risks of the place you’re visiting and get any necessary prescriptions for vaccines or medications.

5. Research the health care system of your destination

It’s important to know what your options are if you get sick or injured. Know hospital locations and phone numbers before you go. Carry them on you when you leave your primary residence, especially if there is a language barrier.

6. Be aware of:

• Traveller’s Diarrhea, caused by bacteria in food or water. Medication can relieve diarrhea and symptoms like nausea, vomiting, cramps and fever.
• Hepatitis A, contracted through contaminated food and water (food, drinks and swallowing swimming or bathing water).
• Hepatitis B, contracted through sexual contact, contaminated needles and other equipment (spa treatment, tattoo needles, etc.) blood and other bodily fluids (transferred from first aid to an infected person, sex, etc.).
Heat stroke
Zika virus

What is Zika virus?

You may have heard of Zika virus, a disease spread through mosquito bites.

Besides mosquitos, the virus can spread from an infected pregnant person to their baby (and potentially cause a birth defect called microcephaly). It can also spread through sexual activity.

The virus can live in semen for up to seven months after infection (even if no symptoms are present) and can spread to sexual partners during that time. If someone is infected with Zika, it’s important to abstain from sex or use a condom every time. The virus doesn’t last as long in women’s bodily fluids. Women should wait at least 8 weeks after travel before trying to get pregnant.

The most common Zika virus symptoms are fever, rash, headache, joint and muscle pain, and red eyes. Many people show no symptoms. There is no medication to treat Zika virus. The best means of prevention is to avoid mosquito bites by using insect repellant, wearing clothing that covers your body when mosquitos are out, and removing any standing water around your home.

VIDEO: What to pack in your vacation first aid kit

Packing is one of the few downsides of going on vacation (if you can call it that!). Fitting everything you need into a compact bag can be stressful, especially if you don’t know what to expect on your trip. Jason Thomas, pharmacist at the Juravinski Hospital and Cancer Centre Retail Pharmacy is here to help. He’s taken the guesswork out of packing your vacation first aid kit with a handy list of must-have supplies.

While you’re thereDaiquiri on the water

1. Watch what you eat and drink. Water in many countries contains bacteria or parasites. Drinking tap water, using ice cubes, or eating fresh fruit or vegetables that have been washed in that water can increase your risk of infection. Pay close attention to how your food is cooked and served. Avoid food that has been left sitting out, or isn’t cooked all the way through. Remember: boil it, cook it, peel it, or forget it!

2. If you’re visiting a country with a disease that is spread by insects, wear long clothes and bug repellant that contains at least 20 per cent DEET or icaridin.

3. Protect your skin from the sun. Wear a cover-up if possible, and use sunscreen with an SPF of at least 15 (30 or higher is recommended for children). Melanoma is one of the most preventable forms of cancer. Learn how to be sun-safe with cancer specialist, Dr. Elaine McWhirter.

4. Avoid high-risk activities. Take precautions like wearing a life jacket or helmet if you ride on a boat or ATV. Remember – scuba diving and mountain climbing activities can be dangerous if you are not experienced.

5. Take your first aid kit (or a mini version) on excursions or when you’re out in nature. There’s no point packing it if it’s not there when you need it.

6. Remember- sexually transmitted infections are generally much more common in countries outside North America and Western Europe.

7. Keep hydrated, especially in hot places or during physical activity. Bring a reusable water bottle with you to fill up constantly.

8. Wash hands frequently, avoid animals, prevent bug bites, get your flu shot, and use your judgement to consume safe food and drink.

For more information on how to protect yourself, and additional precautions you may need to take, visit a travel health clinic. You can find a list of clinics on Ontario here.

teenage girls

How to recognize the signs of eating disorders

by Dr. Sheri Findlay, Adolescent Medicine Specialist, McMaster Children’s Hospital Eating Disorder Program

Eating disorders are serious mental health conditions that usually begin in teens, but can also appear in pre-adolescents. Although they can occur in boys, about 90% of sufferers are girls. Families, teachers and coaches should be aware of early warning signs. Catching the disease early can improve the recovery process and reduce the long term impact on the young person and their family.

Eating disorders symptoms

The most common way for an eating disorder to begin is with a deliberate attempt to lose weight. The reason is often a desire to look better for a special event (such as a vacation or prom) or due to comments from others about appearance. Witnessing or experiencing bullying can trigger this behaviour.

Scale with tape measure and apple implying weight loss

Parents should watch for:

  • Rapid or steady weight loss
  • Skipping meals
  • Avoidance of high calorie foods
  • Frequent visits to the bathroom after meals
  • Episodes of over eating
  • Avoiding eating with family and friends
  • New onset of pickiness around foods
  • Obsession with nutritional content and burning calories by exercising

These symptoms are often noticeable for parents. However, some teens will try to hide their symptoms out of fear they’ll be forced to stop.

Other situations

In some situations, eating disorders can be harder to spot, as not all young people have a desire to lose weight. Instead, they want to “get in shape” or “be healthy”. In which cases they’ll increase their exercise or change their eating patterns to accomplish those goals. This behaviour is considered an eating disorder when the young person becomes unable to function and maintain balance in their life due to their preoccupation with exercise and nutrition. In these cases, parents will notice:

  • A rigid obsession with exercise
  • An inflexible approach to eating
  • Placing too much importance on “healthy eating”

runner tying her shoe

Another scenario is the young person who experiences trouble eating or weight loss due to symptoms such as stomach aches, nausea, or food intolerances. This can be a difficult scenario for the family, and sometimes the doctor to sort out. If the persistent digestive symptoms are unexplained and leading to weight loss, particularly in teenage girls, it could represent an eating disorder.

Don’t delay in contacting your family doctor

Parents worried about a child with a possible eating disorder, should make an appointment with their family doctor as soon as possible. Serious medical complications can arise quickly in children and teens who diet, over exercise, or engage in other eating disorder behaviours, such as purging. The family doctor can help make the diagnosis, and make a referral to specialty services.

Five simple ways to reduce your cancer risk

Studies estimate that as many as half of all cancers in Ontario could be prevented by eliminating known risk factors like smoking, lack of exercise, and poor eating habits. Cancer screening is also an important part of prevention and early detection. Although not all cancers are preventable, there are ways to reduce your cancer risk. Here are five habits you can incorporate for a healthier lifestyle.

Cancer screening

The Province provides free cancer screening through the Ontario Breast Screening Program, Ontario Cervical Screening Program and ColonCancerCheck program to look for signs of breast, cervical, and colon cancers. Thousands of Ontario residents are alive and healthy today because they were able to either prevent cancer or find it early through screening.

The Ontario Breast Screening Program (OBSP) provides free mammograms for women ages 50 to 74 with no signs of breast cancer, every two years. Early detection through mammography can result in more treatment options. For a list of local OBSP locations, click here. You can book your own appointment or book through your healthcare provider.

Dr. Amy Montour stands in front of the Mobile Cancer Screening Coach with her parents
Dr. Amy Montour and cancer screening coach.

The Ontario Cervical Screening Program (OCSP) recommends Pap tests for anyone with a cervix ages 21 to 69, every three years. Pap tests are free and are available through your healthcare provider. Most cervical cancers are found in people who are not screened regularly. However, cervical cancer is almost entirely preventable, but that means getting a Pap test.

ColonCancerCheck provides a free, take-home screening test every two years for anyone, ages 50 to 74, living in Ontario with no symptoms or family history of colon cancer. This test is available through your healthcare provider. Anyone without a healthcare provider can call Telehealth Ontario’s colon cancer screening line at 1-866-828-9213 for information on how to obtain a test. Colon cancer is highly treatable when caught early. In fact, nine out of every 10 people with this cancer can be cured, thanks largely to early detection.

If you have never been screened for cancer and/or don’t have a healthcare provider, you can access all three screening tests on the Mobile Cancer Screening Coach. Call 1-855-338-3131 to book your appointment. Drop-ins are also welcome on a first-come, first-served basis.

Cut back or quit smoking

Smoking is responsible for an estimated 30 per cent of all cancer deaths in Canada. It also causes about 85 per cent of lung cancer cases. The more you smoke and the longer you smoke, the greater your risk of developing lung and other cancers. Other cancers that pose a higher risk to smokers include cancers of the oral cavity and pharynx, nasal cavity esophagus, stomach, colon, liver, pancreas, larynx, cervix, ovary, kidney, bladder and bone marrow.

Your best chance for quitting successfully is through a combination of support and medication.

Ashtray with cigarette buds

Consider sharing your goal with friends, family members and coworkers, as well as ways they may be able to assist. Community resources can be extremely helpful too. Smokers’ Helpline offers a free phone service and 24/7 online and text messaging support. Also, consider

Over-the-counter nicotine replacement therapy comes in many forms including patches, gum, lozenges, mouth spray and inhalers. In addition, there are prescribed medications that you can discuss with your healthcare provider.

Some tips to help you quit include:

  • Identify triggers like drinking alcohol, coffee and smoking after meals and how best to avoid or replace them
  • Manage cravings with the 4 Ds: deep breathing, drinking water slowly, distraction and delaying by reminding yourself that the craving will pass
  • Use rewards as an incentive, such as saving the money not spent on tobacco to treat yourself to something special

Knowing your risk

Cancer Care Ontario (CCO) offers a free online risk assessment tool,, to help people determine their risk for six types of cancer — breast, cervical, colorectal, lung, melanoma and kidney. Anyone can use this easy tool. It takes less than five minutes to complete.

If you’re not comfortable answering some of the questions, there’s a “why is this important?” link that explains the significance of each question. It’s important that you answer each question honestly. You’ll then receive a personalized risk assessment and action plan including information on how to reduce your risk. This assessment is meant to help with lifestyle changes, and is not intended to diagnose cancer.

Since risk can change over time, CCO suggests using this online tool every so often to see whether there has been a change.

Eating well

A diet full of fruit and vegetables may help your body fight many kinds of cancer. They can also help you maintain a healthy body weight, which may also lower your risk of developing some cancers. Health Canada has just issued its new Canada’s food guide with healthy eating recommendations.

Half a plate of vegetables and fruit, a quarter of a plate of protein, a quarter of a plate of whole grains, make water your drink of choice

Physical activity

Maintaining a healthy body weight through exercise can reduce the risk of developing certain cancers, including breast and colon cancer. Although it’s ideal to incorporate physical activity into each day, this doesn’t mean you need to go to the gym everyday for an intense workout. Daily activities like walking the dog, gardening and household chores help keep your body moving and contribute to your daily exercise. Check out the Public Health Agency of Canada’s tip sheets tip sheets for great ways to ensure physical activity is part of your daily routine.

an ipad and computer on a desk

Tips for improving your family’s digital health

by: Dr. Ashley Legate, psychologist

Do you ever think about the relationship between technology and mental health? Technology is a great resource. It can provide connection, information and entertainment at the touch of a button. But as with all things, it should be enjoyed in moderation.

Start by taking stock of your technology habits. How much are you using? How does it make you feel? Is your technology use negatively affecting those around you?

Then use a collaborative approach to improve your family’s relationship with technology. Discuss realistic limits for screen time and social media use and create a family media plan to keep you on track.

How does technology affect our mental health?


Watch for:
• Losing interest in offline hobbies and friendships.
• Technology use overpowering important activities like exercise and school work.
• Setting unrealistic tech limits—this can cause people to become secretive about screen time.

Focus on:
• Using social media to connect with faraway family and friends.
• Finding online groups with similar interests and identities.
• Having conversations about screen time and social media use.


Watch for:
• Too much focus on gaining approval on social media through likes, comments, etc.
• Using technology to avoid face to face interactions that make you anxious.
• Frequent worry about how people will perceive your comments on social media.

Focus on:
• Doing one thing at a time. Avoid dividing your attention between multiple apps and activities.
• Maintaining both face to face and online relationships.
• Practising mindfulness. Try the Stop, Breathe & Think app to refocus.


Watch for:
Difficulty falling asleep. Bright light from technology before bed can disrupt sleep patterns.
• Anxious thoughts about social media that keep you awake.
• Secrecy around late night screen use.

Focus on:
• Giving yourself time to wind down before bed without devices.
• Keeping technology out of the bedroom if it’s too tempting.
• Including rules about bedtime tech use in your family media plan.


Watch for:
• Decreased time spent on other, previously enjoyed activities.
• Sudden academic problems.
• Serious difficulty managing emotions after stopping gaming.

Focus on:
• Establishing gaming rules in your family media plan.
• Offering gaming time as a reward for completing chores and homework. This is much more effective than withholding gaming as punishment.
• Game together as a family and make it a social activity.

Technology and mental health: take it day by day

Does this seem overwhelming? Changing habits can take time. If you want to improve your relationship with technology:

  • focus on one small thing you’d like to change
  • make a plan to change it
  • tell someone about it to keep yourself accountable!

a printable handout on technology and mental health. The text on the handout mirrors what is in plain text above.

Want to keep these tips handy? Download this info sheet and stick it on your fridge!

Screen Time

The average Canadian child racks up 7.5 hours of screen time every day. While there are benefits to certain types of screen time, it’s important for parents to make informed decisions about how and when their children use screens.

For typically developing children, the Canadian Paediatric Society recommends no screen time under age two and less than one hour per day between ages two and five. Even in school-aged children, screen time should be limited and should focus on activities that support health and learning. Young children who are exposed to too much screen time are at greater risk of:

  • Becoming overweight
  • Having difficulty sleeping
  • Being less prepared for school
  • Becoming inattentive, aggressive, and less able to self-soothe

Creating good screen habits early on prepares children to better manage their screen time independently as they get older.

Remember the four M’s

Minimize: Set limits on daily screen time, maintain ‘screen-free’ time for reading and family meals, turn off screens when not in use, and avoid screens for at least one hour before bed.

Mitigate risk: Be aware of the content your child is engaging with and be present and involved during their screen time.

Be Mindful: Take stock of your family’s screen habits and make sure they aren’t interfering with meaningful activities. Teach your children to question advertising messages and think about what they’re watching.

Model good behaviour: Minimize your own screen time when kids are present, especially during meals. Focus on conversation, interactive play and healthy activities.

Did you know? Artificial light and stimulation from screen time before bed can make it difficult to sleep. Make your child’s bedroom a screen-free zone!

Trouble managing screen time? Talk to your family doctor or call your local Contact agency. Contact Hamilton: (905) 570-8888.

An analog watch

This tiny object can cause big damage if swallowed

Magnet injuries now rarely seen

Most of us have heard a story or two about a kid swallowing something they shouldn’t have, either in person or in the media. Any diehard Grey’s Anatomy fan can recall the episode where a collection of ball bearings ripped through a young boy’s intestines as their magnetic forces drew them together. Several years ago, these little magnets became popular toys, and raised wide-spread concern when kids began to swallow them. The powerful magnets could puncture intestines as they gravitated toward one another in a child’s abdomen.

“Thankfully, we haven’t seen a case like that in a long time,” says Dr. Helene Flageole, chief of pediatric surgery at McMaster Children’s Hospital (MCH).

“Their alkalinity is very corrosive.”

After much public outcry, the magnets were banned in Canada. Dr. Flageole says the order seems to be working, and has seen a drastic decrease injuries related to the magnetic toys. But she continues to be concerned by another item that is sometimes swallowed. It has a lot in common with the magnets: it’s small, it’s shiny, and it’s incredibly dangerous.

A button battery.

Surgery often required when kids swallow these batteries

“They can cause major tissue damage in just a few hours,” says Dr. Flageole. “Their alkalinity is very corrosive.”

Button batteries are commonly used in watches, hearing aids, and other small devices. Dr. Flageole says they’re often purchased in multipacks, and when extras are left lying around, they can be tempting for children.

“Many of us have that junk bowl or drawer where we put little odds and ends. When these batteries end up in there, they may look like candy to children.”

She estimates between five and ten children undergo endoscopic surgery at MCH each year after swallowing one of these batteries. Surgery is often required because the contents of the battery are corrosive, and can eat through intestines so they must be removed quickly.

“They can create a hole in the food pipe within six to eight hours,” she says.

Safe disposal is a must

Dr. Flageole recommends people dispose of extra button batteries through a battery recycling program, or store them in a locked cabinet. Carefully secure all devices that use button batteries, adding a layer of tape if the closure can be popped open easily. If you suspect a child has eaten one, call 9-1-1 or go to the emergency department immediately.

Did you know?
Lego bricks, coins, and hair clips are some of the most commonly swallowed objects. About 80 per cent of inedible objects swallowed by kids will pass naturally. Of the remaining 20 per cent, most can be removed using a flexible tube called an endoscope. Only a small number require surgery.


A football player dodges a tackle

You may have more in common with Super Bowl athletes than you think

By Maggie Hitchon and Dr. Ryan Williams

Watching elite athletes on screen or in person, it’s hard to imagine having much, if anything in common with them. The unfortunate reality is that you may have more in common than you think…when it comes to injuries.

Have you ever thought that you could suffer the same injury as an elite, highly trained NFL athlete? Take Rob Gronkowski of the Super Bowl bound New England Patriots as an example. Standing 6’7” tall and weighing in at 265lbs, he has sustained multiple injuries over his years as an accomplished football player. Regardless of protective equipment, the force applied on the field makes football players prone to injuries pretty much anywhere on their bodies. Some say it’s just part of the job. And while many of us spend plenty of time and money trying to be more like the athletes we idolize, beware—copying their on-field injuries is all too easy.

Common injuries on and off the field

Both overuse injuries and traumatic injuries can occur on the football field. The top three most commonly injured joints in football include the ankle, the shoulder and the knee. These injuries can be as simple as a rolled ankle during a practice or as devastating as a dislocated shoulder during a game. They can also just as easily happen to average folk, even people who have never stepped foot on a playing field. They can happen in the workplace, in the backyard, or while out for a walk with the dog.

Ankle injuries

a diagram of the ankle ligamentsThe most common ankle injury is an ankle sprain. This is also known as a rolled ankle. Sprains occur when the foot twists, turns or rolls beyond its normal range of motion. This causes the ligament to stretch beyond its limit like an overstretched elastic band. The most commonly injured part is the anterior talofibular ligament or the ATFL for short. Ankle sprains can happen when you misstep while walking or running on uneven surfaces.

What to look for: Pain, swelling, and bruising.

Diagnosis and Treatment: If you think you’ve injured your ankle, it is important to seek medical care from a trained healthcare professional. The mainstay of treatment for ligament sprains is Rest, Ice, Compression, and Elevation (Remember R.I.C.E.). When returning to sport, athletes often tape their ankles for increased stability. When you are watching the Super Bowl on Sunday, take a look at the athletes’ ankles. You’ll see something called spats taped around the outside of their cleats. This covering both keeps the cleats clean, and provides ankle support for the players.

Shoulder injuries

The two most commonly injured parts of the shoulder include the acromioclavicular (AC) joint and the labrum. The AC joint, which sits at the top of the shoulder, is usually injured from a direct blow to the shoulder, such as a tackle that throws a player to the ground. The labrum is a rubbery tissue that surrounds the shoulder socket to keep the ball of the joint in place. This is most commonly injured in linemen while they are blocking. Because the shoulder joint has a large range of motion, it is easily forced beyond its limits, making it prone to injury.

What to look for: Shoulder injuries can appear differently, but symptoms may include pain, stiffness, and limited movement. You are at risk for a shoulder injury if you do repetitive overhead movements or lift heavy weights regularly.

Diagnosis and Treatment: After assessment by a trained healthcare professional, X-ray and MRI imaging is often ordered to diagnose these types of shoulder injuries. Rest and therapy are the first steps for treatment. Sometimes surgery is required for the AC joint or labrum depending on the severity of the injury.

a person downhill skiing

Knee injuries

Football players commonly injure their knees when they plant and twist to carry out a play, or when they’re tackled to the ground at the knee level. When ligaments of the knee are stretched beyond their limits they can tear partially or completely, depending on the amount of force applied. Commonly injured structures in the knee include the anterior cruciate ligament (ACL), the medial collateral ligament (MCL) and the meniscus. Knee injuries are common in contact sports, as well as skiing and trampoline. They may also occur with something as simple as an awkward twist when getting up from a chair.

What to look for: These types of injuries can cause pain in the knee and a feeling of instability. Some people describe hearing or feeling the tear when it happens.

Diagnosis and Treatment: After your initial assessment, ultrasound or MRI imaging is often used to determine which structure in the knee is affected. Remember your R.I.C.E. principles for treatment. After the initial pain has improved, therapy is a great way to regain strength and mobility in the injured knee.

Injury prevention

The first step in preventing these injuries is to avoid being tackled to the ground by large NFL football players. But in all seriousness, there are ways you can reduce your risk of injury.

• Exercise regularly
• Maintain proper posture
• Eat a healthy diet, and generally take good care of your body

Regular participation in strengthening exercises and stretching can help keep your bones, joints, and muscles stay strong in order to avoid the injuries mentioned above. If you think you’ve been injured, it is important to seek treatment from a trained healthcare professional early on. You know your favourite athletes would!

Maggie Hitchon is a physician assistant at Hamilton Health Sciences’ Regional Rehabilitation Centre. Dr. Ryan Williams is a physiatrist at Hamilton Health Sciences, and a member of the Hamilton Tiger-cats medical staff.