Getting ready to leave the hospital

When you, a friend or a family member makes a trip to the hospital, the focus is usually on medical treatment rather than what is going to happen when it’s time to go home. Yet planning for the journey home is an important part of a hospital stay that should start when a patient is admitted. Being prepared when it comes time to leave the hospital can help ensure a smooth and safe transition from hospital to home for both the patient and/or caregiver.

Five tips to help prepare you for going home

Get packing

The items people choose to help prepare for leaving hospital are diverse, but there are some essentials that you won’t want to be without: clothing, footwear, and personal care products (such as toothbrush, toothpaste, hair products, and brush or comb, and deodorant). Don’t forget a pen and notepad to jot down questions, and answers and important information when meeting with your discharge team.

Be sure you have transportation home

Whether you’ve had a long or short-term stay in hospital, or a visit to the emergency department, you are responsible for arranging and paying for your own transportation home. If a friend or family member cannot pick up and drive you home, there are other transportation options to choose from. Your health care team can help you decide which options are best suited to your needs. You will need to contact the transportation company directly to arrange to pick you up. It’s a good idea to ask for a quote before you book your trip. For information about transportation options, visit our brochure.

Call on a friend

If possible, arrange for one friend or family member to be your point person on discharge day. Even though there may be several loved ones looking out for you, having one person in charge of helping you to handle your discharge information will streamline the process and make your discharge run smoothly.

Know your discharge plan

Your discharge team will work with you to ensure a plan for your recovery and any support you may require. Before leaving the hospital, you will have a conversation with your discharge team and receive written instructions. These instructions will include information about diet, activity, medications, services and supports you may need. It’s important that you take time to review the instructions and ask questions if there is anything you are unsure of before you leave. It’s helpful to repeat what you have been told, and make sure that anyone who is helping with your transition home understands too. Know who to contact in case you have questions after you arrive home.

Follow up is important

After you leave the hospital, you may have a follow up appointment with a physician or another health care provider. Be sure to note any appointments so that you do not miss them. Have a plan for transportation to and from your appointments. Follow up is an important part of your recovery.


If you’re anticipating a hospital stay, or know someone who is, share this helpful list of tips so they can prepare.




school age boy and girl

HPV can cause six types of cancers – but it’s preventable

By Dr. Dustin Costescu, gynecologist

You may have heard about the human papillomavirus (HPV) in the media or from friends. It’s the most common sexually transmitted infection. It’s also the cause of nearly all cases of cervical cancer, and is known to cause five other cancers – anal, vaginal, vulvar, penile, and head and neck. It can also cause genital warts.

More than 75% of men and women are infected at some point in their lives, and most will show no symptoms. Others can go on to develop genital warts, and some will develop pre-cancer or even cancer. There are more than 100 types of HPV, and some carry a higher risk for cancer than others. The good news; HPV is preventable.

One of the most promising, and yet frustrating, aspects of HPV-related cancers is that they are among the only cancers that are highly-preventable.

Since it’s a sexually transmitted infection, practicing safe sex and limiting your number of sexual partners are ways to prevent HPV. Those practices, combined with the HPV vaccine, provide the greatest protection. The vaccine protects against the most common types of HPV, including the two that cause the greatest risk of cancer. Since the vaccine can’t protect against all types of HPV, it is still important for women to get regular Pap tests to screen for cervical cancer.

The vaccine was first introduced in 2006 and is recommended for both females and males age 9 to 26 since anyone can get HPV and HPV-related cancers. Since 2006, the vaccine has resulted in a reduction in HPV causing cancers as well as genital warts.

The vaccine is proven to be very safe and doesn’t increase a young person’s likelihood of taking sexual risks. We aim to vaccinate girls and boys early, before their sexual début, as that’s when the vaccine is most effective. Due to this, the vaccine is available through the school immunization program to all grade 7 students in Ontario. Click here for more information on Ontario’s HPV immunization program.

If you were not vaccinated in school but would like to be, please talk to your doctor or pharmacist.

One of the most promising, and yet frustrating, aspects of HPV-related cancers is that they are among the only cancers that are highly-preventable. Since we have the tools to protect ourselves, we should use them.




a measuring tape wrapped around a sandwich

Pitfalls of the lifestyle ketogenic diet

By Jennifer Fabe, registered dietitian

The therapeutic ketogenic diet has been used as a treatment for epilepsy for nearly a century. In recent years, we’ve learned even more about its potential role in treating other medical disorders. But lately, the lifestyle ketogenic diet has been getting a lot of attention for the wrong reasons. It has become a popular weight loss trend, and many people are jumping on the bandwagon without considering potential risks.

How does the ketogenic diet work?

In a typical diet, more energy comes from carbohydrates than from protein and fat. The reverse is usually true in a ketogenic diet, which is higher in fat and lower in carbohydrates.

Fortunately, our bodies can use two sources of fuel for energy—glucose, which comes from carbohydrates like bread, fruit, and rice, and ketones, which come from fats like butter, cheese, and oil. Because we typically eat more carbohydrates, our bodies use glucose as their primary fuel since it is easy to access. When there isn’t enough glucose available, our bodies will switch over and start using ketones for energy.

The therapeutic ketogenic diet is medically supervised. It intentionally deprives the body of glucose, which helps trigger a switchover to a state called ketosis. The diet prescribes fat rich food choices, often in very precise amounts. With limited access to carbohydrates and increased access to fat, the body adapts to using ketones as its primary fuel. We don’t know precisely how it works, but ketones seem to help stop or reduce seizures in many people who follow this diet strictly.

Therapeutic ketogenic diet versus lifestyle ketogenic diet

The therapeutic ketogenic diet is used to control seizures and other conditions, and is done under strict medical supervision. Just because it’s considered a “natural” therapy, doesn’t mean it doesn’t have risks. A therapeutic ketogenic diet:

• is customized for each patient, and only used when people meet certain medical criteria.
• is ideally started slowly over a period of weeks under close supervision to minimize side effects. Rapid initiation over a period of days is only done if absolutely necessary, and after serious medical consideration.
• may require a review, and/or adjustment of medications so they don’t magnify potential side effects.
• requires a commitment to daily consistency.
• is monitored regularly for effectiveness, tolerance, and side effects at home and by a medical team.
• is supplemented by vitamins and minerals needed for complete nutrition.

When people embark on a lifestyle ketogenic diet with the goal of losing weight, they often fail to consider the potential risks involved, and rarely get the medical monitoring that should accompany this diet. When it’s not being used for medical purposes, keto dieters are also more likely to “cheat.” And because it is so limiting, many people find it difficult to stay on the diet long term and maintain their weight loss.

Other potential risks

Starting the ketogenic diet without input from healthcare professionals can lead to negative effects. On websites promoting the keto diet, you may read that these side effects are normal and will go away if you persist on the diet. They are not normal, and shouldn’t occur if you are following the diet safely.

Keto “flu”?

Some people who follow a lifestyle ketogenic diet report feeling flu- like symptoms when they start, including headache, tiredness, nausea and aching. This should not happen. It is the body’s way of responding to rapid adjustment, but is unnecessary if the diet is introduced properly and under medical supervision.

Vitamin and mineral deficiencies

Fruits and vegetables, grains, and protein are important sources of vitamins and minerals in our diet. The keto diet restricts many of these foods. Without them, it’s hard to get the vitamins and minerals we need. A lack of certain vitamins and minerals can cause complications. For example, lack of selenium, a mineral that’s found in grains and some sources of protein, can cause an irregular heart rhythm.

Lack of minerals can also cause cramps, which are common when people start the keto diet without supervision. If not properly monitored, the diet can pose a risk over time for bone weakness, and can result in compromised growth in children.

a blood sugar monitor and a bottle of vitamins

Interference with medication

The ketogenic diet can also interfere with some medications, which is why patients are carefully screened before being put on this diet to control conditions like epilepsy.
The diet can interfere with some diabetes medications, causing the body to pee out too much sugar. This loss of sugar can drop blood sugars to a dangerously low level.

Expense

In a practical sense, the lifestyle ketogenic diet can add expense to your grocery list. Although you may buy less carbohydrate rich foods, purchasing high fat foods can be pricey.

Advanced Planning

Planning your groceries and meals is a great strategy for staying on track with healthy eating. The lifestyle ketogenic diet requires careful advanced planning to make sure you get the nutrients you need, and aren’t left scrambling for something to eat. Before dining at a restaurant, or accepting a friend’s dinner invitation, you should consider what you are going to eat. It’s also important to carry snacks you are able to eat on the go in case you get hungry.

But I’m losing weight on the ketogenic diet…

The ketogenic diet is a nutritionally extreme option for weight loss when implemented in its strictest form. Most lifestyle ketogenic diets, however, are less restrictive in carbohydrates than their medical counterparts and more liberal in fats. Although small amounts of ketones can sometimes be generated from this ratio of foods, it is likely not the reason for the weight loss. While some people may find it effective for this purpose, it doesn’t generally work well long-term.

Why do people lose weight then? Weight loss works on a very basic principle: calories burned exceed calories consumed. Whenever our bodies don’t get enough calories in the food we eat, they start to use other calorie sources within the body, like body fat or muscle. People who lose weight on the ketogenic diet are losing weight because they are consuming fewer calories than they are burning.

There are a few reasons for this:
• Fats tend to fill you up, so you don’t eat as much on the ketogenic diet.
• Some lower carbohydrate foods in the diet, like leafy greens, are very low in calories.
• The diet requires you to modify foods so they fit within its boundaries, which makes eating on the run difficult—therefore dieters eat fewer calories from takeout, fast food, and junk food.

Ultimately, this calorie imbalance causes weight loss, but it is difficult to maintain.

Because it restricts many important food groups, the ketogenic diet can’t provide complete nutrition without added vitamin and mineral supplements. Restrictive diets also tend to make us want what we can’t have. If we can’t have bread on a diet, we may crave it. When we give into those cravings, our body goes back to using glucose for fuel and the ketogenic diet is no longer maintained.

If you are still interested in trying the ketogenic diet, or are on the diet and want to continue, I strongly urge you to talk to your family doctor or a registered dietitian about how to follow the diet safely and sustainably.

Healthier alternatives

The best way to lose weight is by making healthy lifestyle changes you can stick with in the long run. There is no weight loss diet that ‘fits all’ for our diverse Canadian population. I recommend making healthy food choices that suit your preferences, food availability, and budget.

To work towards your weight loss goal and healthy lifestyle:

• continue to eat a variety of foods from all food groups in moderation, and make healthier choices within those food groups.
• commit time to planning your groceries, meals, and physical activity.
• be mindful of your portion sizes.
• talk to your doctor or registered dietitian for strategies and support to help you achieve your weight loss goals.

Here are some helpful resources on selecting healthy foods and appropriate serving sizes:
https://www.dietitians.ca/Your-Health/Plan-Shop-Cook/Plan-Well.aspx  
http://www.unlockfood.ca/en/FoodPortionsToolkit.aspx 
https://www.hamilton.ca/educational-programming-teachers/healthy-schools/healthy-eating-and-nutrition 


Jennifer Fabe is a registered dietitian in the Division of Pediatric Neurology at McMaster Children’s Hospital. She is the lead dietitian for the hospital’s ketogenic diet program, which helps kids with epilepsy use the medically supervised ketogenic diet to manage their seizures.




Don’t fall for it

Hamilton Health Sciences’ trauma team and Hamilton Paramedic Service are taking the first day of fall (September 22) as an opportunity to remind everyone to be cautious out on hiking trails and up on roofs and ladders.

“There are a lot of seasonal risks that people don’t consider,” says Dr. Tim Rice, a trauma surgeon at Hamilton Health Sciences.

“These incidents are almost always preventable.”

Falls from a height continue to be a leading cause of emergency calls and hospital visits. The trauma team sees about 100 patients a year for non-work related falls that have caused severe injury. This number does not include the many calls Hamilton paramedics respond to that require first aid and/or treatment in the emergency department.

“These incidents are almost always preventable,” says Dr. Tim Rice. “And they result in very serious injuries. We want to make sure people get the message that a fall can be life changing, even from 10-20 feet. We see patients with brain injuries, severely broken bones and major internal injuries.”

In 2016, Hamilton Paramedic Services responded to 323 falls from heights, 220 of which took place at peoples’ homes.

“When we respond to these calls, we often find that the person has put themselves in a risky position by making poor choices,” says Russell Crocker, deputy chief of Hamilton Paramedic Service. “We see people wearing inappropriate footwear, going off-trail on a hike or failing to secure a ladder before climbing it. We don’t want people to stop hiking or doing fall cleanup, we just want them to be smart about it.”

The team’s message is clear: “Don’t fall for it.” Taking a risk to capture a selfie or get a chore done more quickly just isn’t worth your life.




keys left in door

Regular aging or Alzheimer’s?

by Dr. Atul Sunny Luthra, Geriatric Psychiatry Outreach & Behavioural Health, St. Peter’s Hospital 

Alzheimer’s disease is a type of dementia that affects brain cells and, as a result, causes a slow decline in memory, thinking and reasoning skills. It eventually affects all aspects of life. Since each person is affected differently, it’s difficult to predict when the symptoms will appear, in what order or how quickly they’ll progress.

There are 10 common warning signs of Alzheimer’s disease. It’s important to understand how these signs appear in someone with Alzheimer’s disease compared to normal aging. Some of these differences are outlined below. If you notice any of these warning signs or have any questions about dementia, please speak with your doctor.

 

1. Memory loss affecting day-to-day function

Normal aging: Forgetting things often, but it does not affect day-to-day function, i.e. forgetting where you’ve put your keys.
Alzheimer’s disease: Forgetting and not remembering how to do daily activities, i.e. not knowing how to use the washing machine so you don’t wash your clothes.

2. Difficulty performing familiar tasks

Normal aging: Having to follow the recipe of your favourite meal, as you can no longer make it from memory.
Alzheimer’s disease: No longer knowing how to do something you’ve been doing your whole life, such as getting dressed.

3. Problems with language

Normal aging: Forgetting the word you were trying to use.
Alzheimer’s disease: Not realizing you’re using basic words in the wrong context.

4. Disorientation in time and space

Normal aging: Forgetting your way around the local shopping mall that you used to have memorized.
Alzheimer’s disease: Getting lost in the local shopping mall that you used to have memorized, as if you’ve never been in it before.

5. Impaired judgement

Normal aging: You may just forget that you need a sweater on a cold day, but then realize when you go outside that you need one.
Alzheimer’s disease: Going outside on a winter day in summer clothes and not recognizing that it’s too cold for what you’re wearing.

 

6. Problems with abstract thinking

Normal aging: You may just be a little slower at making a calculation on a calculator.
Alzheimer’s disease: Not understanding what numbers signify on a calculator or how they’re used.

7. Misplacing things

Normal aging: Retracing your steps to try to remember where you left what you’ve misplaced.
Alzheimer’s disease: Putting things in strange places and not recognizing that the item is even misplaced.

8. Changes in mood and behaviour

Normal aging: Recognizing and understanding that you’re having mood swings.
Alzheimer’s disease: Unknowingly exhibiting severe mood swings.

9. Changes in personality

Normal aging: This doesn’t occur unless there is an underlying issue.
Alzheimer’s disease: Behaving out of character such as feeling paranoid or threatened.

10. Loss of initiative

Normal aging: This doesn’t occur unless there is an underlying issue.
Alzheimer’s disease: Losing interest in friends, family and favourite activities without reason.




Epipen in its case

How to use an EpiPen

What is an EpiPen?

An EpiPen is an auto-injector device carried by someone at risk of having a severe allergic reaction, also called anaphylaxis, to various allergens like food, insects, medication, latex and other causes. Once administered, it automatically injects epinephrine to decrease the body’s allergic reaction. The drug works to relax the airways to help a person breathe easier, and works to reverse the dangerous decrease in blood pressure that can happen during an allergic reaction.

EpiPens are easy to use and can save a life. Four per cent of Canadians are estimated to have a food allergy. Once someone has had a severe reaction, they are at a higher risk of experiencing another. The risk is also higher for those with asthma. That’s why it’s important for those with allergies (and their caregivers) to always carry an EpiPen, in addition to having them stored in the places they frequent most: at home, work, cottage, school, camp, daycare, etc.

VIDEO: How an Epipen works

There are just two steps to using an EpiPen. Learn how to use one properly with Kirk Wong, a pharmacist at Hamilton General Hospital’s Hamilton General Drugstore.

 

To use an EpiPen on yourself…

  1. Hold the pen in a fist with the blue end facing up to the sky.
  2. Pull of the blue cap.
  3. If the window on the side of the pen is clear, it’s ready to use.
  4. Swing your hand back and push the pen into your thigh.
  5. When you hear a click, hold the pen for five seconds.

 

On someone else…

  1. Have them sit down and kneel beside them.
  2. Complete steps 1-5 from the above list, pushing the pen into their thigh.

 

Once the EpiPen is injected into the thigh and you hear the click sound, hold it in for several seconds. An EpiPen can be used through clothing, even jeans. Once it is pulled out, the orange cover automatically extends to ensure the needle is not exposed. After using an EpiPen, always call 9-1-1 or go directly to your closest emergency department.

Epipen in its case

When should you use it?

Use an EpiPen at the first sign of a severe allergic reaction. Don’t hesitate. Reactions can happen within minutes or hours after exposure. It’s important to know the symptoms to look out for like swelling of the throat, difficulty breathing, skin redness, and fainting – every second counts.

Do you have to go to the hospital after?

Yes, using an EpiPen does not replace going to the hospital. You could have a second reaction or the effects of the medication could wear off. You’ll need to find out if additional medication is required.

Make sure you have another EpiPen with you when you leave the hospital. You’ll want to stay close by for the next 48 hours in case of another emergency.

Children and EpiPens

Those prescribed an EpiPen should carry it with them at all times. If your child has one, ensure their teacher and school have extras and are aware of how to use it. If kids are old enough, they can carry a convenient waste pack so it’s always on their body in case of an emergency.

Remember, EpiPens do expire so know the date and set a reminder when it’s time to get a new one (the expiry date refers to the end of the month).

Storing your EpiPen

Keep your EpiPen at room temperature, not in the fridge, and away from light. EpiPens can only be exposed to temperatures between 15 and 30 degrees. Remember not to leave your EpiPen in the car during hot or cold weather.

To be sure your EpiPen has been stored safety, check the solution in the viewing window and replace it if it’s discoloured or cloudy.

Printable instructions

 




school buses lined up on a street

A smooth school transition for kids with special needs

by Elizabeth McAllister, clinical coordinator, school support program, McMaster Children’s Hospital

Change and transition can be hard for anyone, including children with special education needs. Re-establishing routines and building familiarity when it’s time to go back to school can be an important way to help our children succeed. Depending on your child’s needs, you may want to:

  • Visit the school to see the new classroom, meet the teacher, and play on the playground equipment
  • Read stories about school
  • Arrange playdates with classmates or other children
  • Practice skills for school (e.g., using a lunch box, backpack, walking to the bus stop)
  • Start adjusting bedtime and wakeup routine to match your school schedule
Focus on opportunities

As the school year begins, take time to think about your child’s unique abilities and needs. Help yourself plan ahead: try to anticipate opportunities for success, and areas where your child may face challenges.

Keep the lines of communication open! Teachers and school administrators are an important resource. Talk to them regularly about your child’s progress, strengths, and requirements. If your child has an Individualized Education Plan (IEP), it may be helpful to review it at the start of the school year, and talk to your child’s teacher about new or ongoing goals. If you have them, provide the school with any professional reports that can help them understand how your child learns best.

Discuss resources or accommodations that can support your child’s learning needs. For example, some children may have a difficult time with verbal explanations but respond very well to visual ones.

Choose choices

During the return to school, children, including those with special needs, may feel a loss of control, and that can be stressful. Providing them with choices can give them a sense of control. For example, they could choose their back-to-school materials or pick out a healthy snack for break time.

 

You can get more back to school information and tips, from our Back to School booklet.




a flatlay of back to school materials, including an iPad that says Back to School

Back to school with McMaster Children’s Hospital

Back to school can be a stressful time for parents and kids. Our experts at McMaster Children’s Hospital (MCH) want to make it easier.

Together with both school boards and the City of Hamilton, we’ve developed this downloadable booklet containing advice on a variety of topics like anxiety, vaccinations and allergies.

Wishing you a smooth transition back into the classroom!

Click the arrow in the top left corner to download your own copy.




Child at festival wearing ear muffs as hearing protection

Protecting young ears

By: Karina Chaloux, audiologist, Hamilton Health Sciences

In my role as an audiologist, I’m often asked whether babies and children should wear hearing protection. The answer is: absolutely! Noise that’s potentially damaging to an adult’s ears is even more dangerous to a child’s. And, since hearing loss from exposure to loud noises is permanent, it’s important for parents to start the habit of protecting kids’ ears while they’re young.

When should my child wear hearing protection?

Everyone, especially children and babies, should wear hearing protection when the potential for loud noises is high. We measure sound in “decibels”. Any noise below 75 decibels (about the level of a vacuum cleaner) is considered safe. Noise above 85 decibels (about the level of a lawn mower) is dangerous and can cause hearing damage and loss.

Activities that may lead to hearing loss include:

  • Attending loud events in stadiums, gymnasiums, amusement parks, theaters, auditoriums, and other entertainment facilities.
  • Attending auto races, air shows, demolition derbies, sporting events, music concerts (music lessons, rehearsals), fireworks.
  • Riding a snowmobile, all-terrain vehicle, motorcycles or farm tractor/equipment.
  • Using or in the presence of lawn mowers, leaf blowers, snow blowers, chain saws or any other loud power tools.
  • Participating in or observing shooting sports. The sound of a gunshot can reach the same level as a jet engine at takeoff. At this decibel level, noise can damage hearing immediately and permanently. Hearing protectors should be a standard part of shooting-safety gear.

If you’re unsure about whether hearing protection is necessary in a particular situation, there are mobile apps available for download which measure decibel levels to help you identify a potential risk for hearing damage.

What kind of hearing protection should children wear?

There are three common types of hearing protection products, some of which are better for babies and children.

Earplugs: Earplugs are either soft foam or hard plastic inserts that fit directly into the ear canal. They come in both disposable and reusable options. Because earplugs are usually adult sizes, they may not fit into small ears, while also posing a choking hazard for young kids.

Ear muffs: Ear muffs designed specifically for hearing protection are a good option for kids, since they fit over and form a seal around the entire ear. The ear muffs are held in place by an adjustable band and they come in kids’ sizes, making it easy to find a proper fit. Remember: try to keep hair and glasses out of the way to ensure a proper seal.

Custom earplugs: Custom earplugs are made to fit the individual’s ear, making them the best option for a proper fit. They can fit the ear and the ear canal tightly, and slightly changes shape with the ear canal when talking or chewing. Custom earplugs have advanced filters for a precise, even level of noise reduction. The earplugs can be customized to reduce volume only by the necessary amount, and can filter select kinds of sound more than others so that it’s still possible to hear music and speech. Please note that because these earplugs are custom made children can outgrow them quickly.

To learn more about hearing protection options, talk to your ear doctor or contact the Audiology clinic at Hamilton Health Sciences.




Sun protection tips with skin cancer specialist

We’ve waited a long time for sunshine. But now that it’s here, how can we enjoy it safely?

There’s no such thing as a healthy tan. Stay sun safe this summer with these quick sun protection tips from skin cancer specialist, Dr. Elaine McWhirter.

Video: Sun protection tips

Melanoma is one of the most preventable forms of cancer. When discovered early, it can also be very treatable. But wait too long and melanoma can spread to other parts of the body, growing into the deep layers of the skin and entering the lymph system. Once it spreads to other organs, it can be extremely difficult to treat.

Beyond your control

A fair complexion: If you don’t tan easily or have fair skin, you’re more susceptible to UVR (ultraviolet radiation) damage. So are people with naturally blond or red hair, or blue, green or hazel eyes. Although melanoma is somewhat rare among people with very dark skin, they’re not immune so it’s important to protect yourself.

Family history: People with a first-degree relative such as a parent, sibling or child with a history of melanoma may also have an increased risk of developing this disease. The more close relatives you have with melanoma, the higher your risk.

In your control

Sun exposure: People who spend lots of time in the sun are at increased risk of melanoma. Frequent sunburns — even if they occurred years ago — increase your risk. While you can’t change the past, you can reduce your risk moving forward.

Tanning equipment: Tanning equipment can emit stronger UVR than the sun. In fact, people who use tanning equipment have at least a 25 per cent increased risk of melanoma. The risk increases with younger age of first use, and greater frequency of use.

Moles: Reducing exposure to UVR, especially early in life, can help to reduce the chances of developing moles. Most moles aren’t cancerous. Those signaling skin cancer are typically larger, have irregular shapes and less uniform colour than most moles.

MyCancerIQ: Visit MyCancerIQ.ca. This Cancer Care Ontario website offers a personalized risk assessment and action plan with tips and resources based on your personal risk factors.

How to be sunsafe

• Apply broad spectrum sunscreen, minimum SPF 30, and re-apply every 3 hours; more frequently if swimming (every 90 minutes).
• Wear wide-brimmed hats and sunglasses with UVA/UVB protection.
• A cotton T-shirt only has an SPF of about 3; so consider SPF clothing and swim-shirts.

Remember:

• Cloud cover isn’t protective – the UV rays can penetrate through
• Shade alone isn’t sufficiently protective – especially with reflective surfaces such as water, sand and concrete nearby.
• Snow reflects UV rays so you’ll need sunscreen for your face in winter.
• The high UV index days are from April to October, from 10 am to 4 pm. If possible, plan outdoor activities around these hours. Otherwise, remember to use the tips above!

Learn how to do a skin check with Dr. Elaine McWhirter to check your body for moles that exhibit warning signs of skin cancer.

Read other tips on how to be safe on vacation.




two kids swimming

Water safety for kids

Drowning is a leading cause of injury-related death for Canadian children, and it often happens quickly and silently. Almost half of all child drownings occur in backyard swimming pools.

It’s important to enjoy swimming safely. Here are some backyard pool safety tips with our Dr. Karen Bailey, pediatric surgeon.

Make sure your backyard pool is a feature to enjoy, not a dangerous hazard for your family and friends.

  • All pools must be fully fenced with a self-closing, self-latching gate.
  • Young kids and weak swimmers should wear life jackets or personal flotation devices in and around the water.
  • Ensure there is adult supervision around the pool, even if the children can swim.
  • Have some safety equipment accessible including a reaching pole or ring buoy.
  • Always have a first aid kit handy.
  • Have a phone nearby to call 9-1-1 in case of an emergency.
  • Consider a safety net or removable mesh fence for added protection when the pool is not in use.
  • Enroll kids in swimming classes when they become of age.
  • Don’t leave toys laying around the pool that could entice kids to the edge.
  • Don’t let kids dive in until parents have checked how deep the waters are.

Life jackets and personal flotation devices

It is highly recommended for everyone to wear a life jacket when boating, or doing water activities in open water as nine out of 10 people who drown in boating accidents are not wearing life jackets.

Young kids and weak swimmers should wear a life jacket or personal flotation device when near or swimming in water, including pools and at the beach.

When a child wears a life jacket in the water it not only keeps them floating but can turn them from face-down to face-up. This is can help keep your child safe if they fall into the water.

A personal flotation device also keeps your child floating, however, it doesn’t turn them if they’re face-down. Please remember that water wings and blow-up toys are not considered personal flotation devices. They aren’t approved and therefore will not necessarily keep your child floating. Puddle jumpers are a popular swimming aid, however they’re also not approved so are best to be used under careful supervision.

If your child wears a life jacket, it’s important to ensure it fits properly. Here are some fitting tips with our Dr. Karen Bailey, pediatric surgeon.

Life jacket fitting tips:

  • Ensure you have the correct size.
    • Adult sizes are based on chest measurement and weight.
    • Child sizes are based on weight.
  • Check the label to make sure it’s been approved.
  • Check the life jacket for damage and ensure the zipper still works.
  • The fit should be snug so that it doesn’t ride up over your ears.
  • Life jackets for kids should have the following features:
    • A large collar
    • An adjustable waist strap
    • A strap that buckles between the legs
    • Bright colours and reflective tape
  • Each year test the life jacket not only to ensure it still fits, but to ensure it’s still effective

What to do if you suspect a child is drowning

Children can drown in as little as one inch of water. If you suspect someone is drowning (if they have stopped breathing or have trouble breathing), call 9-1-1 immediately and follow these steps.

Take the child out of the water and place them on their back with their head tilted slightly back to open the airway. Check if the child is breathing by placing your ear near their mouth and nose. Remember, gasping for air is not considered breathing. If they are not breathing, start CPR as soon as possible. Every parent should be very familiar with how to perform CPR.




an older man kissing his wife on the cheek while they walk outside

Managing COPD flare-ups

What is COPD?

Chronic Obstructive Pulmonary Disease (COPD) is a lung disease that develops slowly over time. It is usually diagnosed after 40 years of age, and is a long-term condition. COPD cannot be cured, but it can be treated.  With proper treatment, people with COPD can lead active lives and live for many years.

COPD includes chronic bronchitis and emphysema. Some people have one or the other, but some may have both. COPD makes it hard to move new air (oxygen) into your lungs and stale air (carbon dioxide) out.

In chronic bronchitis, difficulty breathing is caused by swelling and mucus in your airways, which blocks air from passing through. This makes you cough, expel mucous, and feel short of breath.

In emphysema, difficulty breathing is caused by damage to the air sacs at the tips of your breathing tubes. These sacs are stretchy – they stretch out when you breathe in, and shrink as you breathe out. Emphysema makes them stiffer. They don’t stretch and shrink as they should, so stale air gets trapped in your lungs. This makes you work much harder to take in air, making you feel tired and short of breath.

In most cases, COPD is a result of smoking (80-90% of cases). Other causes include genetics, exposure to dust or chemicals, second-hand smoke, frequent lung infections as a child, and exposure to wood smoke.

a graphic depicting the difference between emphysema and chronic bronchitis

 

Managing your COPD

Getting a diagnosis early, making positive lifestyle changes, and taking appropriate medications can help you lead a normal, active life with COPD. Attending your medical appointments is very important. Ask you doctor if a Pulmonary Rehabilitation program is right for you.

If you smoke, quitting is the most important step in treating your COPD. If you need help quitting, call Smoker’s Helpline at 1-877-513-5333 or visit www.smokershelpline.ca.

Consider joining a local support group to learn more about managing your COPD. Email info@lungontario.ca for locations near you.

 

COPD flare-ups

A flare-up, also known as an exacerbation or “lung attack,” happens when your normal day-to-day symptoms get worse over a short period of time (a few hours to 48 hours), or when new symptoms appear. Flare-ups can be caused by a trigger, such as air pollution, scents, or allergens, or by a lung infection caused by a virus or bacteria.

Flare-ups can cause further damage to your lungs. They’re one of the main reasons people with COPD have to be hospitalized, and can be deadly.

You need to pay attention to your normal day-to-day symptoms in order to recognize a change that could indicate a flare-up.  For instance: how breathless are you on a good day, how much do you cough, if you have mucus, what is the amount, thickness, stickiness of it?

Managing COPD flare-ups

There are four main steps to managing flare-ups: preventing, recognizing, beginning treatment, and seeking professional help.

1. Preventing Flare- Ups

To reduce your risk of COPD flare ups:

• Eat healthy foods.

Exercise regularly.

• Get enough sleep.

• Find ways to make daily tasks easier.

• Avoid exposure to triggers such as air pollution, scents, and allergens whenever possible.

• Wash your hands properly before touching your eyes, nose, or mouth to avoid picking up and spreading germs.

• Stay away from people who are sick.

• Take all of the medications prescribed by your doctor.

• Practice any breathing exercises recommended by your healthcare team.

• Ask for help if you have questions about how or when to take medications or what they’re for.

• Ask your doctor for a personalized written COPD action plan.

• Get your flu shot every year.

• Ask your doctor if you need a pneumonia shot.

• Quit smoking and avoid second-hand smoke.

2. Recognizing Flare-Ups

The top three signs of a flare-up are:

• Increased cough

• Unusual increase in shortness of breath (even if just with activity)

• Increase in the amount, thickness, or stickiness of your mucus, which may be more yellow, green, or brown than usual

Other common signs include:

• Fever

• Symptoms of a cold, such as headache, sore throat, or runny nose

• Swollen ankles or unusual weight gain

• Feeling generally unwell and tired

3. How to Begin Treatment

Never wait more than one day to take action. Follow the advice written in the COPD action plan which was developed specifically for you. If you do not have written action plan similar to the example at the link above, be sure to ask your doctor for one.

4. When to call your doctor

Follow the directions in your COPD action plan, and never wait more than two days to call your doctor if you suspect a flare-up.

If you are experiencing any of these signs, call 9-1-1 immediately:

• Chest pain

• Blue lips or fingers

• Confusion, you can’t think clearly, or are very agitated or upset

• Drowsiness or sleeping a lot

• Extremely short of breath

 

For more information on COPD, contact the Lung Health Info Line to be connected to a certified respiratory educator. From Monday through Friday, 8:30am – 4:30pm call 1-888-344- LUNG (5864), or email info@lungontario.ca any time.

OR

Visit the Lung Association

OR

Visit Living Well with COPD