What’s one of the worst errors that young people make early in life? It’s the failure to practice preventive medicine. So, let’s have a talk with young people about how to protect their bones for a lifetime.
We know that kids of all ages break bones playing sports. It’s annoying when this happens, leaving them sidelined from sports and play with friends for a few weeks.
But breaking a bone becomes more than an inconvenience for adults, as full recovery becomes less likely. The older one is, the more breaking a bone may have life-changing consequences, including being forever consigned to a wheelchair. But why do bones become brittle with age, and can it be avoided?
Many people think bones are hard and unchanging like cement. It’s a misconception. To the contrary, bones are constantly undergoing microscopic changes. One group of cells is slowly destroying bone while another group is building up bone. During the early years more bone is produced. But later on, more bone is destroyed.
Look on bones like a bank. A habit of saving money in the bank will mean more to spend later. It’s a comfort to know the investment is guaranteed to pay off. When the inevitable withdrawals begin, there will be no dependency on others for mobility.
Weak bones are the cause of a lot of medical problems. Studies show that over 10 million North Americans have weak bones and an increased risk of bone fracture. But what’s more worrying is that another 40 million have a condition called “osteopenia”, increased weakness of bones from loss of calcium, and a much greater risk of a broken bone. If this happens, the result may be deadly.
Broken bones send more people to hospital than heart attacks, breast cancer, and strokes among women 55 and older. Dr. E. Michael Lewiecki, Director of the New Mexico Clinical Research and Osteoporosis Center in Albuquerque, says, “We’ve reached a global crisis.”
How do you keep out of a wheelchair? Diet will always be vital. But there’s a problem, starting the breakfast young people eat. Many breakfast cereals are loaded with sugar and calories. But they’re dietary disasters increasing the risk of obesity and Type 2 diabetes. The producers of these products should be ashamed, and consumers should make smarter choices. Children should insist their parents buy whole wheat cereals. And these healthier cereals should be eaten with a banana or another fruit and calcium-rich milk. This is the start for stronger bones and a longer life.
Throughout life, diet continues to be of vital importance. Fish provides generous amounts of magnesium and potassium which add strength to bone. And don’t neglect daily sources of calcium that preserve bone.
Vitamin D is important as it helps the absorption of calcium. Vitamin K2 directs calcium to the bone and inhibits blood vessel calcification. And pay attention to protein which makes up a hefty proportion of bone.
Weight bearing exercise such as walking as well as balance and flexibility exercises keep muscles and bones stronger. There’s no better proof of the benefits of exercise than this discovery. A young man lost one arm in a tragic accident. This meant he had to use his other arm more frequently. Later when this other arm was X-rayed the bones were twice their original size.
So, children, save your money and your bones by eating well and by a lifetime of physical activity. After all, who wants to be in a wheelchair later in life?
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Building Up Bones for a Lifetime
Music for the Mind
Music may be the world’s greatest medicine. From infants to centenarians, people love music and the way it makes them feel good. In tribute to its universal qualities, Hans Christian Andersen said, “Where words fail, music speaks.”
Even without lyrics, songs certainly convey feelings. Among healthy people, researchers have shown that across cultural divides, people can readily place vastly different types of music into emotional categories ranging from sad to heroic, annoying to beautiful, and desirous to indignant.
But the miracle of music is in its healing qualities. Scientists studying people with brain injuries and neurological conditions such as dementia and Alzheimer’s disease are making remarkable discoveries.
Music, for example, can improve the gait of people relearning to walk after a brain injury. Listening to music has also been shown to reduce perceptions of pain. People who have lost the ability to communicate due to severe brain damage can regain function by singing the words.
Symptoms of Alzheimer’s typically become evident when the part of the brain involved in memory starts to fail. This gradually erodes the ability to manage everyday life independently. Loss of the sense of identity is confusing for the patient and heartbreaking for family and loved ones.
But playing music lights up wide networks in the brain including areas responsible for motor actions, emotions, and creativity. Researchers are studying how music can help treat Alzheimer’s disease.
Michael Thaut, director of the University of Toronto’s Music and Health Science Research Collaboratory, has studied patients with early Alzheimer’s disease who listen to personally meaningful music.
He identified “autobiographically relevant, long-known music” – wedding songs, for example, or favourite records from teenage years – and played these songs repeatedly to test subjects.
Whether the participants in the research were accomplished musicians or non-musicians, the results were similar: brain function improved.
Ground-breaking research by Dr. Lola Cuddy of Queen’s University demonstrating that patients with Alzheimer’s disease have an ability to recognize music and display musical memory has informed the development of musical therapy programs as simple as creating a familiar playlist for people with dementia.
What’s going on in the brain? It appears that familiar music stimulates activity in the brain that leads to rewiring new circuits that bypass damaged regions and re-establish connections to memories.
“Music is an access key to your memory, your pre-frontal cortex,” Thaut says. For those hoping to prevent dementia, he adds, “It’s simple: keep listening to the music that you’ve loved all your life. Your all-time favourite songs, those pieces that are especially meaningful to you. Make that your brain gym.”
Experts disagree on whether it is better to listen to familiar music or new music. While familiar music elicits happiness, some experts suggest that listening to the grandchildren’s music might help the brain create and reinforce additional neural pathways. On this, the jury is out.
What is certain is that music does what no pill can do. Within seconds of exposure, and for sustained periods, it heals the mind.
More good news, it’s not just the brain that benefits from music. Music can reduce anxiety, lower blood pressure, ease pain, improve sleep, boost mood, and elevate alertness. But there is something remarkable about music that helps stow away and later retrieve deeply valued information and connections.
Shelley, the English Romantic poet, who tragically lived only to 29 years, wrote, “Music, when soft voices die, Vibrates in the memory—” Today’s researchers have proven him right.
And what sweeter medicine than to turn on the music and enjoy the journey through happy memories while also exercising the mind.
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Decarbonizing Healthcare
Last week we wrote about the environmental disaster of plastics choking the world’s oceans and the consequences for human health through the food chain. This week let’s look through a different lens at another environmental disaster of our own making – the carbon footprint of healthcare itself.
Here’s something you may not know. If the global healthcare sector were a country, it would be the fifth-largest greenhouse gas emitter!
A report from Health Care Without Harm calculated that the environmental impact of healthcare amounts to 4.4% of global net emissions – the equivalent of 514 coal-fired power plants.
So far, North Americans are among the main culprits. By way of example, the report notes, “The United States health sector, the world’s number one emitter in both absolute and per capita terms, produces 57 times more emissions per person than does India.”
What exactly is causing all these emissions? Primarily, it is the energy consumption of healthcare facilities, healthcare transportation, and health product manufacturing, use, and disposal.
It’s not easy for individuals to have clout with the healthcare industry and its complex global supply chains. But there are things everyone can do to share a sense of responsibility.
First and foremost, stay healthy. If you need yet another reason to do it, this is it. Staying healthy means not using healthcare products. This will reduce your own contribution to health sector emissions. As it happens, the things that keep people healthy are the same things that protect the environment – e.g., reducing red meat consumption and walking in place of driving.
Second, make use of telehealth. There are times when seeing a doctor in person is an imperative. But telehealth is proving to be a valuable component of the system. It can offer convenience, speed, ease of access, low cost, quality care, safety, and a low-carbon footprint. This is one of the great lessons of the pandemic.
Third, advocate for healthcare providers to decarbonize and be environmentally responsibility. The more people make this an issue, the more the pressure and incentives build for environmental accountability in healthcare.
Here’s an example. People suffering from respiratory conditions may use metered-dose inhalers (MDIs) that work based on a pressurized propellant in an aerosol chamber. Unfortunately, these propellant gases are up to 3,350 times more potent than carbon dioxide in trapping the sun’s heat! A single inhaler can release as much emissions as a small car driven for 180 miles. A typical patient may use 12 inhalers a year. Dry powder inhalers are a good alternative that can be used by the vast majority of patients.
But here are the big conundrums that need innovative solutions. It’s not just older people who inevitably need more healthcare – and therein add to the emissions of the sector. It’s those who fall ill too early in life from avoidable problems. Plus, there are many people around the world who desperately need better healthcare and for whom healthcare spending must increase. To offset the impact of these deserving consumers, there’s an urgent need for a global transition to clean, renewable energy.
In addition, instead of learning from the errors of developed countries where people are eating too much meat and not getting enough exercise, developing countries that achieve higher income levels are making the same mistakes. The epidemic of diabetes in North America is now a worldwide pandemic.
Finally, doctors must think differently. The Hippocratic Oath implores “First, do no harm.” It’s time to include the planet, not just the patient, in the thinking.
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Plastic Soup a Disastrous Meal
W. Gifford-Jones, MD and Diana Gifford-Jones – Common Sense Health
Why is humankind so bent on destruction? Why so apathetic in the face of annihilating warfare, repeated massive oil spills and choking urban smog? Equally awful is the “Plastic Soup” in our oceans.
A picture of a Hawaiian beach reveals the folly of humans. It shows a huge amount of plastic washed ashore – an insult to a beautiful beach. Such ocean garbage is a serious hazard for sea life. Don’t believe the rest us are immune to this environmental disaster. Our lives, too, depend on our oceans.
Small planktonic organisms, through photosynthesis, transform carbon in air and seawater into organic compounds, an essential element of Earth’s carbon cycle. They generate about half the atmosphere’s oxygen, as much per year as all land plants. Plankton also provides a food source for marine animals. But studies show plastic particles are also being ingested by these animals. This poses a major problem for us all.
Microplastics carry toxic chemicals such as DDT and heavy metals. Scientists say concentrations can reach a million times higher than present in the natural environment. The worrying point is that these contaminated particles are in our food chain and who knows what new diseases will emerge.
Humankind should get its act together. Ocean plastics are concentrating in large offshore patches, extending for miles, consisting of floating and submerged debris. Microplastics and other garbage are present in all oceans and found even at the deepest levels. It’s been called “Plastic Soup.”
It’s estimated the “Great Pacific Garbage Patch” contains at least 70,000 tons of ocean plastic across an area twice the size of Texas! But don’t believe it is only the large garbage patches that are the concern. Most of the plastic material is small and distributed throughout the ocean.
The 2018 study confirmed that most waste products in the ocean were made from plastic. A major culprit was cigarettes containing plastic filters. When will humans understand this smoking madness must end?
The fishing industry is not so innocent either. As dependent as it is on preserving a healthy ocean environment, it gets a big F grade. The World Animal Protection Federation, a non-profit association, reports fishers dump an estimated 700 tons of “ghost fishing gear” into the oceans every year. Why? They do not want to spend the money for repairs.
This further pollutes the ocean. It also traps and ensnares sea life. Animals face another problem. They are eating all this garbage. For instance, in 2018 a dead sperm whale washed ashore on the Spanish coast. A necroscopy revealed the whale’s stomach contained 64 pounds of plastic trash! This trash is part of the diet of 800 marine species!
The US-based Natural Resources Defence Council is trying to get this “Plastic Soup” from getting into the ocean in the first place. Other organizations are monitoring the presence of microplastics so small they float in the air. Very, very small nanoparticles have been proven to pass through cell walls in fish and humans, where they can be chemically active and potentially affect endocrine function, for example.
We are late in realizing the impact of plastic waste and far too slow to act. If we want to protect our brain, lungs, kidneys, endocrine system, and other organs, it means getting active. Banning plastic bags and radically reducing plastic consumption is required. Eliminating microplastics from common products is also needed. Consumers need to demand less plastic packaging, always recycle, and change buying habits.
Let’s not make plastic soup our every meal – and our demise.
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Why Wouldn’t You Take Care of Your Heart?
Diana Gifford-Jones: You are starting your 99th year. To what do you attribute your good health?
W. Gifford-Jones, MD: I’ve been fortunate, but it nearly didn’t happen. I suffered a major heart attack when I was 74. My cardiologists insisted on cholesterol-lowering drugs to fight heart disease. But I knew of two-time Nobel Prize winner Dr. Linus Pauling’s research on high-dose vitamin C. I opted for a regimen of 10,000 mg daily which I still continue.
Diana: Why not take cholesterol-lowering drugs?
Giff: There are side-effects I preferred to avoid. Everyone needs to make their own decisions with their doctors, but mine was anchored in the belief Dr. Pauling was right. He knew that animals produce vitamin C and humans do not. This is why sailors used to die of scurvy while the ship’s cat survived long voyages. Vitamin C is necessary for the formation of collagen which holds coronary cells together just as mortar binds bricks. The addition of lysine, an amino acid, provides extra strength to collagen, like steel in concrete.
Diana: This means vitamin C and lysine help strengthen arteries so that they are rubbery and don’t rupture from the pressure of each beat of the heart?
Giff: Yes. Another concern is atherosclerosis or hardening and narrowing of the arteries. This causes a decrease in blood supply to the heart. The research of Dr. Sydney Bush, a distinguished English optometrist, showed it is possible to improve circulation to the heart’s muscle. He prescribed 6,000 milligrams (mg) of vitamin C to patients who experienced reaction to contact lenses. Luckily, he also took photographs of the retina before the use of vitamin C and repeated the photographs one year later. Atherosclerosis decreased and retinal arteries were healthier. In the same way, vitamin C decreases the amount of atherosclerosis in coronary vessels and supplies more blood to the heart’s muscle.
Diana: 10,000 mg every day of the year for 24 years is 87.6 million mg – that’s a lot of vitamin C! Can you take too much?
Giff: A very small amount of vitamin C, just 10 mg a day, is enough to cure scurvy. More is needed for a robust immune system. To decrease chronic inflammation and reverse heart disease, research shows you need high doses consistently over a long period of time. Vitamin C is natural, safe, and effective. Anything the body can’t absorb gets excreted in the urine.
Diana: What else would you advise for heart health?
Giff: There’s no doubt that a balance diet and moderate exercise is crucial. Our diets are changing. People are eating less fresh food and more processed food. Sugar and salt are not your friends, and they are hidden in a lot of foods. They lead to weight gain, hypertension, and other inflammatory conditions that harm cardiovascular performance.
Diana: If you could redo one thing since your heart attack, what would it be?
Giff: I would have started supplementing earlier with omega-3. The amount of key omega-3 essential fatty acids in the blood is a strong indictor of risk for heart disease. Most of us are lacking omega-3 because of low dietary intake of fish and poor fat absorption of the fish we do eat. The problem compounds as we age. I’ve recommended supplementation with omega-3 supplements containing Maxsimil to overcome the absorption problem.
Diana: I am lucky to have had nearly a quarter century of additional high-quality years with you.
Giff: I would ask anyone in similar circumstances, why wouldn’t you want to take care of your heart?
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Do You Have an Inflammatory Lifestyle?
by W. Gifford-Jones, MD and Diana Gifford-Jones – Common Sense Health
Chronic inflammation is unlike what happens with a cut or an invading germ when the immune system mounts a fight and then stands down. In such cases, inflammation is part of the healing response. But when lifestyle issues have the immune system active all the time, there may be no symptoms, but plenty of costs.
Dr. Erin Michos, Director of Women’s Cardiovascular Health at Johns Hopkins Medicine, explains, “Sustained low levels of inflammation irritate your blood vessels. Inflammation may promote the growth of plaques, loosen plaque in your arteries and trigger blood clots — the primary cause of heart attacks and strokes.”
Rheumatoid arthritis and diabetes involve chronic inflammation. Immune cells and the antibodies they produce create swelling to help isolate the problem. But the problem is persistent, and inflammation remains constant, not temporary.
Doctors may suggest a range of new treatments to reduce this inflammation. Yet, a recent headline published by Harvard Medical School reads, “Doctors are learning that one of the best ways to reduce inflammation lies not in the medicine cabinet, but in the refrigerator.”
Dr. Frank Hu, professor of nutrition and epidemiology at the Harvard School of Public Health, says, “Many experimental studies have shown that components of foods or beverages may have anti-inflammatory effects.”
Tomatoes, olive oil, green veggies, nuts, blueberries, apples, and leafy greens are high in natural antioxidants and polyphenols—protective compounds found in plants. Coffee may protect against inflammation, as well.
But now there is compelling evidence that the extent to which omega-3 fatty acids found in fish like salmon and mackerel feature in the diet is a reliable risk benchmark for cardiovascular disease.
Research published in the American Journal of Clinical Nutrition suggests that “a low omega-3 index is as strong of a predictor of early death as smoking.”
The Omega-3 Index measures the amount of EPA and DHA, two types of omega-3 essential fatty acids, through a simple blood test that can be done at home and mailed in for analysis. The results indicate omega-3 status – with an optimal Omega-3 Index being 8% or higher, an intermediate being between 4% and 8%, and a low Omega-3 Index at 4% and below.
Researchers used data from the Framingham Study, an ongoing, longitudinal study involving the collection of biological and lifestyle risk factors for cardiovascular, disease across multiple generations of participants.
They found that individuals with the highest Omega-3 Index were 33% less likely to succumb to heart disease during the follow-up period of their study compared with those with the lowest Omega-3 Index.
Dr Bill Harris, one of the lead researchers, reports that the relative concentration of omega-3 fatty acids in the blood is just as compelling a predictor of mortality as lipid levels, blood pressure, smoking, and diabetic status.
What to do? Make the modifications to lifestyle that will dramatically change the predicted outcome – some of which can reasonable be expected to add years of good life. Don’t smoke and reverse your course if you are pre-diabetic.
If you are interested in testing your omega-3 status, as we did and wrote about in past columns, you can determine if you are, like most North Americans among the vast majority who are not in the healthy range.
The bottom line, it’s not easy to eat salmon and other omega-3 rich foods or to get those oils absorbed sufficiently enough to balance out other fatty foods in the diet. On supplementation, be a smart consumer, as not all omega-3 is the same. Read past articles at docgiff.com to learn why you should look for pre-digested omega-3.
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Grandma Took the Wrong Pill
Unintentional poisonings are on the rise. Deaths from poisoning occur at double the rate of motor vehicle deaths. It’s a heartbreaking fact that many deaths and injuries are completely avoidable, especially when young children are the victims.
Yet, it may be surprising to know this: while children under age 5 account for about 40% of poison exposures requiring contact with emergency services, preventable poisoning deaths are near entirely within the adult population.
Many factors are contributing to these tragedies. The opioid crisis is one of the problems. But there are other issues arising from increased isolation and the impact this is having on overall well-being, including among older adults.
Changes in age, health status, and many other considerations can make adjustments to prescriptions advisable. But many older people are trying to limit potential exposure to COVID-19. This and other COVID-related issues have reduced doctor visits to review prescription medications. Northern winter is another powerful motivator for one less trip to the pharmacy. It’s placing older adults at risk of deviating from prescriptions.
Prior to the pandemic, unintentional poisonings among seniors were largely due to drug interactions. A large percentage of adults over the age of 65 years are prescribed medications from 10 or more different drug classes, accounting for the majority of all adverse drug-related hospitalizations.
But now there is concern about seniors engaging in intentional self-harm. Even in the best of times, older adults often experience loss of purpose. Retirement, the loss of a partner, and decline in physical health and cognitive abilities are the cause. Now, poor mental health resulting from the unabating doldrums of the pandemic are a new cause for concern.
Self-harm by poisoning should be on the radar. Past research has shown that older adults who start thinking about suicide often have relatively easy access to large quantities of potent medications.
What can be done if you fear a loved one has taken the wrong medication, or if there is any other fear of poisoning?
In Canada, more than 4000 people lose their lives each year due to poisoning. In the U.S., about 6000 people call poison control helplines every day. But an estimated 4,000 to 9,000 more don’t call for help when dealing with a poison exposure. That’s a lot of people taking potentially life-threatening problems into their own hands.
Why don’t they call? Some people simply don’t like seeking help over the phone. They may be embarrassed, feel judged, or worry about scaring children who overhear the discussion. Adolescents and young adults are increasingly resistant to using the traditional technology of a phone call!
Despite statistics showing increased cases of unintentional poisonings, poison control organizations report declines in call volumes over the past decade. So they are developing new options.
Fully automated and interactive tools may not be the same as speaking to an expert on a helpline. But these online and downloadable resources do offer a new way to get fast assistance. One example is available at poison.org. It enables people who fear a mix up in medication to scan barcodes on products, use imprinted codes on pills, or even enter descriptions of the size, shape and colour of medications. These tools can help determine if an emergency room visit is needed.
Take a look at online resources for a refresher in poisoning prevention. In addition to medication, they offer reminders about the perils of household cleaners, little batteries, and the ubiquitous hand sanitizer. Helping grandma be safe can involve keeping all these risky items out of reach of her grandchildren too.
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Stand Up To Read This Week’s Column
Get up on your feet. Seriously. It will be good for you.
Sitting is something we have all become accustomed to doing a lot more of lately.
Just prior to the pandemic, studies showed that the average adult spent about 6.5 hours a day sitting – an hour longer than had been the case a decade earlier. In 2019, teenagers were sitting for upwards of 8 hours a day, and for some much longer than that.
During the pandemic, a study in the UK found that people were spending more than eight hours a day sitting. Canadians are reportedly sitting around for 10 hours a day!
Dr. Jennifer Heisz, associate professor of kinesiology at McMaster University, surveyed over 1600 people to compare physical activity prior and during the pandemic. She found that aerobic activity was down by about 20 minutes per week, strength training down roughly 30 minutes per week, and sedentary time was up about 30 minutes per day.
Why worry about it? For starters, the Canadian Cancer Society reports “a growing body of evidence supports a link between sedentary behaviour and an increased risk of colorectal cancer.” A German study found people who worked desk jobs or driving vehicles had a 24% increased risk of developing colon cancer as compared to people who don’t sit at work. Every two-hour increase in sitting time was associated with an 8% increased risk of colon cancer. Sitting and watching television was far worse, with a 54% increased risk for couch potatoes as compared to those spending less time in front of the TV.
If that’s not bad enough, think again. (By the way, as brain scientists suggest, you’ll be better able to think about this if you are standing up.)
Relaxed muscles absorb less glucose from the blood, increasing the risk of type 2 diabetes. A Norwegian study may be good news for otherwise active people who sit for prolonged periods of time, but not such good news for inactive people. The study found sitting time has little association with diabetes risk in the population as a whole. But among physically inactive people, sitting for 5-7 hours a day was associated with a 25% higher risk of diabetes compared with sitting less than four hours a day.
Excessive sitting also has an impact on the brain. Less blood is pumped to this vital organ and even a very small difference in blood flow can impact on memory and create cloudy thinking.
The negative consequences of sitting too much on Alzheimer’s disease is not exactly breaking news. More than a decade ago, The Lancet, Neurology reported, “worldwide, approximately 13% (nearly 4.3 million) AD cases may be attributable to physical inactivity.” Still sitting? Here’s some motivation to get up. The report continued, “A 10% reduction in the prevalence of physical inactivity could potentially prevent more than 380,000 AD cases globally and nearly 90,000 cases in the US, while a 25% reduction in physical inactivity prevalence could potentially prevent nearly 1 million AD cases globally and 230,000 in the US.”
Dr. Heisz observed a shift in what is motivating people to get up and get active. In her recent study, participants reported less interest in their physical health and appearance and more concern for their mental well-being. That’s a welcome trend.
The message is compelling. Reducing the amount of your sitting time improves the chances for better cardiovascular health, lowers cancer risk, diabetes risk and the prospects for Alzheimer’s. So get up from your chair!
Unless you are 98, says Giff.
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Is Virtual Healthcare the New Normal?
by W. Gifford-Jones, MD and Diana Gifford-Jones – Common Sense Health
The current pandemic is deeply affecting many aspects of society. Accelerated usage of virtual healthcare is a good example. While frontline healthcare workers serve patients needing essential in-person care, some doctors and patients are meeting up over the phone or on video calls.
Virtual healthcare is well known to those living in remote communities. But during the pandemic, it has become an option for everyone.
A debate has ensued about whether such care is good or bad. Proponents of either side are lining up evidence to prove the case. How can you argue with the fact that curable cancers in children have been missed in the absence of face-to-face consultations? But how many lives have been saved by “seeing” the doctor virtually, when the alternative is no treatment at all?
The question should be, when is it okay to utilize virtual healthcare, and when not? And how should people approach the option?
Governments and regulators have been beefing up policies and billing structures for online medical consultations and treatments. In Canada’s public system, a plethora of new billing codes have been registered since the start of COVID-19. But there hasn’t been as much attention given to educating the public about virtual care.
Until recently, there wasn’t much interest among healthcare consumers either. A survey of 4,530 American adults conducted by Deloitte in 2018 showed that 77% had never tried a virtual visit.
But as the ancient proverb notes, “Necessity is the mother of invention.” As COVID limited traditional doctor visits, the benefits of virtual care became apparent. Improved access and convenience. Reduced travel. Eliminated parking headaches. No transmission of infection.
A study published in the Canadian Medical Association Journal reported on virtual care use in the province of Ontario before and during the COVID-19 pandemic. The proportion of Ontarians who had a virtual visit increased from 1.3% in 2019 to 29.2% in 2020, with older people being the highest users. Data from the Massachusetts General Hospital psychiatry department switched from under 5% virtual visits in March 2019 to over 97% in March 2020.
Technology advances are also contributing to the trend. Diseases that may have required an in-person diagnosis in the past can now be detected using digital imagery tools, mobile health applications, and wearable medical devices.
Powerful medical groups are busy determining the supports clinicians need for effective integration of virtual visits in the practice of medicine.
Less evident are the support programs needed by consumers. How does a person know when is the right time to pick up the phone and when to make an in-person appointment?
In general, in-person care is always advisable for diagnostic and therapeutic procedures requiring physical contact (e.g., Pap smears and biopsies). The same for pre-natal and newborn care. People dealing with multiple health issues or who struggle to communicate virtually should also present in person.
But virtual visits will likely be a significant part of the healthcare experience henceforth. So its advisable to get good at making the most of them. Just because you are not leaving home doesn’t mean you don’t need to prepare. Preparation is more important than ever.
Make sure you know how to use whatever equipment is required – from the telephone to computers, mobile apps to specialized software. Be in a quiet space, with sufficient light to read and write – and so the provider can see and hear you well. Have patience and fortitude in case technology fails and to avoid misunderstandings.
If you haven’t seen your doctor in person since the start of the pandemic, make an in-person appointment.Sign-up at www.docgiff.com to receive our weekly e-newsletter. For comments, contact-us@docgiff.com. Follow us Instagram @docgiff and @diana_gifford_jones
Ring in the New Year with Your Inner Mountaineer
W. Gifford-Jones, MD and Diana Gifford-Jones – Common Sense Health
It’s not what we were hoping for at this time of year. The doom and gloom of Omicron has many people feeling down. But casting your gaze upwards might be just the right move. For a New Year’s Resolution, this might be a good time to channel your inner mountaineer.
Christmas and New Years should be the season for celebration, not hibernation. Families should be together, not torn apart by differing views on vaccination. Charitable giving should be the theme, not clamouring for rapid test kits. Yet so it goes. Even among those getting out for a would-be joyous wintertime walk, you can see, in the narrow space between their toques and their masks, the melancholy in their eyes.
So, what’s the relevance of mountaineering in these circumstances?
The attributes shared by people who climb high mountains are just what’s needed to fight back against the oppressive weight of pandemic fatigue.
Chase Tucker, founder of Base Camp Training, describes the mountaineering mindset as, “Unwavering self belief. Ability to visualize success in detail. Ability to accept and deal with fear. Ability to manage doubt. Bulletproof positivity.” He acknowledges risk management skills, but this comes at the end of his list.
There are, undoubtedly, health benefits of climbing uphill. The most obvious are improvements to physical fitness, especially cardiovascular health. The aerobic exercise of climbing reduces body fat, lowering the risk of heart disease. Since climbing, especially with a backpack, is a weight-bearing exercise, it helps maintain bone density. Climbers have strong muscles in the hips and legs, resulting in better balance.
Most exercises done for 20 minutes or longer can help lower the risk of developing chronic diseases such as hypertension, type 2 diabetes, stroke, arthritis, and even some types of cancer. Think of exercises that make you feel like you are climbing mountains as a natural antidote to chronic stress too.
There is a full-body exercise called mountain climbers. To do it, from a plank position on the floor supporting your body with your feet and hands, you perform it by taking alternate steps forward to the chest, each time returning to the plank position. It’s a killer, speeding up the heart rate and working all the muscles of the body. If you have ever tried it, you’ll know why climbers are in such tremendous physical shape.
You might want to skip directly to a more manageable, mostly mental, exercise.
But are there health benefits to merely thinking about mountains, and not actually climbing them?
The surprising answer is, yes. Mountaineering involves concentration. The climber’s steel resolve is a mental exercise, not a physical one. Focus on clearing the mind of festering worries has been shown to build confidence and self-esteem. Adherence to a regular routine of concentration exercises can alleviate the symptoms of some mental health problems.
Chase Tucker describes a technique to train your brain for the attribute of positivity using a bracelet. “When you catch yourself thinking negatively, stop take a breath, tell yourself that you can solve the situation with a positive approach and it will all work out fine. Then, swap the bracelet to the other wrist.”
He suggests recording how many times per day you swap wrists. The conscious effort required to stop, reflect, move the bracelet, and try to focus again only on positive thinking involves building commitment to the objective.
Who knows what it will take to break out of the entrenched pandemic mindset while the virus runs its course. But positive mental resolve is a good start for 2022.
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