Category: Medicine Hat News

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The Beauty and The Beast of Sun Exposure

Once again, it is time to remind ourselves that exposure to sun’s rays can be healthy and harmful. They can make us look good and make us feel healthy. They can also damage our skin and can even kill us. There are more than 25 human disorders that are either caused by or aggravated by exposure of the skin to sunlight. But exposure to sunlight is also the most potent and natural way to manufacture vitamin D in our body.

Now, did you ever think that exposure to sunlight can be lethal?

When the skin is exposed to ultraviolet radiation, there is immediate increase in the number of melanocytes and production of melanin pigment. This results in tanning. The amount of melanin produced is genetically determined. That is why some people burn easily without tanning. Melanin also acts as a filter to decrease the harmful effects of ultraviolet rays to the dermis.

The reason people want to tan is to look like me – just kidding! The real reason is they want to look good. They think tanning is healthy. Somehow a tanned person looks healthier if it is not overdone. That is if you haven’t baked yourself.

But the beastly thing is melanoma arises from melanocytes, the very cells which give us a false sense of looking good. Melanoma is a skin cancer if not treated early can be lethal. The death rate from melanoma continues to rise about two per cent annually.

There are two other skin cancers which do not kill but can cause local disfigurement if not treated. These are: basal cell and squamous cell cancers. The risk of skin cancer is increased in individuals who spend too much time outdoors; children who have had episodic sunburn, and if there is a family or personal history of skin cancer (especially melanoma).

What is interesting is, despite having a good understanding of the relation between overexposure to the sun and skin cancer, 81per cent of North Americans still think they look good after being in the sun.

There are indeed benefits to exposing your skin to the sunrays in moderation before 10 a.m. and after four in the afternoon. When the skin is exposed to sun’s ultraviolet rays the skin makes vitamin D, which is rapidly absorbed in the blood and can be stored for several months, mostly in the blood and fat tissue.

We have always known vitamin D is needed for good health and strong bones and teeth. In the last few months, several reports have appeared which advance the case for universal intake of vitamin D on a daily basis to prevent certain types of cancer.

Increased intake of vitamin D helps prevent falls in the elderly. A report in the journal Nutrition Reviews suggests that adults should daily take 2,000 IU of vitamin D to help prevent some cancers. The Canadian Cancer Society is now recommended taking 1,000 IU of vitamin D daily as a cancer prevention step. Experts suggest taking supplements of no more than 2,000 IU per day.

Have you started taking vitamin D yet?

If not, then you need to spend some time out in the sun for your body to manufacture enough vitamin D to last you through the winter. But care and moderation is required. Avoid prolonged exposure, wear protective clothing, and use a sunscreen with a SPF of 15 or higher. To protect the eyes wear good quality sunglasses which block ultraviolet rays.

So, enjoy the summer carefully, if and when it arrives.

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Killer Foods

Recently, a friend said to me, “As I get older, I am expending fewer calories each day. I find my taste buds demand that I eat food heavy in calories, such as fried foods and delicious sweets. I find that my abdominal girth is rapidly (I wish I can say slowly) expanding. I feel I have completely lost control of my diet, weight and girth. What do you suggest I do to get control of my health?”

Answer to a question like this is usually simple, “Eat less and exercise more.”

What most of us do is, exercise and eat carefully for a few months. We get fit, we look good, and we feel healthy and then we become lax. The enthusiasm and the challenge of losing weight run out. We get busy with other things. Then suddenly the clothes do not fit. We get frustrated and depressed. And we start the cycle all over again.

It’s no rocket science to remember that regular exercise, healthy eating and counting calories is a must for staying healthy. Thirty to 60 minutes of daily exercise makes you feel better and helps improve and maintain your health. It does not matter what kind of exercise you do or whether you do all at one time. You can exercise 10 minutes three to six times a day. Important thing is to keep doing something.

Eating healthy and eating less poses the same sort of challenge as doing regular exercise. You should establish certain routine in how you eat and what you eat. Eating slowly and chewing well helps. Cooking and eating at home is better than eating at a restaurant or picking up fast food at lunch or on your way home after work. Eating out means consuming about 30 per cent more calories than you would normally do when you eat at home.

Fruits and vegetables in your diet is a must. Follow Canada’s Food Guide available at Health Canada web site, Health Unit or your dietitian. Make a list of dangerous and what I call killer foods which you should avoid at all cost – these are foods which we commonly eat but are dangerous to our health. My short list of killer foods includes French fries, bagels, croissants, donuts, double cheese burgers, fried fast food chicken, and ice-cream.

Let me tell you little bit about French fries. Potatoes have been around for about 200 years. French fries have been around for about 150 years. The first chip fried in Britain was in 1860 and first sold by a Belgium immigrant in 1870. Who invented the French fry? The honour goes to Belgians.

Only in North America we use the term French fry. In Britain they are called “chips” and in Belgium they are called “patat” and in France “pommes frited” which literally means fried apples. French fries have nothing to do with France. But the name is stuck because the Americans think it started in France.

An average size boiled potato has about 100 calories. If it is sliced and deep fried then naturally the calories almost double. Then you add Ketchup, sour cream, bacon bits or some other sauce, the calories almost triple. Next time you get a serving of French fries, guess how many potatoes have been sliced for that serving and then do your math. To me, eating French fries is like smoking a cigarette, they are both lethal.

In Canada and U.S., 25 per cent of the vegetables consumed are prepared as French fries. This has resulted in widespread obesity. French fries are loaded with saturated fat and trans fat. These are very dangerous substances and can cause blood vessel and heart diseases.

Space does not allow me to detail other killer foods. But you get the point.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

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How Do You Know If You Are Depressed?

The other day I was talking to a lady who said that she was on the verge of depression. She said, “I am not there but I am close.”

“Depression is a major public health problem, which is predicted to be second only to cardiovascular disease as the leading cause of disease-related disability worldwide by 2020,” says an article in the Canadian Medical Association Journal (CMAJ).

The article laments that depression goes unrecognized and poorly treated because physicians are too busy dealing with physical ailments and have no time for mental health care. There is stigma attached to diagnoses of mental illness so patients are in denial for a long time. Lastly, there is uncertainty about treatment efficacy and patients sometimes feel poorly treated.

Amongst teenagers, depression is a very common problem and affects as many as one in eight teenagers. Just like in adults, depression amongst teenagers affects more girls than boys.

Why does one feel helpless and depressed?

There isn’t one single factor that makes a person feel anxious and depressed. Some of the factors which influence how you feel depend on genetics, environment, other medical conditions and events which have occurred in your life and how you react to them.

In western countries, our lifestyle plays a significant role in causing depression. Some of the lifestyle factors are: our constant desire to get rich and acquire materialistic things, our desire to achieve success as defined by our peers rather than our desire to achieve happiness and the ever changing world economics make our job and financial well being insecure.

How can one know that he or she is on the verge of depression?

Life is not fair. There is stress and there is sadness. If the feeling of sadness lingers on and interferes with your ability to participate in normal activities then you know it is a warning sign, either you are depressed or you are on the verge of depression. You need to seek help immediately.

How does one feel if he or she was depressed?

There are various symptoms of depression. For example a person feels sad most of the time (sometimes for no obvious reasons), there is lack of energy, there is inability to enjoy things that used to bring pleasure, you tend to withdraw from friends and family, there is easy irritability, anger, or anxiety, you are unable to concentrate, there may be significant weight gain or loss, there is significant change in sleep patterns, there is feelings of guilt or worthlessness, there is pessimism and indifference, and there are thoughts of death or suicide

If you think you were on the verge of depression then what can you do to get back to “normal”?

Immediately get help from your family doctor. It is as simple as that. It is important to find happiness in life. Happy people live longer, give more, have more energy, are more likely to get married and people generally like to be around happy people rather than people who constantly complain of life’s little or big discomforts.

There are many books written about happiness. That means there is no easy solution to finding happiness. But some of the things you can do to be happy are: practice act of kindness, express gratitude, cultivate optimism, avoid over thinking, learn to forgive, develop social skills, do not depend on others and thank heavens for glass half full rather than half empty.

Do I see you smiling? Well, half the battle is already won!

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

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Euthanasia vs. The Power of Prayer

Terminal care is physically demanding and emotionally nerve wracking. Most families have had the experience of dealing with a family member or a relative who was dying of an incurable illness. They see the ill person suffer from pain, pneumonia, urinary tract infection, back pain, bed sores, sleepless nights, shortness of breath, bowel obstruction, stomach tube, constipation, enemas, multiple pills, multiple injections, confusion, delirium, fear, anxiety, depression …the list goes on and on.

My mother’s last few weeks in this world were no different.

She knew she was going to die. In her room, in a Calgary hospice, she wanted the clock on the wall where she could see the time clearly. During the day, she would ask, “How come the time is moving so slowly?” In the silence of the night, I wondered if she could hear the clock tick telling her that although her time was up, she will have to wait for her turn to die.

The place of her death was already decided, it was not going to be her home in Calgary. Her wish to die at home could not be fulfilled because, after four months of gradual deterioration in her health, the nursing care provided by the members of her large family came to an end when they were physically and emotionally exhausted. The family was rescued by the wonderful people at Home Care, Palliative Care, Foothills Hospital and Agape Hospice.

Now, who was going to decide on the timing of her death?

My mother was a deeply religious woman. She believed in the power of prayer and prayed very hard to God to end her life and stop the misery of pain and indignity. She requested all her visitors and family members to pray for her quick end. During her better days she used to ask me to promise her that I, as her physician-son, would not let her suffer if she was terminally ill and in pain. She wanted me to end her life with some medications. I explained to her that such actions were not legal in this country.

When she was diagnosed with terminal gynecologic cancer, she reminded me of our discussion about euthanasia. When she was in the hospice suffering, I felt she was a right candidate for euthanasia. In the last few days of her life she could not find a comfortable position in bed. She could not get out of bed and she had lost control of her bodily functions. She could not breathe comfortably.

The slowly growing pelvic tumor had made her abdomen very large and eaten away all her body fat and had wasted all her muscles. She had quit eating due to constant nausea and abdominal fullness. She was weak and frail. Every movement was painful.

Lately, she was sleeping a lot with the help of morphine. Each day there were few hours of bright moments. She would watch her favourite television shows. She would listen to her favourite religious songs. She enjoyed all the visits and phone calls she received from friends and relatives locally and from all over the world. Her memory never lost her but her hearing gradually got worse and her voice gradually got weaker. The end was near.

Finally, her prayers were answered. Her role as a wife, mother, grandmother, great grandmother and great great grandmother came to an end at 7.40 p.m. on Saturday April 19, 2008 in the presence of family members. It was end of an era. She was the matriarch of the family. At 87, she was the last surviving member of her and my dad’s siblings.

The power of prayer had won.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!