Category: Medicine Hat News

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Second Hand Smoke

Dear Dr. B: I have a friend who smokes outside her house around her two little children. Isn’t it bad to smoke in the presence of children whether it is indoors or outdoors?

Yes, smoking in the presence of children is bad – whether it is indoors or outdoors. A study carried out by Swedish researchers shows children of smokers have nicotine in their bodies, even if their parents smoke outdoors.

The Medical Post reports that the Swedish researchers studied 366 children age two to three years whose parents smoked. The parents of 216 of the children always smoked outside with doors and windows closed.

The researchers found that theses children had twice as much nicotine in their body as children of non-smokers. If both parents smoked indoors, children had 15 times higher levels than children of non-smokers.

Another study has shown that there is a correlation between passive smoking and respiratory illness (cough, wheezing etc.) in children.

Everyone knows the dangers of smoking. If you are a smoker or if you know somebody who smokes then give them the following ten reasons why one should give up on smoking:

1. Albertans smoke more than the national average.

2. In 2000-2001, 683,900 Albertans were smokers.

3. Tobacco causes one in five deaths in Alberta.

4. Tobacco use is the leading cause of preventable illness, disability and death in Alberta and Canada.

5. Tobacco is the cause of an average of 3,400 premature deaths each year in Alberta.

6. Smokers have two to four times the risk of heart attack and sudden death from coronary artery disease than non-smokers.

7. Smoking around children can negatively impact their health.

8. Smoking during pregnancy is associated with low birth weight and health problems in infancy and later on.

9. Exposure to second-hand smoke can increase non-smokers’ likelihood of developing asthma, heart disease and lung cancer and

10. Nicotine is addictive.

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Tips For Longevity

“Life well spent is long”

Leonardo Da Vinci (1452-1519)

Longevity is defined as length or duration of life. An average person living in an industrialized nation may live to the age of 87.

If you want to live long then do the following:

1. Be an optimist – that is a good way to be cheerful – unless you are a golfer!

2. Approach life with a sense of humor – there is always a funny side to any situation – except when a golfer loses a ball in a water hazard. Laughter is the best medicine.

3. Give up on things which are stressful. Now, golfing should not be stressful if you listen to The Golf Guru in the Golf Digest, “Golf is not about shooting a number, it’s an opportunity to live well”.

4. Exercise at least 30 minutes a day, three days a week. But you can do more. Every movement you make helps keep your muscles trim, melt some fat, and make you feel better.

5. Do things which challenge your brain regularly – like writing a column for Medicine Hat News! Activities which are novel and complex prevent boredom. “Anyone who stops learning is old, whether at twenty or eighty. Anyone who keeps learning stays young. The greatest thing in life is to keep your mind young – Henry Ford (1863-1947).

6. Have a diet which keeps you lean. As somebody has said, if you wish to grow thinner then diminish your dinner. It was in the 1930s, that scientists showed underfed rodents lived up to 40 percent longer than their well-fed counterparts.

7. Do not smoke –reasons should be obvious to most people who are in touch with the reality. For others, there is no hope. They would like to learn lessons the hard way.

8. Be involved in the community.

9. Wear a seat belt – motor vehicle collisions and other types of accidents kill and disable many of our young people. Drive carefully, and do not drink and drive.

10. Cut your consumption of alcohol – alcohol is a calorie loaded drink with no nutritional value.

Important thing about longevity and staying healthy is to make good choices in life and reduce the risk factors – genetic, environmental or lifestyle habits.

Many factors have contributed to our longevity – improvement in nutrition, public hygiene, and discovery of antibiotics, introduction of immunization programs, newer and better methods of understanding, diagnosing and treating many illnesses.

Now we seem to take life for granted – especially in the industrialized and affluent countries we live in. Very few people die of infection or malnutrition. Instead we have an epidemic of obesity – which leads to diabetes, heart disease and other illnesses and disabilities.

It is estimated that if you live up to 80, then the last 10 years of your life will be spent fighting some sort of disease or disability. This burden may be reduced if we take care of our health during our better days. Remember, a life well spent is long.

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Problems of Hands and Feet

There are numerous minor but common conditions of the hands and feet which bother people. Most people do not understand why they get them. The conditions are not life threatening but they are a nuisance. I will describe few conditions here and briefly discuss their cause and treatment.

Ganglion: A ganglion occurs mainly in the hand and foot and joint areas. It is a cyst containing jelly like substance. It may be soft or tense. It is usually smooth. It arises from the bursa within the substance of a joint capsule or the sheath covering a tendon. Some times this occurs after an injury. Sometimes it may cause pain.

Treatment: There are non-surgical methods to treat ganglion. But surgery usually provides satisfactory results. Occasionally it may recur at the same site.

Plantar warts: These are same as common warts. They grow on the soles of the feet. They grow into the skin because we walk on them. They can be painful on walking. The virus causing the wart is picked up from walking bare foot in locker rooms and swimming pools.

Treatment: They may spontaneously disappear if you wait long enough – months to years. They can be managed by freezing, scrapping or burning. They can recur.

Plantar fasciitis: Also known as “policeman’s heel”. It is common in men aged 40-60years. Exact cause of the condition is not known. There is pain beneath the heel. It is tender when pressure is applied.

Treatment: Pain can be minimized by padding and/or by cortisone injection. This may or may not work. Pain usually gets better in six to twelve months.

Callus and corns: These are thickened areas on the hands or feet caused by pressure or friction. This is usually related to work or sporting activities. Uneven pressure of body weight during walking or ill fitting shoes can cause calluses and corns on the feet.

Treatment: Wear proper fitting shoes and use corn pads to relieve pressure on the corns. Thick calluses can be sliced down to normal skin over a period of time. If the source of friction and pressure is removed then corns and calluses should not recur.

Toenail problems: Mainly involves the big toe. It may be ingrown or overgrown. Ingrown toe nails are commonly due to ill-fitting shoes pressing on an incorrectly cut nail. Poor foot hygiene encourages infection.

Treatment: In an acute stage antibiotic, painkillers and bathing the foot in warm salt water are necessary. Surgery is required in most cases. The problem can be prevented from recurring by keeping the feet clean and wear correctly fitting shoes. Cut the nail straight.

Fungus infection of the nails: Usually affects toenails. The nail is thickened and discolored. It is usually yellowish. The nail may grow in a twisted manner. The infection is picked up in a public place where it is transmitted from person to person. Poor feet hygiene does not help.

Treatment: Anti-fungal therapy is required – orally and locally for three months. Cure rate is around 80 percent. Ongoing meticulous foot care is very important to prevent recurrence.

Our feet are subjected to more wear and tear and hence they get more problems than our hands. Our natural tendency is to take care of our hands more than our feet. Many of these problems are preventable.

In my view, walking bare feet is the worst thing you can do for your feet. Wash your feet at least once a day (twice if your feet sweat a lot) with soap and water. Dry them well with a soft towel. Wear good quality clean socks and proper fitting comfortable shoes.

If you love your feet then take good care of them.

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Outbreak of Diarrhea in Calgary and Montreal

Dear Dr. B: I am concerned about the recent reports of outbreak of diarrhea in Calgary and Montreal hospitals. Can you please explain the cause and effect of this kind of colitis?

“More people have died after contracting a virulent infection that has broken out in hospitals in Montreal and Calgary than were killed by SARS – yet neither public health nor hospital officials warned the public until CMAJ broke the news,” says an article in the recent issue of the Canadian Medical Association Journal (CMAJ).

The bacterium responsible for the outbreak of diarrhea is called Clostridium difficile (C. difficile). The condition is known as Clostridium difficile-associated diarrhea (CDAD).

In the last 18 months, at least 12 hospitals in Montreal have been fighting CDAD. More than 1400 patients have tested positive to this organism in that city. At least 79 people have died in Montreal and four in Calgary from C. difficile infection.

The organism was first described in 1935. In the last 25 years, it has been recognized that C. difficile can cause mild to life threatening diarrhea – also called psuedomembranous colitis.

The C. difficile infection is most commonly associated with antibiotic use. The antibiotics cause disruption of normal bacterial flora in the gut and allow C. difficile to thrive and produce toxins which causes diarrhea. C. difficile is resistant to most common antibiotics. Hence, the difficulty of controlling the infection.

July 16th issue of the CMAJ has several articles on the subject. One of the articles written by Dr. Thomas Louie from Foothills Medical Centre, Calgary says, “The root cause of outbreaks of C. difficile diarrhea in our hospitals relates to the difficulty of practicing and maintaining good infection control measures in hospitals.” This is because of high occupancy rate in hospitals, intensive antibiotic use and increasingly complex care of patients.

Many hospitals are old, there are few single or isolation rooms, many patients have to share toilet facilities and there is rapid turn over of patients. All these factors make it difficult to control or contain infection.

What’s the situation in Medicine Hat? I spoke with Dr. Wai Chow, Regional Medical Director of Laboratory Services in the Palliser Health Region. He said that there is no evidence of any outbreak of CDAD in our region. The laboratory continues to get sporadic cases of CDAD which is not unusual. Most cases are due to antibiotic use.

Hospitals in Canada are acutely aware of the situation and continue to implement infection control measures. But there is no guarantee that there won’t be another outbreak of CDAD. Changing behavior of bacteria and viruses will continue to challenge our survival, our resources and our skills. SARS and avian flu are good examples.

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