Category: Medicine Hat News

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Alaska Holiday 1

“Alaska, here I come!” says Dave as he embarks on a week’s cruise with his family.

This, ones in a lifetime cruise, is one way Dave and Susan can escape from the stress of modern day life.

We need holidays to take a break from the daily rituals, have quality time with our family, recharge our batteries, reorganize our thoughts and priorities, and bring new vigor to our outlook.

On his return, Dave is overjoyed with what he saw and the way he felt. He sat down to tell me all about it.

In 1725, a Russian explorer, Vitus Bering, is the first European to set foot on Alaskan soil. In 1867, the Government of United States purchases Alaska from Russia for $7.2million (two cents per acre!).

Initially thought to be a foolish deal, Alaska surprises the world with its wealth of natural resources – gold and oil. While oil continues to dominate Alaskan economy, tourism leads fishing and lumbering as the state’s second major industry.

Dave and family board the 50,000-ton ship on a Monday evening in Vancouver. There is nothing very spectacular about the departure. As the ship cruises at an average speed of 20-knots/23 mph, Dave takes pictures of the breathtaking view of Vancouver sun set.

Well, I am getting impatient to know more about the cruise! About food and entertainment. About the beauty of Alaska – glaciers, whales, and the wilderness.

Is there anything healthy to do on board the ship?

There is lots of food! Food services start at 6 am and end with midnight buffet. There is everything, including pizza and ice cream. There are plenty of fresh fruits and vegetables. Enough for 2000 passengers and 625 crewmembers to last for more than a week.

The best thing about the cruise is that you don’t have to work. The phone does not ring. There are no deadlines. No meetings to attend. No complaints to listen to.

The cabins are cleaned twice a day. The towels are changed twice a day! You can order room service if you like. It’s a big, mobile, floating hotel and a small city put together.

All food served is not “unhealthy”. Besides fresh fruits and vegetables, there are sugarless deserts and low calorie items on the menu. One thing they do not provide is will power to resist “unhealthy” food!

For the fitness buffs, there is fully equipped gym with massage therapists. Variety of fitness classes offered that range from beginners to advanced levels. There is sauna, spa, aerobics, yoga – you name it and they have it.

There is basketball area, small driving range (lousy clubs – not like your own), table tennis, two small swimming pools, two hot tubs, and walking and jogging areas.

Each evening there is lot of laughter and fun. There are outstanding Broadway shows, stand up comedians, and singers. Audience participation programs are very funny.

They have baby-sitting arrangements, children’s programs and teen activities.

For gamblers, there is daily lotto, bingo, and casino.

There are two formal evenings when you can dress up in your best clothes. There is beauty saloon to get you ready if you need their services. You can even rent a tuxedo!

There are gift shops with Alaska souvenirs that are made in Canada for which you pay American dollars!

There are several ship photographers who take innumerable pictures for you to buy. Who is not tempted to buy his own picture – although it may never make it to the cover of Rolling Stones magazine!

There is plenty of open seas, fresh air, sunshine (if it does not rain), and blue skies. You can watch sunrise and sun set. You can sit on the deck and watch the stars and the moon. You can watch beautifully lighted cruise ships sail by. Evenings are beautiful, calm and relaxing.

In the next column, I will tell you what Dave and his family saw in Alaska.

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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Substance Abuse

“Substance abuse is an enormous problem in Canada,” says Dr. John S. Millar, MD, in an editorial in the Canadian Medical Association Journal. Dr. Millar is Provincial Health Officer for British Columbia.

The exact cost –monetary and nonmonetary- of disease, disability and death due to substance abuse is difficult to estimate. But it is thought to be in billions of dollars.

Three commonly abused substances are tobacco, alcohol, and drugs.

Tobacco use continues to be the leading lifestyle-related cause of death in Canada – 45,000 each year. About 30 percent of adult Canadians over 15 smoke regularly. Teenage girls are more likely to smoke (39 percent) than teenage boys (22 percent).

Alcohol use takes its toll. About 10 percent of adult Canadians have a drinking problem. Impaired driving is a major cause of death. About 45 percent of the dead drivers have some alcohol in their blood and 38 percent are over the legal limit of .08 percent blood alcohol concentration.

Use of drugs like cannabis, cocaine and heroin amongst Canadians has been increasing. In 1994, the daily use of cannabis in Canada was estimated at 7.4 percent of the population, cocaine at 0.7 percent, and LSD, speed or heroin at 1.1 percent.

In Alberta, the most popular illicit drug is cannabis (marijuana and hashish).

In 1994, 32.8 percent of Albertans (aged 15+) reported using cannabis at some time in their lives, while 8.4 percent said they had used this drug in the 12 months preceding the survey.

What about Medicine Hat? I asked Paul Jerry, a Chartered Psychologist and Instructor at Medicine Hat College in the Addictions Counseling Program.

“Compared to other places in Alberta, Medicine Hat is doing well,” says Jerry. Out of 26 AADAC service areas, Medicine Hat ranks 14th for rate of cannabis and other drug possession charges; 24th for sexual and physical assault charges; and 19th for total rate of alcohol-related primary and secondary diagnosis admission to hospital.
According to AADAC’s breakdown of client demographics, 60 percent of these clients are adult males, 23 percent adult females, 10 percent collaterals and 6 percent teens, says Jerry.

Why are some people prone to substance abuse?

According to Dr. Millar, there is a biological or genetic propensity for substance abuse. This is similar to chronic diseases such as diabetes, hypertension and asthma.

It has also been shown that people who have been abused or neglected in childhood or children from low socio-economic background (poverty, homelessness) have high incidence of substance abuse.

It is also common among people with mental illness.

Dr. Millar says that it is important to understand the underlying cause for substance abuse for any intervention program to succeed. We should stop treating addicts and substance abusers as criminals and begin treating them as patients who deserve respectful, effective care.

I asked Paul Jerry, who has 10 years’ experience in the field of mental health and addictions, about the Addictions Counseling Program at Medicine Hat College.

“Our program is unique in that we hold the view (different from AADAC) that eating disorders and sexual compulsivity can be framed in an addictions perspective. So we apply the addiction model to alcohol, drugs, gambling, food and sex. We train counselors to intervene with these issues in individuals, couples, families, groups, and communities.”

Finally, Carl Jung (1875-1961) has the last word: Every form of addiction is bad, no matter whether the narcotic be alcohol or morphine or idealism.

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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Blood Transfusion

Dr. B, is blood transfusion safe?

Susan, blood can never be 100 percent safe. Therefore, it is important for health care professionals to develop strategies to avoid the need for blood.

But this not always possible. In Canada, approximately 600,000 people receive blood each year. It saves lives of critically ill patients. It also improves the quality of life of other patients who require blood transfusion.

So the need never stops!

Then, Dr. B., how safe is it to have a blood transfusion?

The safety level of blood transfusion in Canada has improved a lot. Recently, a not-for-profit, charitable organization called Canadian Blood Services (CBS) was given the task of collection and distribution of blood.

Susan, unlike Red Cross, blood is the sole focus for CBS. Safety, through research and development, is a priority for the Canada’s new blood agency, says Lynda Cranston, CEO of CBS in a recent article in Hospital Quarterly.

CBS spends $20 million annually for a new screening weapon that allows earlier detection of the viruses that cause hepatitis C and AIDS. Further $10 million is spent annually on leukoreduction – a process in which white blood cells are removed from the blood supply. This will further reduce the risk of transfusion reaction and infection.

Currently, the risk of viral infection to a recipient is too low to measure.

Dr. B, is it true that only 5 percent of the population donates blood, yet virtually all Canadians will need blood or blood products in their life time?

Yes Susan, that is correct. In the last 10 years, the amount of blood collected in Canada has dropped from 1.2 million units a year to just under 700,000 units. This is not good.

CBS needs donors. The bottom line is without donors there would be no Canadian Blood Services, says Gaylene Smith, Communications Coordinator of CBS in Calgary. She adds, “Medicine Hat is a terrific supporter of our mobile clinics.”

In the first five months of this year, Medicine Hat and Lethbridge have had 6 blood donor clinics each. The average attendance in Medicine Hat is 214 with average collection of 190 units of blood at each clinic. Figures for Lethbridge are: 211 and 186 respectively.

How much blood do we use in Medicine Hat?

In 1984, we used 80 units of packed red blood cells per month. In the last one year we have used 150 units per month, says Dr. Michael O’Connor, pathologist at Palliser Health Authority. He adds, “Like other places our need never stops either!”

“We certainly need more donors. Donors should remember that they are at no risk of contracting viral infection,” emphasizes Dr. O’Connor.

Dr B., can I be a donor?

Sure Susan, you can be a donor if you are between 17 and 61 years of age. You should weigh 50kg (110 lbs.) or more. Have a proper ID. You should not be on any medication, which will affect the recipient. You should wait at least 56 days between donations.

Thank you Dr. B. I better phone the toll free number (1-877-444-9284) and find out the date of next blood donor clinic in Medicine Hat.

Sounds like a good idea! Remember, a unit of blood saves more than one life! Good luck, Susan.

This series of articles explore the health problems of Dave and his family. They are composite characters of a typical family with health problems.

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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Abdominal Gas (Flatulence)

“Doc, your column on constipation was interesting. What about bloating and flatulence? Don’t you think it is a major problem for many individuals!”

Dave, you are absolutely right. Call it what you want – flatulence, burp, belch, gaseous distention, wind, flatus, fart – excess intestinal gas can be a nuisance.

There is a social taboo associated with this topic. Unlike Eddie Murphy’s family dinner explosions in The Nutty Professor, most of us find a socially convenient place to “cut the cheese”.

From birth to death, the production of gastrointestinal gas continues unhindered. We are all familiar with our child’s difficulty with gas and colic. What about that burp? I bet that gave more sense of relief to the parent than the child.

There are 3 phenomenon of gas production: 1) Flatus is mainly due to production of gas by colonic (large intestine) bacteria, 2) Belching or burping is due to swallowed air, and 3) Bloating – the mechanism of which is not very clear.

A normal diet emits about one liter of gas in the intestine. Some gas is absorbed by the body. The rest, about 50 to 500 ml, is passed as flatus in small quantities several times a day. At night, minimal gas is produced, but we continue to release wind in our sleep. So, first thing in the morning, our abdomen is as flat as can be.

It is normal to pass flatus. Usually, it consists of odorless gas – carbon dioxide and hydrogen – produced by bacterial action on carbohydrates and the proteins in the food we eat.

Hydrogen, carbon dioxide, methane and swallowed nitrogen comprise 90 percent of colon gas. The remaining one percent consists of trace gases that compensate for their small quantities by their strong odors. Smelly gases include hydrogen sulfide, ammonia, indole and volatile fatty acids.

Belching and burping occurs from the air ingested with breathing and swallowing. Anxiety, thumb sucking, gum chewing, drinking carbonated drinks, rapid eating and wearing poor dentures increase the amount of gas swallowed. Stomach gas has the same composition as the atmosphere.

Bloating occurs in 30 percent of adults. Individuals complaining of bloating and distention are convinced that they have excess gas. But this is not true.

In the morning the abdomen is nice and flat. As the day progresses, the abdominal girth increases by 3 to 4 cm. Plain x-rays and CT scan of the abdomen fail to show that this is due to gas. Passing flatus may temporarily relieve the symptom but the
phenomenon is not due to gas. By next morning the distention is gone.

“What influences the production of excess gas?” Dave asks.

Beans, broccoli, and cabbage have a high content of nondigestible polysaccharides. Other foods are cauliflower, corn, brussels sprouts, eggplant, nuts, onions, and prunes.

Most of the intestinal gas consists of swallowed air. Only about 10-30 percent of gas is produced in the intestine.

Furne and Levitt did a study looking at factors influencing frequency of flatus emission by healthy subjects. They concluded that some subjects consistently passed gas more often than did others. The individual differences depend on the ability of the bacteria to produce gas from the fermentable food residue.

Therefore, the management of “too much gas” should be directed toward reducing swallowed air and avoiding gas producing food. This is not always easy. But worth trying.

Finally, Dave, here is what Sir John Suckling (1609-1642) said about love and flatulence:
Love is the fart
Of every heart:
It pains a man when ‘tis kept close,
And others doth offend, when ‘tis let loose.

This series of articles explore the health problems of Dave and his family. They are composite characters of a typical family with health problems.

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