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BournetoBournetoQuitQuittoQuittoAfter 17 years of puffing , MATT
DAMON embraced a new smoke-free identity
THE PERFECT HOLIDAY
GIFT page 54
St. Josephs Honours Two Surgical Visionaries
DIABETES EDUCATION CENTRE MARKS 40 YEARS
Ending the Stigma of Not Criminally Responsible
WINTER 2013
vim&
FdVVWI1386_00_Cover.indd 1 9/19/13 11:30 AM
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sjhc.london.on.ca
Renowned for compassionate care, St. Josephs is one of the best
academic health care organizations in Canada dedicated to
helping
people live to their fullest by minimizing the effects of
injury, disease and disability through excellence in care, teaching
and research.
St. Josephs is helping Rick live healthier.
Because every 7 minutes someone has a heart attack...
we are teaching people how to limit their risk.
THREE MONTHS AFTER HE UNDERWENT quintuple heart bypass
surgery,
44 year-old Rick Ho was able to bike five km. At five months, he
ran 10 km.
Rick calls the Cardiac Rehabilitation and Secondary Prevention
Program
at St. Josephs completely transformative. From the edge of
death, Rick
is more fit than hes been in decades. Visit our website to learn
more about
St. Josephs cardiac rehabilitation program.
CARING FOR THE BODY, MIND & SPIRIT SINCE 1869
Renowned for compassionate care, St. Josephs is one of the best
academic health care organizations in Canada dedicated to
helping
people live to their fullest by minimizing the effects of
injury, disease and disability through excellence in care, teaching
and research.
St. Josephs is helping Rick live healthier.
THREE MONTHS AFTER HE UNDERWENT
44 year-old Rick Ho was able to bike five km. At five months, he
ran 10 km.
Rick calls the Cardiac Rehabilitation and Secondary Prevention
Program
at St. Josephs completely transformative. From the edge of
death, Rick
is more fit than hes been in decades. Visit our website to learn
more about
St. Josephs cardiac rehabilitation program.
CARING FOR THE BODY, MIND & SPIRIT SINCE 1869
CLIENT
SIZE
8.375w x 10.5h (+ 0.125 bleeds)
St. Josephs Health CareJOB DESCRIPTION
Cardiac V&V Ad Full page - InsideNovember Issue
PRODUCTION NOTES
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King Street London, Ontario, Canada N6B 1S8
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FdVVWI1386_C2_7minutes.indd 2 9/19/13 12:59 PM
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In announcing the award, the London Community Foundation
describes him as a dedicated leader, mentor and com-munity builder
whose actions in sup-porting numerous community groups demonstrate
that he believes in helping people who are less fortunate by
provid-ing them with the opportunity to reach their own personal
potential.
Do You Have MeMorY ProbleMs?Do you have trouble remembering
things? Are you 65 years old or older? Older adults interested in
participating in a research study looking at the relationship
between walking and cognition (how you think and reason) are
invited to call St. Josephs Parkwood Hospital at 519 685-4292, ext.
2179. For those who meet the criteria, this is an opportunity for a
com-plete memory evaluation.
125 Years of faitH anD caringSt. Josephs Hospital has reached a
remarkable mile-stone125 years of faith and caring. On Oct. 15,
1888, the hospital officially opened its doors with 10 beds and a
staff of four doctors and three Sisters of St. Joseph. From this
mod-est beginning, the hospital would grow and change. Today, it is
the cornerstone of what is now St. Josephs Health Care London, one
of Canadas leading multispecialty academic health care centres.
Then and now, it is a history of which St. Josephs is proud.
tHe figHt against influenzaThe statistics are staggering.
Londons 20122013 influenza season saw 26 deaths, 297
hospitalizations and 472 labora-tory-confirmed cases. To fight
against influenza, St. Josephs Health Care London is taking a new
direction. In addition to the annual flu vaccination and education
campaign of staff, physicians and volunteers, St. Josephs has
adopted a new policy. When an influenza outbreak is declared in the
com-munity, all non-vaccinated staff, physicians and visitors must
wear a mask while in our facilities to prevent the spread of
influenza. To view vaccination results at St. Josephs through-out
the season, visit
sjhc.london.on.ca/our-performance/quality-improvement-plan.
a Partner of DistinctionDale Brain Injury Services is the 2013
recipient of St. Josephs Health Care Londons Partner of Distinction
Award. This award recognizes partnership and collaborationessential
requirements of health care delivery and community ser-vice. Dale
Brain Injury Services has been a valued commu-nity partner in the
care of those living with acquired brain injury since
rehabilitation began at St. Josephs Parkwood Hospital in the 1980s.
The organization provides assisted living services in residential
settings as well as a community day program. Together, St. Josephs
and Dale work to ensure patients receive the support they need
during their rehabili-tation journey.
a leaDer, Mentor anD coMMunitY builDerJeff Macoun, a long-time
volunteer with St. Josephs Health Care Foundation, has been
honoured with the Governor Generals Caring Canadian Award. The
award recognizes Canadians who have made a significant, sustained,
unpaid contribution to their community, in Canada or abroad. Known
for his energy, enthusiasm and strong leadership, Macoun has made a
substantial contribution to St. Josephs, the YMCA, United Way and
other London organizations.
St. JoSephS Notebook
Helping HandsIndividuals and organizations are making a
difference every day
On behalf of Dale Brain Injury Services, Sue Hillis, executive
director, centre, accepts the Partner of Distinction Award from
Marcie Grail, outgoing chair of St. Josephs Health Care Londons
board of directors, left, and Dr. Gillian Kernaghan, St. Josephs
president and CEO.
Jeff Macoun
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ConneCting With our Community
Focusing on Those We Serve
W ith the holiday season and a brand new year soon upon us, we
at St. Josephs have much to be grateful for and even more to look
forward to. The past year has been one of change and achievements
on our journey to earn complete confidence in the care we provide,
and to make a lasting difference in the quest to live fully. From
the opening of our new Southwest Centre for Forensic Mental Health
Care, to the launch of the inaugural Bust a Move for Breast Health,
to exciting innovations in care and ser-vice across our programs,
we are proud of what we have accomplished.This year also marked a
special anniversary
for St. Josephs Hospital125 years of faith and caring. From
humble beginnings, the hospital has grown to become a medical force
in Canada and beyond while remaining committed to the values
instilled by our founding Sisters of St. Joseph.The year ahead
promises to be equally exciting. With the support of the com-
munity and the dedication of our excellent staff, physicians and
volunteers, 2014 will see the opening of our new London mental
health facility next to Parkwood Hospital and raising of the bar
ever higher in delivery of care for patients and residents across
St. Josephs.We could not do so without the generosity of our
community that, every year,
steps up to support our Season of Celebration, which begins Nov.
15. Raising funds for patient and resident care comfort items,
Season of Celebration is a heartwarm-ing tradition that brightens
the holiday across our organization. Watch for the pink Lights of
Caring to shine at all our sites.In this issue of Vim & Vigour,
we highlight inspiring work that shows the great
diversity, impact and reach of St. Josephs expertise. The focus
on those we serve is the key to our continued success and will
remain paramount in the coming year in a continuing challenging and
uncertain economic climate. To all who give of themselves for St.
Josephsour staff, physicians, volun-
teers, health care partners and donorswe wish you a joyous
Christmas and good health for the New Year.
Dr. Gillian KernaghanPresident and CEOSt. Josephs Health Care
London
Michelle CampbellPresident and CEOSt. Josephs Health Care
Foundation
Dr. Gillian Kernaghan, left, and Michelle Campbell
Vim & Vigour,TM Winter 2013, Volume 29, Number 4, is
published quarterly by McMurry/TMG, LLC, 1-888-626-8779. Vim &
VigourTM is published for the purpose of disseminating
health-related informa-tion for the well-being of the general
public and its subscribers. The information contained in Vim &
VigourTM is not intended for the purpose of diagnosing or
prescribing. Please consult your physician before undertaking any
form of medical treatment and/or adopting any exercise program or
dietary guidelines.
801 Commissioners Road EastLondon, ON N6C 5J1519
646-6085sjhcfoundation.org
If you prefer not to receive Vim & Vigour TM from St.
Josephs Health
Care Foundation, please call 519 646-6085.
ST. JOSEPHS HEALTH CARE FOUNDATION
20132014 Board of DirectorsPeter Mastorakos, Chair John
Haasen
Tim Brown Dr. Gillian Kernaghan
Michelle Campbell, President Dr. Roman Kozak
Lesley Cornelius Frank Longo
Michael Dale Ron Martindale Jr.
Ian Dantzer Margaret McLaughlin
Dr. Tim Doherty Theresa Mikula
Samira El-Hindi Rick Spencer
Dianne Evans Tania Testa
Mark Farrow Brian Waltham
Murray Faulkner Paul Way
Stacey Graham
ST. JOSEPHS HEALTH CARE LONDON
20132014 Board of DirectorsMargaret McLaughlin, Chair Paul
Kiteley
Brad Beattie Gatan Labb
John Callaghan Ron LeClair
Kimberley Chesney Rev. Terrence McNamara
Dr. Robert DiCecco Dr. Mohan Merchea
Murray Faulkner Karen Perkin
Marcella Grail Scott Player
Phil Griffin Pat Pocock
Darcy Harris Bruce Smith
Dr. Sarah Jarmain Dr. Michael Strong
Margaret Kellow David Van Trigt
Dr. Gillian Kernaghan, President
Contributing WritersKelsi Break, Sara Cameron, Julia Capaldi,
Sarah Dicker, Caitlin Holwell,
Amanda Jackman, Anne Kay, Dahlia Reich, Renee Sweeney
Editors in ChiefKathy Burrill and Michelle Campbell
EditorDahlia Reich
ProductionMcMurry/TMG, LLC
Publications Mail Agreement #41661016. Return undeliverable
Canadian addresses to: 801 Commissioners Road East, London, ON N6C
5J1.
2 W I N T E R 2 0 1 3
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CONTENTSC
OV
ER P
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TO
BY
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MA
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ALL
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53DEPARTMENTS1 Notebook Individuals
and organizations are making a difference every day.
2 Connecting with Our Community A focus on those we serve.
8 Faces Introducing two new St. Josephs board chairs.
46 Virtual Health Supportive apps, one supersmart heart chart
and the worlds most clever piece of cutlery.
55 In Your Own Words A grateful patient shares her St. Josephs
experiences.
56 Inspired to Give A familys legacy of commitment to St.
Josephs.
FEATURES
4 Honouring Two of the Best An innovative centre is renamed for
its visionary founders.
5 Care Within Reach Parkwood Hospitals operational stress injury
service expands to Toronto.
6 Reclaiming Independence, Resuming Life Helping stroke patients
reach their full potential.
10 Got Excuses? Skipping your screenings may be put-ting your
health in danger. Stop with the excuses and put on that gown.
14 Managing Your Health with a DIY Tool KitApps and gizmos that
can help control diabetes and heart disease.
18 Is It the Stress Talking? From heartburn to breakouts, heres
how anxiety may affect your health.
20 The Wonderful World of GreensGreen vegetables can strengthen
bones, sharpen your vision, even prevent birth defects. Eat up.
25 Knee-to-Know Basics This joint keeps you jumpingand walking ,
climbing and moving. Lets see how it operates.
34 Run for Your Life With a cancer diagnosis, exercising may be
the last thing on your agenda. Heres why to reconsider.
38 Circle of InfluenceThe five people in your life who
contribute to your overall health.
42 Special Delivery And you thought choosing your babys name was
tough. Here are three other important birth decisions.
49 Relentless Scientific Curiosity St. Josephs imaging expert
Dr. Frank Prato earns a prestigious international award.
50 Stop the Stigma, Know the Facts Clearing up misperceptions
about a verdict of not criminally responsible.
52 Where Good Health Begins St. Josephs Diabetes Education
Centre has been helping patients for 40 years.
54 Gifts of the Season Season of Celebration provides vital
funding for a variety of St. Josephs projects.
ON THE COVERAfter 17 years of a daily pack-and-a-half habit, it
waslove that persuaded one of Hollywoods true nice guysto put down
the cigarettes. For inspiration, advice and a boy-meets-girl
romance, see how Matt Damon quit smokingand how you can tackle it
yourself.
28
SPECIALBy DesignA custom-made gown for breast care patients is
comfortable and versatile.
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The Hand and Upper Limb Centre (HULC) at St. Josephs Hospital in
London has a new name in honour of two of Londons most widely
acclaimed surgeons.
In a special dedication ceremony in September, the centre was
renamed the Roth McFarlane Hand and Upper Limb Centre as a
permanent tribute to its visionary foundersthe late Drs. James Roth
(19512013) and Robert McFarlane (19272006).
The expertise, foresight, acumen, leader-ship and hard work of
the two surgeons were the building blocks of the centre, which
opened in 1992 and quickly became recognized interna-tionally as a
leader in surgical innovation, excep-tional patient care, and
teaching excellence, says Dr. Gillian Kernaghan, president and CEO
of St. Josephs Health Care London. It is most fitting that the
centre honours the ambitious vision of these remarkable surgeons,
whose con-tributions continue to make a lasting difference in the
lives of patients.
UniqUe Scope of ServiceSThe Roth McFarlane Hand and Upper Limb
Centre is the largest of its kind in Canada and one of the most
respected in the world. It is a com-bined orthopedic and plastic
surgery unit spe-cializing in the care of patients with injuries or
conditions of the hand, wrist, elbow and shoulder. Unique in its
scope, the interdisciplinary team
of specialistsorthopedic and plastic surgeons, occupational and
physiotherapists, radiologists, physiatrists, cast technicians,
nurse practitioners, nurses, residents, trainees and othersannually
handles about 35,000 clinic visits, 14,000 ther-apy visits and
3,800 surgical cases.
At the same time, cutting-edge research in four labs at the
centre focused on bioengineer-ing, cell and molecular biology,
clinical research and surgical mechatronics digs deep to further
understand and improve treatment for injuries and conditions of the
hand and upper limb.
The centres expert team works every day to ensure the legacy of
Drs. Roth and McFarlane lives on, says medical director Dr. Graham
King. The renaming is a well-deserved tribute to two exceptional
physicians whose brilliance, leader-ship and mentorship gave us a
remarkable centre of excellence that continues to thrive.
AcAdemicS And AthleticSDr. Roth was a leading orthopedic surgeon
spe-cializing in hand surgery, while Dr. McFarlane was a Canadian
pioneer in plastic surgery and hand surgery. As students at Western
University, both were top athletes and football stars. Dr.
McFarlane went on to hold five Canadian records in track and field
and was the flag bearer for the Canadian Olympic team at the 1948
Summer Olympics. During their tenures as professors at Western,
both trained many surgeons, who now practice all over the world.
Recipients of numerous awards, the two medical giants col-lectively
authored more than 171 articles and 73 book chapters.
An innovative centre is renamed for its groundbreaking
founders
The Hand and Upper Limb Centre at St. Josephs Hospital in London
has been renamed in honour of two surgical visionaries, the late
Drs. James Roth, left, and Robert McFarlane, co-founders of the
internationally recognized centre, now called the Roth McFarlane
Hand and Upper Limb Centre.
Honouring Two of the BestBy Kelsi BreaK
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S t. Josephs Parkwood Hospital has mobi-lized to make it easier
for veterans and active members of Canadian Armed Forces to reach
the help they need for operational stress injuries.
The Operational Stress Injury (OSI) Clinic at Parkwood treats
those struggling with post-traumatic stress disorder, anxiety,
depression and addiction resulting from military service. The
clinics vast catchment area stretches from Windsor to Pickering and
north to the Owen Sound area. Within this area, many referrals are
generated from the Greater Toronto Area (GTA).
To increase accessibility and reduce the num-ber of
200-kilometre treks people were making to London from the GTA, OSI
outreach services were established in Toronto in 2011 by Parkwood
psychologists Drs. Maya Roth and Alexandra McIntyre-Smith.
When we fi rst started in the GTA, we felt like two soldiers
parachuting into unknown terri-tory, but with tremendous support
from the OSI Clinic at Parkwood and our partners at Veterans
Affairs Canada (VAC), we quickly rolled into action, says Dr.
Roth.
ENSURING ACCESSPotential clients are assessed in the GTA to
deter-mine whether the OSI Clinics services are right for them. If
clients would benefi t from these ser-vices, psychological
treatment is provided in the GTA and clients access additional OSI
services at Parkwood, such as psychiatry, group treatment and
family services.
Drs. Roth and McIntyre-Smith, in partner-ship with the VAC offi
ce at Sunnybrook Health Sciences Centre, provide psychotherapy and
assessment services to veterans at Sunnybrook. They also provide
assessment and treatment to veterans and still-serving soldiers out
of the VAC
District Offi ces in Mississauga and Scarborough. The OSI Clinic
works closely with VAC in London and Toronto and across the
remainder of its catchment area, as well as with the Canadian
Forces, the Royal Canadian Mounted Police and community resources
to ensure clients and their families have access to the right
programs, ser-vices and supports.
Periodically, Drs. Roth and McIntyre-Smith return to the
Parkwood OSI Clinic. Even though we connect regularly with London
by video con-ference to consult on clients, its benefi cial to meet
face-to-face to stay connected with the London team, says Dr.
McIntyre-Smith.
Pleased with the success of the outreach efforts in the GTA, the
Operational Stress Injury National Network recently leveraged the
exper-tise of Drs. Roth and McIntyre-Smith to develop a similar
outreach clinic in Halifax, Nova Scotia.
BY ANNE KAY
Parkwood Hospitals operational stress injury service is now
available in the Toronto area
Care Within Reach
Psychologists Drs. Maya Roth and Alexandra McIntyre-Smith from
the Operational Stress Injury Clinic at St. Josephs Parkwood
Hospital serve the Toronto area as part of an outreach service.
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P eter Ashby was just 45 years old when he suffered a stroke.
After treatment at a Chatham hospital, he came to St. Josephs
Parkwood Hospital for inpatient rehabili-tation. The owner of a
physiotherapy clinic that serves nursing and retirement homes,
Ashbys unexpected fi rst-hand rehabilita-tion experience would give
him a whole new perspective on life and the services his own
company provides.Now that Ive had a stroke, Ill be a bet-
ter therapist because I can really under-stand and appreciate
what my patients are experiencing.
The stroke/neurological rehabilitation inpatient program at
Parkwood serves those who have had a stroke or are living with
BY ANNE KAY, PHOTOS BY PAULINE DEVILEE
Parkwood Hospitals stroke rehabilitation program helps patients
reach their full potential
Reclaiming Independence, RESUMING LIFE
A DAY IN THE LIFE OF ST. JOSEPHS
ter therapist because I can really under-stand and appreciate
what my patients are experiencing.
inpatient program at Parkwood serves those
2
3
another neurological condition. An interdisci-plinary team helps
patients reach their reha-bilitation potential, reclaim their
independence and resume their lives. For a glimpse into this
program so vital to stroke recovery, we follow Ashby throughout a
routine day, which starts early and runs until 6:30 p.m., even on
weekends:
1
4
6
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Reclaiming Independence, RESUMING LIFE
7
9
5
6
8
1 After a stroke, patients may grieve the loss of their life as
they knew it. Counselling is a vital role of Parkwood Hospital
social workers, like Colleen Churchill, seen here in a session with
stroke patient Peter Ashby. We help them find the inner strength to
move on, says Churchill, who also helps patients plan for
discharge. Most patients continue outpatient therapy at Parkwood or
through the Community Stroke Rehabilitation Teams for those living
outside London.
2 Occupational therapist (OT) Stefanie Balcarras uses prism
glasses to help Ashby open up his field of vision on the right
side, which has been affected by the stroke. In addition to working
on visual and perceptual skills, OTs help patients re-learn
activities of daily living, such as dressing and cooking, adapt
tasks and the environment to increase their independence and
safety, and provide therapy to improve arm and hand movement and
function.
3Ashbys stroke left him with transcortical sensory
aphasiadifficulty understanding others and expressing himself.
Here, speech language pathologist Becky Orenczuk helps Ashby access
his words using visual cues.
4 Ashby and his wife, Sandi, spend a few quiet moments in the
garden at Parkwood during a break in his therapy.
5 Having progressed well, Ashby needs only stand-by assistance
from registered practical nurse (RPN) Sarah Pardy to get in and out
of bed. In addition to nursing duties, RPNs also liaise with
physicians on behalf of patients, participate in weekly rounds, and
teach patients and their families self-care skills, such as ways to
control blood pressure to help prevent another stroke.
6 One of Ashbys goals is to play golf again, so therapeutic
recreation specialist Breanne Carr works with him on improving his
balance on the putting green.
7 Physiotherapist Benj Gesink, seated, and Western University
physiotherapy students Julia Findlay, left, and Simon Janik support
Ashby while he works on balance, gait and regaining movement. In
stroke rehab, the focus of physiotherapy is primarily on gross
motor skills, strengthening and conditioning.
8 In the railway garden, raised flower beds give Ashby a chance
to practice standing while gardening, with the help of therapeutic
recreation specialist Breanne Carr.
9 Occupational therapy/physiotherapy assistant Cheri McGahan
works with Ashby on arm movements and posture control. Helping
patients with dressing and grooming is also part of McGahans
role.
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Margaret McLaughLinIt was as a Toronto nursing student that
Margaret McLaughlin first encountered the Sisters of St.
Josephtheir influence and mastery in running a hospital, car-ing
for patients and overseeing the young nurses in their charge. Today
McLaughlin sits at the helm of St. Josephs Health Care London,
founded by the pioneering Sisters 125 years ago. At this historic
juncture, McLaughlin takes over as St. Josephs chair of the board
of directors for a two-year term. A director and partner in
Excalibur Communications of London, McLaughlin brings expertise in
strategic communica-tions counsel to her role. She has also held
senior positions in corporate communica-tions with the Province of
Ontario and the Roman Catholic Archdiocese of Toronto, where she
served as special advisor to the late Gerald Emmett Cardinal
Carter. Her educational background includes gradu-ate studies in
theology at the University of Toronto and at St. Peters Seminary in
London.McLaughlin, a board member for the past
seven years who has led the boards Health Care Ethics Committee,
chose to give of her time to St. Josephs because of what she saw in
the staff, who truly embrace the mission and vision of the
organization and live the values of respect, excellence and
compas-sion, she says. Ready for challenges ahead, McLaughlin
hopes to build on the firm foundation of col-laboration between
St. Josephs and its many partners across the regions academic
health care system, focus on strategic planning to drive forward
patient care, research and teaching, and find innovative solutions
to the financial hurdles ahead. As chair, she sees a strong future
for St. Josephs.
There are many uncertainties about how to sustain excellent
hospital care and innova-tion during times of economic uncertainty.
St. Josephs has strong pillars on which we will weather the
challenges, work with oth-ers and continue to build on our
legacy.
Peter MastorakosEnergy, experience and a commitment to suc-cess
are qualities Peter Mastorakos brings to his newly minted role as
chair of St. Josephs Health Care Foundations board of directors. A
natural leader and skilled professional in the financial services
sector, Mastorakos says he feels privileged to lead the foundations
board.St. Josephs has a long history of provid-
ing excellent and compassionate care, and I am proud to be part
of the volunteer team dedicated to continuing that legacy.Currently
president and CEO of Ekaton
Wealth Management, Mastorakos will lend a wealth of knowledge to
his volunteer position. He also serves as the executive
entrepreneur in residence INVP (New Venture Project) at the Pierre
L. Morrissette Institute of the Richard Ivey School of Business,
has worked with Financial Executives International, and as part of
the judging committee for the Business Awards at the London Chamber
of Commerce.Born and raised in London and educated
at the University of Windsor and Western University, Mastorakos
resides in nearby Lucan with wife Peggy and sons Dylan and Collin.
Having served on the foundation board since 2009, Mastorakos is a
long-time community volunteer across a broad spectrum of
organizations, including minor league hockey, the Lucan District
Lions Club, and the Heart and Stroke Foundation, where he received
the Award of Volunteer for Excellence in 2007.
taking st. Josephs into the FutureTwo new board of director
chairs bring a wealth of experience and a high level of commitment
to their roles
Faces oF St. JoSephS
Margaret McLaughlin
Peter Mastorakos
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Well let you in on a little secret. No one loves to get a health
screening.Are there people who dont fear nee-dles? Sure. But no one
actually enjoyshaving a blood test.
In fact, I know of no woman who looks forward to her mammogram
or a Pap test. And if I had a nickel for every person who is eager
for a colonoscopy, Im pretty sure I wouldnt have a single
nickel.
But even if there are a hundred things youd rather dothings that
are far more fun than getting poked and proddedthere are few things
you can do that are better for your health than getting your
regular screenings.
But you have your reasons for skipping them. Right? Well, hear
this.
I DONT HAVE TIME.
IT WILL HURT.
IM NERVOUS.
B Y S T E P H A N I E R . CON N E R
IM TOO BUSY.
PHO
TO
GR
APH
Y BY
TH
INK
STO
CK
If youre skipping your health screenings, you may be putting
your health in danger
GotExcuses?
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I DONT HAVE TIME. IM
SCARED.
I FEEL FINE.
IM NERVOUS.
SCREENINGS ARE UNCOMFORTABLE
AND PAINFUL.
I MIGHT HEAR BAD
NEWS.
EXCUSE I DONT HAVE TIMEYes, youre busy. Between getting the kids
to school, caring for older par-ents and working, its easy to
overlook your own health.
Plus, what happens if the imaging centre or the lab runs behind
schedule?
Take a deep breath and remember why youre having these
screenings in the fi rst place: To potentially give you more time
with the people you love.
If the tests reveal a problem, youll be glad it was found early,
when treatment is easierand yes, less time-consuming.
If youre a multi-tasker, take heart. A blood test takes care of
many of your important screenings, including blood sugar and
cholesterol, with just one draw.
In the end, says Beth Cowper-Fung, a primary healthcare nurse
practitioner and the presi-dent of the Nurse Practitioners
Association of Ontario, its a matter of deciding that your health
is important to you. You will make time for something that is
important to you, she says.
EXCUSE I FEEL FINE, SO ITS OK TO SKIP THE DOCTOROften, people
feel fi ne and dont think its necessary to see a doc-tor. But some
conditions, like heart disease, take years to develop. The earliest
signs of heart problems stealthily appear much sooner. So, people
who get regular screen-ings starting in their 20s are at an
advantage.
If you learn that your blood sugar or cholesterol levels are in
a potentially dangerous range, you can take steps early to bring
those
Ontario, its a matter of deciding that your health is important
to you. You will make time for something that is important to you,
she says.
EXCUSE
SKIP THE DOCTOROften, people feel fi ne and dont think its
necessary to see a doc-tor. But some conditions, like heart
disease, take years to develop. The earliest signs of heart
problems stealthily appear much sooner. So, people who get regular
screen-ings starting in their 20s are at an advantage.
If you learn that your blood sugar or cholesterol levels are in
a potentially dangerous range, you can take steps early to bring
those
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numbers down. Not to mention that when people adopt healthy
habits at a younger age, theyre likely to stick with them.
Cowper-Fung notes that men in particular need an extra nudge to
get the doctors offi ce.
Men are far less likely to come in for screen-ing unless they
have a reason, she says, noting that nurse practitioners really
focus on illness prevention and overall wellness. So, when men come
in for something more acutelike a back strain or an ear infection,
for exampleits an opportunity to talk about their overall health
and see whether theyre due for any screenings.
Waiting for symptoms of disease to develop is a dangerous risk:
In some cases, it might be too late to do anything about it.
EXCUSE SCREENINGS ARE PAINFUL
AND UNCOMFORTABLEColorectal cancer is the third most common
can-cer in Canada and the second leading cause of cancer death,
according to the National Cancer Institute of Canada. But with
screening, many of those deaths are preventable. Thats because if a
screening fi nds polyps in the colon, the growths can be removed
before they develop into cancer.
People older than 50 should talk to their doc-tors about
screening, Cowper-Fung says. For people at high risk, colonoscopy
is the screening tool of choice, while those at average risk may
choose to have a colonoscopy (every 10 years is recommended) or a
fecal occult blood test (FOBT), which can be at home, every two
years. If the FOBT detects abnormalities, a colonoscopy will be
needed.
But unfortunately, fear can keep people from getting their
colonoscopy.
Most people complain about the prep. Theyve heard its
unpleasant, Cowper Fung says.
And while she wont lie to patients and tell them its fun, its
also not as bad as it is in their
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online
Access Our ExpertiseFor more information on the expertise of
the
Osteoporosis and Bone Disease Program of St. Josephs Health Care
London, visit sjhc.london.on.ca/osteoporosis .
Bone Up on BonesMore than 80 per cent of all fractures in
people
over age 50 are caused by osteoporosis, which
costs Canadas health care system more than
$2.3 billion a year and those with the condition
a reduced quality of life. Its recommended that
all men and women over age 65 routinely have a
bone density test to screen for osteoporosis, as
well as younger individuals with certain risk factors.
At St. Josephs Hospital in London, the
Osteoporosis and Bone Disease Program provides
bone density testing and specialized outpatient
care for those living with osteoporosis and other
bone diseases.
When the St. Josephs osteoporosis program
began in the 1980s, osteoporosis was still often
thought of as a natural part of aging and defi-
nitely a womens issue, explains endocrinologist
Dr. Terri Paul. Things have changed. At least
one in three women and one in five men will suf-
fer from an osteoporotic fracture during their
lifetime. Fractures from osteoporosis are more
common than heart attack, stroke and breast
cancer combined.
Dr. Paul advises individuals to talk to their family
doctor about their risk for osteoporosis and rec-
ommendations for screening.
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heads. Plus, she can offer advice for making it a better
experience.
I work with them in terms of comfort mea-sures, she says. I say,
How can we make your prep day less horrible?
For women, the perception of pain might lead them to avoid
mammograms. And its no wonder when you consider the description of
a mammogram: having your breasts compressed between two plates. But
heres some good news: A group of researchers at Wake Forest
University found that mammogram pain is mildsimilar to discomfort
caused by a pair of tight-fitting shoes or a mild headache.
And we all know how often we women choose to wear tight-fighting
shoescertainly more than once a year! So, just remember: A
mammogram could save your life.
ExcusE I mIght hear bad newsThats the denial piece, Cowper-Fung
says. I talk about how curable it is if we find it early.
Heres the bottom line: Screenings identify diseases in their
earliest stages, which is when they are most treatable.
Just think about how much better your life can be if its
[detected] early, Cowper-Fung says. Its about stressing the
importance of your health.
no more excusesSure, there are plenty of reasons to skip see-ing
the doctor. But the truth is there are few things you can do for
your health that offer a greater return on your time investment.
And who knows, maybe with a new appreciation for the benefits of
tests, youll start to look forward to these screenings. (Hey,
theres nothing wrong with a little positive thinking!)
Lets do this thing!
Your Recommended ScreeningsNow that youre on board with getting
your
screenings, lets talk specifics. Below is a list of
general recommendations for adults. If you
have increased risk due to family history or
other factors, your doctor likely will recom-
mend a different screening schedule for you.
Fecal occult blood test. Every two years, starting at age
50.
(Other screening tests are available and have
varying frequency recommendations depend-
ing on your risk factors.)
Mammograms (for women). Every two to three years, starting at
age 50.
Pap test (for women). Every three years, starting at age 25.
Source: Canadian Task Force on Preventive
Health Care
im taking controL
of my heaLth!
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Diabetes and heart disease ha
ve a lot in
commonincluding your abili
ty to control
them. Weve packed these pag
es with
apps and gizmos that can help
MANAGING YOUR HEALTH
WITH A
BY ALLISON THOMAS
Tool Kit
YOUR HEALTH WITH A
Tool Kit
YOUR HEALTH WITH A
Tool Kit
YOUR HEALTH WITH A
D I Y
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Evil Sisters?Why are heart disease and diabetes so similar? It
could be because theyre
an extension of the same disease, says Aruni Bhatnagar, PhD, a
professor,
an author and a cardiovascular researcher.
Bhatnagar and other researchers are studying both diseases as
one
continuum known as cardiometabolic disease, and the
connection
between the conditions is already being addressed in caring for
patients.
Clinicians are now being asked to assume that if you have
diabetes,
you already have heart disease, so thats how serious it is,
Bhatnagar says.
Often, were on the hunt for a two-for-one deal. But heres one
package wed rather avoid: diabetes and heart disease. The two
conditions frequently come as a set because of shared risks, such
as being overweight or obese, a sedentary life-
style, smoking, and high blood pressure and high cholesterol
levels. But the upside is this: Along with those shared risks come
shared ways to reduce or eliminate them. Well show you some of
the
best strategies for reducing your chance for developing
compli-cations from diabetes and heart disease, and give you the
tools to make it all easier to manage.
GOALGOALGOALLose a few Lose a few Lose a few
poundspoundspounds
GOALGOALGOALEmbrace a Embrace a Embrace a smart dietsmart
dietsmart diet
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Of all the risk factors for both diabetes and heart disease,
weight may play the biggest role.
For type 2 diabe-tes, the central cause
is a chronic calorie surplus. We eat too much and dont expend
enough, and its causing the epidemic, says Janet Bond Brill, PhD,
RD, a dietitian and the author of Prevent a Second Heart Attack: 8
Foods, 8 Weeks to Reverse Heart Disease. But the research shows
that losing even a small amountjust 10 per cent of your body
weightcan help reverse the damage.
And, as you might imagine, those benefi ts only increase with a
greater loss.
Weight loss can help with improving glyce-mic [blood sugar]
control, with lowering blood pressure, and it improves blood lipid
levels, says Shadab Rana, a senior specialist in Mission
Information at the Heart and Stroke Foundation of Canada. And the
greater the sustained weight loss is, the greater improvement in
risk factors you achieve.
TOOL: Withings Smart Body Analyzer ($150). It might look like an
ordinary bathroom scale, but this wizard will help you stay on top
of your weight while also analyzing your body composi-tion,
checking your heart rate, and automatically logging and tracking
your data over time.
Finding the right eating plan to man-age diabetes and heart
disease can be frustrating, because while experts easily agree on
recommen-
dations like eating plenty of vegetables, they part ways on
other guidelines. Should you go low-fat? Should you aim for
low-carb?
The choice may not be as diffi cult as you think. The focus
should be on using a balanced
approach, and that can be achieved following Canadas Food Guide,
Rana says. And if a per-son has diabetes, its imperative that they
talk to their physician or a nutritionist to chalk out a plan thats
best for them based on their target blood sugar levels.
TOOL: DASH Diet app ($1.99). Originally designed to help lower
blood pressure lev-els, the DASH (Dietary Approaches to Stop
Hypertension) eating plan is a favourite among health experts for
its rock-solid nutritional prin-ciples and simplicity. This app
gives you more than 100 DASH-approved recipes that help you stick
with the plan.
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FOR: SEE YOUR:
Regular health checkups and basic diabetes and heart disease
care,
including glucose, cholesterol and blood pressure monitoring
Primary care physician
Specialized treatment for cardiovascular disease, the
number-one
cause of death in patients with diabetes
Cardiologist
Specialized help with diabetes complications or managing
advanced
disease
Endocrinologist
An annual eye exam to detect and prevent diabetic eye disease
Ophthalmologist/Optometrist
Problems with kidney function that can lead to kidney disease
and
dialysis
Nephrologist
Diabetic nerve pain and advanced treatment Neurologist
Problems related to neuropathy or general foot physicals to
keep
feet healthy
Podiatrist
Depression and anxiety related to diabetes and heart disease
Psychologist/Psychiatrist
A Team ApproachIt takes a team to manage serious conditions like
diabetes and heart disease. Here are some of the key members you
should consider adding to your roster.
GOALGOALGOALManage Manage Manage
your glucose your glucose your glucose levellevellevel
GOALGOALGOALKeep your Keep your Keep your
blood blood blood pressure pressure pressure
downdowndown
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TOOL: GluCoMo ($.99) tracks blood sugar levels, diet, and
insulin intake, and can send the data to your healthcare providers
to seek their feedback.
While diet and exer-cise go a long way toward managing blood
pressure, many people also need medication.
Adopting a healthier lifestyle is
always the fi rst approach to reducing blood pres-sure. But if
we see that it isnt helping and that blood pressure isnt being
controlled, then we have to move on to medication, Rana says.
Blood pressure medications such as ACE inhibitors or ARBs can
work to prevent blood vessels from narrowing, keeping them relaxed
so that blood fl ows freely. The goal for healthy blood pressure is
less than 130/80 mm Hg.
TOOL: Withings Blood Pressure Monitor ($130). You should have
your blood pressure level checked at regular physician visits, but
this device can keep track of it daily at home or on the go. Just
plug it into your smartphone or computer
As people with dia-betes know, a high blood sugar level isnt the
only problem they need to watch out for. Hypoglycemia is
another.
You dont want your blood sugar to dip very low. If your blood
glucose goes too low, youll get an allergic response, your heart
rate would go up and you would have an increase in cardiac output,
so we have to be particularly vigilant, says Aruni Bhatnagar, PhD,
a cardiovascular researcher, a professor and an author. He notes
studies that show intensive control of blood sugar can decrease the
microvascular complications associated with diabetes, such as
kidney and eye diseases and neuropathy (diabetic foot disease).
Generally, the Canadian Diabetes Association says, adults with
diabetes should strive for daily fasting glucose levels of 4.0 to
7.0 mmol/L before meals and 5.0 to 10.0 two hours after eating.
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TOOL: Nike+ FuelBand ($149). This activity bracelet lets you
easily track how active you are throughout the day and engage in
friendly com-petition with your friends.
Ive given these to several people, and its actu-ally very
useful, Bhatnagar says. You set your targets and if you dont have
enough steps or activ-ity, you can do extra things to meet the
goal.
GOALGOALGOALLower your Lower your Lower your cholesterol
cholesterol cholesterol
levellevellevel
GOALGOALGOALMake fi tness Make fi tness Make fi tness a
prioritya prioritya priority
W I N T E R 2 0 1 3 17
and strap on the cuff. From here you can record and track your
readings over time, and even email data to your doctor.
Reducing blood cho-lesterol levels is an important goal for
everyone, but espe-cially so when it comes to diabetes, Bhatnagar
says.
For people with diabetes, its recommended that we treat high
cholesterol more aggressively than you would treat it in
non-diabetics. It takes a multi-facto-rial interventionmedication,
exercise and diet, smoking cessation, and sometimes even vitamin
and mineral supplementation, he says.
TOOL: MediSafe Virtual Pillbox app (free). This app helps you
remember to take your pills, and it means business. In fact, if you
dont con-fi rm that youve taken your meds, the app can be set to
notify a relative or a caregiver as needed.
A combination of aerobic exercise and strength training for at
least 30 minutes a day, fi ve days or more each week, is
recom-mended as part of any diabetes management
plan. But those on insulin should seek expert guidance in
developing a workout regimen.
Exercise has an insulin-like effect, so your blood sugar can
drop dramatically, Brill says. Those who are insulin-dependent need
to work with a health professional to prevent situations where
their blood sugar drops too low.
FdVVWI1300CND_14-17_Toolkit.indd 17 8/13/13 8:41 AM
An Inside LookIn February 2012, St. Josephs Hospital became home
to Canadas first whole-body PET/MRI scannerthe most exciting and
talked about development in imaging. Now, London area patients are
reaping its benefits as it is used to diagnose and treat
inflammatory diseases of the heart.Sarcoidosis is associated with
inflammation of a number of organs, most importantly the heart and
lungs, explains cardiologist Dr. Gerry Wisenberg, a researcher at
Lawson Health Research Institute. One of the most important factors
influencing the treat-ment of sarcoidosis is determining whether
inflamma-tion is present, its extent, and whether scar formation
has already occurred in the heart. The PET/MRI enables Dr.
Wisenberg to gather information about these two processes at the
same time and image their spatial relationships to each other.
Using this informa-tion, he can guide therapy to decrease
inflammation, reducing the possibility of scar tissue.
ONLINE Discover More
For more information on the advantages and potential uses of the
PET/MRI in the diagnosis and treatment of patients at
St. Josephs Hospital, visit Lawson Health Research Institute at
lawsonimaging.ca/imaging/node/71 .
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More than
2.7 MILLION Canadians suffer from migraine headaches, Statistics
Canada reports, many caused by vascular changes and muscle tension
related to stress.
Men and women with
type-A personalities have double the risk of stroke than
less-stressed people, according to a study in the U.K.-based
Journal of Neurology, Neurosurgery & Psychiatry.
The Womens Health
Study found that
women with high stress at work had nearly double the risk of a
heart attack compared with
women with lower
job-related stress.
Crave sugar and fat when
youre stressed?While stress can shut down
your short-term appetite, over the long term, your bodys
stress hormone, cortisol, increases appetiteand your
motivation to eat.
H eartburn. Headaches. Insomnia. Breakouts. You know the signs
of stress. And the Canadian Mental Health Association and the Heart
and Stroke Foundation have a few to add to the list: high blood
pressure, anxiety, depression, diabetes and obesity.
Heres the frustrating part: Though you may know whats causing
your stress, you probably cant eliminate the sources of itafter
all, you cant just up and quit your job, leave your spouse and
ignore your kids.
But heres what you can do: You can recognize that prolonged
exposure to stress wreaks havoc on your health. You can understand
its effects. And you can create a plan to cope.
Here are a few things to know about the impact of stress on your
bodyfrom head to toe.
StressIS IT THE
WHAT ANXIETY COULD BE DOING TO YOUAND WHAT YOU CAN DO ABOUT IT |
BY BART BUTLER
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The Womens Health
Study found that
women with high stress at work had nearly double the risk of a
heart attack compared with
women with lower
job-related stress.
Chronic stress can suppress
body systems that arent
needed for immediate
survival. For example,
the digestive system may
not work normally,
possibly contributing
to heartburn
and even ulcers.
For people with arthritis, stress may worsen the pain. Some
research shows that
arthritis and rheumatism are more prevalent
in people who recently
experienced a stressful life event
(job loss, divorce) than in the general population.
Source: Statistics Canada
Stress is highest among Canadians ages
35 to 54.
23.6 per cent of Canadians age 15 and
older say that most days are extremely or
quite a bit stressful.
Common stressors were: Work
Finances Not enough time
Family
In studies, stress is associated with female reproductive
failures. And psychological factors, including
stress, can lead to sexual performance problems for men.
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QUIZ
Test Your Stress Smarts
The more you know about stress, the better equipped you are to
fight back. Take
the Canadian Mental Health Associations Whats Your
Stress Index? quiz. Start by visiting cmha.ca/mental-
health/your-mental-health, then click Stress and
scroll down to find the quiz.
Hair Holds SecretsYour hair can say a lot about your
personality, but did you know it
can also reveal how much stress
youve been under? Dr. Stan Van
Uum, an endocrinologist at St.
Josephs Hospital in London,
and colleague Dr. Gideon Koren
developed a method to measure
cortisol levels in hair to provide an
accurate assessment of stress lev-
els in the months prior to an acute
event such as a heart attack.
Cortisol is a hormone released
into the blood by the adrenal
glands during moments of high
stress, explains Dr. Van Uum. Hair
follicles are exposed to whatever
circulates in the bloodstream, so
more cortisol in the blood means
more ends up in the hair.
Stress has long been linked to
an increased risk of heart attack.
By analyzing a strand of hair, we
can look back in time before the
heart attack to determine stress
levels, says Dr. Van Uum. One
strand of hair five inches long can
give us a year of information.
The findings are important in
seeing how preventive programs
for stress can help decrease the
risk for heart attack.
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GreensThe
Wonderful World of
By Colleen RinGeR
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GreensGobble up these 6 good-for-you veggies BY COLLEEN
RINGER
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What if you could fi ll your plate to overfl owingeven go back
for secondsand be healthier? Well, you can! Grab the nearest green
vegetable and start noshing.Leafy greens in particular are
exceptionally nutritious and offer a number of health benefi ts,
says Leslie Beck, a registered dietitian based in Toronto and the
author of The Plant-Based Power Diet.
That means that when it comes to your greens, theres
no such thing as too much. These six superstars can do
everything from reduce your risk of cancer to boost your bone
health. And, to misquote Lucy Ricardos immortal Vitameatavegamin
commercial, Theyre so tasty, too!
KaleWhy its good for you: Kale is the king of superfoods. When
it comes to vitamin K, kale beats out all other leafy greens, Beck
says. In fact, one serving of raw kale gives you 525 per cent of
your daily dose of vitamin K, which is great for bone health. Its
also a good source of calcium, folate and potassium.
What it tastes like: Expect it to be deep, earthy and slightly
bitter, although the smaller leaves can be milder.
How to eat it: Use it in place of your usual go-to leafy green
(such as romaine or spinach). Put it in salads, on burgers or in an
omelet. Feeling adventurous? Bake it to make kale chips.
Why theyre good for you: The long maligned martyr of the produce
aisle, Brussels sprouts offer all the benefi ts a good cruciferous
veggie should: anti-oxidants, vitamin C, folate and more. Theyll
last up to one week when stored in the refrigerator.
What they taste like: Think of them as mini cabbages.
How to eat them: If you think you know Brussels sprouts, think
again: Drizzle with olive oil and rice vinegar, then sprinkle with
Parmesan cheese. Roast in the oven at 400 F (205 C) for 30 minutes.
Youll discover a whole new delicious side of these small green
globes.
Brussels Sprouts
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3W I N T E R 2 0 1 3 23
Why its good for you: Swiss chard gives you a lot of bang for
your calorie buckjust 15 calories in two cups. Plus, it provides a
boost of fi bre, magnesium, and vitamins A and K. Like all greens,
it is a heart-healthy addition to your diet.
What it tastes like: Do you like beets? Then youll like Swiss
chard. But remem-ber, the taste is all about how you pre-pare the
veggie and what you combine it with, Beck says.
How to eat it: After sauting it, add apples or dried cherries
for a sweet and sour mixture. And, as with other leafy greens, you
can add it to salads or sand-wiches, or even mix it into a smoothie
or a soup.
Swiss Chard
FdVVWI1300CND_20-24_Greens.indd 23 8/13/13 8:46 AM
Nutrition Know-how
Visit EatRight Ontario and browse a list of nutrition
topics,
menu plan or track nutritional goals. You can also call or
email
to contact a dietitian at no cost. 1 877 510-5102 ;
eatright ontario.ca .
CALL
St. Josephs Serves Up GreensSpinach with its dark green leaves
is often considered the worlds healthi-
est vegetable. It contains significant amounts of vitamins C and
K, fibre,
folate and carotenoids, explains dietitian Susan Greig,
professional practice
leader at St. Josephs Health Care London.
Raw spinach has a mild flavour that is delicious on its own or
blended
with other leaf vegetables to create a salad. When cooked,
spinach often
has a bitter taste that can be easily overcome with seasonings
such as
lemon juice or garlic, by incorporating it into soups and pasta
dishes, or
marrying it with cheese, Greig suggests.
Patients and residents at St. Josephs enjoy a large variety of
veg-
etables, she says. Green vegetables, including brussels sprouts,
broccoli,
asparagus and spinach, are on the regular menu every day.
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AsparagusWhy its good for you: Is your diet high in sodium? The
potas-sium in asparagus can counteract sodiums negative effect on
your blood pressure. Hoping to get pregnant? Asparaguss folic acid
can prevent birth defects.
What it tastes like: It has a mellow fl avour, and is a bit
earthy, Beck says.
How to eat it: Serve steamed, sauted, roasted or grilled as a
side dish. I like to roast them because it changes the taste profi
le, and you dont lose any nutrients to water as with boil-ing, Beck
says. To keep asparagus fresh for as long as possible, store
standing up in the fridge in a small dish of water.
4
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CollardsWhy theyre good for you: Collards offer similar vitamins
and nutrients as kale, mak-ing them good for your bones (calcium)
and your skin and eyes (vitamin A).
What they taste like: Think about biting into a strong cabbage
leaf.
How to eat them: Trim the ribs and use the wide, sturdy leaves
in place of tortillas or bread for a healthy wrap. If the taste is
too biting for you, cook them to mellow the fl a-vour. Saut the
leaves with olive oil and gar-lic, and then sprinkle with Parmesan
cheese.
BroccoliWhy its good for you: A cousin to cabbage, broccoli is a
cruciferous vegetable that is packed with vitamin C, calcium, fi
bre and phytochemicals, which may reduce the risk of cancer.
What it tastes like: You may pick up on a hint of cabbage, but
its fairly mild and there are many ways to prepare it.
How to eat it: Raw is best since cooking damages some of its
cancer-fi ghting com-pounds. Not a fan of raw broccoli? Toss it
into stir-fries and omelets, or top your pizza or baked potato with
it.
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BY ELLEN OLSON
Knee-B A S I C S
BY ELLEN OLSONBY ELLEN OLSON
W I N T E R 2 0 1 3 25
Your overall mobility
hinges on this joint. Heres
how to keep it well oiled
We run. We jump. We cli
mb stairs. Sometimes we (
well,
some of us) compete in m
arathons or climb mounta
ins.
Throughout our lives, ou
r knees take a beating. S
o its
no wonder that a good bit
of pain is associated with
this
important joint. But just h
ow important is it?
to-Know
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Coupe recommends following the RICE steps to ease the pain:
rest, ice, compression, elevation.
People are often tempted to put heat on pain, but that could
actually make it worse. Ice will reduce the swelling and numb the
pain, Coupe says. And most importantly, rest! Get off your feet for
a bit.
Arthritis Most common in older people, arthritis of the knee is
a result of damaged cartilage. The cartilage is there to protect
the kneelike a cushiony layer of insula-tion, DiNubile says. When
its healthy, the bone can slide across the cushion like ice on
ice.
But when that cartilage becomes damaged, problems ensuenamely,
arthritis. In the early stages, arthritis is treated with
non-sur-gical methods, like lifestyle changes, medica-tion and
supportive devices. If the arthritis progresses, your doctor may
recommend a bit of excavating through arthroscopic sur-gery or a
partial or total knee replacement.
Ligament tears If youre a sports fan, youve probably heard the
term torn ACL. Its a common injury in athletes, especially among
women. ACL stands for anterior cru-ciate ligament, and actions like
twisting your knee with the foot planted, getting hit on the knee
and stopping suddenly when run-ning can tear it. The ACL is the
best-known ligament, but it isnt alone in being at risk. Your knee
is made up of four ligaments, all of which can be torn. Depending
on the sever-ity of the tear, surgery may be needed.
What Lies BeneathUnderstanding the construction of the knee can
be tricky. Most of us are only aware of the visible kneecap, but
theres much more to this joint, says Dr. Nicholas DiNubile, an
ortho-pedic surgeon and the author of FrameWork for the Knee: A
6-Step Plan for Preventing Injury and Ending Pain.
The main structural elements are bones, tendons and ligaments.
Think of those like the walls, floor and roof of your house, he
says.
Heres how its laid out: The knee joins the thighbone (femur) to
the shinbone (tibia). The smaller bone (fibula) that runs alongside
the tibia and the kneecap (patella) round out the bone structure of
the knee. Tendons con-nect the knee bones to the leg muscles that
move the joint, and ligaments join the knee bones and provide
stability to the knee. All these elements work together to help you
twist, turn, walk, run and jump.
CraCks in the FoundationEven the best feats of engineering are
sus-ceptible to a few structural weaknesses, and the knee is no
exception. The three main structural weaknesses that eventually may
call for repair:
Overuse and inflammatory injuries These are the types of
problems we see in runners, gardeners and other people who simply
use their knees a lot, Coupe says. Overuse can result in tendinitis
or swollen ligaments, which is painful, but not overly
detrimental.
The knee is a hinge joint that essentially allows us to move.
Without it, we would be immobile, says Dr. Kevin J. Coupe, an
orthopedic surgeon in sports medicine.Makes you want to sit down
for a minute, doesnt it? Heres how to prevent or treat knee pain
and injury, and keep
this marvel of design healthy and hinged for years to come.
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Fixer-UppersMuch like your house, your body will hold up a bit
better if you perform basic upkeep.
Its always better to prevent injury than treat it, DiNubile
says. He offers these tips:
1Keep a healthy weight.Have you ever loaded your car with heavy
objects or multiple people and noticed that the ride wasnt quite as
smooth? The same holds true for your knees. When you are
overweight, youre putting an extra burden on the knees cartilage,
which can cause it to wear down more quickly.
2 perform a balanced, regular exercise routine. If you only work
out the first week of January, youre not doing yourselfor your
kneesany favours.
The knees are meant to be moved, DiNubile says. Plus, strong leg
muscles help take the strain off of the knee.
3experiencing knee pain? Get it checked. By ignoring it, youre
almost asking for it to worsen. If you notice persistent pain, dont
brush it offtalk to your doctor.
With all the treatment options available today, theres no reason
why you should have to suffer, DiNubile says.
W i n t e r 2 0 1 3 27
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ON
LIN
E
Learn MoreEach year, the Rheumatology Centre of St. Josephs
Health Care London sees more than 10,000 patients requiring
diagnosis and specialized treatment for
a multitude of rheumatologic disorders. For infor-mation on the
centres leading-edge care, visit
sjhc.london.on.ca/rheumatology.
WHAT YOU KNEE TO KNOW
With no easy answers when it comes to osteoarthritis of the
knee, St. Josephs Hospital in
London has undertaken innovative
studies to determine the best treat-
ment approach.
Osteoarthritis, the most com-
mon form of knee arthritis, causes
the joint cartilage to gradually
wear away. Proven treatments,
says St. Josephs rheumatologist
Dr. Janet Pope, include nonsteroidal
anti-inflammatory drugs (NSAIDS),
physiotherapy for strengthen-
ing the quadriceps, taping of
the knee, weight loss, exercise,
orthotics, and injections with intra-
articular steroids.
Glucosamine, thought to pro-
mote formation of cartilage, and
chondroitin, thought to prevent
cartilage breakdown, have been
widely promoted as treatment
but that verdict is still out, says
Dr. Pope. Herbal treatments are
also unproven.
Studies done at St. Josephs
compared the benefits of a NSAID
to a placebo and glucosamine to a
placebo. These studies are novel
in design to determine who really
needs their current medication
so that, long term, only those still
benefitting are receiving it, explains
Dr. Pope.
FdVVWI1386_12-46_Commons.indd 27 9/19/13 11:31 AM
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When Matt Damon went smoke-free, his motivation came from the
heart. See how you can discover your inner quitter and breathe
free
Bourneto
W I N T E R 2 0 1 328
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Bourneto
By Teresa Caldwell
Board
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30 W I N T E R 2 0 1 3
Quitting: a Team SportNo question, cigarettes are poison. But
even when you know how deadly they are, it takes practical
strategies and support to turn the desire to quit into a smoke-free
life.
The physical dependence on nicotine is one of the most diffi
cult things for people to overcome, says Tracy Fehr, tobacco issues
spokesperson for the Canadian Lung Association. Its also the
behavioural, psychological conditioning thats happened over
time.
Since the majority of smokers are both physically and
psychologically addicted to cigarettes, the best chance of success
comes through a combination of medication and counselling. These
address both physical cravings and psychological urges to
smoke.
Smoking cessation counselling can prepare you with a
personalized strategy. You can talk to your doctor, attend a
hospital support group, or get online or phone support.
To help with physical cravings, nicotine replace-ment is
available in patches, gum, lozenges, inhalers or nasal sprays.
Prescription medication to ease with-drawal symptoms can be used
instead of or in addition to nicotine replacement.
Get O to a Good StartTo get started, fi rst set a quit date;
then tell your friends and family that youre quitting. Theyll be
important sources of support as you embark on your journey to being
smoke-free. Be sure you trash all of your cigarettesand
Blame It on LoveAug. 5, 2004, was a life-changing day for
Damonthe day he became a non-smoker and put 17 years of
pack-and-a-half days behind him.
Rewind a year or so: This story begins, as many good stories do,
with a boy-meets-girl epiphany. When Damon met his wife, Luciana
Barroso, in Miami in 2003, there was a halo of light around her,
and I absolutely knew that moment had changed my life before I even
spoke to her, he told Macleans in a 2011 interview.
The desire to have children with Barroso became part of his
motivation to quit smoking.
I remember my brother gave up [smoking] before he had kids,
Damon told The Observer in April 2013. He said, Im going to give
myself six months or a year to clear out my system. I remember
thinking, Yeah, Ill do that, too.
Damons motivation was sound: In addition to the better-known
health risks of smoking, men who smoke cigarettes have a lower
sperm count and increased abnor-malities in sperm shape and
function, according to the American Society for Reproductive
Medicine.
In a July 2004 interview with the Washington Post, just a month
before he quit, Damon was already refl ecting on the toxins in
cigarettes. He had switched to a more natu-ral brand, he said. Its
amazing. You know, its about 350 additives your average cigarette
has, from arsenic, from cyanide to ammonia.
Theres a down-to-earth charm about Matt Damon.Maybe its his
earnest gaze when he talks about clean water
issues or the fl ash of dimples as he blazes forth with that
daz-zling grin. He just comes o as a likeable guy.
Whether playing things bald and bionic in Elysium, bad to the
bone in the Bourne trilogy or scrappy and brilliant in his breakout
role in Good Will Hunting, the actor himself seems like someone
youd enjoy hanging out with over a beer.
But not a cigarette. Those days are behind him.
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Up in Smoke: Whats Really in a Burning Cigarette?A lit cigarette
produces more than
4,000 chemicals. Many are poison-
ous, and at least 50 are known
to cause cancer. Here are some
examples of the chemicals in ciga-
rette smoke:
Carbon monoxide (found in car exhaust)
Arsenic (used in rat poison) Ammonia (found in
window cleaner)
Acetone (found in nail polish remover)
Hydrogen cyanide (gas chamber poison)
Naphthalene (found in mothballs)
Sulfur compounds (found in matches)
Lead Volatile alcohol Formaldehyde (used as
embalming fluid)
Butane (lighter fluid)These chemicals mix together
when you smoke, forming a sticky
tar that clings to clothing, skin and
the hair-like cilia that line the lungs
and act as filter for dirt and germs.
When tar impairs the function of
the cilia, the lungs are more vulner-
able to infection.
Source: Canadian Lung Association
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Source: smokefree.gov
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Achieving a Smoke-free HospitalTo promote a healthy
community,
St. Josephs Health Care London is
taking the next steps in becoming a
smoke-free hospital organizationone
site at a time. The Southwest Centre
for Forensic Mental Health Care was
the first site to go smoke-free and
St. Josephs Hospital will follow by
year-end. A smoke-free policy has
been developed and staff and patients
alike are being encouraged, and
helped, to quit the habit.
As health care providers, we
know the toll smoking and second-
hand smoke have on people and
the cost to our health system, says
St. Josephs president and CEO
Dr. Gillian Kernaghan. Its now time
to go further in our commitment
to a smoke-free environment for
patients, staff, volunteers and visitors
using various strategies to address
this important issue.
At St. Josephs, a smoke-free
hospital task team is at work using
approaches that have been successful
at other organizations.
CA
LL
Access HelpYou may wish to speak with your health care
team, or call the Smokers Helpline to start or maintain a plan
for stopping smoking for
good. Quitting smoking is the best thing you can do for your
healthit is never too late to
quit. Smokers Helpline: 1 877 513-5333 ;
smokershelpline.ca/.
FdVVWI1386_12-46_Commons.indd 32 9/19/13 11:31 AM
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For a successful START to your new smoke-free life:
Anticipate and plan for the challenges youll face.
Remove cigarettes from your home, car and work.
Talk to your doctor about getting help to quit.S T A RSet a quit
date. T Tell family, friends and colleaguesyoure quitting.
dont forget the packs you have stashed in your drawer at work or
in your glove compartment.
The insomnia, irritability and anxiety that can strike as
nicotine dependence wanes tend to be most intense in the fi rst
couple of weeks. Where most people fl ounder is once theyre past
that and trying to get through day-to-day coping, Fehr says.
When you think about situations that might trigger the urge to
smoke, remember that both a diffi cult or a happy situation can be
a trigger, Fehr says. One fellow I talked to recently had quit
smoking for six months and then he won $1,000 and asked the woman
next to him for a smoke.
Claim a New IdentityThe majority of smokers want to quit, and
many have tried before. Only a third of ex-smokers were successful
on their fi rst quit attempt, according to a report by the Canadian
Lung Association.
We really stress visualizing yourself as a non-smoker, says
Marianne Popovacki, a tobacco cessation specialist with the
Canadian Cancer Society Smokers Helpline. Instead of labelling a
past attempt a failure, its truly a learning experience that can
strengthen you for the next time youre attempting to quit. You can
identify what worked for you in the past and build on that.
When asked by The Observer earlier this year how his life had
changed since Good Will Hunting made him famous 15 years ago, Damon
came up with one big dif-ference: He doesnt smoke anymore. Quitting
is a whole new lifestyle change, Popovacki agrees.
In transforming from eager aspiring actor to satisfi ed family
man, his priorities and identity changed. Ben [Affl eck] and I
started [smoking] when we were in high school, Damon said. Wed see
the great actorsBrando, James Dean, Mickey Rourke, who we loved
back thensmoking, and we just thought it was cool.
A healthy lifestyle became a priority for Damon as he got older,
got married and became a father. (He and Barroso now have four
daughters.) When asked in 2011 how turning 40 had felt, Damon said,
Actually, it felt really good. I felt lucky to have the family that
I have and the wife that I have, and the job that I have, and I
just kind of found myself wanting health and more of the same.
Finding Your Motivation As with any big change, motivation is
key. Its very good to build a strong case for yourself about why
you want to quit, Popovacki says. You can bring those reasons back
to the forefront of your mind and thats what can keep you from
giving in to that cigarette.
Beyond better health for you and your family, the money you save
by not buying cigarettes can be another motivat-ing factor. You can
put the money toward a weekly mas-sage, add it to your college or
retirement savings, or donate it to a cause you care about. In
fact, while saving your own life you could contribute to saving
another persons.
Damon became passionate about public health issues while
travelling in Africa. I co-founded water.org, which focuses on
water and sanitation. I was in Ethiopia, and I watched children
taking fi lthy water out of a hand-dug well and putting it in
bottles to take to school. The water was so dirty, it looked like
chocolate milk, he told Parade magazine in 2009. Parents in these
impoverished areas lose children every year to diseases that could
be com-pletely prevented if they had access to clean water.
Just $25 will give someone clean water for life, Damon said.
In the 2011 movie We Bought a Zoo, Damons character is giving
his son advice on talking to a girl. He tells him, Sometimes all
you need is 20 seconds of insane courage. And I promise you,
something great will come of it.
To quit smoking, all you have to do is get through the next 20
seconds without a cigarette. Then do it again.
33W I N T E R 2 0 1 3
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for Yourfor Yourfor Yourfor Yourfor Yourfor Yourfor Yourfor
Yourfor Yourfor Yourfor Yourfor Yourfor Yourfor Yourfor Yourfor
Yourfor Yourfor Yourfor Yourfor Yourfor Yourfor Yourfor Yourfor
Yourfor Yourfor Yourfor Your
W I N T E R 2 0 1 334
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Y BY
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BY STEPHANIE PAT
ERIK
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for Yourfor Yourfor Yourfor Yourfor Your
W I N T E R 2 0 1 3 35
When 34-year-old Monika Carlson got the news that an inoperable
tumour was growing in her brain, she asked her doctor an unusual
question.
Can I run a marathon?She successfully had run 18 marathons,
including two that
year, even as her cancer grew, and she was training for
another.He looked at me like I was crazy, she says with a
laugh.Carlson had surgery and wasnt allowed to run for 30 days.
Six
months later, 11 days after a potent dose of chemotherapy,
Carlson crossed the fi nish line at the LA Marathon in a Wonder
Woman costume and T-shirt that read Powered by Chemo. A friend ran
beside her in a Supergirl costume with the message Impossible
Things Happen Every Day.
Carlson has learned what studies now show: Exercise is safe for
most cancer patients, and more than that, it fi ghts fatigue,
nausea, depression and possibly the disease itself.
Its safe to say the evidence is growing, says John M. Saxton, a
clinical exercise scientist and the author of Exercise and Cancer
Survivorship. Theres a large volume of research now to show that
exercise is benefi cial not only for cancer patients but for
helping to prevent certain cancers.
Even better news is that you dont have to be Wonder Woman or run
marathons. Just 150 minutes of moderate exerciseor 75 minutes of
vigorous activityand two days of strength training per week will
do. If you or someone you love has cancer, consider these fi ve
powerful reasons to get moving. >
It may be the last thing on your mind after a cancer diagnosis,
but exercise can ease treatment side e ects, boost strength and
even fi ght the disease itself
PHO
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Working Out SafelyIf you have cancer, chances are your health
has risen to the top of your priority
list. In some ways, its the perfect time to start a workout
regimen, says Nancy S.
Brennan, author of Active Against Cancer: A Guide to Improving
Your Cancer Recovery
with Exercise.
But first, consider these five precautions.
1. Dont push it. If you werent active in the past, start slowly.
And if you
were very active, scale back. Even marathon runner Monika
Carlson, who is bat-
tling a brain tumour, takes a walk break every mile.
2. Listen to your body. When youre in cancer treatment, your
goal is to
recover your health, not to train for an event and stay super
fit, Brennan says.
If you need a day to rest, take it.
3. Prevent injuries. Some treatments cause numbness in the hands
and
feet, or alter your sense of balance. Holding the rails of a
treadmill or using a
stationary bike might be safer than running on uneven
streets.
4. Avoid risks. If your red blood cell count is low, your doctor
might ask
you to delay activity. Also, people with compromised immune
systems should
wear masks outdoors, and those with catheters should avoid pools
and lakes.
Radiation patients should stay away from chlorine, and those
with ports should
avoid upper-arm strength training.
5. Talk to your doctor. No one knows your health status better
than your
oncologist. Be sure to discuss an exercise plan before you
begin.
W I N T E R 2 0 1 336
your life. Thats what happened to Carlson when she learned her
head-aches werent the result of work stress or a neck injury, as
doctors initially thought.
They were signs that cancer had grown like a tangled weed in her
brainstem.
Carlson is a passionate market-ing professional, runner and
board member of the Girls on the Run charity in San Diego. After
her diag-nosis in September 2012, life became a funnel cloud of
surgery, radiation and chemotherapy.
Carlson took her dog for long walks after surgery, and when she
felt well enough a month later, she started running again. It makes
me feel that Im taking charge.
Running was part of my routine, and being able to get back to
that routine helps me feel more normal, she adds. I ran marathons
every year, my friends are all runners, and being able to maintain
that helped me feel like myself.
Exercise is a powerful way to gain control over your body,
self-image and daily routine, says
Nancy S. Brennan, a survivor and the author of Active Against
Cancer: A Guide to Improving Your Cancer Recovery with Exercise.
The cross-country skier took 20-minute
walks and swims during treat-ment for ovarian cancer in 2007.All
my best memories from
treatment are when I was exercis-ing, taking a walk or a short
swim. It felt like the most normal thing I did compared to putting
chemi-cals in my chest and [experi-
encing] the ridiculous side effects, says Brennan, who has been
in good health since treatment. Having
your identity taken away as a healthy person is rugged, and for
a few minutes you can feel
like a healthy person again.
once sent patients to bed to pre-serve their strength, but now
Saxton reports they are urging people to throw off the covers and
work out.
The message is getting out, he says. Its slow moving, but more
and more modern medics are becoming aware of the potential benefi
ts. The medics I work with are all keen on promoting exercise with
patients.
Your type of cancer, treatment and level of activity before
diagnosis will decide how much you can do, so talk with your
oncologist about a safe plan. It might range from stretching in bed
and walking around the block to yoga and competing in a race.
Show em Whos BossCancer has a way of taking over
Fight That Bad BoyThe number-one goal for anyone with cancer is
to beat it. In the battle for your life, exercise is your ally.
First, physical activity keeps off unnecessary weight, builds
muscle, improves bone density, boosts cardio health and acts as an
anti-infl amma-tory. This creates the ideal environ-ment for cells
to fi ght disease.
Second, mounting research sug-gests that exercise helps fi ght
breast, prostate, colorectal and ovarian can-cers. Some studies
have found that people who exercise are more likely to complete
treatment and survive and less likely to see their cancer return,
Saxton says.
This marks a major shift in con-ventional cancer wisdom.
Doctors
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W I N T E R 2 0 1 3 37
Beat the BlahsFatigue is a major problem for peo-ple going
through radiation and chemotherapy. The solution is
coun-terintuitive but true: Activity can help with fatigue.
Staying active was Carlsons secret weapon against radiation
fatigue. She says it gave her the energy to keep up her daily
activities.
Some people feel fi ne, some sleep for 18 hours a day, some
people end up going on disability, Carlson says of radiation
effects. I started walk-ing three times a week, and never got tired
enough to miss work.
Her experience isnt unique. A study of breast cancer patients
found that women who stayed active dur-ing treatment not only had
more energy to fi ght the disease, but they also had more energy
one and two years later, Brennan says.
The author experienced the bounce back effect fi rst-hand.
I bounced back after chemo pretty fast. I personally think a
daily menu of light exercise has a lot to do with helping the body
heal, she says. A little bit goes a long way.
Tame Your TummyAnother unpleasant side effect of treatment is
nausea, and managing it will help keep your strengthand spiritsup.
Exercise can help with this, too.
Brennan had a queasy stomach after every round of chemo. The
only
thing that helped was taking a walk.That alone can be an
enormous
benefi t for people in treatment, she adds.
While researching her book, she found that exercise also aids in
digestion and helps you make better choices about what to eat. That
adds up to a more settled stomach.
Seize the DayCarlson is the most positive person with an
incurable brain tumour you will meet. Her hope is to keep the
tumour from growing so that she can live as long as possiblespend
time with her new husband, enjoy friends and family, and yes, run
another marathon or 20.
I kind of feel like its a choice you have to make, she explains.
You can choose to think about the what ifs, or you can focus on
today. Focusing on today is what has helped me. I feel mostly fi
ne. Im more fi t than the average person. Im not in a hospital bed
yet. Why worry about that happening?
Thanks to endorphinsthose brain chemicals that trigger pleasant
feelingsexercise is a natural mood booster and stress reliever.
When youre fi ghting for your health, you need both.
Youre ruining today by worry-ing about tomorrow. I feel like Im
living the reverse of that, Carlson says. I think continuing to run
has been a huge help emotionally for me as Ive gone through all of
this.
Monika Carlson (right) and her glam-runner.com partner Taramae
Baize finishing the LA Marathon.
FdVVWI1300CND_34-37_Cancer_v3.indd 37 8/13/13 9:08 AM
Fun Fitness for Breast HealthImprove your health and the health
of
others by taking part in Bust a Move for
Breast HealthTM , a national fundraising ini-
tiative returning to London this spring.
For a second year, hundreds of women
and men will gather at the London
Convention Centre on March 29, 2014,
for six hours of fun group fitness led by
industry experts. With dance-worthy
beats, healthy snacks, crazy costumes and
a special celebrity guest, this is one event
you wont want to miss.
Proceeds from the event will support
the Breast Care Centre at St. Josephs
Hospital in London, which brings together
breast imaging, assessment, surgery ser-
vices and an interdisciplinary care team in
one specially designed location.
Join the movement today and support
those in the community facing medical
challenges like breast cancer.
online
Register for 2014Bust a Move for Breast Health is hosted by St.
Josephs Health Care
Foundation. Last year, the event raised more than $1 million for
St. Josephs Breast Care Centre. Visit bustamove.ca for details
on how to register for 2014, support a friend or make a
donation.
FdVVWI1386_12-46_Commons.indd 37 9/19/13 11:31 AM
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CircleCircle BY STEPHANIE R. CONNER
Meet the fi ve people most likely to infl uence your healthand
learn how you can make these relationships the healthiest they can
be
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CircleCircleYOUR SPOUSE Dr. Linda Waite, author of The Case for
Marriage: Why Married People Are Happier,
Healthier, and Better Off Financially, has studied the effect of
marriage on health and found that married people tend to be
healthier than unmarried people.
Research suggests that both women and men see improvements in
their health when they get marri