Achieve your potential in health

 

Dave and Baldev high five at WWYD

Drs. Davidicus Wong and Baldev Sanghera at the 2014 WWYD

When we think about health, many consider it from the negative.

The focus is on symptoms, injuries, illness or disease.

Many approach their healthcare the same way.

They see a doctor or other healthcare provider mainly for the treatment of these conditions. Health is defined in the negative: the absence of disease, and healthcare becomes passive: the treatment given by a healthcare professional.

I think of health as the optimal balance of the important areas of your life (physical, emotional, intellectual, spiritual, family, social, work, rest and play) – guided by what you value and where you find meaning – and the achievement of your positive potential in life.

I believe we each have a unique potential. It is our duty to realize our potential and to help others achieve theirs.

Though we all need the assistance of doctors, nurses and other healthcare providers at different points in our lives, most of your healthcare is provided by just one person. That person, of course, is you.

In this way, real healthcare is self-care. The best predictors of your future health are the habits you practice today.

The four foundations of self-care are (1) what you eat (what you put into your body), (2) what you do (physical activity), (3) how you feel (emotional wellbeing) and (4) how you relate (healthy relationships).

WWYD Albert and Donna Gomes

With patients, Donna and Albert Gomes

Over the past two years, I’ve led the Burnaby Division of Family Practice’s Empowering Patients health education campaign. Our goal is to improve the health of our community by providing unbiased health information on a variety of topics including the four foundations, chronic conditions such as heart disease, high blood pressure and diabetes, preventive and proactive care, medical ethics, improving your hospital experience and communicating with healthcare providers.

So far we’ve delivered 14 free public lectures in Burnaby’s schools, libraries and community centres and created health education posters, handouts and videos. To see our growing library of health information, check the Burnaby Division’s website at divisionsbc.ca/burnaby.

The family doctor’s circle of care has expanded from the care of the individual patients of a practice to the care of our community. We care about our patients, and we care about our community.

On Monday, April 25th at 7 pm, I’ll be speaking at the Tommy Douglas Library (7311 Kingsway, Burnaby) on “Healthcare is Self-Care: Achieve Your Potential for Health.” You can register for this free talk online at www.bpl.bc.ca/events or by phone (604) 522-3971.

If you’re thinking of improving your future health by becoming more active today, jump on board with the rest of us next month as we celebrate Move for Health Day and the Doctors of BC’s Walk With Your Doc events. On Saturday, May 7th at 10 am, I’ll be the emcee for the Doctors of BC’s annual Walk With Your Doc at Kitsilano Beach Park.

To celebrate Move for Health Day in Burnaby on Tuesday, May 10th, I’ll be presenting a talk, “We Were Made to Move” at 1 pm at the Edmonds Community Centre and again at 5:45 pm at the Confederation Community Centre (to be followed at 6:15 pm with an easy Walk With Your Doc around the Confederation Park track). You’ll learn about the benefits of exercise, how it can improve your enjoyment of life and your ability to do everyday activities, and how you can make daily physical activity a new healthy habit. All members of the public of any age are welcome to join our team of Burnaby doctors as we walk the talk! Each participant at the walks will also get a free pedometer (while quantities last).

WWYD Greg Kennelly Michelle and John Albano

With patients, Greg Kennelly, Michelle and John Albano

For more information on the variety of fun events Burnaby has planned for Move for Health Day look on page 5 of the Leisure Guide (or check online at burnaby.ca). https://www.burnaby.ca/Assets/New+Things+To+Do/Festivals+$!26+Events/Move+for+Health+Schedule+of+Events.pdf

To find out about the Move for Health Day and Week events close to you, check out your local community centre or the BC Recreation and Parks Association website http://www.bcrpa.bc.ca/mfhd2016/events. To learn more about the Walk With Your Doc events in every community, check walkwithyourdoc.ca.

WWYD Burnaby

Drs. Davidicus Wong, Karime Mitha and Shelley Ross

Posted in Burnaby Division of Family Practice, Empowering Healthcare, Healthy Living, Physical Activity, Positive Change | Tagged , , | Leave a comment

Live with the end in mind

Nitobe Memorial Garden, UBC (Davidicus Wong)

Mindfulness of death is a Buddhist practice that informs more meaningful living.

If anything can happen anytime and if your next breath was your last breath, you would pay attention to the quality of each remaining moment of your life – every sensation, thought, word and action.

If this was your last week or today was your last day, what would you do differently?

You may update your facebook . . . or you might not.

Would you spend more time on social media, go shopping one last time, go to your favourite restaurant and eat all you can? Would you reflect on your life in retrospect, recognize what really matters and spend your remaining time there?

If you had one last chance to talk to the people you love, what would you say?

Dr. Ira Byock, a palliative care physician wrote in his book, “The Four Things That Matter Most” that those four things are what we need to say to our loved ones before we part: “Please forgive me,” “I forgive you,” “Thank you,” and “I love you.”

We are all human and imperfect. We hurt the people we love, and they hurt us. We take one another for granted. We don’t always speak or act in loving ways.

If we knew our time together was limited, we might be kinder, more patient and loving. The truth is our lives are indeed limited, and few of us knows how much time we have left. In fact, the only ones who know this have been diagnosed with a terminal condition.

My mother died suddenly in April 13 years ago.

I was fortunate that my profession had taught me how precious life was and that I was able to give back to my mom the love that she gave me. Yet I have often thought of how her kind and generous presence would have enriched my life and those of my children if she was still here.

When grieving, I recalled every word from those who offered comfort. One patient said that to die suddenly is a good way to go. Ten years later, that patient would die from end-stage congestive heart failure. Without warning or in palliative care: neither is easy for loved ones.

Last year, my dear aunt passed away in palliative care at St. Michael’s Hospice. She was surrounded by her loving family, and we all had the opportunity to express our love and gratitude for all that she had done for each of us.

Palliative care focuses on the comfort of the patient suffering from a life-limiting condition. The aim is the best possible quality of life even in the final stages of illness.

It takes a team to attend not only to the physical aspects of care but just as importantly the psychological and spiritual. Patients with their families and friends are supported by a team that includes nurses, doctors and volunteers.

Since 1986, the Burnaby Hospice Society has provided trained volunteers to offer emotional and practical support at home, in hospitals and in long term care facilities to those with life-threatening illnesses and their families. They also offer free grief counseling to family members.

On Sunday, May 1st, the Burnaby Hospice Society will be hosting the 2016 Hike for Hospice at Central Park to raise money for these services. The cost is $25/person (children under 12 are free). For more information, see their website at burnabyhospice.org.

Though we cannot predict how our lives will unfold, we can live with the end in mind. We can invest in our most important relationships with the gift of each day and each moment together. We can stop wasting our time, doing things that don’t matter, holding grudges or putting ourselves before others. In the end, what can we hold on to?

We can say what needs to be said. We can use each moment more mindfully. We can express all the love we have in our hearts because it’s only worth something when we give it away. We can’t take it with us.

Davidicus Wong is a family physician and his Healthwise columns appear regularly in the Burnaby Now, Vancouver Courier, Royal City Record and Richmond News.

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Nitobe Memorial Garden, UBC (Davidicus Wong)

Posted in Caregiving, Compassion, Coping with Loss, Forgiveness, Friendship, Letting Go, Love, Relationships | Tagged | Leave a comment

Your Heart: What Have You Done for It Lately?

IMG_3960We all play favourites.

We look at the attractive, we hang out with the most fun, and we take for granted the reliable and dependable in our lives that are always there day after day.

What is your favourite organ?

You may not choose two of the most important – your brain and heart, but the rest of you couldn’t survive without them.

With every beat, your heart keeps every cell of your body alive, pumping blood freshly oxygenated by your lungs. If your heart stopped pumping or an artery was blocked, you would suffer a stroke, blindness, organ failure or the loss of your legs.

So take a moment to think about your heart. What have you done for it lately?

You can increase your odds for a long and happy life by thinking about your heart as you should your most important relationships. Are you paying attention? Are you showing care each day? Are you working to make it great?

  1. Listening (for Trouble)

Sometimes, it’s obvious when something is wrong – irregular heart beats with lightheadedness; pain or pressure on exertion in your chest, throat or arms.

Sometimes the signs are subtle and mistaken for normal aging – or being married a long time: fatigue or exhaustion, feeling out of shape and short of breath, calf pain while walking, and decreased sexual function.

Before considering vitamins, Viagra or marriage counseling, see your doctor.

  1. How Do You Care for Your Heart?

The best predictor of your future health are (1) the health of your parents and (2) the habits you practice today.

If a parent or sibling had heart surgery, a heart attack or heart failure, you should ask your doctor to assess your personal risk factors, including high cholesterol, diabetes and high blood pressure.

Are you living a life that minimizes risks? Care for your heart by limiting salt, alcohol and a lazy, leisurely lifestyle. Don’t sacrifice long term health for short-term pleasure.

Enjoy the rewards of daily healthy living. Eat more fruits and vegetables and other foods that really make you feel good. If you can sit, stand. If you can stand, walk. If you can walk: run, swim or cycle.

Butt out, get outside and live.

  1. Make a Good Thing Great

Why settle for good enough when you can get great?

You don’t know what you’ve got ‘til it’s gone, and you don’t know great ‘til you’ve got it.

Your heart is another muscle you can train. Unless you’ve already been a world-class athlete, none of us knows what we can achieve.

When you’re fit and strong, everyday life is easier. You’ll have plenty of energy to shop, clean, mow the lawn, get out and dance. Everyday tasks – climbing a flight of stairs, lifting and moving – become effortless and fast.

For those with heart disease or its risk factors, Healthy Heart programs in your community can safely move you to your fittest state.

Be the best you can be today.

To learn more about “What You Should Know About Heart Disease”, come to my next free public lecture on behalf of the Burnaby Division of Family Practice’s Empowering Patients series. You’ll learn if you are at increased risk, practical tips to reduce your risks and how to maintain your best health in spite of heart disease.

I’ll be speaking on Wednesday, March 30th at 7 p.m. at the Alan Emmott Centre at 6650 Southoaks Crescent in South Burnaby. Register online with lcullen@divisionsbc.ca or call Leona at (604) 259-4450.

Davidicus Wong is a family physician and his Healthwise columns appear regularly in the Vancouver Courier, Burnaby Now, Royal City Record and Richmond News newspapers. 

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What do you know about heart failure?

Davidicus Wong's Black Bag

What do you know about heart failure?

If you’re like most people, not enough.

In fact, it is believed that most people who have heart failure are not even aware of it. It is estimated that 30% of those who have heart failure but are not aware of it will go on to develop full blown symptoms requiring urgent medical care within the next three years.

The overall one-year mortality rate (risk of dying) for patients diagnosed with heart failure is 30%. The risk is higher with those with three or more other chronic health conditions (up to 50%) and higher still in the elderly (up to 61%).

But patients who are informed and engaged in self-management in partnership with their family physicians have much better outcomes – slower disease progression and fewer hospitalizations.

Your heart is a muscular organ that acts as a pump. The right side of the heart receives blood returning from the body through veins and pumps this oxygen-depleted blood to the lungs. Oxygen-rich blood then returns to the left side of the heart which delivers it to the rest of the body (including the brain) through the arteries.

Congestive heart failure (CHF) is due to the decline in the pumping ability of the heart. This results in shortness of breath when blood backs up into the lungs, edema (or fluid retention) particularly in the legs and feet when blood backs up into the extremities, and fatigue because less blood is getting to the brain, muscles and organs.

The most common causes of heart failure are high blood pressure and atherosclerosis (narrowing of the arteries). Because the effects of these chronic conditions accumulate over time, the onset of symptoms is often gradual, unrecognized or mistaken for normal aging or deconditioning.

Other causes for heart failure include irregular heart rhythms, smoking, obesity, thyroid disease and excessive alcohol. Less common causes include disease of the heart muscle following viral infections, as side effects of medications (including some types of chemotherapy) or due to metabolic conditions such as hemochromatosis (iron overload).

In addition to the symptoms of fatigue, fluid retention and shortness of breath with physical activity, another classical symptom is shortness of breath when lying flat. In patients with worsening heart failure, blood fills the lungs unless they are sitting upright.

Several classes of medications have been shown to improve both the survival and quality of life in heart failure. These include beta blockers and ACE inhibitors. The condition requires close medical follow-up and regular monitoring.

Individuals with heart failure can maintain their health with diligent self-care and lifestyle management, monitoring their weight to pick up on fluid retention that may indicate a sudden worsening of their condition; limiting salt, alcohol and fluid intake, and maintaining regular appropriate exercise.

To learn more about “What You Should Know About Heart Disease”, come to my next free public lecture on behalf of the Burnaby Division of Family Practice’s Empowering Patients series. You’ll learn if you are at increased risk, practical tips to reduce your risks and how to maintain your best health in spite of heart disease.

I’ll be speaking on Wednesday, March 30th at 7 p.m. at the Alan Emmott Centre at 6650 Southoaks Crescent in South Burnaby. Register online with lcullen@divisionsbc.ca or call Leona at (604) 259-4450.

Posted in Burnaby Division of Family Practice, Empowering Healthcare, Exercise, Physical Activity, Preventive Health | Tagged , , | Leave a comment

Are you at risk for heart disease?

Tapestry Foundation, VanDusen Garden September 10th, 2015

Are you at risk for heart disease?

The simple answer is yes. We all are.

As we age, so do our blood vessels. With advancing years, plaque accumulates within the arteries that supply the heart muscle (causing angina and heart attacks), our brains (causing dementia and strokes) and our extremities (causing peripheral vascular disease).

If we are lucky enough not to die from accidents, cancer or dementia, by the time we are in our 80s, we are likely to die from a heart attack or stroke.

But some of us are at much higher risk for premature heart disease.

Most of the causes are modifiable – meaning we can reduce our risks through healthy living or medications. We can’t change our age, but we can slow down the aging process. We can’t choose our parents, but knowing family history can empower us to be proactive – to identify and modify our risk factors.

When we think about cardiovascular (heart and blood vessel) risk. The first place to start is with family history. We consider first degree relatives (parents and siblings), multiple generations and the ages at which they were diagnosed.

In general, premature heart disease is an event (such as a heart attack) in a male under 55 or a female under 65. Increased family risk may also be indicated by heart disease in each generation (e.g. your father, his mother and maternal aunts and uncles).

Some people think of family history with a sense of fatalism.

One patient, whose father and paternal uncles all died in their 40s, expected to die soon after his 40th birthday. It didn’t stop him from smoking.

But a strong family history is like a visit from Christmas Future. That might be your fate if you don’t make changes today. A family history of heart disease should encourage us to be proactive, identify the particular risk factors common in the family tree and treat them early.

Common hereditary conditions that predispose us to premature atherosclerosis (narrowing of the arteries) are high blood pressure, diabetes, high LDL cholesterol and low HDL cholesterol. All of these conditions can be identified early and when appropriately treated with healthy eating, appropriate monitoring and medications, we can reduce or eliminate the increased risk.

The more details you know about your family history the better. Some people only know that their parents had heart conditions. Heart disease might refer to several distinct conditions.

Angina refers to chest pain due to narrowed coronary arteries (These are the blood vessels that supply the muscle of the heart). If those arteries are narrowed, the individual may feel chest pain or pressure with exercise or stress, both of which raise the heart rate and make the heart muscle work harder. The pain is due to ischemia (insufficient blood flow).

A heart attack or a myocardial infarction is the result of a complete obstruction of a coronary artery. When no blood flows at all to an area of the heart muscle, the muscle dies and no longer functions. With a massive heart attack, an artery supplying a large area of cardiac muscle is blocked and the heart can no longer pump blood to the brain and the rest of the body.

Heart failure refers to a significant decline in the pumping function of the heart. When the heart is too weak to pump blood throughout the body, the individual feels short of breath and weak. When the pump is failing, blood backs up into the lungs and extremities, causing swelling of the feet and legs and chest congestion, especially when lying down.

Valvular heart disease refers to abnormalities of one or more of the valves (pulmonary, aortic, mitral or tricuspid) between the chambers of the heart. A valve can be narrowed (e.g. aortic stenosis) or leaky (e.g. mitral regurgitation). Valvular heart disease is associated with murmurs (sounds heard with the stethoscope due to turbulent blood flow). Patients may experience chest pain or shortness of breath.

To learn more about “What You Should Know About Heart Disease”, come to my next free public lecture on behalf of the Burnaby Division of Family Practice’s Empowering Patients series. You’ll learn if you are at increased risk, practical tips to reduce your risks and how to maintain your best health in spite of heart disease.

I’ll be speaking on Wednesday, March 30th at 7 p.m. at the Alan Emmott Centre at 6650 Southoaks Crescent in South Burnaby. Register online with lcullen@divisionsbc.ca or call Leona at (604) 259-4450.

Davidicus Wong is a family physician and his Healthwise columns appear regularly in the Burnaby Now, Vancouver Courier, Royal City Record and Richmond News.

Aneroid BP

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The magic of self-compassion

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St Stephen’s Basilica, Budapest, Hungary

Sometimes what we long for is right in front of us, and like Dorothy in the Wizard of Oz, we already have what we need.

Each day, I see patients searching for a solution to their suffering that can come as feelings of emptiness, anxiety, stress, low self-esteem or depression. They may expect that solution to come in the form of medication or counseling.

An example is the burnt out accountant or business owner, giving 100% of himself to his work, leaving nothing for friends, family or self. Another is the perfectionistic student, struggling to keep up with her extracurricular achievements and maintain an A+ average.

There are many unhappy in their own bodies, concerned about their weight or magnifying perceived imperfections. Some with wavy hair like it straight; those with straight hair want the waves. Some with big body parts want them smaller. Some with smaller body parts want them bigger.

When you look at those you love unconditionally – children, parents and friends, do you wish them to look different or “better” or to be anything other than who they are?

What we all need is self-compassion, an essential aspect of emotional wellbeing.

It’s not what we usually think about when we say self-love that most might associate with narcissism – a self-centred obsession with a superficial self.

Self-compassion is an extension of the authentic love we more freely give to others.

Through the habits of negative self-talk, guilt, perfectionism or self-neglect, we can become our own worse critics and fail to give ourselves the care we need.

Through the magic of self-compassion, our world becomes a better place – even if nothing else has changed. We struggle less. We are happier, less judgmental and more accepting of our selves and others. When we look in the mirror, we smile instead of furrowing our brows.

How can you nurture self-compassion?

Practice this lovingkindness meditation borrowed from Buddhism. Picture someone you care about, someone who makes you smile when you think of them – a child, parent or friend, and say in your mind, “May you be happy, healthy, peaceful and safe.”

You can nurture compassion for others, by imagining their faces and saying, “May you be happy, healthy, peaceful and safe.” Foster self-compassion by saying, “May I be happy, healthy, peaceful and safe.”

Be mindful of critical, judgmental thoughts towards others and yourself. One key to a happier marriage is to offer five honest positive comments for every negative one. Be a good partner to yourself.

A good parent ensures the children are well fed, exercise, play safe and get enough sleep, yet so many good parents don’t extend that care to themselves. Be a good parent to yourself – eat well, don’t skip meals, avoid recreational drugs and limit alcohol. Engage in daily exercise and get enough rest.

Being human, we are by nature imperfect yet we are still beautiful and worthy of love. Be kind to yourself, and may you be happy, healthy, peaceful and safe.

Davidicus Wong is a family physician and his Healthwise columns appear regularly in Burnaby Now, Vancouver Courier, Royal City Record and Richmond News. For more on achieving your positive potential in health, see his website at www.davidicuswong.wordpress.com.

Posted in Compassion, Forgiveness, Happiness, Letting Go, Love, Uncategorized | Tagged | 1 Comment

The gifts that give back

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7 Mantras (Davidicus Wong)

At one time or another, we all think about ourselves when we give to others.

That’s perfectly fine when your gift is a shared experience: a nice meal, a concert or a movie. You’re celebrating your relationship and saying “I love you so much that I want to enjoy some special time together.”

Some gifts are thinly veiled gifts to your self. Examples among spouses abound. Consider the husband who buys a big screen TV for his wife a week before Valentine’s so that they can enjoy watching the Super Bowl together. Have you ever received a gift that someone else uses more than you?

When I was 14, I gave my brother a record album that I liked myself. He immediately noted that I would be enjoying the music as much as he so I exchanged it for something he really liked (that I couldn’t use).

There are three virtues that I call “double blessing”: forgiveness, gratitude and generosity. They are two-way gifts – gifts that give back. They benefit the giver as well as the receiver. They strengthen our relationships, and they nourish our souls.

Forgiving

Shakespeare said it best in The Merchant of Venice:

The quality of mercy is not strained.

It droppeth as the gentle rain from heaven

Upon the place beneath; it is twice blest;

It blesseth him that gives and him that takes.

Sometimes we are loath to forgive someone who has hurt us. It is especially difficult if that person’s actions have caused great suffering, were done with ill intent and with no remorse.

To forgive may feel like you’re letting the other off the hook, giving something up or diminishing yourself, but what you give up and lighten may be a load that has been weighing you down and holding you back.

If you’ve travelled by plane recently, you’ve noticed that most passengers are maximizing their carry on luggage, stuffing them under seats and overhead. This makes for an even more uncomfortable flight for themselves and their neighbours.

We weigh ourselves down by carrying into each new day the baggage of our past: resentments, prejudices, insults and slights. They hold us back from stepping lightly, moving forward and welcoming new experiences.

Forgiveness isn’t so much letting someone else off the hook as it is unhooking you from the load you’ve been towing. You are the one who is freed.

Appreciation

I taught my children that two of the most important prayers are those of gratitude at the dawn of each day and at dusk. When we frame the day counting our blessings, we nurture both optimism and happiness. We greet a new day with a cup half full and go to bed, with a cup overflowing.

But we can do much more than just counting our blessings and acknowledging the gifts of the day. We can strengthen our relationships and spread happiness by thanking those who have helped us.

We all need to feel appreciated and to know that we make a difference to the people around us. If someone has touched you and made your life better, thank them. Don’t take anyone for granted. Don’t miss a day’s opportunities to express appreciation and to make a difference. All is fleeting.

Generosity

Each day you can see people in need, and you can help in ways big and small.

You don’t have to be rich to enrich your own day and make a positive difference. You can make someone’s day with an act of kindness, a sincere complement, a helping hand, encouragement and appreciation.

When we give freely and without expectation, we are nurturing our own capacity for unconditional love. We are each beneficiaries of kindness and love from many people throughout our lives: teachers, coaches, health care providers, family, friends and benevolent strangers. We cannot give back all that we’ve received, but we can give that love forward.

It is the greatest re-gift.

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