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COVID 19 Emotions empowering patients Self-care stress management

From Surviving to Thriving During the Pandemic: Managing Our Emotions and Stress

I recently gave a community webinar through Burnaby’s Primary Care Network.

I provided some practical strategies for managing the increased stress and difficult emotions we are all experiencing with all the changes of the Pandemic.

I also provided links to resources for the many of us who need more support.

Please share this information with anyone you know who may benefit.

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Burnaby Division of Family Practice Compassion Empowering Healthcare empowering patients Growth Love Positive Change Positive Potential Purpose Relationships Self-care Wisdom Your Calling

Your Positive Potential: Notes from my keynote for Inspiration Day

inspiration-day

Saturday, February 22nd, 2020 was Inspiration Day at Century House in New Westminster. Gracious members of the audience requested my speaking notes. Here they are.

I began with a brief introduction to my Empowering Patients public education program sponsored by the Burnaby Division of Family Practice. The purpose of my series of workshops, videos, posters and key points handouts is to provide everyone in our community with unbiased health and wellness information essential to live healthy, happy lives.

With respect to the things within your control, the best predictor of your future health are the habits you practice today.

Real healthcare is self-care as it is individuals – not professional healthcare providers – who provide over 90% of their healthcare.

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

These are all key topics of my Empowering Patients talks. The slides and handouts are available in addition to videos on the public website for the Burnaby Division of Family Practice. https://www.divisionsbc.ca/burnaby/for-patients/empowering-patients

Upcoming 2020 Health Talks

Everyone is welcome to attend these no-cost talks, however registration is required as space is limited.


March 12, 7:00 – 8:30 PM – ‘Emotional Wellness’
Brentwood Community Resource Centre, 2055 Rosser Avenue, Burnaby
CLICK HERE to register.


March 31, 7:00 – 8:30 PM‘The Positive Potential of our Relationships’
Bonsor Recreation Complex, 6550 Bonsor Avenue, Burnaby
CLICK HERE to register.


April 8, 7:00 – 8:30 PM ‘Healthy Eating’
McGill Public Library, 4595 Albert Street, Burnaby
CLICK HERE to register.


May 14, 6:00 – 6:45 PM – ‘Healthy Physical Activity’ & Walk With Your Doc
Confederation Seniors Centre (4585 Albert Street, Burnaby)
CLICK HERE to register.


For more information, check out all Empowering Patients materials.

THE POWER OF OUR STORIES

How we tell our stories affects how how we experience our lives.

HOW OUR STORIES CAN LIMIT US

The helplessness of the victim can feed anxiety.

If we can’t let go of anger, what we hold continues to harm us.

Remembering only loss and surrendering to hopelessness begets depression

With an attitude of entitlement, you will never be satisfied.

THE DEFAULT MODE NETWORK is the brain on autopilot creating stories. This typically happens when we are daydreaming, neither focussed on a specific task nor meditating. We can adopt unquestioned assumptions and core beliefs – many of them limiting beliefs, such as: “I have to be perfect to be loved.” “I can’t trust anyone.” “Life is unfair.” “I’m not good enough.” “I don’t deserve success, happiness or love.” “I am powerless.”

COGNITIVE BIASES are unconscious cognitive shortcuts with which we misinterpret reality. One such bias is the negativity bias. We notice more of what is wrong than what is right – with our partners, our situation and ourselves. To counter the negativity bias, we need to see (and hear) FIVE positives for every negative. This is a key principle for maintaining positivity in your most significant relationships and in creating a happy home for our children.

Actively see the positive in your life by the daily practice of gratitude. I start each day – before I even get out of bed, with a prayer of thankfulness for all the blessings in my life, beginning with the person lying next to me: my wife. This attitude primes the pump for noticing the positive aspects of all that I will see throughout the day. By days end, when I will reflect on the day with another prayer of thankfulness, my cup is overflowing.

I teach quality improvement to my physician colleagues to improve patient safety and health outcomes. When problems arise, we do a root cause analysis. This might include using the Five Whys. Ask at least 5 whys to get beyond the proximate or superficial causes of problems to get to the root cause.

I applied the Five Whys to every problem I could think of and found a single root cause for every problem in the world: a false sense of self.

We live with the illusion of separateness . . . and a life of competition.

There is the illusion of the Other . . . that engenders prejudice based on colour, gender, age, body shape, clothing, faith, language, accents and customs. The other may appear strange, different, less than, threatening or dangerous.

We went through an exercise in compassion to dissolve this false separation. I asked audience members to look at a person directly across the table from them. They were to look into each other’s eyes – not speak – but rather listen to these words. This person was once a baby, loves and held in the arms of parents . . .  just like you.

This person was once a child who laughed and cried, with big hopes and dreams . . . just like you.

This person has felt alone and sad, heartbroken and disappointed . . . just like you.

This person just wants to be happy . . . just like you.

This person needs to be loved . . . just like you.

The inescapable truth: you are not a separate, independent individual. You are a global citizen interdependent with every other person on this planet. Your wellbeing is dependent on the wellbeing of others.

We are all a part of a greater whole, members of a family, supported by a network of friends, neighbours and peers.

We are part of a community, citizens of this country and members of humankind, connected to all living things, a part of nature and this planet.

This is your true identity.

You belong here.

Another exercise to foster unconditional love. Imagine in front of you, one whom you love naturally and easily. Someone who always brings warmth to your heart and a smile to your face.

Say these words to them: May you be happy, healthy, peaceful and safe.

Now imagine someone you have had a disagreement with in the past week.

And say those same words: May you be happy, healthy, peaceful and safe.

The big problems of our society and the world will never be solved by people looking out for themselves. When we realize our interdependence and connection with the global community and all life on this planet, we will see the positive evolution of humanity and life on Earth.

It begins with us.

Together let us be the change we wish to see.

What is your story?

Engaging with Life and Coping with Change

The reality of change. Change is the nature of all things. It is our very nature. It is futile to pursue and cling to that which does not last. Nothing lasts.

We must appreciate what we have when we have it.

Every gift is not ours to hold forever. We must love and appreciate others while we can and let go when we need to. Accept what you cannot change. Accept responsibility to change what you can.

Be an Agent of Positive Change

Be dynamically response to change. Seek out the positive potential of each moment. Be responsive not reactive.

The Science of Neuroplasticity

Though our habits of thought and behaviour seem hardwired, with effort and repetition, we can transform our own minds. Donald Hebb, Canadian neuropsychologist said, “Neurons that fire together wire together.” this is how we can adapt to our changing world. You can retell your life story . . . and see beyond the illusion of a separate smaller self.

Evolving into Our Positive Potential

Discovering your potential in life. Your calling is the intersection of four circles: your passions, your talents, your values and the needs of the world.

Joseph Campbell said, “Follow your bliss.” When you listen to life and rise up to meet the challenge, you will find meaning and purpose.

Heed the call which may change at different stages of your life. There is a potivie potential to be realized in each day. We must see, feel and act.

We are all a part of the Love Cycle. In our lives, we receive love in many forms. We give it forward. The giving of love does not diminish us but connects us and makes us stronger.

At the end of each day . . . and at the end of this life, you don’t want to regret having not given enough or loved enough. The greatest tragedy in life is that we may die not knowing how much we were loved.

Life is lived fully by loving without limit, giving all you’ve got and holding nothing back.

We are all human and imperfect but still deserving of love, beautiful and able to love.

You ARE good enough.

You ARE worthy of love.

You DESERVE to be happy.

You are BEAUTIFUL just as you are.

You belong here.

We are all interconnected in the Cycle of Love. When we realize our interdependence and connection with the global community and all life on this planet, we will see the positive evolution of humanity and life on Earth.

It begins with us.

We are part of a greater whole.

We are all Agents of Positive Change.

You are greater than you think. We can make a difference.

Together let us be the change we wish to see.

Dr. Davidicus Wong is a physician and writer. 

Tapestry Talk

Categories
Burnaby Division of Family Practice Emotions Empowering Healthcare empowering patients Healthy Living patient-doctor relationship Physical Activity Positive Change Positive Potential Preventive Health Screening Tests Self-care stress management

Free Public Health Talks for 2020: The Empowering Patients Program

Tapestry Talk

The Empowering Patients Free Public Talks for 2020

with Dr. Davidicus Wong

 

  • Monday, February 3rd, 2020 The Keys to Positive Change
    • Tommy Douglas Library in the Edmonds neighbourhood

 

  • Monday, February 24th, 2020  The Patient-Doctor Relationship
    • Bob Prittie Library in Metrotown

 

  • Thursday, March 12th, 2020  Emotional Wellbeing
    • Brentwood Community Resource Centre, 2055 Rosser Avenue

 

  • Wednesday, April 8th, 2020  Healthy Eating
    • McGill Library in North Burnaby)

 

  • To be scheduled: Healthy Relationships and Healthy Physical Activity

 

To register online lcullen@divisionsbc.ca or call (604) 259 4450

For more information about our Empowering Patients Public Health Education Program, please see the Burnaby Division of Family Practice’s website divisionsbc.ca/burnaby or Dr Davidicus Wong’s website https://davidicuswong.wordpress.com

inspiration-day

Categories
Christmas empowering patients Healthy Living Physical Activity Relationships

Four Ways to Give

Dr. Pooh & Tigger

 

The perfect gift is the one most needed.

This season, consider four gifts that we often take for granted.

Mobility and Physical Independence

Unable to stand or walk without crutches, I’ve been dependent on my family these past two weeks. Almost everything takes twice as long: getting out of bed and to the washroom, showering, dressing, preparing meals and simply negotiating stairs.

I have even greater empathy for my elderly patients – and those with back and limb disabilities – for whom getting up from a chair and onto an exam table is a precarious effort. At any time, a fall is possible.

Many of our elderly are at high risk for falls at home and would benefit from a homecare assessment from a registered nurse, physiotherapist or occupational therapist. Many would qualify for Handidart – a transportation service for the disabled who are unable to use regular transit services – and handicapped parking.

One in three seniors (over 65) has had one fall in the past year, and the effects of a fall can be devastating for the frail. 95% of hip fractures are caused by falls. Vancouver’s falls prevention clinic is at VGH. If you or someone you know is at risk for falls, you can contact the clinic at fallsclinic.ca. Fraser Health has a mobile clinic that moves from city to city (but not directly to your home). To find out more, call (604) 587-7866 or e-mail fallsprevention@fraserhealth.ca.

Be patient with older adults and others who are limited in their independence. Give them time and space to get on elevators or escalators. Take the time to hold doors or to lend a hand. A small gesture of kindness from the able-bodied can make a difference.

Food

Though many of us will be feasting during the holiday season and resolving to lose weight in the New Year, the cost of food is rising. Many of your neighbours are struggling to get enough nutrition.

The Canada Food Price Report recently released from Dalhousie University and the University of Guelph predicts that in 2020, the average Canadian family will spend $487 more on food than in 2019.

With rising housing costs, some families can’t afford their daily meals.

Though food banks may get more food donations during the holiday season, the need is present all year long. There are food banks open throughout Greater Vancouver on most days of the week. The schedule is available at foodbank.bc.ca.

Consider making a cash donation. This requires less work for the volunteers, allows the food bank to take advantage of bulk buying and may ensure a better supply of all the essentials.

A Safe Home

I’m not able to drive at the moment, but I feel lucky to have a car.

Because of the disproportionate cost of housing, I know of many for whom their vehicle has taken the place of their home. One of my patients, though working, cannot afford to rent and sleeps in his car each night.

For those without nearby family, the loss of a job can herald homelessness. It can happen to almost any of us.

Consider a donation this year to the Society to End Homelessness in Burnaby (burnabyhomeless.org) or the Progressive Housing Society that won the Burnaby Board of Trade’s Best Non-Profit Award for 2019.

Burnaby has three warming centres that are open from 8 pm to 8 am from November 15th to March 30th. They provide overnight shelter, hot beverages and snacks for the vulnerable in our community. They are located at the Kensington Pitch and Putt, Swangard Stadium and 5970 Beresford Street.

To find a warming centre in Vancouver, call 211.

Donations of blankets, socks and warm clothing are welcomed.

Family and Friends

Though some social gatherings may seem an obligation, consider the many among us who do not have family and friends with whom to celebrate. Newcomers and the elderly living alone can be socially isolated in our big cities.

Neighbourhood houses have been created to fill the need for social support and connections. Burnaby has two neighbourhood houses: 4908 Hastings Street in North Burnaby and 4460 Beresford Street in the Metrotown. For more information: burnabynh.ca.

There are six Neighbourhood Houses in Vancouver. For more information: anhbc.org.

I wish all our readers a safe, happy and healthy holiday season.

Whistler view

Dr Davidicus Wong is a family physician. His Healthwise column appears in the Vancouver Courier 

Categories
Burnaby Division of Family Practice Empowering Healthcare empowering patients patient-doctor relationship

The Patient-Doctor Relationship in Family Practice

EP pt-dr relationship poster

In the office of my family practice, hidden from the view of patients, is a sign along the edge of the counter for my staff to see each day. “Treat every patient like family.”

It’s at the heart of our daily work: to give every individual the care and consideration we would want for a best friend or family member.

If you’re seeing unfamiliar healthcare providers and worry that they may have rushed to the wrong diagnosis, ask two questions. What else could it be? What’s the worse thing it could be?

This may open clinical minds prematurely closed with the pressure of time.

If you’re not sure about the management of your concern, ask, “What would you recommend to your mother (brother or child)?”

This might remind the healthcare provider what should be obvious – that you are a precious individual – someone else’s best friend and loved one.

I remember the moment I knew I wanted to be a doctor.

I was in grade 6 and hospitalized for a painful flare up of rheumatoid arthritis. On the pediatric ward of Burnaby Hospital, I felt that the caring nurses and doctors were treating me as a whole person and not just my condition, and I knew I wanted to do this work when I grew up.

The doctors seemed to have the easier job and it seemed that everything the doctors ever told me I had already read about in my family’s medical encyclopedia. That’s how I chose medicine.

I chose family practice though I considered paediatrics, obstetrics and psychiatry.

Family practice is a unique specialty. We don’t treat particular diseases or organ systems for a limited period of time. Rather we treat the whole person over many years. The family doctor sees the medical condition only in the context of the rest of the individual’s life including their important relationships.

I expected it to be a more satisfying calling, nurturing my relationship with each patient over time while working together in attending to that individual’s wellbeing. Guiding and advocating for my patients through health, illness, the ups and downs of their personal lives, we earn trust and confidence over many years.

I spend many hours each week counselling my patients through the challenging times in their lives. My clinic and sleep schedules are still interrupted by the delivery of babies. It is gratifying guiding patients I have known for years through the most exciting times in their lives: pregnancy, childbirth and the adventure of parenthood.

Family doctors specialize in the care of you, the whole person in the context of your life and relationships over a lifetime.

At 7 pm on Monday, April 29th, I’ll be presenting, “The Patient-Doctor Relationship: Getting the Most Out of Every Visit” at the Bob Prittie (Edmonds) Branch of the Burnaby Public Library. This free talk is part of the Burnaby Division of Family Practice’s Empowering Patients public health education series. I’ll discuss tips on how to work with your doctor to achieve your goals, the key information you need to know about every prescription, test and treatment, what you should know about your medical history, and the key screening tests adults should have at different ages. As space is limited, please register online bpl.bc.ca, at any BPL information desk or by phoning 604-436-5400.

Dr. Davidicus Wong is a family physician. His Healthwise Column appears regularly in this paper. For more on achieving your positive potential in life, read his blog at davidicuswong.wordpress.com.

Categories
Burnaby Division of Family Practice Compassion Empowering Healthcare empowering patients Friendship Healthy Living Relationships

The Root Cause of the Problems of the World: A Limited Sense of Self

Tapestry Talk

What might be the root cause of the great problems of the world: poverty, homelessness, crime, violence, war, racism, discrimination, hunger and global climate change?

I contend that it is a case of mistaken identity: a false sense of self.

We each see ourselves as separate individuals – single selves distinct from other human beings, our neighbours, nature and the world. And with this illusion, we seek first what is best for our selves.

Even in our most significant relationships, discord arises with our differing views and competing needs; love and good will can be displaced by anger and resentment.

From the vantage of our separate selves, we create the illusion of the Other.

We can judge others in an instant, emphasizing differences (gender, age, body shape, colour, ethnicity and accent) with which we categorize them into groups of others.

They are then seen as competitors, enemies or threats whom we regard with fear, anger and hatred. Often we simply ignore them and treat their unmet needs and rights with apathy.

These attitudes widen the gulf between us and ultimately contribute to the problems of the world.

How can we close this gap and create a more cohesive community?

  1. We must first recognize that every human being has a personal story but also the same fundamental needs as you. We all need food, clothing, freedom, education, safe housing, meaningful activity and a sense of belonging.

We each share the same range of emotions. We all have our dreams and goals. We have all experienced disappointment, loss and heartache. We all want to be happy.

Only by seeing beyond our personal prejudices and recognizing the three-dimensional human being behind outward appearances can we foster empathy and care.

  1. We must recognize our shared connection and interdependency. None of us can survive without others. We take for granted public education, healthcare, safe streets and neighbourhoods. These are the products of the ongoing planning and work of countless individuals working for the greater good. Consider all the people who have contributed to you having food on your table – from farms to processing plants to warehouses and to stores.
  2. We must identify our shared challenges and not blame others as the enemy or the scapegoat. The problems in our community, including homelessness, hunger, injustice and crime, can only be solved with our collective creativity and collaboration.
  3. We can then begin building and strengthening our personal and social connections. This requires the support of our institutions, including our government, but it begins with each of us.

Where is the need? Who among us feels alone and needs help? What can we do together?

What is a stranger? Someone you don’t yet know.

When you are irritated by the lineups and crowds in the shopping mall or the traffic on our roads, ask yourself “What is a crowd?” and “What is traffic?” Lots of people just like you. You are part of the crowd and traffic.

When you ask “What is the world coming to?”, ask “What is the world?” You are. We are the world.

You are not just an individual. You are an integral part of a greater whole – a partnership and a family, a network of friends and a community, a part of humanity, nature and the world.

On Thursday, December 6th, 2018, I’ll be giving a free talk at the Bonsor Recreation Centre in Burnaby from 7 to 8:30 pm. The topic: The Positive Potential of Your Relationships. I’ll discuss how healthy relationship and social connections are essential to your happiness and wellbeing; the qualities of healthy relationships; recognizing and managing challenges, and how we can foster a greater sense of belonging and connectedness in our community. It’s part of the Burnaby Division of Family Practice’s Empowering Patients health education program. To register, email Leona at lcullen@divisionsbc.caor call (604) 259-4450.

 

 

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Burnaby Division of Family Practice Empowering Healthcare empowering patients Healthy Living Positive Potential Preventive Health Relationships

Your Health Depends on Your Relationships

 

Burnaby WWYD 1

What determines your health and happiness?

We know that it is much more than timely access to a good healthcare system. In the 2009 report of the Senate Subcommittee on Public Health, only 25 per cent of the health of the population was attributable to the health care system, 15 per cent was due to individual biology (i.e. genetics) and 10 per cent to environmental.

The remaining 50 per cent was due to a variety of social determinants, including poverty, work conditions, housing, diet and community factors.

One of the key determinants of physical and emotional health – and therefore, happiness itself – is our sense of belonging – our connection with our community.

Among the interesting findings of the 2013 My Health My Community survey were the responses to two questions addressing social connectedness. Only 45% of residents in metropolitan Vancouver had four or more people to confide in; 6% of residents had no one. Only 56% of metropolitan Vancouver residents felt a strong sense of community belonging. Not surprisingly, recent immigrants had lower rates of community belonging.

What can we do to nurture our social connections at a personal and community level and improve both our personal health and happiness and that of everyone in our community?

On an individual level, we could make our relationships a priority. Of course, at the end of every life, it is our relationships that were primal. Yet we all tend to take our most important relationships for granted.

Without daily care and attention, we can fall into conflict, become distant and neglect our most important partners in health and wellbeing. We spend more time and attention invested in work, school, personal goals and entertainment; they can take over our daily lives, leaving little for what and who matters most.

We must prioritize time each week and every day for the people in our lives. We must nurture positive interactions to offset our human brains’ natural negativity bias.

As neuropsychologist, Rick Hanson has said, our minds are Velcro for the bad and Teflon for the good. We hear criticisms and demands from others more loudly than affection and appreciation.

Your child, friend and partner need to hear five positive comments to balance out one negative just to come out even.

We need real – not electronic – face time with one another. Our lasting happiness has nothing to do with experiencing transient pleasures and acquiring more material things. Happiness can only be enjoyed in the moments we are fully present, connected with our lives and the people that are an integral part of it.

You are not just an individual. You are part of a greater whole – a partnership and a family, a network of friends and a community, a part of humanity, nature and the world.

We can help others feel more connected in our community by getting to know our neighbours, recognizing what we have in common and offering assistance when and where it is needed.

As a community – at work or school, in our neighbourhoods, and in our church and social groups – what are we doing and what can we do to reach out and connect with others? We are all a part of a greater whole, and we each play a role in the health and wellbeing of our community.

On Thursday, December 6th, 2018, I’ll be giving a free talk at the Bonsor Recreation Centre in Burnaby from 7 to 8:30 pm. The topic: The Positive Potential of Your Relationships. I’ll discuss how healthy relationship and social connections are essential to your happiness and wellbeing; the qualities of healthy relationships; recognizing and managing challenges, and how we can foster a sense of belonging and connectedness in our community. It’s part of the Burnaby Division of Family Practice’s Empowering Patients health education program. To register, email Leona at lcullen@divisionsbc.caor call (604) 259-4450.

IMG_7694

Categories
Empowering Healthcare empowering patients Healthy Living

What You Should Know About Diabetes

Are you at risk?

Risk factors for diabetes:

  1. Family history of diabetes
  2. A personal history of diabetes in pregnancy, polycystic ovary syndrome or metabolic syndrome
  3. Aboriginal, Hispanic, South Asian, East Asian or African descent
  4. Overweight
  5. Sedentary
  6. High Blood Pressure, High Cholesterol
  7. Over 40 years of age

If you think you might be at risk, ask your doctor or take the Canadian Diabetes Risk Questionnaire (CANRISK)

http://www.diabetes.ca/take-the-test

When to test for diabetes (CDA guidelines)

Screen every 3 years in individuals over 40 years of age or at high risk using a risk calculator (e.g. CANRISK)

How do you screen for diabetes?

  1. Hemoglobin a1cover 6.5%
  2. Fasting glucoseover 7.0 mmol/L
  3. 75 gm 2 hour glucose tolerance testwith a fasting glucose over 7.0 mmol/L or

2hr glucose over 11.1 mmol/L

Know your numbers – What everyone with diabetes needs to know about their lab tests

  1. Hemoglobin a1c:reflects your average glucose level over the past 2 to 3 months; does not require fasting; not equivalent to glucose levels in mmol/L; Goal: less than 7.0% which generally corresponds to blood sugars under 7.0 mmol/L before breakfast, lunch & dinner AND under 10.0 mmol/L 2 hours after meals.
  2. LDL cholesterol: the “bad” cholesterol correlated with plaque clogging arteries;

Goal: under 2.0 mmol/L

  1. HDL cholesterol:the “good” cholesterol; reduces plaque in arteries; raised by eating fish and exercising; Goal: over 0.9 mmol/L for men and over 1.1 mmol/L for women
  2. Total cholesterol/HDL ratio:a measure cardiovascular risk; Goal: less than 4.0 mmol/L
  3. Microalbumin:a test for small amounts of protein in the urine; associated with potential early kidney disease; Goal: ACR under 2.0
  4. Blood pressure:a separate risk factor for vascular disease; Goal: under 130/80
  5. Estimated GFR:a blood test ordered as “creatinine”; a measure of kidney function; Normal: over 60

What physical examinations are important for people with diabetes?

  1. Complete Physical Examination

At least every 2 years to detect early complications

  1. Foot Examination by a Physician

Every year to check for damage to nerve sensation or circulation

Check your own feet every day for sores, injuries or infections.

  1. Eye Examination by an Optometrist or Ophthalmologist

Every 1 to 2 years to assess the retinal blood vessels 

What and how to eat for diabetes

  1. Don’t skip breakfast or eat one big meal at night!Frequent, smaller meals keep glucose levels more even.
  2. Healthy portion sizes.

Half the plate:Vegetables

¼ plate:starches (rice, potatoes, pasta)

¼ plate:lean meat, beans and other protein sources

One portion of fruit:e.g. one apple, ½ cup of berries

Avoid sugar-containing drinks

  1. Attend to the Glycemic Index (GI) a measure of the ability of a food to raise your blood sugar. Consume foods with a low GI in preference to those with a high GI

The GLYCEMIC INDEX (GI)

Low GI Foods to choose most often:

100% stone ground whole wheat

All Bran, Bran Buds

pasta, noodles

parbroiled or converted rice

sweet potato, yam, legumes

Medium GI Foods to choose more often:

whole wheat, rye, pita bread

oatmeal

couscous, brown & basmati rice

popcorn, green pea soup

 High GI Foods to choose less often:

white bread, kaiser roll, white bagel

bran flakes, corn flakes

white rice

russet potato

pretzels, french fries

soda crackers, rice cakes

(Source: The Canadian Diabetes Association) 

For more information read Rick Gallop’s book, The GI Dietor see the Canadian Diabetes Association’s website http://www.diabetes.ca/diabetes-and-you/healthy-living-resources/diet-nutrition/the-glycemic-index

 

The importance of PHYSICAL ACTIVITY

Some physical activity (such as walking or housework) after each meal will reduce after meal blood sugars

Guideline recommendation: 150 minutes of exercise/week or 30 minutes/day.

 

The Four Foundations of Self-Care

  1. What you eat(What you put into your body).
  2. What you do(physical activity and rest).
  3. How you feel(emotional wellbeing).
  4. How you connect(healthy relationships). 

Keys to Achieving Your Goals

  1. Choose wisely.A goal that matters to you.
  2. Visualize yourself having achieve your goal.Reprogram your subconscious and prime the pump for success.
  3. Break it down from supersized to manageable morsels.You’ll gain confidence with early successes.
  4. Write down the details
  5. Anticipate and prepare for roadblocks.
  6. Enlist support. Choose a coach or a teammate – your partner, friend or neighbour. Consult your family doctor.

Create the SMARTEST Goals for Yourself

Be Specific.What are you going to do? Eat more fruit and vegetables? Where and by when?

Measurable.How many fresh fruit/day? One salad every day? Two glasses of skim milk each day?

Achievable.Set realistic goals that are do-able.

Relevant.The goal has to be important to you and your health.

Time-specific.What day will you start, and when will you finish?

Evaluate.How did you do? What did you learn?

Stepping Forward. What will you do next? What will you do differently?

Together.Who will work with you next? Who will you share with?

 

Your Positive Potential

I believe that we each have a unique potential in life, and it is our duty to realize that potential and help others achieve theirs.

With knowledge, engagement and support, we can manage chronic health conditions and lives well.

Dr. Davidicus Wong is a physician in Vancouver, British Columbia, Canada.

Categories
Burnaby Division of Family Practice Empowering Healthcare empowering patients patient-doctor relationship

The Patient-Doctor Relationship: Making the Most of Every Medical Visit

Prepare for your medical visit by:

(1) making a list of your concerns,

(2) sharing it with the staff when you call for an appointment,

(3) briefly reviewing that listat the beginningof your visit with your doctor and

(4) bring a pen and paper to write down the things you wish to remember.

 

The 4 things you should know about every medication, treatment or investigation a doctor recommends:

  1. Indication (What is it for?)
  2. What are the common risks(or side effects)?
  3. What are the major risks (or side effects)?
  4. What are the alternatives?

 

The key details you need for every drug:

  1. Indication (What is it for?)
  2. Potential Interactions (with food or other drugs)
  3. Brandname& generic name
  4. Dose (e.g. mg) and frequency (e.g. twice daily)

 

5 things you should know about your Medical History:

  1. Allergies
  2. Family History
  3. Hospitalizations, Major Illnesses, Operations
  4. Chronic Medical Conditions
  5. Medications

 

KEYS TO ACHIEVING YOUR GOALS

  1. Choose wisely.Make it a goal that matters to you.
  2. Visualize yourself having achieved your goal.Use the power of attraction to reprogram your subconscious mind and prime the pump for success.
  3. Break it down.Turn that daunting supersized goal into manageable morsels. Gain confidence with early success and progressive achievement.
  4. Write down the details.

 

SMART goals are:

Specific.What are you going to do? Cycle, swim or run? Where will you do it? When will you do it?

Measurable.How many minutes? What distance? How fast?

Achievable.Realistic goals that are do-able for you.

Relevant.The goal has to be important to you and your health.

Time-specific.What day will you start the change? When will you finish?

  1. Anticipate and prepare for roadblocks.
  2. Enlist support.Consult your family doctor, choose a coach you’ll answer to, or get a friend to join you.

Dr. Davidicus Wong is a physician in Vancouver, B.C., Canada. 

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Burnaby Division of Family Practice Empowering Healthcare empowering patients patient-doctor relationship

What You Should Know About Medical Ethics

Medical Ethics or Bioethics is the application of ethical principles to healthcare

Dilemmas arise when these principles conflict.

A treatment is considered appropriate if the potential benefits outweigh the potential burdens or harm.

Life support (e.g. CPR, artificial feeding and ventilation) is appropriate if it provides an acceptable quality of life (as judged from the patient’s perspective).

Why Ethics Matters

Medical ethics is the foundation of medicine and applies every time you interact with a healthcare provider.

Our tests and treatments are merely tools. Ethics guides us in their appropriate use.

The Principles of Bioethics

  1. Nonmaleficence: The first rule of medicine: “Above all else, do no harm.”
  2. Beneficence:Do good. The primary goal of medicine is to help the individual patient.
  3. Autonomy:The right of the capable individual to direct his or her own healthcare. Informed consent is an essential aspect of autonomy.
  4. Justice:Be fair. Treat like cases alike.
  5. Confidentiality:Respecting personal information

When Confidentiality Can Be Breached

Duty to Protect: When you pose a serious threat to others

Duty to Report: unsafe drivers, child protection, certain sexually transmitted infections

Court Order

Minors and others who rely on others to provide consent

What has access to your records?

  1. Your physician’s professional staff
  2. Other healthcare providers involved in your care (your hospital team, specialists to whom you are referred)
  3. 3rdparties (insurance companies, lawyers) with your written consent (or by court order)

Informed Consent requires:

  1. Sufficient information about the benefits, risks and alternatives of a test, procedure or drug before you can choose or refuse it.
  2. An individual capable of understanding the situation and the available options and able to make and communicate a decision.

 Preventive Bioethics

With proactive reflection and discussion, future ethical dilemmas may be avoided.

  1. Anticipate the future when you may be incapable of medical decision-making and suffering from serious illness.
  2. Understand the benefits and burdens of CPR, artificial feeding and artificial ventilation.
  3. Consider what gives your life meaning and what constitutes a good quality of life.
  4. Communicate your values and your wishes while you can. Ensure your family knows what you would want.

 An Advance Directive is a statement of what kind of medical care you would want in the event that you are unable to make your own decisions.

What procedures do you want?

What procedures do you refuse?

Under what conditions?

Who do you choose to make decisions for you?

e.g. You may not wish to have CPR (chest compressions, assisted breathing, a tube down your throat, electric paddles on the chest) if you had an irreversible, terminal condition with no hope for a return to an acceptable quality of life (by your standards).

You may not wish to be kept alive on machines if you were in a persistent coma with no hope of recovery.

For more information: google “My Voice”

Click to access MyVoice-AdvanceCarePlanningGuide.pdf

Dr. Davidicus Wong is a physician in Vancouver, B.C., Canada. Please note that this article related to Western medical ethics. Healthcare providers in other countries may not follow the same principles or interpret them in the same way and laws regarding access to your medical records and who can make decisions on your behalf may vary in different countries and states.