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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

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Burnaby Division of Family Practice Empowering Healthcare Healthy Living Preventive Health Screening Tests Self-care

What you need to know about high blood pressure

Aneroid BP

On Monday, August 21st at 7 pm, I’m presenting “What You Need to Know About High Blood Pressure” at the Tommy Douglas Metrotown Library in Burnaby. This free presentation is sponsored by the Burnaby Division of Family Practice and the Burnaby Public Library. Because seating is limited, please register by phone at 604-436-5400, in person at any branch or online at http:// http://bpl.bc.ca/events/what-you-should-know-about-high-blood-pressure-0

Do you have high blood pressure?

If you’re an adult, you have a one in five chance, and your lifetime risk for developing hypertension is 90%. Your risk may be even higher if you have a family history of high blood pressure, heart disease, kidney failure or strokes.

Blood pressure is the measurement of the pressure of blood inside your blood vessels, specifically, the brachial artery of the upper arm. A normal blood pressure of 120/80 (“120 over 80”) represents a systolic pressure of 120 mm Hg (when the heart contracts) and a diastolic pressure of 80 (when the heart relaxes).

But blood pressure is more than just a number.

High blood pressure damages the delicate inner walls of arteries throughout the body, including the kidneys, brain, heart, eyes and extremities. Over time, it contributes to atherosclerosis (narrowing of arteries), manifested as progressive kidney failure, loss of circulation to your feet and legs, dementia, loss of vision, erectile dysfunction, heart failure (weakness in the pumping of the heart) and angina (chest pain due to impaired circulation to the heart muscle).

The catastrophic end results are premature heart attacks, strokes, blindness, kidney failure requiring dialysis, amputations of toes and feet, aneurysms (the expansion and rupture of blood vessels in the chest, abdomen or brain) and end stage heart failure.

Unless you have it measured, you won’t know your blood pressure. Most people with high blood pressure feel perfectly fine. That’s why it’s recommended that all adults have their blood pressure measured “at appropriate medical visits.” I recommend at least once a year.

High blood pressure may be caused by medical conditions such as kidney disease or an overactive thyroid, by medications including ibuprofen or an unhealthy lifestyle; however, 95% of people with high blood pressure have essential hypertension that is often genetic. Blood pressure also increases with age.

White coat syndrome is a real condition wherein a person’s blood pressure is much higher when taken by a doctor or nurse than at home. For this reason, many clinics now rely on automated office blood pressure machines. The operator sets it up, leaves the room and allows the machine to take three measurements. I ask my patients to measure and record their home blood pressures with a reliable machine (that we compare to our office equipment).

If blood pressure is never high at home or work, we don’t prescribe medications. However, some people have significant rises in their blood pressures with stressful situations, including their work. If the blood pressure is high at least 8 hours/day (i.e. at work) in addition to the medical clinic, it should be treated.

I coined the term “White Collar Syndrome” when I discovered that my patient – an accountant – had the highest pressures when he was at work.

As a physician, I want my patients to maintain safe blood pressure levels and avoid long-term complications. Medications have a potent effect in lowering blood pressure but they are not addictive and don’t make the body dependent any more than before they are started.

I have many patients who have been able to reduce the doses and numbers of medications they take through major lifestyle changes. Some now have normal blood pressures without any drugs.

These potent lifestyle changes include quitting smoking, limiting or stopping alcohol, increased physical activity, weight loss (if overweight), eating more fruits and vegetables and less red meat, and limiting sodium (salt) in the diet.

On Monday, August 21st at 7 pm, I’m presenting “What You Need to Know About High Blood Pressure” at the Tommy Douglas Metrotown Library in Burnaby. This free presentation is sponsored by the Burnaby Division of Family Practice and the Burnaby Public Library. Because seating is limited, please register by phone at 604-436-5400, in person at any branch or online at http:// http://bpl.bc.ca/events/what-you-should-know-about-high-blood-pressure-0

Dr. Davidicus Wong is a family physician. To learn more about upcoming health education events, see the BDFP website at divisionsbc.ca/burnaby.

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Burnaby Division of Family Practice Empowering Healthcare Happiness Healthy Living Medical Ethics patient-doctor relationship Preventive Health Screening Tests Self-care

Empowering Patients with Knowledge

The Future of Family Practice.jpg

When you think about the work of your family physician, you probably envision the one-on-one care he or she gives to each individual patient. It may be a clinic, hospital or – more rarely – home visit.

That still remains the priority of virtually every family physician: the wellbeing of every patient in his or her practice, but you might be surprised to hear that the circle of care is expanding. More physicians in our community care about the health of the entire community.

The Burnaby Division of Family Practice is a non-profit organization founded in 2011 and funded by the General Practices Services Committee. Its members are the family physicians who serve our community.

With the other founding board members, I wrote our organization’s vision and mission statements. Our vision for the Burnaby community: patients and physicians achieving health and happiness. Our mission: to engage, support and mobilize family physicians in co-creating a network that will support the wellbeing of all members of the Burnaby community.

Although I’ve recently stepped down from the board of directors, I continue to lead the Burnaby Division’s Empowering Patients public health education program. Recognizing that the public receives confusing and often incorrect medical information from the media, we sought to provide unbiased information

Our vision is that by raising general health literacy (public knowledge about healthy living and how best to use the healthcare system), we can improve the health of our community. We may be able to reduce the burden of chronic disease in the future.

Since we started the public education program in October 2014, we’ve delivered 11 public presentations in our community’s libraries, schools and community centres. The topics have included healthy eating, healthy relationships, emotional wellness, healthy physical activity, patient-doctor communication, making the most of your hospital stay, medical ethics and common chronic health conditions, such as diabetes.

Summaries of each of these presentations is available on the Burnaby Division of Family Practice’s website https://www.divisionsbc.ca/burnaby/empoweringpatients. There you will also find the dates for future talks in the series and links to our videos on emotional wellbeing, making the most of a hospital stay and important symptoms for which you should seek medical care.

I’ll be speaking on “Making Sense of Symptoms and Screening Tests” at 7 pm on Tuesday, December 8th at the McGill Library on 4595 Albert Street in North Burnaby. Growing up in North Burnaby, this was my “home library” close to the Eileen Dailly Pool and the Confederation Community Centre. I’ll go over the “review of systems”, the questions that physicians include in a complete physical examination. Because no one gets routine physicals anymore, most people are never asked these questions about the symptoms that may indicate important medical conditions.

When patients receive episodic care at drop-in clinics, they may not be aware of what tests they should be having and when. For this reason, I’ll also review the key screening tests that are recommended at different ages.

To register for this free talk, please contact the McGill library at (604) 299-8955 or http://www.bpl.bc.ca/events

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Burnaby Division of Family Practice Empowering Healthcare Healthy Living Screening Tests Self-care

What you need to know about diabetes

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November is Diabetes Awareness Month. So raise your awareness of this common condition by correcting these five common myths.

Myth #1: I don’t need to worry about diabetes.

Diabetes is a very common condition. The prevalence of diabetes in adults over age 20 is 1 in 11, and the incidence of diabetes is expected to increase as the population ages, becomes less active and more obese.

There’s a good chance that you – or someone that you care about – will develop diabetes. That’s why we all need to know more about it.

Myth #2: Diabetes is all about sugar.

Diabetes is a problem with metabolism – how your body converts food into energy. Because glucose is a source of energy for every cell in the body, diabetes has potential effects on multiple organ systems, including the nervous and circulatory systems.

Poorly controlled diabetes is a major cause of heart attacks, strokes, kidney failure, amputations and blindness. A person who has had diabetes for several years is considered by physicians to have the same risk of a heart attack as someone who has established vascular disease.

Poorly controlled diabetes is a common cause of erectile dysfunction. More bad news: Viagra doesn’t work as well for people with diabetes.

Myth #3: Diabetes is caused by being overweight or eating too much sugar.

There are two types of diabetes. Type I is insulin-dependent. For some reason, usually related to the immune system, the pancreas no longer produces sufficient insulin. Therefore, type I diabetes requires insulin injections or infusions.

90% of diabetes is type II or insulin-resistant. This is commonly a hereditary condition. You might inherit a tendency for diabetes from your mother or father. As you grow older or gain weight, your cells may become more resistant to the effects of your body’s own insulin. You become glucose intolerant, and carbohydrates, such as rice, pasta and potatoes cause a greater rise in your blood sugars than they normally should.

Not everyone who is overweight or drinks a lot of pop will develop diabetes, but if you have the genes for type II diabetes, gaining weight, getting older and consuming excessive sugar will allow diabetes to manifest.

Myth #4: All diabetics have to take insulin and check their blood sugars many times each day.

People with type I diabetes – because they do not produce enough natural insulin – are dependent on insulin injections or infusions. They have to monitor their blood sugars regularly throughout the day to keep their glucose levels in a safe range.

Most people with type II diabetes do not require insulin with the onset of their condition so they usually do not have the same need for multiple daily glucose testing. There are a variety of oral medications to control type II diabetes. Two essentials are regular exercise and smaller, more frequent meals with low glycemic index foods (carbohydrates that do not cause a sharp rise in blood sugars).

If blood sugars continue to rise with type II diabetes, insulin may be needed.

Myth #5: Everyone with diabetes will get complications.

With the careful management of diabetes, most of the complications of diabetes can be avoided. This requires optimal self-management in which individuals are given the support and education they need to be effective managers of their own health.

In addition to blood sugars, we monitor and manage blood pressure, cholesterol levels, changes in the eyes and kidney function.

I’ll be giving a public presentation on “What You Should Know About Diabetes” at the Bonsor Recreation Complex at 7 pm on Wednesday, November 25th. You’ll learn if you are at risk for diabetes and how you can prevent it; how diabetes can affect your heart, circulation, nervous system and brain; and what you would need to know to effectively manage your health and avoid these complications.

To register for this free event, contact Leona Cullen at lcullen@divisionsbc.ca or (604) 259-4450. This presentation is part of the Burnaby Division of Family Practice’s Empowering Patients public education series.

Dr. Davidicus Wong is a family physician and his Healthwise columns appear regularly in the Burnaby Now, Royal City Record, Richmond News and Vancouver Courier. For more information about diabetes, talk to your family doctor or check the Canadian Diabetes website http://www.diabetes.ca.

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Empowering Healthcare Medical Ethics patient-doctor relationship Positive Potential Preventive Health Screening Tests Self-care

Become empowered in your own healthcare

Photoshoot 2

At some time, we will each play the role of the patient.

In the 1991 film, The Doctor, William Hurt plays an arrogant physician who gets a taste of his own medicine when he is diagnosed with cancer. His experience from the patient’s perspective transforms his life and his practice.

My experience as a patient came early. As a child, I was diagnosed with rheumatoid arthritis, hospitalized for two weeks and had more blood tests than most of my patients.

But the personal experience of both acute and chronic illness and receiving care from good doctors and nurses has informed both my calling to the profession and my practice.

The Burnaby Division of Family Practice is the non-profit organization of the family physicians that serve the people of our community. In our ongoing public education program, that includes free public lectures and information on the organization’s website, we seek to empower all members of the community.

Through our organization, the family physicians’ care for the patients of their own practices has expanded to the care of our community. We seek to raise the level of health knowledge and healthy living to support the wellbeing of all.

Although we’ve thought of ourselves as the big providers of healthcare, 90% of your healthcare is self-care – what you do for your self. The best predictor of your future health are the habits you practice today.

We’ve been promoting the four foundations of self-care: healthy eating, physical activity, healthy relationships and emotional wellbeing. The next three public lectures focus on empowering patients in their interactions with healthcare providers.

On March 4th, I’ll be talking at the Bonsor Community Centre about preventive care and the early recognition of illness. We’ll review the important screening tests (what tests you need at different ages) that identify medical conditions before symptoms appear. We’ll also talk about symptoms that may indicate conditions for which you should seek medical attention.

Although you may do your best with healthy living and preventive care, you might still find yourself in the hospital as I did. It can be a very unsettling experience and at times you may feel a loss of control. On March 27th at Confederation Centre, I’ll provide useful information on making the most of your hospital stay and ensuring you have the best experience.

On April 7th at the Bonsor Community Centre, we’ll discuss what you should know about medical ethics, including how to ensure your wishes are respected, who has access to your medical records and how to make informed decisions about medical interventions.

In the patient-doctor relationship, the patient comes first. The role of your healthcare providers is to support you in both managing illness and achieving your goals. We envision the Empowering Patients education program will provide some of that support.

Dr. Davidicus Wong is a family physician. For more information on the Burnaby Division of Family Practice’s public health education series, check our website at divisionsbc.ca/burnaby.

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Burnaby Division of Family Practice Empathy Empowering Healthcare Healthy Living patient-doctor relationship Positive Change Preventive Health Screening Tests Self-care

The evolving patient-doctor relationship

When I was in medical school, physicians used a now archaic term to describe patients who didn’t follow doctors’ orders: noncompliant. I laugh when I think about what the old time doctors meant. The patients didn’t bend to their will?

In our society, the authoritarian physician is an icon of the past. Doctors’ orders are more likely what they’re having for dinner at White Spot than what they’ve instructed their patients.

The patient-doctor relationship has evolved into collaboration. Though the physician may be an expert on matters medical, patients are experts on their own lives and the most appropriate decision-makers.

A little better is the term now in vogue for patients following through on agreed plans: adherence. But calling patients nonadherent suggests that they didn’t stick to the plan as if they broke a contract. This implies a judgment and a belief that deviance from the goal is solely the patient’s fault.

I have a better word for patients who are successfully achieving their goals: engaged. If a patient returns for a follow-up visit not having achieved a goal to eat healthier meals, quit smoking or begin an exercise program, that patient isn’t noncompliant or nonadherent. The patient is not engaged.

Patient may have become disengaged from their goals by unexpected road blocks – an injury while exercising, a family emergency or other obstacles, some unpredictable but others that may have been anticipated.

They may also become disengaged when they are not adequately prepared and supported.

They may never have been engaged in the first place if they did not choose their own goals.

The keys to successful self-care and self-improvement are personally chosen goals that matter to you, the anticipation of potential obstacles, and collaborative planning and support.

Recognizing that much of the medical information in the media (in print, online, on television and radio) is commercialized, sensationalized, biased and incomplete, the Family Doctors of Burnaby have launched a public health education program to raise health literacy.

The Empowered Patient program is designed to raise general knowledge about healthy living (proactive, preventive self-care; healthy eating; healthy relationships; and physical activity), enhancing patient-doctor relationships, and improving self-care for health in general and in the management of chronic conditions.

Our goals are to provide all members of our community with the information they need to live healthy lives, get the care they need from their healthcare providers and effectively self-manage their health. We anticipate a reduction in the burden of chronic disease in the future and envision a healthier community of empowered individuals.

On Thursday, December 18th at 7 pm, I’ll be speaking in the library of Byrne Creek Secondary School. The topic: The Patient-Doctor Relationship – Making the Most of Every Medical Visit. I’ll share some practical tips on how to work with your doctor to achieve your goals; review the key information you should know about any proposed treatment, prescription, test or procedure; outline what you should know about your medical history; and summarize important screening tests – what tests you need and when.

The presentation is sponsored by the Burnaby Division of Family Practice and is free to the public but because space is limited, register online with lcullen@divisionsbc.ca or call Leona at (604) 259-4450.

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Balance Exercise Healthy Living patient-doctor relationship Screening Tests

How Do You Think About Your Health?

Superman at the Cleveland Airport

I have been a doctor for almost all of my adult life, but long before that, I was a patient.

In grade 6, I missed three weeks of school when I was hospitalized with rheumatoid arthritis, and during my childhood, I had more medical appointments than most of my patients and more blood tests than any of them.

I learned never to take my health for granted, I learned not to define myself by a diagnosis or illness, and from the nurses and doctors of Burnaby Hospital who looked after me as a whole person and not just the disease, I discovered my vocation.

It’s human nature to grumble about appearances at different stages in our lives – a blemish in our teens, wrinkles and grey hair as we age, our height or our weight. These concerns fade into insignificance in contrast to the seriously ill or those who would be happy just to feel normal and not in pain.

How we think about health informs how we approach our lives.

How do you define health?

Is it youth? Is it the absence of illness? Is it when everything in your body, your emotions and your mind are in perfect order?

If that were the case, few of us would be healthy and none of us would stay that way.

When I gave public talks for the Canadian Diabetes Association, I learned of the organization’s preference never to refer to people with diabetes as diabetics. So easy it is for health care providers and patients themselves to label them with a condition that they may have.

For some, that labeling is limiting. It can bring a negative focus to their healthcare and how they see themselves.

This negative approach to health is endemic. Almost all medical visits are problem-based. Most people only see the doctor because of infections, distress or other symptoms of illness. The minority comes for preventive care. Even fewer are proactive.

As a family physician, when patients have made appointments to address their problems, I’m usually the one to remind them of things they should be checking – for example, an annual blood pressure measurement for most adults, diabetes testing over age 40, stool tests for hidden blood over 50, prostate exams for men over 50, and pap smears and mammograms for women.

Although accidents can happen and we cannot avoid every illness, we can all live longer, healthier lives with a positive approach to health. Preventive care includes healthy and safe living, with attention to a good, balanced diet, a variety of regular physical activity and eliminating unnecessary risks (such as smoking, unsafe driving, recreational drugs and alcohol abuse).

Secondary preventive practices include the early detection of potentially life-limiting conditions while they are treatable. Screening tests can detect early signs of cervical, prostate, breast and colon cancer long before a person has any symptoms.

In the next few weeks, I will be reviewing the preventive and proactive practices you need to know in order to take control of your health. You may come to think of your health – and your life – in a more active and positive way.

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Empowering Healthcare Healthy Living Preventive Health Screening Tests

Screening Mammograms: When Should You Begin?

In a recent article on breast cancer screening, I noted recent changes in the recommendations of the Canadian Task Force on Preventive Health Care. The national organization did not recommend regular screening mammograms for women under the age of 50. Though mammograms detect breast cancers better than any other screening test in women between the ages of 40 and 50 – and save lives, the Task Force argued that this benefit was outweighed by the risk of false positives (abnormal screening mammograms later shown not to be cancer). The “harm” of the false alarms consisted of further diagnostic procedures, including biopsies and the resultant fear, anxiety and distress this causes.

In our province, the Screening Mammography Program continues to screen women annually beginning at age 40 and every 2 years from age 50 to 79. It remains a cost effective program that saves women’s lives.

On October 24th, Dr. Ian Gardiner, a radiologist with expertise in breast imaging – and my medical school classmate – presented a review of the evidence at the UBC Radiology Grand Rounds. He showed that annual screening mammography beginning at age 40 conferred a definite survival advantage.

If women did not start screening until age 50, a significant number of women would die with the late detection of cancer. With any breast cancer, the earlier the diagnosis, the better the survival rate.

He noted that 24.7% of breast cancer cases were women in the 40 to 49 age group.

If you are a woman considering when you should start your regular screening mammograms – as with any other medical procedure or treatment, consider the relative risks versus the benefits.

For most of my patients, the risks of emotional distress caused by false positives are outweighed by the benefits of early detection and improved survival. The risks of not starting regular screening mammograms at age 40 are life-limiting and devastating: missing cancers, discovering them at a later stage and increasing the risk of death.

The mammogram remains the single best screening test for breast cancer.

Women between the ages of 40 and 79 may book the test themselves through the Screening Mammography Program of B.C. (www.smpbc.ca, 1-800-663-9203 or 604-877-6187).

If you have breast symptoms – including a lump, tenderness, skin changes, palpable lymph nodes or nipple discharge, you should see your physician as soon as possible. Don’t wait for a screening mammogram. You would need a careful examination by a physician and other appropriate diagnostic tests.

All women should talk to their family physician about breast health and the timing of the most appropriate screening tests for breast cancer. A new free service is available to any woman in Greater Vancouver who is concerned about her personal risk for breast cancer and would like to attend workshops to reduce the modifiable risk factors through healthy lifestyle changes, including maintaining a healthy weight, increasing physical activity, eating a healthy diet and limiting alcohol consumption. The Breast Cancer Prevention & Risk Assessment Clinic is funded by the Canadian Breast Cancer Foundation – BC/Yukon Region. There is no cost to attend. For more information on this empowering resource for women, contact the clinic at (604) 603-5140 or breastcancerprevention.med.ubc.ca.

When one of my patients is diagnosed with any cancer – including breast cancer, in addition to appropriate standard medical therapies, I recommend they attend Inspire Health, where they will have a choice of a variety of evidence-based medically supervised complementary therapies, including nutrition, herbs, yoga, acupuncture and meditation. Inspire Health (inspirehealth.ca) – a non-profit clinic founded by pioneering physicians, Dr. Hal Gunn and Dr. Roger Rogers – treats the whole person in a positive and empowering atmosphere.