5 Myths About Blood Pressure

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On Thursday, December 8th at 7 pm, I’m presenting “What You Need to Know About High Blood Pressure” at the McGill Library 4595 Albert Street in North 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 604-299-8955, in person or online at http://www.bpl.bc.ca/events/mcgill

Do you know your numbers?

You know by heart your birthdate and age, home and cell numbers, your address and maybe even your social insurance number.

But there’s one number that every adult should know: your blood pressure.

To understand why this measurement is so important, let’s explore five myths about blood pressure.

Myth #1: “It’s just a number.”

It’s more than a number. It’s one of your vital signs (e.g. heart rate and temperature, not your astrological sign).

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).

Of course, we need a normal amount of pressure to deliver blood to all your vital organs, but chronically high blood pressure (hypertension) damages those organs and arteries themselves.

Myth #2: “I don’t need to worry about it.”

High blood pressure damages the 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.

Myth #3: “If I feel good, it can’t be bad.”

A lot of us might assume that if we feel good, we must be healthy and our blood pressure couldn’t be a problem. There’s a common misconception that individuals with high blood pressure are stressed out or angry like Donald Duck. Mickey Mouse is just as likely to be hypertensive.

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.

In fact, one in five adults has high blood pressure, 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.

Myth #4: “It’s only high at the doctor’s office.”

White coat syndrome is a genuine condition wherein the patient’s blood pressure is much higher when taken by a doctor or nurse than at home. 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 only elevated at the clinic but never at home or work, we don’t prescribe medications. However, some people have a significant rise in their blood pressure with any stressful situation, 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.

Myth #5: “If I start a medication, I’m stuck on it for life.”

As a physician, I want my patients to maintain safe blood pressure levels and avoid the 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.

So get to know your numbers – especially your blood pressure. Most adults should check their blood pressure at least once a year and more frequently if they have a personal or family history of high blood pressure.

Dr. Davidicus Wong is a family physician. To learn more about upcoming health education events, see the BDFP website at divisionsbc.ca/burnaby. For more on achieving your positive potential in health: davidicuswong.wordpress.com.

Posted in Empowering Healthcare, Healthy Living, Preventive Health, Self-care | Tagged , , , | Leave a comment

The Daily Management of Stress

Ducks at Ellison Provincial Park (Davidicus Wong)

In my last column, we saw stress as an essential part of our lives.

It can be positive when it moves us to change and grow, but it affect our minds and bodies in negative ways when we are overwhelmed. This happens when there’s just too much of it: more than we can handle given the time, abilities and support that we have at hand.

But sometimes, it is our perspective that needs to change. It’s been said that 20% of our emotional reaction is due to the reality of a situation; 80% is what we bring into it – our assumptions, attitudes and memories.

Most of us don’t think much about stress until we are right in the middle of it. Suddenly, we’re overwhelmed. What can you do each day to maintain a healthy balance and manage stress more positively?

Be a good parent to yourself.

The best advice I can give my patients is essentially the advice my good parents gave to me.

  1. Be good: live in accord with your values.

My parents both taught and modeled ethical behaviour. Doing the right thing keeps your conscience clear and helps you sleep at night. Telling the truth is easier than remembering all the lies you could tell. Being kind just makes you feel good.

Doing work we are passionate about with people we care about makes each moment more meaningful.

  1. Think before you speak or act: reflect. If you are operating on automatic, you may end up far from your original destination. If you respond only to your emotions, you’ll be reactive in what you say and do.

Throughout your day, pause and reflect upon your words and actions. “Am I being mindful of my words? Am I doing good work? Am I helping or harming?”

  1. Choose good friends, and talk to them. We all need the support of friends we trust and who love us without question. They listen when we need to vent, and they care about us enough to set us straight when we’re on the wrong path.

The value of such a support group is even more important when we grow up and cope with the many roles and stages of our lives, including parenthood, relationship crises, midlife and retirement.

  1. But remember family comes first. I didn’t get it when my mom told me this during my teens. “Friends and girlfriends come and go, but family is always here for you.” She was right again.

Too often we neglect our partners and children because of work and other misplaced priorities. If we wait too long, we mistake family relationships to be the source of our stress.

The time you invest in your most important relationships is never wasted.

  1. Go out and play. We all need regular (aim for daily) exercise. It can keep you fit, burn off steam and help you manage the rest of the day.
  2. Don’t skip meals. Schedule regular healthy meals to keep your energy up and your body healthy. What you save in time by skipping a meal, you lose in fatigue and poor health.
  3. Take a break. Our brains and bodies were not designed to work without a break for more than a few hours at a time. We all need regular breaks to maintain our attention and energy.
  4. Go to bed. Get enough sleep each night.
Posted in Happiness, Parenting, stress management | Leave a comment

Say What Needs to be Said: The Positive Potential of Your Relationships

On Thursday, November 24th at 7 pm, I’ll be speaking on the topic of healthy relationships at the Tommy Douglas Library 7311 Kingsway (at Walker Avenue). 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 604-522-3971, in person or online at http://www.bpl.bc.ca/events.

blank sand beach

As family doctors, we carry a heavy responsibility and profound privilege to serve each patient at every point in this precious human life. We share in our patients’ dreams and aspirations, support wellbeing, treat illness, and provide comfort at the end of life.

I continue to enjoy the soul-renewing service of delivering a newborn baby into the arms of a mother. I see every baby as a bundle of potential.

As a physician, I share in that child’s parents’ and our society’s responsibility in the realization of that child’s uniquely positive potential.

But at the end of our lives, the greatest tragedy is not that we have failed to reach our potentials but rather we die not knowing how much we were loved.

How many times are we moved to act with kindness and generosity – giving up our place in line, offering a kind word and donating to others in need – but hold back and let the moment pass? How many times do we let the sun set without saying what needs to be said? We seem to be given countless days as we go about the busyness of living, distracted by the news of the day and preoccupied with the world of material things. Yet when we lose the special people we have taken for granted, we realize we were short one precious day when we could have expressed how much we cared.

How do we get off track?

The biggest illusion in life is our case of mistaken identity. We get so caught up in our personal autobiographies that we mistake ourselves as separate and alone. We begin seeing every one else as for us or against us. We value those who serve us but not when they seem to work against us.

This may be the biggest problem in the world today: the illusion of our separateness, and the perception of a world of “others.” The “others” are no longer three-dimensional individuals who share with us the same emotions and needs with their personal dreams and stories. They become our enemies or our scapegoats. They literally become objects of our hate and fear. They represent the darkness that lies within our own hearts.

The antidote for our disconnection is remembrance of our connection – all that we share. Begin with family and friends. When we argue and disagree, we may begin to separate; but the alternative is to see different opinions and different goals as different points of view – an opportunity to deepen our understanding.

In everyday life, we take cognitive shortcuts based on caricatures (2-d stick people versions) of even those we know best, and we interpret what they say and do with assumptions we don’t check out. This leads to greater misunderstandings and separations.

For example, if your friend doesn’t call you back, you might assume she’s avoiding you and not that she didn’t get your text or lost her phone. If your brother brings up an embarrassing event from your past, you could take it as a personal attack rather than affectionate ribbing.

We are worse still with people we don’t even know but perceive as different based on outward appearances: clothing, accents, skin colour and position. We may even be guilty of the ridiculous assumption that the “other” is less important and of less value than ourselves.

We need new rules of engagement. The goals of conversation are not to get our point across and get what we want but rather for personal connection, mutual understanding and cooperation.

As a separated human being in your individual life, you will never be able to achieve and hold onto all that you seek. Together we are better.

Our place in this world becomes clear when we remember our very real connection with all of humanity. As infants we are connected to our mothers through the umbilical cord; we are dependent on our families as we mature and grow; we create a network of connections with our friends, in school and at work; we become participants of the greater society; we discover our uniquely positive potentials – our gifts to the world, and we help others and the rest of the world achieve theirs.

But in each day there lies a profound potential – the potential to nurture each of our relationships in many ways big and small. We can express our potential for love in countless forms – by forgiving and apologizing; by giving without expectation; by expressing gratitude. We can say we care with words, with actions, with a smile, a hug and a gentle touch.

Each day is a gift with which we can make a positive difference in the lives that we can touch, and let them know that they make a difference to us. At the end of life and at the end of the day, that may be all that really matters.

 

Posted in Forgiveness, Friendship, Grace, Happiness, Love, real love, Relationships | Tagged | 1 Comment

Our Stories and How They Affect Our Relationships

 

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Cousins hiking in Banff – Davidicus Wong

Self-care is essential to healthcare. How you live each day impacts your future health.

The four foundations of self-care are emotional wellbeing, healthy eating, healthy physical activity and healthy relationships. Each day in my practice, I see patients whose problems are directly or indirectly related to difficult relationships. On the other hand, a supportive family, mutually positive relationships and a network of good friends support both physical and emotional wellbeing.

Difficult relationships at work, conflicts at home and problems in school can be major sources of stress or the causes of depression or anxiety.

It makes sense to take stock of your relationships, do what you can to get away from or get help with abusive situations and do what you can to improve relations with the people in your life. Though we recognize that our relationships produce the drama in our lives, it’s hard for most of us to know what we can do to make them better.

It can start with reflection on the art of storytelling.

We all love a good story.

That’s one of the keys of a compelling TED talk. We can get wrapped up in a good novel and miss our bus stop or be so caught up with the Game of Thrones that we don’t realize that we’re consuming a whole bag of potato chips.

It is with stories that we make sense of our lives. It begins with the stories our parents tell us, the stories taught in school and the stories told through media. We sometimes mistake our stories for reality.

Like my mom, I loved reading, and every week, we would each reach our borrowing limits of library books – twenty in those days. Books opened my mind to many views, seeing through others’ eyes.

I was drawn to family practice because of my patients’ stories – the ups and downs of daily life, their challenges and triumphs and their joys and sorrows. My profession opened my heart to the experiences and feelings of others.

When we seek to understand the backstory of others, we open the door on compassion. Each of us, even siblings in the same family, may have uniquely different stories of childhood. Those early life experiences shaped our sense of self – who we are, how we fit in the world, how we felt loved or how we did not.

If our sense of self is rigid and doesn’t allow for growth and change, we can get stuck in the same old story as our lives change anyway. If we see ourselves as unchanging personalities with well-worn habits and permanent character flaws, the future will be a self-fulfilling prophecy.

If in your life story, you are the sole protagonist and everyone else is an antagonist in a world of danger and scarcity, life will remain a struggle and a futile fight to win. You may even compete with your loved ones and friends and fail to fully connect.

What is the premise of your life story?

Did you come into this world alone, expecting to leave the same way?

Or are you connected to every person in your life and through your life the entire world – accepting, sharing and giving forward love in its many forms – discovering and giving back to the world your unique gifts.

Every human being has the same basic needs – for warmth, clothing, food, shelter and love, and we share the same range of emotions. But each of us tells a unique story. We relate best when we understand each others’ stories.

Be mindful in your communications. We may talk to be understood, but we must listen first to understand.

And we understand better with a phone call than by text. Face to face is better than phone.

Words are best interpreted in the context of body language and facial expressions. These nonverbal cues deepen the meaning of words. We can see how others feel and how our words may affect them.

On Thursday, November 24th, 2016 at 7 pm, I’ll be speaking on the topic of healthy relationships at the Tommy Douglas Library 7311 Kingsway (at Walker Avenue). 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 604-522-3971, in person or online at http://www.bpl.bc.ca/events

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My Working Summer Staycation

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What can you do when plans go awry?

Accept what you cannot change; appreciate what you have, and make the best of it.

I had the opportunity to put this into practice when I had to cancel my family vacation. Summer is usually the best time to take time off from my busy practice. Patients have fewer respiratory infections and with school out, many are on vacation themselves. To celebrate my daughter’s high school graduation, we had planned seven months ago to take her to New York and the Calgary Stampede.

But through circumstances beyond his control, my locum physician had to cancel without time to arrange a replacement. Realizing how disruptive it would be for patient care, I cancelled my trip and let my family travel without me.

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For part of my first day in an empty home, I appreciated the quiet order. Coming home after work, there were no shoes to trip over. The dishwasher was loaded the way I like it to allow for efficient unloading. There were no dishes in the sink except for my breakfast cereal bowl. I could choose what I wanted for dinner – and prepare and eat it alone.

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I made a list of things to do over the next two weeks (My wife was no longer around to write her list). Of course, the work of medical practice could consume as much as I would allow. The daily review of test results and consultation letters and making referrals consumes at least two hours after the last patient leaves the office.

After the long weekend, I worked an extra Saturday morning to reduce my patients’ wait time for appointments. I finished two medical legal reports (about 10 hours of work) on evenings and weekends. I was happy that I wasn’t out of town for the maternity and newborn care for two of my long-time patient families.

I missed my family especially on my wife and daughter’s birthdays. This was the first time I wasn’t with them on their special days. I was thankful for texting, email and facetime.

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I turned my quiet home time into a mindfulness retreat. I listened to Tara Brach’s podcasts on dharmaseed.org each morning and night and throughout the weekends. They inspired me to remain mindful at all times. I chose my thoughts and my activities.

I enjoyed being a tourist in my own town. We are lucky to live in a vacation destination for the rest of the world, and summer is a magical time with special community events every weekend.

I enjoyed Burnaby’s Canada Day concert and the awesome fireworks at Swangard Stadium. I called up my oldest friend and we met up at Deer Lake for the VSO’s Symphony in the Park. I enjoyed the live music at the Khatsalano Street Party.

I enjoyed weekend and evening cycling through busy, beautiful Central Park, and extra swims in the outdoor pool.

I cycled around my alma mater, UBC and explored the rich displays of the Museum of Anthropology. I treated my eyes and my soul to the Nitobe Memorial Garden, a uniquely beautiful Japanese garden hidden in the northwest corner of campus.

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I cycled the seawall of English Bay and Stanley Park. I must have taken over 200 photos during my two-week working staycation.

Life is never perfect and may not always go our way, but it’s still beautiful. Missing the people in our lives reminds us to appreciate them and our precious time together. Being tourists in our own town shows us the beauty around us each day.

Posted in Awareness, Happiness, Meditation, Positive Potential, real beauty, real love, Relationships, stress management | Tagged , , , , , , , | Leave a comment

The Slogans You Live By: Are You Due for Rebranding?

 

Made to Move

In business, branding is everything.

A lot of thought goes into a company’s choice of name, trademark and slogan, and that slogan – the catchy way that it expresses its values, vision and purpose – influences how the organization is seen by its employees and customers.

Well-chosen slogans are sticky. We automatically associate them with the brand. Nike: Just do it. Kentucky Fried Chicken: Finger lickin’ good. Coke: It’s the real thing.

Those sticky ideas get into our heads – sometimes through creative commercials and advertising campaigns; often through shear repetition. They can have greater impact when spoken by charismatic or influential personalities.

Over time, we just accept them as part of our daily landscape, soundscape and mindscape. We eventually stop questioning their validity.

Therein lies the danger of slogans. We quickly adopt them as habits of thought. They shape our beliefs and influence how we see the world.

As children, memorable phrases can help us learn important rules and good behaviour. “I” before “e” except after “c”. Look both ways before you cross the street; use your eyes and use your ears, before you use your feet. An apple a day keeps the doctor away.

Through the power of habit, what we repeatedly think becomes our inclination. The connections between specific neurons are reinforced over time and like a well-travelled path become engrained.

This is fine when those habitual thoughts are true and useful. Unfortunately, we all carry personal slogans adopted from the past. They may have been said first by influential people, like parents or teachers, or you may have come up with them through past experiences. They are reinforced by self-talk: what we say to ourselves that shapes our opinions, feelings and actions.

Negative self-slogans that are never totally true and don’t help anyone include: “I’ll never be happy.” “I can’t control myself.” “I’m a loser.” “I can’t win.” “I’m not good enough.” “There’s something wrong with me.” “Those people are different.”

Negative self-slogans can limit your thoughts, narrow your perspective, shape your emotions and keep you from trying.

What are your limiting beliefs about yourself and others? In what ways are you heeding the slogans of past advertising campaigns of companies long out of business? Some of the things we bring forward from the past no longer apply or may never have been true. If you need help identifying negative self-talk, do what businesses do. Put together a small focus group of your best friends. Ask them what negative phrases you regularly use.

Try out some new slogans. Here are some of mine. “Be an agent of positive change.” “We were made to move. When we don’t, our health suffers; when we do, we thrive.” “Of the things within your control, the best predictors of your future health are the habits you practice today.” “Help yourself to happiness by helping others.” “Give more than you get.”

Posted in Healthy Living, Positive Change, Positive Potential, Uncategorized, Your Calling | Tagged , , | 1 Comment

The Game Changer in Life: Seeing the Best in You

Central Park Lake 1

I confess that whenever I came across a green bag labeled for donation after my children had cleaned their rooms, I would rummage through it.

There I might find books and collectible items I thought they would treasure forever. After all, I had spent many hours finding just the right birthday or Christmas gifts at each stage of their lives.

Over time, I realized that such material things (though inspired by love) are not made to last forever nor should any of us cling to them. Kids grow up and outgrow them all.

The best gifts we can give our children are those they will keep forever.

A priceless gift my parents gave me continues to enrich my life, and I’ve done my best to pass it on to my children. Their gift was to always see (and expect) the best in me.

Though my parents were very thoughtful and deliberate in the decisions they made, I suspect that the ability to see the best in brother, sister and myself was a natural byproduct of their love for us.

 

We were each unique and as flawed as any other kids. They would give us feedback and correction when we could do better, but they always gave encouragement and praise when we did our best. Much more than looking for what’s wrong in us, they were always looking for what was good.

That simple but profound view – to the see the best in others – is a game changer in everyday life.

More often, we live on the surface of society and when looking at others, stop only on the outer surface. We judge – and then behave – based on appearances, gender, dress or disability, race and roles. We make sweeping judgments, and we forget that we see only glimpses of whole people.

We forget that every person that we pass on the street, sit beside on the bus, and interact with in the course of our daily lives is a complete and complex individual.

Every one of us has hopes and dreams, pain and disappointment. Everyone is someone’s friend or cousin, sibling or parent. When we remember this, we are more open to compassion and it becomes more natural to treat others with kindness and understanding.

Consider this when you disregard or ignore another human being or when you immediately dislike someone you don’t even know. We all have good and bad days, but we can always make someone else’s day better.

With those we live and work with, we can get caught up in our quirky habits and differences. We can take one another for granted and keep a running tally of what we don’t like about each other. One of the secrets of a happy marriage is to deliberately make more positive than negative comments about your partner. It reminds us to look for and express the best in the other, who in turn feels more appreciated.

The teachers who see the best in their students can inspire them to work harder and achieve their best. The manager who sees the qualities of each team member will lead a productive and positive team.

The doctors who can help their patients see themselves as agents of positive change in their own lives will guide them towards their potential for wellbeing.

Today, take a good deep look into the mirror and in every face you meet. See the best in everyone.

Posted in Compassion, Friendship, Growth, Happiness, Love, Parenting, Positive Potential, real beauty, real love, Relationships | Leave a comment