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 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.

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Categories
Burnaby Division of Family Practice Medical Ethics patient-doctor relationship

Keys to a Better Hospital Stay

Illnesses and accidents are unpredictable and we can’t always predict when we may end up in a hospital. Here are some tips to prepare and how to maintain a sense of control in the mysterious world of the hospital.

PREPARING FOR YOUR HOSPITAL VISIT

  1. Always wear clean underwear but don’t count on it staying clean if you’re surprised by an accident.
  2. Don’t miss an opportunity to use a washroom.
  3. Remember to wash your hands!

 

WHAT TO PACK

Essential Medical Information

  1. Your Medical History A one-page summary should include: allergies, chronic conditions, past illnesses and surgery, and family medical history
  2. Your Medicationsdrug name, dose, directions

and reason for taking it

e.g. Brand name: Tylenol

Generic name: acetaminophen

Dose: 325 mg

Directions: one tablet twice daily

Reason: for knee pain

  1. Your Preferences: 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.

TIPS:

Always plan in advance.

Talk it over with your family and friends (to avoid difficult family conflicts).

Choose someone you trust to respect your wishes.

Inform your doctor.

Put it in writing.

For more information: google “My Voice”

Click to access MyVoice-AdvanceCarePlanningGuide.pdf

 

Comfort Items ear plugs, music, reading, word puzzles, eye mask for sleeping, toothbrush and paste, warm socks, non-slip slippers, a sweater

 

To Keep You Oriented a calendar,a quiet inexpensive clock

 

For Communication a pad of paper, pens, your glasses, hearing aid and teeth

 

What NOT to bring expensive jewelry, watches, electronics, wallets, purses, credit cards, your nicest clothes and shoes, and other prized possessions

 

Don’t bother with perfume or cologneYour neighbours may have allergies and respiratory problems

 

3 KEYS TO A BETTER HOSPITAL STAY

  1. Stay in control (and informed)

4 Things you need to know about every test, procedure and treatment

  1. The purpose or reason
  2. Common side effects or risks
  • Serious side effects or risks
  1. Alternatives (e.g. other treatments)
  2. Know your team
  3. Ask for each person’s name and role

(e.g. nurse, respiratory technician, dietician, physiotherapist, occupational therapist)

or specialty (e.g. family physician, hospitalist, surgeon, internist)

  1. Ask who is your attending or most responsible physician
  2. Set up a channel of communication

Prepare your list of questions.

Find out when your attending doctor will visit.

Key questions: What is the plan? The working diagnosis? The schedule of tests or procedures?

The results of tests? The expected day of discharge?

 

This information could be shared on a WHITE BOARD in your room or a large pad of paper at your bedside.

 

Make sure your family doctor knows you are in hospital and that hospital reports are sent to the office He or she can provide important medical information to your hospital care team

Preparing for Your Hospital Stay https://www.youtube.com/watch?v=cR0qs4lY19Q&feature=youtu.be&list=PLAWTWe0JNCdHrKBo0F03pjLdDeENFrctX

Three Keys to Improving Your Hospital Stay https://www.youtube.com/watch?v=X1t3qDTQ48I&index=2&list=PLAWTWe0JNCdHrKBo0F03pjLdDeENFrctX

The Lonely Patient’s Guide to Hospital Land  https://www.youtube.com/watch?v=Uu08JBbNKe8&list=PLAWTWe0JNCdHrKBo0F03pjLdDeENFrctX&index=3

 

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

                

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. 

Categories
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.

 

 

Categories
Burnaby Division of Family Practice Emotions Empowering Healthcare empowering patients Happiness Healthy Living Love Relationships Uncategorized

Healthy Relationships (Davidicus Wong)

 

Why relationships matter

  1. Social support from friends, family and partners are key to your emotional health and resilience.
  2. Harmony in the home is essential to your wellbeing.
  3. Loving friends and family support your health.
  4. Conflicts at home, work or school are major sources of stress and contribute to anxiety and mood disorders.

The sources of conflict

  1. Incompatibility (religion, culture, language, introversion/extraversion, values and beliefs.)

Game changers: incompatible values (core beliefs about right and wrong)

                                     abuse(physical, emotional or sexual)

  1. Cognitive Distortions– When we start seeing each other differently.
  2. Mind reading: making negative assumptions about the other’s intentions without checking them out.
  3. Excessive blaming: when something goes wrong (or is left undone), it’s the other’s fault.
  4. All or nothing thinking: seeing all of the BAD (and none of the good) in the other, in your relationship and your situation.
  5. Neglect and loss of intimacy.Too often we can let the rest of our lives take over our life together.
  6. Feelings change.We mistake the inevitable fading of infatuation and romantic love with not being in love. With attention and commitment, we can transition into enduring love, from passion to compassion.

The quirks that endear us when we fall in love eventually irritate us when the honeymoon is over, but they are the things we’ll miss when our loved ones are gone.

The 5 Love Languages (Gary Chapman)

  1. Words of Affirmation
  2. Quality Time
  3. Receiving Gifts
  4. Acts of Service
  5. Physical Touch

The Qualities of Healthy Relationships

  1. Mutual respect– for our individuality, our feelings and our ideas
  2. Commitment to one another and to our relationship. We express our commitment with time, thought, patience, effort and a willingness to work together.
  3. Acceptance and management of the differences that make us unique– personality, passions, preferences, spirituality, customs. Extraverts are energized by people and parties; introverts need solitude to recharge. Extraverts need to speak to think; introverts think before they’ll speak. With acceptance and understanding, we complement one another.
  4. Unconditional love: mutual positive regard, compassion and good will.

Nurturing Your Relationship

  1. Foster emotional intimacy.Agree on a habit of checking in with one another each day. How are you feeling? How was your day?
  2. Show your affection.Express your positive feelings. Remember the 5 languages of love.
  3. Schedule regular dates. Commit your time to what matters most. Don’t wait ‘til there’s time; make time!
  4. Communicate in a healthy way.Take a breath and let anger cool before you react. Acknowledge the other’s feelings and point of view. Express how you feel without blame.
  5. When things get stale, have an affair . . . with your partner.

The Four Things That Matter Most (Dr. Ira Byock)

  1. “Please forgive me.”
  2. “I forgive you.”
  3. “Thank you.”
  4. “I love you.”

THE 4 FOUNDATIONS OF SELF-CARE

What you eat(What you put into your body). What you do(physical activity and rest).

How you feel(emotional wellbeing). How you connect(healthy relationships).

 

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

Healthy Eating (by Davidicus Wong)

 

The Empowered Patient: Healthy Eating

Canada’s Food Guide indicates the recommended servings per day for each of the 4 food groups:

  1. Vegetables and fruit
  2. Grain products
  3. Milk and alternatives
  4. Meat and alternatives

We require a small amount of oils and fats in our diet (30 to 45 ml or 2 to 3 tbsp of unsaturated fat). Healthy choices include vegetable oils such as olive, canola and soybean. Avoid saturated and trans fats. Limit butter, hard margarine, lard and shortening.

For patients with diabetes or glucose intolerance: Glycemic Index is a measure of how quickly a carbohydrate-containing food raises your blood sugar. Lower GI foods (such as quinoa, whole grains or brown rice) raise blood sugars more slowly than high GI foods (such as white bread or bagels).

For more information on diabetes and glycemic index: diabetes.ca.

If you have a question about nutrition, Dial a Dietitian (8-1-1).

For more on healthy eating: healthlinkbc.ca/healthyeating

Tips on Healthy Eating on a Budget

  1. Cook at home (cheaper than prepared foods).
  2. Cook extra portions and freeze the leftovers for quick meals.
  3. Plan your meals and shop with a list.
  4. Keep an inventory of your pantry supplies and use what you have.
  5. Buy only what you need unless you are sharing with family and friends for cost-sharing.
  6. Know your prices and buy on sale.
  7. Plan healthy snacks, such as raw veggies, low-fat cheese, popcorn, whole wheat bread.
  8. Read labels for unit cost (i.e. cost/100 gm) and best before dates.

Money saving tips:

For meats and alternatives

  1. Buy larger packages of meat on sale. At home, divide them into smaller portions for freezing.
  2. Eat dried or canned beans and lentils; tofu, eggs, canned fish and peanut butter.

For vegetables and fruits:

  1. Buy in season.
  2. Don’t buy fruit that will ripen before you can eat them.
  3. Buy larger bags of frozen vegetables.
  4. Buy canned, frozen or dried fruit.

Grains:

  1. Buy rice, flour, oats and pasta in bulk.  Buy whole grain bread in bulk and freeze the loaves.

Milk:

  1. Buy larger portions.  Buy no name brands.

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? Eat more fruit and vegetables? Where and when will you do it?

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

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.

THE 4 FOUNDATIONS OF SELF-CARE

What you eat(What you put into your body). What you do(physical activity and rest).

How you feel(emotional wellbeing). How you connect(healthy relationships).

Categories
empowering patients Physical Activity

HEALTHY PHYSICAL ACTIVITY Davidicus Wong

Empowering Patients: HEALTHY PHYSICAL ACTIVITY  Davidicus Wong

 We were made to move. When we don’t, our health suffers. When we do, we thrive.

 7  BENEFITS OF PHYSICAL ACTIVITY

  1. Decreases your risksfor heart disease, stroke, diabetes, high blood pressure and cancer.

Exercise plays an important role in managing and improving chronic health conditions.

  1. Prevents weight gainand – complementing healthy nutrition – helps you maintain a healthy weight.
  2. Improves the fitness of your heart, lungs and muscles. Physical activity conditions your body to function better, making everyday activities easier.
  3. Prevents falls and improves cognition. When your limbs, eyes and brain are accustomed to movement, your balance, agility and ability to react improve. When blood flows better throughout your body, it also provides better circulation to your brain. A healthy body promotes a healthy brain.
  4. Weight bearing exercise(e.g. walking, hiking, weight training) helps maintain bone density, reducing your risks for osteoporosis and fractures.
  5. Improves sleep. Although vigorous exercise just before bed may be too stimulating, activity earlier in the day can improve the quality of your sleep.
  6. Improves emotional wellbeingby decreasing stress hormones, such as cortisol, and raising endorphins, natural painkillers. Exercise can raise your confidence and sense of accomplishment. There are social benefitsto physical activities such as yoga, zumba, dance and spin classes, ballroom and line dancing, Tai Chi, weight training, running clubs, lap swimming, badminton, ping pong, walking groups and hiking.

 

PHYSICAL LITERACY: The 7 Fundamental Movement Skills These are the essential sports skills taught to children from birth and throughout their school years, but each remains relevant throughout your lifetime.

  1. Running You may need to run without falling if being pursued, trying to retrieve a purse, escaping a burning building, chasing your newspaper down the street or avoiding a collision with a fast-moving object.
  2. Jumping You have to be able to do this without tripping to avoid falling into a puddle or stepping on the droppings of dogs (or horses in Victoria).
  3. Kicking To kick out the window of a burning or sinking bus or car. To defend yourself from an attacker.
  4. Striking (as with a racquet) To swat a mosquito with a flyswatter.
  5. Throwing When you don’t want to walk to the trash can. A faster way to move your laundry.
  6. Catching To catch the keys someone tosses you. To catch a dish before it crashes on the floor.
  7. Agility, Balance & Coordination To change your own clothes, shower and bathe, cook, shop and drive. To avoid falls and fractures. This is especially important for the man who does all his shopping at the mall on Christmas Eve.

 

The 6 Aspects of PHYSICAL FUNCTION (from the textbook,“Therapeutic Exercise” by Carolyn Kisner and Lynn Allen Colby)

  1. CARDIOPULMONARY FITNESS: Endurance housecleaning, yardwork, walking, laundry, cooking, shopping
  2. FLEXIBILITY: The Ability to Move Freely picking up the paper, reaching the top shelf, changing, bathing, footcare
  3. COORDINATION: Smooth, efficient Movement cooking, dusting, eating, drinking, changing, driving, grocery shopping
  4. STABILITY: Joint Stability, Muscle Balance putting on socks, shoes & support stockings; getting into the tub; bathing
  5. DYNAMIC BALANCE: Maintaining Balance in Action walking at home & outdoors; shopping; bathing; ladders; stairs
  6. MUSCLE PERFORMANCE: Strength, Power and Endurance driving, taking out the trash/recycling, vacuuming, mowing the lawn, raking leaves, moving tables and chairs, sweeping, dusting, grocery shopping

 

 

TOYS EVERY GROWNUP SHOULD OWN (and play with regularly)

  • A skipping rope; sidewalk chalk for hopscotch: to practice balance and jumping
  • A soft rubber ball: to kick, dribble, bounce, catch and throw outdoors
  • A foam ball: to toss and catch indoors
  • Badminton racquets and shuttlecocks: to practice striking and promote agility, balance and coordination 

FITTING PHYSICAL ACTIVITY INTO EVERY DAY Look for simple ways to increase your level of physical activity.

  1. Walk or bike to school or work.
  2. Get off the bus a few blocks further from your destination.
  3. Buy a bright, new umbrella and raincoat, embrace the rain and do an extra walk each day.
  4. Go hands-free at home and walk while you talk on the phone.
  5. Dance to your favourite music.
  6. Limit your screen time (in front of the television or computer).
  7. Stretch and exercise while you watch your favourite shows.
  8. Check out the local pool, gym and community centre. There’s sure to be something you’ll enjoy learning and doing.

 

REDUCING RISK WITH EXERCISE

  1. Talk to your doctor before starting a new exercise program ifyour current workout is moving from couch to fridge, you’re over 40, at risk for heart disease or have a chronic health condition (such as diabetes, heart failure, asthma, chronic bronchitis or arterial disease).
  2. If you have osteoarthritis, choose activities that do not harm your joints(e.g. With degenerative arthritis of the knees and hips, avoid running. Swimming would be a better choice.)
  3. To reduce injuries: start at a lower intensity, b. exercise in a safe environment, c. get expert assistance and instruction, and d. use proper equipment (e.g. helmets for cycling, appropriate footware).
  4. Avoid dehydrationby drinking adequate fluids
  5. Avoid OVERexercise. Watch out for the signs of overexercise: a. excessive weight loss, b. constant muscle soreness and tiredness, c. recurrent injuries, d. recurrent infections, chronic fatigue, and e. neglect of work, school, friends and loved ones.
  6. Balance activitywith rest and healthy nutrition.

 

KEYS TO ACHIEVING YOUR GOALS

  • Choose Wisely. A goal that matters to you.
  • Visualizeyourself having achieved your goal, reprogramming your subconscious mind and priming the pump for success.
  • Break it downfrom supersized into manageable morsels. You’ll gain confidence with early successes.
  • Write down the details.

SMARTEST goals

  • Specific: What will you do? Where?
  • Measurable: How much? How long?
  • Achievable: Realistic and do-able
  • Relevant: Important to you, your values and your health
  • Time Frame: When will you start? 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 you work with? Who will you share with?
  • Anticipateand prepare for roadblocks
  • Enlist support. Consult with your family doctor. Choose a coach or teammate: your partner, friend or neighbor.

 

THE 4 FOUNDATIONS OF SELF-CARE

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

 

Please share this information with your family, friends and anyone else who may find helpful.

Together we’ll create a healthier community and a healthier future.

 

 

Categories
Burnaby Division of Family Practice Emotions Happiness Healthy Living mindfulness Uncategorized

Mastering Your Emotions

I will be speaking on the topic of finding inspiration on Saturday, March 3rd at Century House 620 Eighth Street, New Westminster. Century House’s annual Inspiration Day events run from 10 am to 1 pm. Tickets are $8.00 ($6.50 for Century House members). Please call 604-519-1066 for more information.

inspiration-day

Everyone wants to be happy.

While we consume much of our time, attention and energy in the pursuit of happiness, the experience of happiness may seem transient and fleeting; we may enjoy pleasure, satisfaction and even joy for a time but these feelings always fade, and we’re back on the hunt for happiness.

Although emotional health is as important as physical health, most of us haven’t been taught how to foster emotional wellbeing. We recognize when we are sad, angry, anxious or happy but we usually ascribe the cause of these emotions to our circumstances.

We are sad when we suffer a loss, angry when we are insulted, anxious when facing adversity and happy when luck comes our way. Sometimes our emotions can be so strong that they narrow our thoughts. When anxious, we overestimate the challenges before us and underestimate our ability to meet them. When depressed, we think negatively about our selves, our situation and the future. When angry, we can only see our own points of view and how we have been harmed.

Our emotions exist because they helped our ancestors survive in the primitive world of the past. They have served important functions. Sadness helps us appreciate what we value most. Anger moves us to defend our selves and our loved ones. Anxiety alerts us to potential danger.

When a situation arouses our emotions, the less evolved early mammalian areas of the brain (the limbic system) are activated, highjacking our higher cortical functions, including our thoughts. That’s why judgment can be so impaired with anger . . . or when we fall in love.

The drama of human history and our own personal narratives arise from the sea of our emotions in which we toss and turn under the apparent influence of outside forces – what happens to us by circumstance or the actions of others. And throughout history, we have sought relief outside of our selves by consuming alcohol and other mood-altering chemicals.

Today we have reached a momentous time in history. Although we see daily in the news the best and worst in human behaviour, neuropsychology has essentially unveiled the user manual for the human mind. The established therapeutic approaches of mindfulness and cognitive behavioural therapy have been shown to change how our brains function and help us manage our own thoughts and emotions.

In upcoming columns, I’ll share these proven strategies to tame our emotions and foster emotional wellbeing.

I’ll be speaking on the topic of Emotional Wellness on Monday, March 5th at 7 pm at the Bob Prittie Metrotown Branch of the Burnaby Public Library in a free presentation put on in partnership with the Burnaby Division of Family Practice’s Empowering Patients public health education program. I’ll talk about how emotional health is as important as physical health, affecting every aspect of our lives; recognizing the symptoms of stress, anxiety, mood and other psychological conditions; key emotional health skills including emotional awareness and mindfulness, stress management and the managing of thoughts and feelings; and where to find help. Because seating is limited, please register online at www.bpl.bc.ca/events or in person at any branch. For more information, call 604-436-5400.

Davidicus Wong