SEPTEMBER 2013
HEALTH CARE
DIRECTORY2013
Part 4
HEALTHCARE DIRECTORY A SPECIAL ADVERTISING SUPPLEMENT OF THE BERMUDA SUN SEPTEMBER 27, 2013 PAGE 1
Wealth is not a factor in your health In this edition of the Bermuda Sun’s Healthcare Directory, we focus on women’s health and well-being. Inside, you will find advice on a range of health issues, ranging from Premenstrual syndrome to what to expect from the menopause. October is Breast Cancer Awareness Month and you can read about the importance of regular mammograms, inside. November is Diabetes Awareness Month and you can read advice from the experts on how to prevent this condition and treat it. We wish you a happy, healthy end to 2013.
BY DR HILDA DUNSMORE AND GLORIA BURGESS Department of Health
When it comes to our personal health and that of our loved ones, we all are looking for the best affordable healthcare. We are fortunate in Bermuda to have the choice of well-qualified and helpful medical, dental and nursing practitioners, and allied medical professionals. When necessary, connections to specialist medical centres in Canada and the
US are also well established. However, in these times of recession and financial strain, specialist medical care may seem out of reach at times, and we have to do our best with limited resources and cut our coat according to our cloth. That does not mean second-best, but rather, a compromise where we take more responsibility for our health and that of our family, and seek appropriate care when necessary. The goal of the Ministry of Health and Seniors is
‘Healthy people in healthy communities’. The Department of Health holds clinics at St George’s, Hamilton, Warwick and Somerset in order to reach out to all island areas. We hold clinics for babies, childhood immunization, child health, travel health, family planning, sexual health and communicable diseases, and seniors.
Screening The Maternal Health and Family Planning Clinics (MHFP) are staffed by doctors, nurses and midwives experienced in obstetrics and gynaecology. We hold daily clinics in Hamilton and weekly clinics in St George’s and Somerset. Free information and advice on sexual health is offered, and emergency (‘morning after’) contraception is available as a drop-in service at all clinics.
We offer affordable contraception (birth control), gynaecological screening, sexual infection screening and treatments. When needed, referrals for breast investigations and specialist gynaecologist/physician services are arranged. No woman without medical insurance in Bermuda should feel unable to afford her annual gynaecology review, with appropriate cervical screening, pelvic examinations and regular screening tests. We work in collaboration with Bermuda Cancer and Health Centre to offer breast screening and mammograms, bone densitometry screening, and information about cancer prevention. Pregnant women without medical insurance cover are welcome to attend our clinic See ACCESS FOR ALL, page 15
Inside this supplement How the Department of Health is ensuring universal access to care Pages 1 and 15 Health Disparities Report 2013: How women shape up Page 2 Breast Cancer Awarness Month: How early detection can bring a cure Pages 3 and 12 The reproductive cycle: Premenstrual syndrome (PMS) Page 4
Bermuda Sun 19 Elliott Street, Hamilton, Bermuda HM 10 Tel 295-3902 Fax 292-5597 E-mail feedback@bermudasun.bm This special supplement is produced and published by Bermuda Sun Limited and printed in Bermuda by Island Press Limited.
What can I expect from the menopause? Page 5 Bring energy and peace into your home, with feng shui Page 6 How learning CPR can mean the difference between life and death Pages 7 and 16 Home births in Bermuda Page 8 Diabetes Awareness Month: The warning signs Pages 9-10 Are you at risk? Pages 10 and 13
Publisher Randy French President Lisa Beauchamp Editorial Amanda Dale Layout Amanda Dale Advertising Sales Carlita Burgess (deputy advertising manager), Larissa French, Diane Gilbert, Claire James Creative Services Christina White, Colby Medeiros Circulation & Distribution Michelle Furbert
’Shopping Sense’ tours to help your family stay healthy Page 12 Discover a holistic oasis at My Sereni-Tea Page 13 Non-invasive weight loss with Ultrasonic Cavitation Page 15 Blood — the life force inside every one of us Page 16
The Bermuda Sun publishes twice weekly and is a subsidiary of MediaHouse Limited. We are members of the Inland Press Association, International Newspaper Marketing Association and the Newspaper Association of America. We are located at: 19 Elliott Street, Hamilton HM 10; P.O. Box HM 1241, Hamilton HM FX Tel: 295-3902 Fax: 292-5597. Visit our website: www.bermudasun.bm
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HEALTHCARE DIRECTORY: A SPECIAL ADVERTISING SUPPLEMENT
THE BERMUDA SUN
How healthy are Bermuda’s women? Routine check-ups, but a fifth suffer from domestic abuse SUPPLIED BY THE BERMUDA HEALTH COUNCIL (BHEC)
‘Women smoked less, ate more fruit, had fewer sexual partners, and skipped breakfast less often than men.’
If good health were a competition, then the female residents of Bermuda appear to be on to a winner. Earlier this year, the Bermuda Health Council (BHeC) published the Health Disparities Report 2013. The report examined health inequalities on the island in four areas: health outcomes; healthcare access; health-related behaviours; and health expenditure. These areas were then further explored through various demographics, including gender, household income, education, age, marital status, employment status and race.
Support What did we find in terms of women and their health? Overall, the report found that women were more likely to practice healthy behaviour and to access healthcare compared with men. Women smoked less, ate more fruit, had fewer sexual partners, and skipped breakfast less often than men (see Graph I). They also reported feeling more satisfied with life – 32 per cent vs. 22 per cent of men, however, they were less likely to report feeling well every day — at 62 per cent vs. 69 per cent of men. Women however, were more likely to receive social and emotional support when they needed it compared with men (36 per cent vs. 26 per cent). And though Bermuda’s road accident death rate in 2006 was three times higher than other Organization for Economic Co-operation and Development (OECD) countries, women were less likely to be in an accident and were more likely to use a seatbelt than men. Women were also more likely to undergo routine
n GRAPHS SUPPLIED
GENDER DIFFERENCES: Graphs I and II above, show the contrasts between men and women in outlook and behaviour. check-ups compared with men. In the year prior to the survey, they were more likely to have visited their doctor and dentist (see Graph II). These routine visits help to catch health concerns before they escalate, and are vital for staying healthy. With Bermuda’s adult population reporting increasing rates of high blood pressure (36 per cent in 2011 vs. 25 per cent in 2006), women were also more likely to have undergone blood pressure tests in the year prior to the survey. These tests are important in order to address any issues early. Prevention is better than cure, and the data shows Bermuda’s women understand this. In the two years before the survey, up to 80 per cent of eligible women underwent a mammogram and Pap test. For mammograms we focused on screening exams
starting at age-50, prescribed according to the 2009 US Preventive Services Task Force (USPSTF). For Pap tests we focused on the starting age of 21, according to joint guidelines issued by the USPSTF and American Cancer Society. The rate of mammogram screening in Bermuda however, varied by employment status and race. And for Pap tests, the rate was affected by age, employment status and education levels. White women were more likely to have undergone a mammogram, while women with a higher education were more likely to have never had a Pap test. Pap tests were most common among young women. While women generally do a good job in taking care of their physical health, their physical safety is less clear-cut. Women were three times more likely than men to report experiencing domestic violence, with a fifth
having suffered abuse (19 per cent vs. seven per cent of men). They were also more likely to report experiencing fear of violence than men (12 per cent vs. eight per cent). Fearing violence, however, was disproportionate to actually sustaining an injury resulting through violence. Men were more likely to have suffered an injury from violence than women (six per cent vs. two per cent). What these results show us is that health, though not a competition, is not equal either. While we should celebrate women’s healthy behaviour, we should also encourage men to join us in its pursuit. Furthermore we should always be concerned over results that show either gender experiencing more, or fearing more, violence in their lives. While some of the numbers are unfortunate, the Health Disparities Report 2013 provides Bermuda with a picture that can help to illuminate the trends where health system stakeholders should work together to eradicate problem areas. n
FOR MORE INFORMATION and the full Health Disparities Report, visit: www.bhec.bm
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n OCTOBER / Breast Cancer Awareness Month
Early detection brings a 90 per cent cure BY DR PAUL COTY Bermuda Hospitals Board
There were 81 cases of newly-diagnosed breast cancer in Bermuda in 2011, reported by the Bermuda National Tumour Registry. Most of the women were between the ages of 50 to 69, and only DR COTY one was younger than age 40. According to recent data, women in the US have a one-in-nine chance of getting breast cancer in their lifetime.
Mammograms The rate of new breast cancer in Bermuda is very close to the incidence of breast cancer there. If caught early, breast cancer is curable. Early detection is primarily accomplished with regular mammograms. Internationally, recommendations for mammograms vary slightly. In general a woman is advised to get a baseline mammogram at age 40 and to start regular mammograms from 50. Most cancer organizations
n PHOTO SUPPLIED
LIFE SAVER: Regular mammograms are recommended. recommend annual mammograms. Mammograms don’t find all breast cancers, so an additional annual breast exam by a doctor is also recommended. Other breast imaging, like ultrasound and MRI (magnetic resonance imaging) are sometimes used, but not recommended for regular screening, except in special circumstances. One out of 100 breast cancers is found in men. When cancer is discovered by a mammogram
or physical exam, the primary treatment is surgery to remove the cancer (tumour). Surgically removing an early breast cancer gives a good chance of cure. Over the years, we have improved surgical cure rates by adding chemotherapy, radiation therapy and hormonal therapy. For most early breast cancers, the chance of cure is now more than 90 per cent. Metastatic breast cancer is an unfortunate situation where the cancer has already spread around the
body. In these cases the cancer is not curable but is treatable, using mostly hormonal therapy and chemotherapy. Women with metastatic breast cancer commonly live several years, through a variety of treatments. You may know someone with breast cancer or with a history of it, and this is because many women are survivors of breast cancer. This is due to the many great advances of modern medicine. We applaud all cancer survivors for their courage and strength, and we encourage all women to screen for breast cancer. It is easy and readily available. The following services for diagnosing breast cancer are offered at King Edward VII Memorial Hospital. Please call 239-9729 to make an appointment. Mammography has become an essential tool for the detection of breast cancer before it spreads to other parts of the body. The breast is compressed and X-rayed to reveal abnormal-looking masses, that can then be biopsied using fine needle aspiration or stereotactic breast biopsy, a minimally invasive See BREAST CANCER, page 12
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n WOMEN’S HEALTH / Our reproductive cycle
Demystifying premenstrual syndrome BY AMANDA DALE adale@bermudasun.bm
PMS — premenstrual syndrome — is often referred to as ‘that time of the month’, and in the past was often trivialized and misunderstood. In days gone by it was often dismissed without further disDR FULTON course, but these days there is a much greater understanding about its complex emotional and physical side effects. Treatments to ease the symptoms have advanced greatly, but research continues into this complicated condition. In severe cases it can make women suicidal and so this condition needs to be taken seriously by all. Dr Ian C. Fulton, a consultant gynaecologist, explained the effects of PMS and what can be done to ease the symptoms.
Bloating “PMS is a recognized condition that can affect women at any time during their reproductive years,” said Dr Fulton. “It is most common among women in their forties and can last until the menopause, at age 45 to 55. “There are times in a woman’s life when the symptoms may get a lot worse, but we still don’t fully understand the real cause, so it is hard to treat. “Up to 75 per cent of women probably get some premenstrual type of symptoms, with 10 per cent getting a more serious disorder, known as premenstrual dysphoric disorder. This is quite a severe condition that can have a significant impact on their lives. “Many years ago, premenstrual symptoms were just thought to be related to the progesterone hormone,
as the defining factor. But scientific studies went on to show that this didn’t affect symptoms.” Dr Fulton said scientific research into PMS was fraught with indefinite conclusions, because — as is normal with medical testing — up to a third of people report a placebo affect. “The problem with any kind of treatment for PMS is that it’s hard to measure the improvement of any symptoms. “Whatever you give someone, 30 per cent of a study group will say they ‘feel better’, so the placebo rate makes harder to judge the effectiveness of medication.” He said current thinking is that “oestrogen and progesterone hormones are somehow involved in premenstrual syndrome, along with neurotransmitters in the brain, such as serotonin”. “There is probably some interaction between the ovarian hormones and neurotransmitters, among the women most susceptible to PMS. “A small percentage can get very severe symptoms, which can have a terrible impact on their lives, but if you measure the ovarian hormones, there is no difference in the levels, so it’s not just these hormones — something else is going on which causes PMS symptoms, and this comes down to the individual woman. “Also, some women seem genetically predisposed to more severe symptoms,” he added. PMS symptoms can range from mild to severe, in each individual woman. “The symptoms usually start on ovulation (14 days before a period) and last until the first two or three days of the period (bleeding),” said Dr Fulton. “They are usually at their worst about four or five days before the period. “PMS is often a combination of emotional and
physical symptoms, and can include mood swings, irritability, anxiety and depression. “Physical symptoms can include breast tenderness, bloating, headaches, and some people also get fluid retention. The bloating is caused by bowel distension, when the bowel distends with fluid. “When the period starts, the symptoms are relieved, but in some women they may continue for two or three days into the bleeding as well. “Once the symptoms ease, many women say it’s like a ‘cloud has been lifted’, and their life returns to normal. “It’s the severity of the symptoms which causes problems,” said Dr Fulton. “Some women can get suicidal. There have also been crimes committed by women in their premenstrual phase —anything from assaults to shoplifting.
Short-tempered “Women can also struggle at work. Sometimes, if they find themselves under more pressure or in a difficult situation with a colleague or client, they can ‘go off the deep end’, at the minimal amount of provocation. “This can result in angry outbursts, crying for no apparent reason, and being short-tempered at home and at work. PMS can therefore also affect marital and family harmony. “But most women have some understanding of PMS these days.” In order to combat PMS, the first step is to try some ‘lifestyle adjustments’. “Most women are aware of the times when it’s going to be more difficult for them during their monthly cycle, and so they will try to avoid difficult situations and unnecessary stress, and try to get as much rest as possible,” said Dr Fulton. “There is a suggestion that exercise helps PMS symptoms, so you may want to try more exercise during
that time of the month, and avoid stimulants such as caffeine and alcohol. “Some women also get an addiction to chocolate in the premenstrual phase, but probably the most effective treatment for PMS is an antidepressant, such as paroxetine or fluoxetine (eg. Prozac) that raises the levels of serotonin in the brain. “For women with more severe symptoms and who don’t respond to lifestyle changes, they are usually prescribed these antidepressants. “They can be taken every day or just from the 14th day of your cycle until after you start to bleed, so you can also take them on a cyclical regime. “Oral contraceptives can also be used to help alleviate symptoms. Recent studies have shown there is some benefit, that if you take the Pill for three months on a continuous basis, without any ‘Pill-free’ weeks, this can improve PMS symptoms. “There is also another treatment used for very severe cases, that causes a ‘medical menopause’. “This is when you give the patient a GnRH agonist (a gonadotropin-releasing hormone), which depletes the pituitary gland in the brain of hormones stimulating your ovaries, so this induces a menopause. “Your ovaries stop functioning as there are no ovarian hormones produced, but once you stop the medication — which is a monthly injection — things go back to normal.” He said: “The majority of women do improve their PMS symptoms through lifestyle changes. “But if that’s not working they can be referred by their GP to a specialist for further treatment.” n
DR IAN C. FULTON is a consultant gynaecologist. His practice is at Ralmar, 15 Point Finger Road, Paget. Call 232-0789.
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What can I expect from the menopause? BY DR DALE WILMOT Bermuda Hospitals Board
While many women may have concerns about ‘going through the change,’ the good news is that with proper care by a physician knowledgeable in managing menopausal conditions, most women will DR WILMOT find their symptoms can be controlled. Menopause is the time in a woman’s life when menstruation ceases, due to a decreased production of estrogen, and it marks the end of a woman’s reproductive years. Perimenopause refers to the early signs of menopause and usually causes a change in a woman’s menstrual cycle that can include skipping periods during months.
Hot flushes Eventually, the ovaries will stop producing estrogen and menstruation will cease completely. It is important to note a woman is not free from the risk of pregnancy until one year after her last menstrual period. While the average age of menopause is 51, it can also be brought about by surgical removal of the ovaries. Hot flushes, the most common symptom of menopause — experienced by nearly 75 per cent of women — are when a woman feels heat rushing to her upper body and face, causing her to break out in a sweat. A hot flush may last from a few seconds to several minutes and can interrupt sleep. A lack of sleep may be one of the biggest problems a woman faces in menopause, resulting in increased anxiety, irritability and fatigue. Decreased levels of estrogen in menopause also cause vaginal thinning and dryness, which can result
n ISTOCK PHOTO
FREEDOM: With advances in treatments, the menopause is not the purgatory it used to be for previous generations. in frequent vaginitis, painful sexual intercourse, accelerated bone loss and an increased risk of bone fractures. In addition, the urethra may become dry, irritated and easily inflamed, leading to urinary frequency and an increased risk of urinary tract infections. Treating menopausal symptoms may include medications such as the antidepressant Effexor, or the anti-seizure medication, Gabapentin, both of which relieve hot flushes. Clonidine and Aldomet — anti-hypertension medications — may also mitigate hot flushes. Non-hormonal treatments for the accelerated bone loss of menopause include medicines like bisphosphonates or Selective Estrogen Receptor Modulators (SERMs) and calcitonin. Calcium supplementation and weight bearing exercises are also helpful. Vaginal dryness may be relieved with the use of lubricants or moisturizers like Replens that are absorbed into the lining of the vagina, where they replenish moisture, restore natural acidity and may alleviate painful sexual intercourse. Because these effects last
a few days, vaginal moisturizers are used every two to three days, as needed. Lubricants can be used each time a woman has intercourse, to relieve discomfort and dryness. Silicone-based lubricants last longer than watersoluble lubricants. Oil-based lubricants, like petroleum jelly and mineral oils, work well, but should not be used with condoms, as they may cause condoms to break. Plant-based, botanical products, like soy, black kohosh or primrose oils are often used to treat the symptoms of menopause. Available as pills, teas, tinctures and oils, studies do not indicate they consistently work. Although some women may find relief with botanical products, there are some safety concerns associated with these products, which are not regulated and do not comply with formal manufacturing standards. Botanical phytoestrogens act very much like standard hormone therapy and consequently may increase the risk of some medical conditions, interact with other medications and cause side effects. Hormone replacement therapy (HRT) consists of estrogen, estrogen and pro-
gesterone, or progesteroneonly regimens. They are administered in a variety of forms, including pills, patches, gels, creams, sprays and intrauterine devices. While HRT has proven effective in treating menopausal symptoms, by preventing osteoporosis and hip and spine fractures, relieving vaginal dryness and reducing the incidence of breast cancer (estrogenonly use), it also carries some risks. These may include an increased risk of strokes, breast cancer, deep vein thrombosis (DVT), gallbladder disease and endometrial cancer. Researchers continue to look closely at the risks and benefits of HRT. Studies are underway to determine whether the risks associated with HRT are related to when therapy is started, how long it is used and how therapy is administered. If a woman currently has a DVT or a history of DVT, a pulmonary embolism, active or recent cardiovascular disease, breast cancer, liver disease or undiagnosed uterine bleeding, she should not receive HRT. However, if a woman is healthy, HRT may be used safely, but should be limited to treating the symptoms of menopause and preventing bone loss. The lowest effective dose used for the shortest duration of time possible is recommended. Continued use of HRT should be reviewed on a yearly basis by a physician familiar with managing menopausal conditions. With proper care and treatment, many of the unpleasant side effects our mothers and grandmothers faced may not prove as challenging to women these days. n
DR DALE WILMOT is Chief of Obstetrics and Gynaecology for the Bermuda Hospitals Board.
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BY MICHELE SMITH
and grow, as families. With growth comes change, and with change comes an opportunity to try feng shui. Feng means wind and shui means water. Feng shui applies various techniques to enhance the life of a person as a whole. And while the practice can seem quite complex, you’d be surprised how close you can get just by simply letting your intuition tell you what you like in the
THE BERMUDA SUN
Bring peace and energy into your home OBMI
To promote health, happiness and prosperity there are many easy feng shui tips you can apply to create a better quality of energy in your home. Our home is where we live, gather SMITH
ARCHITECTURE
INTERIOR DESIGN
‘The two most important corners of the home are the northwest and southwest... ’ house, and how you want to arrange it. For women, here are some Yin Yang-based feng shui
LANDSCAPE ARCHITECTURE
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techniques for enhancing the quality of a woman’s life. The two most important corners of the home are the northwest and southwest, as they signify the husband and wife, father and mother. These two corners are the Yin and Yang and they form the foundation of the family and ensure it stays firmly bound. As the southwest is the woman’s sector, enhancing the southwest corner of the living room, the bedroom or the house in general increases the qi (chi) energy beneficial to women. Introduce elements such as ‘earth and fire’, which are represented by square and pointed shapes, and the colours of red, orange, purple, pink, beige, cream and yellow, in objects like porcelain, clay, stones, crystals, candles and birds. Alternatively, displaying metallic or earth objects in the northwest enhances luck in networking and brings influential friends and mentors into one’s life. Candles and other fire objects should be removed from the northwest. Other feng shui components introduced without much effort are: n Air-purifying plants, such as peace lilies, spider plants and African violets. n Allow fresh air and natural light to infiltrate your home. n Use essential oils to purify. n Create a clutter-free environment. n
MICHELE SMITH is managing director of OBM International/Bermuda. Contact 278-3550. For more information on feng shui see www.fengshui.aboutcom
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SUPPLIED BY BERMUDA RED CROSS
CPR is a combination of chest compressions and rescue breaths. When the heart is not beating, chest compressions can help to circulate blood and oxygen to the brain and organs. Given together, they help to take over the role of the arrested heart and lungs, increasing the person’s chances of survival.
SEPTEMBER 27, 2013 n 7
The difference between life and death When it comes to risk and responding to emergencies, we know that a lot of emergencies happen in our own homes. Most emergencies tend to be of a personal nature, with cardiac arrest and heart attacks common. Cardiovascular disease is a condition that affects the heart and blood vessels, and is the number one killer in the US. It is also a major cause of disability. The most common conditions caused by cardiovascular disease include coronary heart disease and stroke. Learning how to give cardiopulmonary resuscitation (CPR) saves lives. When someone suffers a heart attack or cardiac arrest, the brain and other vital organs are deprived of oxygen-rich blood.
Signals The most common signal of a heart attack or cardiac arrest is persistent pain. This can be discomfort or pressure in the chest that lasts longer than three to five minutes, or that goes away and comes back again. Unfortunately, it is not always easy to tell the difference between heart attack pain and the discomfort of indigestion, muscle spasms or other conditions. The pain commonly associated with a heart attack
can range from discomfort to an unbearable crushing sensation in the chest. The person may describe it as pressure, squeezing, tightness, aching or heaviness. Many heart attacks start slowly as mild pain or discomfort in the centre of the chest. The pain becomes constant and is not relieved by resting, changing position or taking medicine.
ing the person to take it. Call 911 or the local emergency number. Also try to comfort and reassure the person. Do not give anything by mouth unless the person is fully conscious. Be prepared to give CPR and to use an AED (Automated External Defibrillator) if one is available.
Take action
CPR on its own is not enough to help someone survive. Advanced medical care is needed as soon as possible. A person in cardiac arrest will have the greatest chance of survival by following these four links in the Cardiac Chain of Survival. n Early recognition and access to the emergency
If the person is conscious, get them to stop moving and to rest. Sitting up can be the most comfortable position. Find out if they have experienced such a situation before and ask if they have a history of heart disease. Some people with heart disease take a prescribed medication for chest pain. You can help by getting this medication and assist-
Cardiac Chain of Survival
See SAVING LIVES, page 16
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The growth of the home birth movement BY SOPHIA CANNONIER It’s hard to believe that only nine years ago, every pregnant woman in Bermuda gave birth at the hospital. There was simply no choice in the matter. But I am happy to report now that CANNONIER a lot has changed since then. Bermuda’s home birth movement was born on September 17, 2004. I will always remember this date as it is the day I took my innate birth power into my own hands and welcomed our son Ravi into this world. His was an ecstatic and undisturbed home birth. Immediately afterwards, I remember thinking, ‘Why can’t all women experience this? They don’t know what they are missing.’ I was a new mother, a devoted partner, successful entrepreneur and business owner. I did not really have time to spare. Nevertheless, I was so deeply moved by my birth experience that I set forth to find out why my sisters in Bermuda were not being offered the choices that I had courageously revived for my son. My mother had lovingly shared all four of her positive home stories with me throughout my early childhood and into adulthood. I just knew that when it was my turn, I wanted to birth like she did. She was my first birth hero. But once I started digging, what I discovered was shocking and depressing. For example, around 1970, all but a few of Bermuda’s midwives had been erased from the community to make way for medicallytrained surgeons, or obstetricians, to practice. I found out it was common for women to have episiotomies and forceps
‘I will continue to strive for the Midwifery Model of Care.’
n FILE PHOTO
NATURAL: A woman gives birth in the comfort of her home. used during their deliveries, as well as stitching up afterwards. All women were conditioned to believe that birth was neither safe nor legal at home anymore. I needed to find a way to support women both emotionally and physically during birth in the hospital, so I became one of Bermuda’s first doulas — and the most ‘radical’ one, to say the least. I attended more than 200 births at the hospital.
Misunderstood It was soon unveiled that the only form of pain management on offer on the maternity ward at the time was pharmacological drugs. There were no water tubs, birth balls, squat bars or ‘home like’ rooms with windows. No place for the husband or partner to snuggle up for the first night with his goddess and newborn child. And even more frustrating was the reality that the midwives on staff at the hospital had been recruited to work as obstetric nurses, and therefore ‘not allowed’ to catch the baby if the obstetrician had not arrived by the time the mother felt her body pushing. Doulas were a new phenomenon and totally misunderstood. They were told to
wait in the waiting room. No one on staff wanted them around as they had no idea of the proven benefits of using one as yet. My desire to change the way women in Bermuda birthed became a passion. I organized the island’s first doula training sessions. Next, The Mother Baby Film Festival, where The Business of Being Born and Orgasmic Birth premiered. I even included a film called The Drugging of Our Children, and invited Dr Gary Null to speak. In between all of these necessary path-paving exercises, I had Bermuda’s first planned home water birth in my living room. Vidya Josephine was born in her ‘caul’, which was very magical indeed, with a Bermudian midwife who helped her arrival into the hands of her supportive father. Despite controversy in certain circles over my actions, amazing things began to happen. Couples began contacting me to find out how they too could plan a safe and satisfying home birth experience. In 2005, the average number of births in Bermuda per year was 850, and regardless of whether women were considered
low-risk, five obstetricians managed the births between them. Today, in 2013, there are an average 600 births per year and seven obstetricians. Where are we now? I am happy to report several positive changes that have taken place over the years. Five out of the seven practicing obstetricians have each witnessed at least two clients plan, execute and enjoy home water births. The obstetricians, however, were not present at the home births. There have been 42 home and water births in the last nine years, with two more families planning to birth at home this month. Doulas are more welcome on the maternity wards and recognized for their value. The hospital has painted each of the four delivery rooms a pretty colour. Delayed umbilical cord clamping has been approved and implemented by the hospital staff. I assure you that I will continue to strive for water tubs, birth balls, squatting bars and family rooms for overnight stays. I will continue to strive for the Midwifery Model of Care. But will it take another 10 years to implement these simple yet profoundly effective changes? This is the big question. n
SOPHIA CANNONIER is a certified birth doula, midwife assistant and co-director of Lotus Mind Body Spirit Wellness and Birth Centre (Best of Bermuda Award 2013). Go to www.consciousbirthbermuda.com
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SEPTEMBER 27, 2013 n 9
n NOVEMBER / Diabetes Awareness Month
Look for the warning signs and act early BY DEBBIE JONES Bermuda Hospitals Board
When people think of diabetes, they often think it means injections with needles. However, only about 10 per cent JONES of people
with diabetes have Type 1, which does require insulin injections. More than 95 per cent of people with the condition have Type 2, and when managed properly, they rarely need injections of insulin. While Type 1 diabetes has been around for thousands of years and cannot be prevented, Type 2 diabetes is the result of poor lifestyle
choices. This includes calorie-rich and nutrition-poor diets and a lack of exercise. Although Type 2 diabetes can be prevented and even reversed, it has now become an epidemic affecting almost 500 million people worldwide. The Centers for Disease Control and Prevention have reported that the prevalence of diabetes in
adult Americans grew by 45 per cent over the past 20 years. The greatest increase was seen in those over the age of 65. Diabetes means there is too much sugar in the blood, caused by not having enough insulin. Insulin is a hormone made in the pancreas that See PREVENTION, page 10
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6:15am-7:15am Challenge Ride (Spinning) - Gladwin
6:15am-7:15am X-Treme Passion Ride (Spinning) - Bertha
6:15am-7:15am X-Treme Fitness - Bertha
6:15am-7:15am X-Treme Fitness - Bertha
7:30am- 8:30am X-Treme Passion Ride (Spinning) - Bertha
9:30am-10:30am Les Mills Body Combat® - Nerseh
9:30-10:30am Total Fit - Andrea
9:30-10:30am Les Mills Body Combat® - Beks
9:30-10:30am Cardio Fit - Sharlene
9:30am-10:30am Les Mills Body Combat® - Beks
9:00am- 10:00am Les Mills Body Combat® - Nerseh/Alnisha/ Beks
12:15-1:00pm Step/Kick - Sharlene
12:00pm-1:00pm Les Mills Body Combat® - Nerseh
1:15pm-2:00pm Performance Ride (Spinning) -Fish (Derek)
1:00-1:45pm Core Fit - Sharlene
5:15- 6:00pm Les Mills Body Combat® - Alnisha 6:15- 7:30pm X-Treme Passion Ride (Spinning) - Bertha
5:15-6:15pm Island Flava (Zumba Toning®) - Bertha
10:30pm-11:30am Les Mills Body Combat® - Christina
10:00am-11:15am Cardio Combo - Sharlene
12:15-1:00pm Body Blast - Beks
12:00-1:00pm Les Mills Body Combat® - Nerseh
12:15-1:00pm Keep Calm and groove on - Beks
11:30am- 12:30am X-Treme Fitness - Bertha
1:15pm-2:00pm Performance Ride (Spinning) -Fish (Derek)
1:15-2:00pm Performance Ride (Spinning) - Fish (Derek)
1:00pm-1:30pm Core Strength Training - Sharlene
1:00pm-2:30pm Jujitsu - Master Burnell
5:30pm-7:30pm Xtreme Fitness -Bertha
5:30pm-6:15pm Socaerobics - Andrea
5:30pm-7:30pm Xtreme Fitness - Bertha
Sunday
9:05am-11:00am Xtreme Fitness - Bertha 11:00am 12:30pm Jujitsu - Master Burnell
6:30- 7:15pm Total Fit - Andrea
* Jujitsu classes are not included with club membership or punch cards. Please inquire with Mater Burnell for further details. AEROBIC CLASSES ARE SUITABLE FOR ALL LEVELS OF FITNESS - SCHEDULE EFFECTIVE AUGUST 31, 2013
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Health is Wealth - Call 292-4095 today and invest in yourself for less!
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Know your risks: how to avoid diabetes BY MICHELLE JACKSON The Argus Group
Diabetes is a condition that affects how your body uses blood glucose, commonly called blood sugar. Glucose is vital to your health as it is an important source of energy for the cells that make JACKSON up muscles and tissues. However, people with diabetes have too much glucose in the blood. Your body needs insulin produced by the pancreas to change the sugars from food into energy and to regulate blood glucose levels. When your body doesn’t produce enough insulin or doesn’t use insulin properly, the blood sugar levels elevate, which can eventually cause serious health complications, such as blindness, kidney failure and amputation of the feet and legs due to poor circulation and nerve damage. Poorly-controlled diabetes
PREVENTION Continued from page 9 transports sugar from the blood into muscle and fat cells. Diabetes can also be caused when insulin is not working properly. In Type 2 diabetes, you still make insulin but this process no longer works effectively. Called insulin resistance (IR), this is linked to excess weight. At the start, the pancreas keeps up with the need for excess insulin, helping sugar to enter the cells. But over time, the pancreas is unable to keep up with demand and blood sugar levels start to go up. High blood sugars damage nerve and blood vessels, leading to problems such as heart disease, stroke, kidney disease, blindness and amputations. Studies from around
n ISTOCK PHOTO
ACTIVITY: Exercise can help to keep diabetes at bay. also increases the risk of heart attacks and strokes. Gestational diabetes and pre-diabetes can be reversed if the right care is taken. Gestational diabetes develops when the body is not able to properly use insulin during pregnancy. Gestational diabetes disappears once the baby is born but the mother may be at risk of developing Type 2 diabetes. Whereas pre-diabetes occurs when a
person has higher levels of blood sugar than normal, those numbers are not high enough to be diagnosed as Type 2 diabetes. Pre-diabetes, if managed, is reversible with healthy lifestyle changes. Both Type 1 and Type 2 diabetes are lifelong conditions once developed and must be managed properly. Type 1 diabetes occurs when the body fails to produce insulin. The exact
the world have confirmed that weight loss through increased physical activity and a healthy meal plan can delay or prevent Type 2 diabetes. It is very important, therefore, to know if you are at risk for Type 2 diabetes. If any of the following apply to you, see your physician and have a blood test, to determine if you have diabetes or are at risk of developing it. Risk factors are: n You are 45 years of age or older. n You are overweight or obese. n You have a parent, brother or sister with diabetes. n You have an African Bermudian, Native American Indian, Hispanic or Asian family background. n You have had gestational diabetes. n You have given birth to
a baby weighing more than nine lbs. n You have elevated blood pressure, greater than 135/85, or have been told you have hypertension. n You have higher than normal cholesterol levels, with a low good cholesterol (HDL), high bad cholesterol (LDL) and/or elevated triglyceride level. n You are inactive. n You have been diagnosed with polycystic ovary syndrome. n You have high blood sugar levels. n You have acanthosis nigricans, characterized by a dark velvety rash around the neck or armpits. n You have a history of cardiovascular disease. You should also consider: Have you noticed you need to use the bathroom more often and that you are getting up through the night to urinate? Your blood
cause is unknown but it is usually diagnosed in children and young adults. Type 2 diabetes is the most common type in Bermuda and takes place when the body becomes insulin-resistant. At first, the pancreas makes extra insulin to make up for it. But over time, it isn’t able to keep up and cannot make enough insulin to keep the blood glucose at normal levels. Risk factors for developing Type 2 diabetes are: n Weight. Being overweight is a primary risk factor for Type 2 diabetes. n Fat distribution. If your body stores fat primarily in your abdomen, your risk of Type 2 diabetes is greater than if your body stores fat elsewhere, such as your hips and thighs. n Inactivity. The less active you are, the greater your risk of Type 2 diabetes. n Family history. The risk of Type 2 diabetes increases if your parent or sibling has this condition. n Race. Although it’s See DIABETES RISKS, page 13 sugar may be high. Are you thirsty all the time? If this goes hand in hand with urinating more often your blood sugar may be elevated. Are you tired all of the time? Is your vision blurred ir do you difficulty reading the newspaper? If you have noticed any of these symptoms or have any of these risk factors, you should make an appointment to see your doctor. Don’t put it off. The sooner you are diagnosed with Type 2 diabetes the sooner you can start learning how to be healthy. By making a few simple changes to your meal plan and beginning a regular physical activity programme, you will be feeling better in no time. n
DEBBIE JONES is a diabetes nurse educator at the Bermuda Hospitals Board.
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SEPTEMBER 27, 2013 n 11
ALCOHOL, TOBACCO, & OTHER DRUG USE AND PREGNANCY Submitted by the Research Unit of the Department for National Drug Control (DNDC) www.dndc.gov.bm
The use of alcohol, tobacco, and other drugs (ATODs) during pregnancy is common in jurisdicutions such as the UK and US; and Bermuda is no exception. According to the 2009–2010 Alcohol Use Disorder Identification Test (AUDIT) conducted by the Department for National Drug Control, 14.3% of pregnant women surveyed indicated use of marijuana in the 12 months prior to the survey, while 3.6% indicated use in the 30-day period prior to the survey. Further, 21.2% of all pregnant women who indicated episodes of binge drinking (five or more alcoholic drinks at once in the past two weeks) were, in fact, in their third trimester. The same survey also found that women who used marijuana and drank alcohol, also smoked cigarettes and participated in other activities that can also cause problems in a newborn baby. For instance, 13.7% of the respondents indicated tobacco use in the past–year reference period, while 3% indicated using tobacco in the month preceding the survey. Moreover, the majority of those who were current tobacco users were in their first pregnancy. Further, between January and July 2013, there were 16 women who were screened for drug use at the Maternal Health Clinic within the Department of Health. Of the screens conducted, 43.7% or seven women were positive for THC, the main psychoactive substance found in marijuana. On average, those who tested positive were in 17 weeks of gestation, with a gestational range between 10 and 27 weeks.
What are the risks of using ATODs during pregnancy? Pregnant women who use alcohol and drugs during their pregnancy pass them along to the baby through the placenta. Drinking alcohol during pregnancy can cause miscarriage, stillbirth, and a range of lifelong disorders, known as foetal alcohol spectrum disorders (FASDs). Women who smoke marijuana while they are pregnant are more likely to have low birth-weight, premature babies. Pregnancy complications, including premature rupture of the membranes, meconiumstained fluid and foetal distress, are more common in women who misuse drugs. Antenatal care is often inadequate in women who misuse drugs because of late presentation for reasons including a chaotic lifestyle and a reluctance to have involvement with social services. Commonly seen symptoms in neonates include irritability, high-pitched cry, tremors, hypertonicity, vomiting, diarrhea, and tachypnoea.
What is the long-term outlook for babies exposed to ATODs before birth? Studies indicate that children who were exposed to ATODs prior to birth may be more at risk for developmental delays and respiratory problems. Babies also face the obstacle of withdrawal symptoms for almost a whole week after birth. The most common long-term effect on these infants is that they may have a shorter attention span than children who were not exposed to drugs.
How can a woman protect her baby from the dangers of ATODs? Women who use alcohol and/or drugs are advised to stop before they become pregnant or to delay pregnancy until they believe they can avoid the drug completely throughout pregnancy. For pregnant women already using drugs (with the exception of heroin), stop using the drug immediately because of the harm associated with continued drug use. Women who use heroin should consult their health care provider or a drug treatment center about methadone treatment.
Suite 304 Melbourne House | 11 Parliament St. | Hamilton | HM 12 292-3049 | www.dndc.gov.bm
12 n SEPTEMBER 27, 2013
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Choosing healthy products is ‘shopping sense’ Shopping Sense
BY SARA MCKITTRICK Bermuda Diabetes Association
One of the most important factors in preventing and managing diabetes is following a nutritious diet. Most of us think we understand what ‘eating healthy’ means, yet when we get to the grocery store and are faced with a myriad of products claiming to be healthy, it can become overwhelming and confusing. To help educate people on navigating the grocery store, I work with Lindo’s to provide ‘Shopping Sense’ tours. On these tours, I show people how to find healthy items appropriate for diabetes management and prevention. Here are some of my favourite tips.
Plan Plan ahead for grocery shopping and take a list to the store. Try to stay in the perimeter of the store where fresh foods such as fruits, vegetables, dairy and meat are located. Canned, processed and ‘junk’ foods are usually found in the centre aisles.
Reading food labels Food labels are essential tools for nutritious meal planning. They provide details of the food you eat such as the calories, carbohydrates, fibre, fat, salt and sugar. Watch for heart-healthy ingredients, such as whole wheat flour, soy and oats. Monounsaturated fats, such as olive, canola or peanut oils also promote heart
BREAST CANCER Continued from page 3 procedure that uses mammography to pinpoint the location of a tumour. Magnetic resonance imaging (MRI) combines radio waves, a powerful electromagnet and com-
The next Shopping Sense tours will be on October 10 and 24, between 11am and 12:15pm at Lindo’s in Devonshire. The tours are free but people must register by calling the Bermuda Diabetes Resource Centre on 297 8427. n
Fibre
n PHOTO SUPPLIED BY LINDO’S
NUTRITION: Lindo’s grocery stores are full of fresh, healthy produce for you and your family. health. Avoid unhealthy ingredients, such as hydrogenated or partially-hydrogenated oil.
Portions Pay attention to portion sizes. If you eat twice the serving size listed on the label, then everything on the label — the calories, fat, carbohydrates, protein, sodium — is doubled.
Carbohydrates Look at total carbohydrates, which includes sugar, complex carbohydrates and fibre. If you only look at the sugar number, you may end up excluding nutritious foods such as fruits and dairy, thinking they are too high in sugar. Double-check carbohydrates in sugar-free food. puter software, to create images of soft tissue without using radiation. MRI can often diagnose and assess certain diseases earlier than is possible with other diagnostic techniques. Exams typically last between 20 minutes and an hour. Patients are asked to arrive 30 minutes early for
Compare standard products and their sugar-free counterparts, and only go with the sugar-free version if it has noticeably fewer carbohydrates. Often the sugar-free version is also higher in fat than the original product. Don’t be fooled by ‘no sugar added’ labels. Although these foods don’t contain high-sugar ingredients and no sugar is added during processing or packaging, foods without added sugar may still be high in carbohydrates. Beware of ‘fat-free’ products as they can have more carbohydrates and contain nearly as many calories as the standard version of the same food. ‘Light’ versions of a product are often a healthier choice.
screening and preparation. All jewellery must be removed and the technician notified about any implants, such as fibrillators or artificial joints. Ultrasound uses highfrequency sound waves to image parts of the body for diagnostic and interventional procedures.
Fill up on fibre as it decreases feelings of hunger and helps to prevent overeating. It is recommended adults consume 25-30 grams of fibre per day. Choose ‘real’ foods, like 100 per cent whole grain items, or products made with natural ingredients, with as little processing and as few additives as possible. While these tips were created with diabetes in mind, they also apply to anyone who wants to follow a nutritious diet. The key is to educate yourself and take the time to examine the food you buy. Remember the foods that have no labels at all, like an apple, an avocado or an egg, are often the healthiest, offering no processed sugars or fats. Time spent filling your grocery cart with fresh ingredients and healthy choices is a valuable investment in good health for you and your family. n
SARA MCKITTRICK is a registered dietitian who works as a nutritionist and diabetes educator for the Bermuda Diabetes Association (BDA). See the EatWell plate at eatwellbermuda.org Its use has become routine in imaging the foetus during pregnancy. It has also proved useful in imaging breast tumours that are not clearly imaged using mammography. n
DR PAUL COTY is a consultant oncologist with the Bermuda Hospitals Board.
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SEPTEMBER 27, 2013 n 13
A holistic oasis in the centre of Hamilton SUPPLIED BY MY SERENI-TEA My Sereni-Tea is more than a tea shop, it’s a holistic oasis in the centre of Hamilton for your mind, body and soul. Owner Deryn Higgins, mh.d CST, is a holistic health practitioner who offers treatments such as spiritual psychotherapy (RoHun therapy), Reiki, Energy Balancing and Metatronia Therapy.
Relaxation Since earlier this year, services also include massage and Thai massage. Massage can relieve muscle tension and stiffness, tension-related headaches and eye-strain, and injuries. It relieves stress and improves the circulation of blood and lymph fluids, as well as improving the health of your skin.
DIABETES RISKS Continued from page 10 unclear why, people of certain races — including blacks, Hispanics, American Indians and Asian-Americans — are more likely to develop Type 2 diabetes. n Age. The risk of Type 2 diabetes increases as you get older, especially after age 45. The growing number of people being diagnosed with Type 2 diabetes is of huge concern in Bermuda. As a result of the genetic risk factors and rising incidents of childhood obesity, more children are becoming at risk of developing the condition, which is an alarming trend. According to the Bermuda Diabetes Association, you can minimize your risk of developing Type 2 diabetes by living a healthy lifestyle. Eliminate soft drinks and sugary fruit juices. Drink plenty of water. Choose healthy carbohydrates. Include more vegetables, fruit and whole grains in your diet. Avoid high-fat
n PHOTO SUPPLIED
WELL-BEING: From left, My Sereni-Tea therapists Saipet Sievers, Deryn Higgins and Pikul Gibbons. Saipet Sievers is the Thai massage therapist and instructor, and also specializes in Thai herbal compress. Pikul Gibbons is the massage and beauty therapist. She offers deep tissue, Lomi Lomi, Swedish, Thai, sports and Indian head massage. Mrs Gibbons also gives
pedicures and doTERRA facials. Every two months, clients can also receive Quantum Energetics and Crystal Medicine from Kimberly Jennings. There are also workshops to enhance your well-being and yoga classes. Yoga is offered each day at lunch-
meals and empty calories. Also, stay active. Being active helps the body to use glucose for energy while making the body more responsive to insulin, which helps to control weight.
Maintaining a healthy weight, enjoying regular physical activity and maintaining a well-balanced diet will go far in helping you to achieve good health and wellness. For more informa-
time and two nights a week, with Sarah Palmer Cox (Pretzel Yoga) and Todd Crews. My Sereni-Tea also offers Isagenix products to improve weight loss, cleansing and general health maintenance. Every month there is also a free seminar on doTERRA oils and how they can enhance your wellbeing. My Sereni-Tea also offers 160 types of tea. Among its Wellness Teas are Teas for Him and Her, Throat Therapy, Endurance, Cleanse, Happy Teas, Feel Better Blend and Ayurvedic Teas. My Sereni-Tea can help you to find peace within. n
MY SERENI-TEA, Chancery Hall, 52 Reid Street.Call 2962114 or e-mail myserenitea@ logic.bm.Website www.myserenitea.com tion go to www.bermudadiabetes.org n
MICHELLE JACKSON is an executive vice president for Group Insurance at Argus Group. See www.argus.bm
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THE BERMUDA SUN
BermudaDiabetesAssociation
www.DIABETES.bm
VISIT OUR TER RESOURCE CEN in Hamilton on Beacon Street ecialized care to receive the sp m an that you need fro armacist. expert diabetes ph
RESOURCES & PROGRAMMES SHOPPING TOURS
LUNCH & LEARNS
Shopping tours that aim to empower consumers by teaching them how to read nutritional labels in a simple way
Lunch & learns that promote a better understanding of the impact food, medication, activity and stress have on blood sugar levels
PHARMACIST
PHARMACY
On-site pharmacist to alert both you and your doctor before a problem may develop
Pharmacy with blood glucose testing & blood pressure monitoring supplies
DIABETES EDUCATOR 1 on 1 sessions with diabetes educator to help explain your treatment plan and help you follow it
MARK YOUR CALENDARS FOR DIABETES MONTH! NOVEMBER 5TH
NOVEMBER 14TH
Rotary Club Presentation Royal Hamilton Amateur Dinghy Club
Blood Screening • Washington Mall
NOVEMBER 5TH
World Diabetes Day Church Service • St. Mark’s
Blood Screening • Robertson’s Pharmacy
NOVEMBER 9TH Bermuda Diabetes Rugby Classic Tent National Sports Centre
NOVEMBER 17TH NOVEMBER 19TH ‘Healthy Living with Diabetes’ Seminar • Argus
NOVEMBER 29TH
Bermuda Diabetes Tag Day Visit our website’s calendar for more information on upcoming events
E!
BE MORE ACTIV
nefits to regular There are many be ise can help erc Ex ity. tiv physical ac r lower blood suga you lose weight, to ity itiv ns se and increase your your blood s insulin, which keep ge. in a normal ran
Find us on Facebook
TEST YOURSELF! Try to be active for at least 30 minutes every day, walking, gardening, cycling or swimming.
True or False…
Losing weight increases your risk of diabetes.
VISIT US ON FACEBOOK TO FIND OUT IF YOU ARE RIGHT! www.facebook.com/ BermudaDiabetesAssociation
BermudaDiabetesAssociation | visit www.diabetes.bm | 441-297-8427 BDAaccounts@northrock.bm
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SEPTEMBER 27, 2013 n 15
Lose the fat without the pain BY DR KYJUAN H. BROWN North Shore Medical & Aesthetic Center
You’ve tried every diet known to man, faithfully putting in time at the gym and eating right, but the love handles and saddle bags just don’t seem to budge. With time and money nearly non-existent these days, however, there is a solution that produces results, is pain-free and won’t break the bank or take up valuable time. Ultrasonic Cavitation (UC), designed in Europe, is a non-surgical fat removal procedure.
Tone-up This revolutionary treatment uses cavitation technology, giving patients immediate results by destroying intractable fat cells by using high frequency sound waves. The ultrasound forces a powerful sound wave which by cavitation forms bubbles in fat cell membranes. The membrane then succumbs to the pressure and reduces to a liquid, which is then expelled through the body’s normal metabolic method, destroying fat cells at such a rate and in such a quantity that fat storage is significantly reduced or eliminated. Fat elimination is accelerated by the amount of water you drink and through exercise. Therefore water and exercise are key compo-
ACCESS FOR ALL Continued from page 1 for free antenatal visits, to meet their health visitor and discuss antenatal classes. We liaise with all of Bermuda’s obstetric specialists to book our clients for care and delivery. We liaise with our Oral Health Programme, Nutritionists and Child & Family Services to ensure that our clients and their families receive support
n FILE PHOTO
SLIM DOWN: Get a flat stomach without invasive surgery.
Cavitation requires no surgery, anesthesia, knives, scars, or pain; there is no recovery time and a client can return to work immediately. Treatment times may vary depending on the area being treated but a typical session will last between 45 minutes to an hour, and it’s not uncommon to see a oneinch loss per session. Although virtually safe and painless, Ultrasonic Cavitation is not for everybody. People with kidney failure, heart disease, who are pregnant or have other medical conditions should seek advice from a medical practitioner with experience in such a procedure. UC is not a treatment for obesity, nor is it a weight loss procedure, nor does it replace a healthy diet and exercise. North Shore Medical & Aesthetic Center (NAMC) provides comprehensive care for the mind and body, including full medical care, nutrition and life coaching, and a medical weight loss programme. A range of aesthetic treatments including Ultrasonic Cavitation, RF Skin Tightening, acne treatments, spider-vein removal, massage, laser treatments, microdermabrasion, waxing and meditation are also available. n
nents to eliminating the fat after your procedure. The ultrasound energy is designed to target fatty tissues beneath the skin only, and does not affect the blood vessels, nerves and connective tissues. Along with fat removal, with the addition of Radio Frequency (RF), Ultrasonic Cavitation has added benefits of improving skin texture and circulation, slimming, shaping and tightening connective tissue. The most common problem areas are the abdomen, love handles (flanks), saddle bags (thighs), upper arms, and inner knees. Ultrasonic Cavitation also works well on cellulite by focusing the ‘cavitation effect’ on the superficial fat tissue. It is recommended that for cellulite we employ RF
skin-tightening treatments to help tighten and tone the skin. The success and safety of this procedure is backed by clinical studies, including two published in the Aesthetic Surgery Journal. In an October 2010 study it was found that UC treatments decreased the waist circumference in 85 men and women by an average of 4.6 inches after three months. In the May 2011 Aesthetic Surgery Journal, it was reported that “the application of the high-intensity focused ultrasound energy appeared to provide a safe and effective means for ablating fat with no clinically significant changes to serum liver function, free fatty acids or cholesterol levels”. Because Ultrasonic
during and after pregnancy. Teen Services can also provide a range of services for young mums-to-be, to support them in their adaptation to motherhood and in ongoing education. Health visitors support mothers and their families by visiting them at home, providing advice on feeding and in monitoring children’s growth and development, from baby clinics until they enter school. Our partner for the promotion of breastfeeding is
the La Leche League. They offer home-based practical support and meetings for breastfeeding moms. Many of our staff offer free educational talks on women’s health topics, as well as school health talks on sexual health. We also provide support for health fairs run by churches and other organizations. n
Department of Health clinics:
DR HILDA DUNSMORE is the Medical Officer for the Department of Health.
Gloria Burgess is Maternal Health Coordinator. See www.gov.bm.
FOR MORE INFORMATION call 293-5476 or e-mail info@ nmac.bm. www.nmac.bm
Somerset Health Centre, 55 Mangrove Bay Road, Sandys. Call 234-0202. n St George’s Health Centre, 1 Old Military Road, St George’s. Call 297-8200. n Hamilton Health Centre, 67 Victoria Street, Hamilton. Call 278-6460. n n
16 n SEPTEMBER 27, 2013
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which consists of A, B, AB and O blood types. O positive is the most common blood type. Not all ethnic groups have the same mix of these blood types. Hispanic people, for example, have a relatively high number of O’s, while Asian people have a relatively high number of B’s. People with type AB blood are called universal recipients, because they can receive any of the ABO types. People with type O blood are called universal donors, because their blood can be given to people with any of the ABO types.
THE BERMUDA SUN
Blood — the life force in every one of us Blood is a specialized body fluid that makes up about seven to eight per cent of our total body weight, and is composed of plasma, red blood cells, white blood cells and platelets. An average-sized man has about 12 pints of blood in his body, and an averagesized woman has nine pints. Blood transports oxygen and nutrients to your lungs and tissues, forms blood clots to prevent excess blood loss, carries cells and antibodies that fight infection, and brings waste products to our kidneys and liver. Your blood is typed, or classified, according to the presence or absence of certain markers called antigens. These are found on red blood cells and in the plasma that allow your body to recognize blood as its own. Some antigens can trigger an immune response if they are foreign to the body. For this reason, safe blood transfusions depend on careful blood typing and cross-matching. Like eye colour, blood type is passed genetically from our parents. Your blood group is based on the blood types of your mother and father. Although all blood is made of the same basic elements, not all blood is alike. In fact, there are eight different common blood types, which are determined by the presence or absence of antigens. Blood is classified according to the ABO system,
SAVING LIVES Continued from page 7 medical services (EMS). The sooner someone calls 911 or the local emergency number, the sooner EMS personnel will take over. n Early CPR. CPR helps to supply blood containing oxygen to the brain and
Reactions In addition to the ABO system of classifying blood, the Rh system classifies blood as either Rh-positive or Rh-negative, based on the presence or absence of Rh antibodies in the blood. While people with Rh-positive blood can receive either Rh-positive or Rh-negative blood, people with Rh-negative blood should only receive Rh-negative blood in order to avoid a serious transfusion reaction. There are many more socalled minor blood group systems whose antigens may not be as readily apparent as those of the two major ones. These are capable of causing transfusion reactions, particularly if the recipient has previously been exposed to any of them. For this reason, after donor units of blood are chosen for a patient according to the major groups, donor cells are directly vital organs until an AED can be used, or advanced medical care provided. n Early defibrillation. An electrical shock — defibrillation — may help to restore an effective heart rhythm. n Early advanced medical care. EMS personnel will provide more advanced care and will transport the person to hospital.
reacted against the potential recipient’s serum — the cross-match. All these antigens are inherited and like the major types, occur with different frequencies in different populations. Hence, sometimes if the donor and recipient are from the same ethnic background, the chance of a reaction can be reduced. That’s why an AfricanBermudian blood donation may be the best hope for the needs of patients with sickle cell disease, 98 per cent of whom are of AfricanBermudian descent. There are four types of products that can be derived from blood: red cells; platelets; plasma; and cryoprecipitate, a frozen blood product prepared from plasma. Typically, two or three of these are produced from a pint of donated whole blood, which means each donation can help to save up to three lives. Red blood cells are needed by people who lose blood in surgery or in an accident, or who are anaemic. Platelets help control bleeding in people who can’t make their own platelets, such as patients receiving cancer medication. Plasma is given to burn patients and critical care patients. n BERMUDA BLOOD DONOR CENTRE Is always looking for new blood donors. If you would like more information, contact 236-5067 or e-mail blood. donor@bhb.bm. You can also find out more on Facebook/Betsie Blood Drop.
Learning to do CPR can mean the difference between life and death. For each minute that CPR and defibrillation (with an AER) are delayed, the chance for survival is reduced by 10 per cent. The Bermuda Red Cross encourages everyone to get training in CPR and first aid.
The Rh factor and pregnancy Although Rh factor doesn’t affect your health, it can affect pregnancy. Your pregnancy needs special care if you’re Rh-negative and your baby’s father is Rh-positive. If you’re pregnant, your healthcare provider will recommend an Rh factor test during your first prenatal visit. The Rh factor test is a basic blood test that indicates whether you’re Rh-positive or Rh-negative. If you’re Rh-negative, you might need to have another blood test during your first trimester and again during week 28 of pregnancy. The antibody screen is used to detect antibodies to Rh-positive blood. If you haven’t started to produce Rh antibodies, you’ll need an injection of a blood product called Rh immune globulin. The immune globulin prevents your body from producing Rh antibodies during your pregnancy. If your baby is born Rh-negative, no additional treatment is needed. If your baby is born Rh-positive, you’ll need another injection shortly after delivery. You’ll likely need injections during any subsequent pregnancies and after the delivery of each Rh-positive baby as well. n
Knowing what to do when an emergency happens can mean the difference between life and death. n
THE BERMUDA RED CROSS runs courses in CPR, AEDs and first aid. Contact 236-8253 or e-mail redcrossadmin@logic.bm or redcrosstraining@logic.bm.Website www.bermudaredcross.com.
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