T h e M e d i c a l P r o f e s s i o n a l ' s G a t e w a y t o H e a l t h & We l l n e s s
HEALING FROM TRAUMA COULD YOU HAVE ADRENAL FATIGUE? SURVIVING THE SHIFT WORK GRIND
TORONTO REHAB AN INSIDE LOOK FROM CINDY YELLE
THE ABCS OF VITAMINS & MINERALS CHOOSING HEALTHY FAST FOOD
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S P O N S O R E D E D U C AT I O N & T E A M B U I L D I N G Graymatter Education offers courses, seminars, webinars, and many other programs designed to educate professionals and further their skills and knowledge to be applied in his or her line of work. These programs are intended to educate persons on new advancements, or to build upon a person’s expertise in a given field. These may be optional for the nursing profession, legal profession, or the insurance profession. We have various topics and certificates of completion are awarded. Canadian Nurses receive credits for their ongoing education.
• Discharge Follow Up
• Advocacy and Ethics
• Mock Trial
• Funding the Medical
• Brain Injury in the ER
• Pediatric Emergency
System Through the Legal
• Compassion Fatigue
• Record Keeping
System
• Consent Form Education
• Spinal Cord in the ER
• Heart Attack in the ER
• Critical Incident Debriefing
• Teamwork/Adult Bullying in
• Homecare: What happens
• Cultural Sensitivity
when a patient goes home • Insurance Ins and Outs
the Workplace
• Cancer in the ER • Self-Defence in the ER
• Medical Malpractices
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The Medical Professional's Gateway to Health & Wellness I m p r o v i n g t h e L i f e o f t h e E m e r g e n c y R o o m H e a l t h c a r e Wo r k e r
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INSIDE THE SHIFT WORK GRIND....................................3
D.O.N.T. QUICK FACTS...................................... 14
CHOOSING HEALTHY FAST FOOD.........................4
HOW TO CHOOSE A PERSONAL INJURY LAWYER.............................................. 17
WHAT YOU NEED TO KNOW ABOUT VITAMIN & MINERAL SUPPLEMENTS....................6
19TH CENTURY RULES OF NURSING.................. 18
KAT'S CORNER...................................................7
HEALING FROM TRAUMA.................................. 19
UNDERSTANDING ADRENAL FATIGUE..................8
A NEW WAY TO THINK OF WEIGHT LOSS............20
GOLF? IMPOSSIBLE!........................................ 11
THE LAW & YOU..............................................21
AN INSIDE LOOK AT TORONTO REHAB............... 12
STREET DRUGS................................................22
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THESHIFTWORKGRIND WAY S T O S TAY HEALTHY W H IL E W O RKIN G 12- H O U R S H I FT S By Kerri Penney
The ER–a place that never closes. There's never a break, never a dull moment. One minute you can be dealing with a simple medicine request and the next minute performing CPR. It's a chaotic environment of ringing alarms, yelling patients, ringing phones and overhead paging. I've been working in the ER for almost eight years, and it's true that 12-hour shifts can wreak havoc on your mind, body and soul. As a nurse, you spend long work days taking care of other people at the most vulnerable times of their lives. You require the mental, physical and emotional energy to stay on your game in order to provide the best care possible for your patients. In order to ensure a positive performance, I believe all nurses need to take care of themselves at home and at work. Not only are shift workers at a higher risk for weight gain and heart disease but they also tend to suffer more from sleep disturbances, injuries, depression and even some forms of cancer.
of exercise, nutrition, sleep and stress management in maintaining a healthy lifestyle. Incorporating what I learned in my previous degree into my lifestyle has allowed me to stay healthy as an ER nurse. Here are some tips to help you stay healthy while working long, demanding shifts.
• It's important to get enough sleep. Sleep helps the body rejuvenate and recuperate from busy work days.
• Eat wholesome foods to make shift work easier on your body and to improve your overall performance. Healthy foods, such as fruits, vegetables and whole grains, help stabilize your blood sugar and provide slow energy release throughout the day, whereas high-fat and high-sugar foods give you extreme highs and lows.
• Create and follow a schedule that works for you. A routine will help Before I began my career as an ER nurse, I graduated from York University with a bachelor of science in kinesiology and my certification in exercise physiology. The advantage of having such a degree is my knowledge and understanding of the importance
you stay on track. Set aside time to prep meals for the work week ahead. If you have packed healthy snacks, you will be less likely to eat junk food on breaks. Make sure to incorporate protein into each meal/snack to feel full longer. It's important to not skip meals; aim to eat three meals and three snacks a day.
• Drink plenty of water to stay hydrated throughout your shift. It's easy (but not a good idea!) to only drink coffee, tea or other caffeinated drinks to keep energy levels up (limit these to two per day).
• For those on the night shift, eat lighter meals and snacks throughout the night. Try eating breakfast as soon as you get home, lunch when you wake up and dinner before you start work. This way you will feel less sluggish at work.
• Finally, add exercise to your weekly regime. On work days, aim for 30 minutes of moderately intense exercise. While at work, try taking the stairs, walking an extra bus stop or taking a walk on your break. On days off, get in an hour-long session at the gym. Spend 30 minutes performing moderately intense cardio followed by strength training. Add stretching, pilates and yoga, too. All of these help keep the body and mind strong and healthy.
Kerri Penney is an emergency room nurse at St. Michael’s Hospital in Toronto and owner of Lifecents, a wellness coaching company that focuses on the development and implementation of fitness and nutritional programs. For more information, visit www.lifecents.wix.com/getfit. The Medical Professional's Gateway to Health & Wellness | 3
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Choosing Healthy Fast Food By Karen Sheviak
Eating healthy can be a challenge at any time, but if you are working long hours, and simply don’t have time, or forget, to pack your lunch, you may think that the easiest solution is to visit a fast-food restaurant. But if you do, you can easily exceed your daily fat and sodium counts with just one meal – and that’s not good for your health. Andrea Miller, a dietitian in private practice for more than 20 years and an instructor at the University of Ontario Institute of Technology, offers suggestions for lunch that will give you energy for your shift and help you stick to a healthy diet.
Coffee Shop
Pizza
Good: A whole-grain bagel with peanut butter Better: A whole-grain sandwich with ham or turkey Best: Lentil or bean soup with a whole-grain bagel
Good: Cheese pizza slice Better: Vegetarian pizza slice Best: Grilled chicken and veggie pizza slice with a whole-wheat crust
If you choose a bagel skip the cream cheese, which Miller refers to as “spreadable fat with few nutrients.” Peanut butter gives you added protein. To make it even tastier (and remind you of your childhood!) slice a banana onto the bagel. You’ll get a boost of potassium as well. The sandwich is healthy if you pile it with as many vegetables as possible. Limit the cheese and mayo to reduce fat, but you can add mustard for flavour. The soup and bagel will give you a serving of vegetables, which are often lacking in fast-food restaurants, plus fibre from the beans. Stay away from cream soups (which are usually high in fat) and chicken noodle soup, which won’t have enough staying power. “You’ll be hungry in an hour and a half,” says Miller.
Choose pizza that has lean meat and small amounts of cheese. A cheese or pepperoni pizza slice is loaded with fat and sodium and has little fibre, but adding some vegetables can make it a slightly better option. Your best bet by far is a whole-grain thin-crust slice with plenty of vegetables and minimal cheese.
No matter what you choose to eat, if you work shifts, staying healthy can be a challenge. Here are some tips from Miller. • Pack portable snacks such as plain nuts and prepackaged unsweetened apple sauce or fruit cups for the whole week. If you have access to a fridge, include yogurt, too. Having these foods available can reduce the temptation to visit the vending machine.
Burgers or Subs
• Eat regular meals at regular intervals: a breakfast-type meal whenever you wake up, lunch about four hours later, a snack four hours after that and a light dinner. A heavy dinner can negatively impact your sleep.
Good: A whole-wheat wrap or salad with grilled chicken. Better: A small burger (no cheese) or a 6-inch sub combo with ham or turkey Best: Grilled chicken or fish burgers (not breaded or fried) or veggie burgers or a 6-inch sub on a wholewheat bun with ham or turkey and lots of veggies.
• Limit coffee to two to three cups per day. It can interrupt your sleep and, if you add cream and sugar, the calories can add up very quickly. Have a caramel Frappuccino only once in a while as a treat. Miller calls these beverages “hot milkshakes,” and says that “people don’t compensate for liquid calories,” so consuming these drinks can mean you’re consuming too many calories.
Salads and wraps may seem like a healthy choice, but they are often too small to keep you satisfied for long. If you bring a side from home, it can be enough for a meal. Make sure any meat is grilled, not fried, and ask if you can get minimal sauce or get it on the side to add yourself to reduce the fat content. The burger or small sub can be nourishing if you top it with vegetables and avoid French fries or bags of chips and cookies on the side. If you really want those extras, get a small order, or share a large with a friend. Chicken or fish burgers are a healthy if you follow the same principles as if you ordered a beef burger: add vegetables, limit mayo, and skip cheese and the fries. On a sub, substitute mustard and flavourful vegetables and pickles for mayo and sub sauce.
• Drink lots of water and limit sweetened beverages such as soft drinks and sports drinks. Staying hydrated can keep you alert and can help prevent you from mistaking thirst for hunger, which can lead to overeating. Add a slice or two of cut up fruit to your reusable water bottle to make it more appealing. • Try to go for a 15-minute walk after meals and on breaks. Keep your calorie intake and physical activity consistent from dayto-day to help you manage your weight. • Cook once, eat twice. No matter what you’re cooking, make extra. Cook a few extra chicken breasts, double your batch of soup or chili, or even prepare double the vegetables if you’re making pasta sauce, and put the cut up ones in the fridge so your meal prep for a stir-fry is done for tomorrow. • Even if you don't pack your full lunch or dinner, when going to work, try to pack healthy snacks, fruit and water. These small changes can make a big difference to your overall nutrient intake and energy level. The Medical Professional's Gateway to Health & Wellness | 5
What You Need to Know About Vitamin & Mineral Supplements I m p r o v i n g t h e L i f e o f t h e E m e r g e n c y R o o m H e a l t h c a r e Wo r k e r
By Andrea Miller MHSc, RD Are you overwhelmed by the towering shelves of vitamin and mineral supplements in the grocery store? There are so many options, but there are also so many questions: Which ones really work? Exactly how effective are they? Are they worth the money?
• Women of childbearing age who are thinking of getting pregnant
Supplements can be beneficial, but the key to vitamin and mineral success is eating a balanced diet. Before taking vitamin and mineral supplements, talk to a registered dietitian or your physician about your personal nutrition. Make an effort to consume a healthy, wellbalanced diet, including three meals and one to two snacks, from a variety of food choices. Keep in mind that foods provide a variety of vitamins and minerals and other nutrients, including fibre, that are not found in a vitamin or mineral supplement.
• Women who are pregnant need added folic acid and iron, which
Here are the answers to some common questions to help you determine if a vitamin supplement may be right for you.
should take a supplement that contains at least 400 ug (0.4 mg) of folic acid. This is to prevent neural tube defects that can begin early in pregnancy, even before many women realize they are pregnant.
can be obtained from foods and with a multivitamin.
• Men and women over the age of 50 should consider vitamin D and vitamin B12 supplements. A daily supplement of 400 IU of vitamin D for both men and women over the age of 50 is recommended. Also, adults over 50 may not be able to fully absorb vitamin B12 that occurs naturally in foods and as a result, they should take a supplement. A daily multivitamin designed for people over 50 years of age is a good way to get both of these nutrients.
• People who don’t consume dairy products or use fortified soy
1. Will vitamin and mineral supplements increase my energy?
beverages may need a vitamin D and/or calcium supplement.
No. The energy that your body needs to think, work and play comes from the food that you consume. Vitamins and minerals in pill form do not provide calories/food energy.
• Vegans need a source of vitamin B12 either from a supplement
2. Can vitamin and mineral supplements reduce stress?
• People with certain medical conditions, such as anemia or
No. Vitamin and mineral supplements do not reduce stress. Eating a healthy, well-balanced diet is one strategy that may help you cope with the stress of daily living. A supplement will only provide some missing nutrients if you are not eating well.
or foods fortified with vitamin B12. They may also benefit from a calcium and vitamin D supplement.
osteoporosis, may require more of some nutrients. Or if you’ve had surgery or an infection you may require extra nutrients or a supplement until you regain your health. Talk to a registered dietitian about your specific nutrient needs.
• People with very restricted diets, such as those with poor appetite,
3. Should I take vitamin and mineral supplements to make sure that I am getting what I need or give them to my kids when they don’t eat right?
• People who smoke have an increased need for vitamin C, so they
Not necessarily. Vitamin supplements do not replace a healthy diet. Vitamin and mineral supplements do not provide the macronutrients we get from food, such as fibre, carbohydrates, fat, protein and calories. If you’re concerned about whether you or your children are getting enough nutrients, speak to your health-care provider or a registered dietitian.
Remember that no supplement will take the place of a healthy diet or camouflage the impact of a poor diet. Eat well and be active every day.
4. Who should consider taking a supplement? There are some situations in which you may require a vitamin supplement. Remember, if you are concerned about your nutrient intake or think you may need a supplement, speak to your healthcare provider or registered dietitian. 6 | www.navigatemag.com
very low calorie diet or food allergies, may need a supplement.
should take a vitamin C supplement and eat foods rich in vitamin C, including citrus fruits, strawberries, tomatoes, peppers and potatoes.
Andrea Miller is a consulting dietitian in Whitby, Ont., and an instructor at the University of Ontario Institute of Technology. For more information, visit www.amillerrd.ca.
Kat’s Corner
Kat, a nursing student, gets her top questions answered by experienced nurses.
freedom canada Kathleen Crandles
Not everyone is cut out to work in an emergency health-care setting. What are some specific skills that employers may look for in a potential nursing applicant wanting to work in an emergency department? Flexibility and good priority identification are great assets. Demonstrating the ability to defer one task because a higher priority need has arisen is something that employers will test you on in an interview. You must be able to participate as a team player, including the ability to contribute with ideas and suggestions. A personal desire and commitment to continuing education throughout your career will serve you well. Taking advantage of the various educational opportunities through courses and conferences will enhance your knowledge base and skill set. Emergency employers are seeking candidates with skill proficiency and nursing experience. Desirable candidates for working in the emergency department would be nurses who are knowledgeable, have critical thinking skills, have the ability to multi-task, possess great organization skills and who are effective communicators. The ED needs nurses who are good with adaptation, reprioritizing acuity, and are able to cope with an ever changing pace and acuity of their patients. Recommended courses include BCLS, ACLS, and PALS.
Keep dreaming, but start planning Your goals and dreams are unique. Your plans to get there should be just as unique. Find out more about how I can work with you to create a financial security plan to help achieve your goals at all stages of life. Please call today. Daniel Zanzonico Financial Security Advisor Cell: 416-903-2558 416-291-0451, ext. 290 Daniel.Zanzonico@f55f.com
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The Medical Professional's Gateway to Health & Wellness | 7
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I m p r o v i n g t h e L i f e o f t h e E m e r g e n c y R o o m H e a l t h c a r e Wo r k e r
By Virginie Markussen
How many times have you heard yourself or others say, “I just always feel so tired.” In today’s busy life, you may feel like you are constantly running on empty, but brush it off and continue with everything that is asked of you. You never stop to think, “Is this normal?” By ignoring your body’s cry for help, you are setting yourself up for disaster. More and more people are suffering chronic illnesses and diseases that rob them of a quality life. This is why I want you to join me on the quest to learn more about a condition called adrenal fatigue.
factors that can contribute to adrenal fatigue, such as not getting enough sleep, a poor diet, or being a perfectionist (if you constantly push yourself to do more than you can handle). Being in an unhappy marriage or job can also wreak havoc on your health. So can constant drug and alcohol abuse. Some professions have a higher risk for adrenal fatigue. Even those who suffer physical traumas like head injuries, burns or colds, or live with allergies, asthma and other diseases can be susceptible to adrenal fatigue.
We all know that old sins of the past can catch up to us. We have all experienced times of high stress, whether it be emotional, physical, psychological, environmental, infectious or a combination. But we never stop to think what damage this can have on our health.
What Are the Adrenals?
Adrenal fatigue can happen to anyone. If you don’t rest your body often enough, or if you ignore unhappy feelings toward your job, partner or friends, or you just feel overwhelmed by life’s demands, you are setting yourself up for adrenal fatigue. The more stresses you have, the higher the likelihood is of suffering this little-known condition. We all handle stress in different ways. What might be stressful for one person may have no effect on someone else. Some people may already be born with adrenals that are weak. There are many lifestyle 8 | www.navigatemag.com
The adrenal glands are small organs (3.5 to 5 grams) that are located on top of the kidneys, near the spine and just underneath the last rib. These extraordinary glands produce many different hormones that serve a variety of functions in the body, and one of the hormones is adrenaline. As we all know, this is the “fight or flight” hormone, which helps the body to respond to any stressful situation. But within this organ there is an area where cortisol is secreted and this is by far the largest part of the adrenal cortex. Cortisol plays a huge role in the metabolism of fats, proteins and carbohydrates and helps maintain steady blood sugar when you are faced with a stressful situation. It also has anti-inflammatory effects on tissues and helps regulate sodium and potassium in the heart cells, as well as increases the strength of the contraction of the heart muscle. In addition, cortisol
can influence behaviour, mood, excitability and even the electrical activity of neurons in the brain. As you can see, without cortisol, many of the body’s organs and cells can’t function properly and will not respond in the right way to a stressful challenge. The lack of cortisol is what causes adrenal fatigue. Unfortunately, it is difficult to get a clear diagnosis from a doctor because there is no conventional test that will indicate adrenal fatigue. The only test done will either indicate that you are suffering from Addison’s disease (extreme low adrenal function) or Cushing’s disease (extreme high adrenal function), which are two very extreme cases of adrenal fatigue.
Improving the Life of the E
The Importance of Exercise Exercise can be one of the biggest challenges for someone with adrenal fatigue. Physical exercise is crucial for a healthy body and mind, but overdoing it can have serious repercussions for someone with adrenal fatigue. Don’t forget, exercise that is being performed too vigorously or over an extended period of time can cause stress for the body. This is when a person struggling with adrenal fatigue should consider physical activities that are gentler on the body. Swimming, yoga, going for walks and dancing are all activities that can contribute to a body in motion without too much stress. Even parking your car a little farther away from the mall entrance can give you those extra steps per day. (And remember, making love to your partner is also exercise and it gives you endorphins, which in turn help your stress level.)
Symptoms of Adrenal Fatigue • Difficulty getting up in the morning • Still feeling fatigued even after many hours of sleep • Having a craving for salt and salty foods • Lack of energy • Increased effort to do your daily chores • Decreased sex drive • Difficulty handling any stress, small or big (road rage, anxiety, compulsive eating)
How Can a Person Deal with Adrenal Fatigue? It all comes down to lifestyle. Being able to recognise what steals your energy, be it your work situation, your home environment or the types of food you eat, is the first step to recovery. From there you have three options: change your situation, change yourself to adapt to the situation or leave the situation all together. As with any recovery from a physical ailment, you have to work with your body as a whole. Your food choices have to be looked at (how much you eat, what you eat, when you eat, how often you eat and the environment that you surround yourself with when you eat). It is vital that you find out if you are suffering from any food allergies or sensitivities. This is very common with people suffering from adrenal dysfunction. The amount of sleep and the quality of sleep is a major factor in this recovery, but so is your emotional and mental mindset. We all know the saying; “you are what you eat,” but perhaps most importantly, you are what you think. Correcting your emotional and mental mindset is another important step. The mind is a powerful thing, so do what is needed to face your emotional baggage, be it getting professional help, getting social support or even starting a diary to help you through the muddle in your mind. Give yourself permission to be who you are supposed to be. The road to recovery from adrenal fatigue is often a long and challenging journey. It is important to know and understand that with progress there will also be setbacks. Learn to listen to your body and be kind to it.
Virginie Markussen is a nutritional consultant and freelance health writer. For more information, contact vmarkussen1@outlook.com.
• Longer recovery time after a cold, injury or trauma • Feeling light-headed when you stand up quickly • Mild depression • For women, increased PMS • Hypoglycemia (low blood sugar) • Unfocused thoughts • Less accurate memory • Decreased tolerance • Don’t wake up until 10 a.m., then getting an afternoon low between 3 and 4 p.m. and then feeling better after 6 p.m. and your supper in the evening. • Less productivity Some people might experience just a few of these symptoms; others might have all of them. It’s when you take all of the signs and symptoms together that you get an indication that you might be suffering from adrenal fatigue.
How Supplements Can Help Supplements are often necessary for the body to completely recover. Vitamin C is one of the most crucial vitamins, since the more cortisol is made, the more vitamin C is used. Other vitamins that help in the healing process are vitamin E, vitamin B (especially B5), magnesium and calcium. A good multi-mineral, along with the vitamins listed beforehand, is also beneficial. Fibre is also important when dealing with constipation, which often occurs when experiencing this dysfunction. Licorice root is the best known herb for the support of the adrenal gland, but ashwagandha root, Siberian ginseng, ginger root and ginkgo biloba can also be used. Always make sure you talk to a trained health-care provider before taking any supplements or herbs.
The Medical Professional's Gateway to Health & Wellness | 9
I m p r o v i n g t h e L i f e o f t h e E m e r g e n c y R o o m H e a l t h c a r e Wo r k e r
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Improving the Life of the E
By Karen Sheviak Todd Keirstead practically grew up on a golf course. He bonded with his dad on the course as a child. He was a pro golfer for 20 years. Then he travelled the world doing trick golf shots at charity and corporate events. The shots he can make include hitting rolling golf balls, hitting them off a metre-high tee, and hitting them off a tee over, ahem, certain body parts. The latter one was voted number one trick shot for 2014 by the Golf Channel. Despite the unique career, the travel and the money he raised for charity, he was looking for something more. “I took playing the game of golf for granted,” says Keirstead. ”I took being a golf professional for granted. I took the ability of hitting golf balls blindfolded, off my knees and out of mid-air for granted. It wasn't until performing at a Veterans Hospital in the United States that I realized that the shots that I took for granted were actually motivating for individuals. It was motivating for these wounded warriors as I was emulating each and every one of their physical situations.” The result of that realization is Bring Back the Game, his program that teaches people to relearn the game after they have lost their ability to golf. His clients might have paralysis, multiple sclerosis or PTSD, or they might be an amputee or visually impaired. Whatever their situation, Keirstead’s experience in hitting a golf ball from pretty much any position can be used to help them. He might be on his knees, in a wheelchair, using a prosthetic limb, blind-folded or using only one side of his body. He places the same restrictions on his own body that the client has, and he can then teach each client how to hit the golf ball successfully. Some people learn the technique in just one session, and are then able to get back on the golf course, often after thinking that their golfing days were over.
That goal of a wounded veteran or a stroke survivor enjoying a game with their loved ones again is a very personal goal for Keirstead. His father, the one who introduced him to golf, helped him hone his abilities and guided his career, passed away quickly due to cancer in 2009. “I just wish I could hit one more golf ball with my dad, but I can’t,” he says. “What I can do, in his memory, is give others the opportunity to do the one thing they wish they could do with their dad, their mom, their sister or brother. The opportunity to do something they either thought they couldn’t do, or were told they would never do again.”
For more information, visit www.bringbackthegame.ca or www.gwagolf.com. The Medical Professional's Gateway to Health & Wellness | 11
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“Building people up.” That phrase comes up again and again in a conversation with Cindy Yelle, president and CEO of the Toronto Rehab Foundation, which advances the vision of the Toronto Rehabilitation Institute. "Building people up" might mean motivating cardiac patients to change their lifestyle and habits or helping people with paralysis who need to learn how to recapture their potential. Doing just that, giving them the tools to change their lives or adjust to a new reality after an injury or diagnosis, is a very important part of what happens at Toronto Rehab. And it’s not an easy road. The first thing that happens when a patient arrives is a consultation with his care team. The team may include an occupational therapist, physical therapist, speech pathologist, social worker nurse and physician. Together, they talk to the patient and his loved ones about his goals, and create a plan to help him achieve those goals, whether it’s walking across the room or running a marathon. “The clinicians and scientists that choose to work here don’t just help; they treat patients like family and truly want them to succeed,” says Yelle. “The team around the patient and the depth of our expertise and relationships really does help our patients along their journey to recovery.” And they provide support not just to the patient but also to their loved ones because an illness or injury affects a whole network of friends and family. “I noticed a vibe, a feel that’s upbeat and friendly, within the first few months of working here,” says Yelle. “I often hear a lot about how wonderful the staff is – supportive and encouraging.” 12 | www.navigatemag.com
And she has personal experience that proved to her how important that type of support is. Yelle grew up in the west end of Toronto, and says her parents encouraged her and her brother to seize every opportunity. Her older brother was a natural athlete and great at many different sports, and she tried to keep up with him even though he was seven years older than her. “I loved swimming from the very beginning,” she says. “Swimming is as close as human beings can get to flying. It’s that feeling of weightlessness and freedom.” Yelle also tried different sports, but says she was not great at very many of them. But she started swimming at an early age and joined a swim team when she was eight years old. Her swimming career skyrocketed by the time she was in high school, and when she was just 17 years old, she was a member of Team Canada at the Summer Olympics in Los Angeles in 1984. She would later compete in the Commonwealth Games and the World Championships.
Improving the Life of the E
By Karen Sheviak
I believe that things can be better and should be better, whether it’s giving young people a chance to pursue dreams at college or, in health
care, facilitating innovation and new technology to help people with the most important commodities: health, well-being and family.
She says that without “a strong work ethic and extraordinary coaches,” she would not have made it as far as she did in swimming. And, in a way, those swimming coaches were similar to the staff at Toronto Rehab. “Coaches are essential for guiding and motivating,” says Yelle. “Our staff are like coaches. We are in the patients’ corner, helping them set goals and achieve them.” Her leadership in philanthropy can also be credited to her early swimming days. “I was a born fundraiser, especially when it came to raising money for my swim team,” she says. “I had no hesitation about talking to anyone about swimming and my swim team and encouraging them to help in some way.” Just as she has done throughout her career. Yelle is a former senior vicepresident of the SickKids Foundation and was the executive director of advancement at the University of Toronto. “I wanted something more than the average career – that’s why I do it. I am helping through the philanthropists.
Now, at Toronto Rehab, her focus is on gaining community support for research, education and innovative programs at the facilities. “I get an opportunity to see the very best side of people,” she says of the philanthropists who contribute. “I talk to them about possibilities, about personally making a difference, making things better, advancing and accelerating research, improving the lives of people they may never meet.” Her goal for the future at Toronto Rehab is to continue to elevate the stature of the organization through promotion and contributions. Yelle is more than optimistic that the Foundation can help Toronto Rehab continue to be one of the top rehabilitation hospitals in the world. “We have extraordinary minds here. We have so many ideas that could potentially advance health care. That’s why philanthropy is so important. Philanthropy, community support and individuals and companies stepping forward take a good organization and allow it to dream.”
For more information, visit www. torontorehabfoundation.com. The Medical Professional's Gateway to Health & Wellness | 13
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TEXTING & DRIVING Promoting the Responsible Disposal of Medications and Sharps Did you know that in Ontario, the public can responsibly dispose of their unused or expired medications and used sharps free of charge at over 90 per cent of community pharmacies? The Ontario Medications Return Program and the Ontario Sharps Collection Program are 100 per cent industry funded and designed to give the public an accessible means to dispose of these materials. Free sharps containers are available at pharmacy counters. Sharps not placed into approved sharps containers are not considered safe for transport. Bleach bottles are not approved containers. Ontarians have access to the free 4.5 L sharps containers at over 3,500 locations province wide. Encourage patients to visit www.healthsteward.ca to find their nearest participating pharmacy for free sharps containers and disposal. And remember: medications should not be flushed or poured down the drain. Remind patients that they should bring their unused and expired medications back to the pharmacy. Pills should be placed into clear plastic bags with their outer plastic and cardboard packaging recycled. Liquids and prescription creams should be returned in their original bottles
14 | www.navigatemag.com
D.O.N.T. Quick Facts Brain injury is the leading killer and disabler of people under the age of 44 and kills more people under the age 20 than all other causes combined. (U.S. Centers for Disease Control) Acquired brain injury is 15 times more common than spinal cord injury, 30 times more common than breast cancer and 400 times more common than HIV/AIDS. (U.S. Centers for Disease Control)
40%
?!
40 per cent of acquired brain injury survivors sustained their brain injury as a result of an automobile collision. (2012 OBIA Impact Report) Distracted driving is cited as a causal factor in 30 to 50 per cent of traffic collisions in Ontario, but is probably much higher due to under-reporting. (Ontario Provincial Police) Texting while driving is the same as driving blind for five seconds at a time. (Virginia Tech Transportation Institute) In three seconds, at 60 kilometres per hour you travel 50 metres — that’s the distance across half a football field. (Ontario Ministry of Transportation) In 2012, 83 people were killed in motor vehicle collisions within OPP jurisdiction in which distracted driving was a causal factor. (Ontario Provincial Police)
DRIVE ONLY…NEVER TEXT (D.O.N.T.) Take the pledge www.idont.ca
e founding father of brain injury law. Roger Oatley is much more than the founding partner of Oatley Vigmond. is proud father of 5 daughters and grandfather of three also has a special insight and deep understanding into the complexities behind brain injury and jury law in Canada. e nurturing of his law firm, and the sharing of his incredible knowledge is part of his DNA. Roger’s outstanding track record in brain injury and jury litigation has led him to become a successful published author, highly awarded leader, speaker, teacher, and philanthropist. As head of the firm, Roger shares the wisdom of long experience. He believes that by working together as a team, everyone grows and achieves success. at’s why Oatley Vigmond is a thriving family of personal injury litigators.
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www.dyeandrussell.com (905) 427-2000 16 | www.navigatemag.com
Hope & Recovery
How to Choose a Personal Injury Lawyer by John Russell
“I can’t believe this happened to me!” The first thought that goes through anyone’s head when they suffer an injury is one of disbelief. We all know that accidents happen, but we often don’t believe they will happen to us, or to our loved ones. As Canadians we have access to one of the best, if not the best, medical system in the world. We do not have to worry about which hospital to go to or which clinic has the best doctors when we are injured. We can simply go to the closest hospital or doctor and know that we are going to receive excellent care. Our doctors and other health-care professionals all receive world-class education and training. Canadians have a strong belief in everyone’s right to have access to the best possible medical care regardless of how much money they have. Some things are just too fundamentally important to be left to chance — or to advertising. I think it is this belief that causes people to react with disdain when they see aggressive advertising by personal injury lawyers. When you have been injured you are at one of the most vulnerable times in your life. You need help. People naturally resent being manipulated at the best of times, but especially when they are in need. As soon as you have a need for a personal injury lawyer, you will notice how many of them advertise on TV, the radio and other media. All of the ads, of course, explain how the lawyers in question are “leaders in their field.” So how do you choose a law firm? Choosing a personal injury lawyer is too important a decision to be based solely on information contained in an ad or on a website. Advertising can lead you to a lawyer but there is no question that the best way to find a personal injury lawyer is through a recommendation from a friend, family member or some other trusted adviser such as a doctor or other health-care professional. Simply put, you want to be referred to your lawyer by someone who has your best interests at heart and is not motivated by financial gain. You need to select a lawyer who practises only personal injury law and has extensive experience with the system you will have to navigate on your way to physical, mental, emotional and financial recovery from your injuries.
The lawyer should have the resources to spend whatever is necessary to build and present your claims properly to the insurance company that will be responding to your claims. The lawyer should be able to help you access the benefits and funds you will need to support yourself if you are unable to work following your injuries. The lawyer should be able to explain the claims process to you plainly and let you know when you can expect things to happen. You need to be comfortable with your lawyer and confident in his abilities. The process of choosing a personal injury lawyer should feel natural and not forced in any way. Many lawyers are more focused on getting you to “sign up” than they are with making sure you understand the claims process. If you do not feel comfortable with a lawyer when you speak to him, that lawyer is not right for you.
Dye & Russell My partner, Peter Dye, and I believe we have created a different type of personal injury law firm. We are not desperate to expand our brand everywhere and anywhere by advertising aggressively. Instead of spending a lot of time and money saturating the market with ads, we spend our time making connections with doctors and other health-care professionals that you will encounter on your road to recovery. We take care of our clients. Current and former clients, as well as doctors and other health-care professionals, know that we care and that we get results for our clients. We trust that they will refer people to us. We get results because of our unique experience and approach. Personal injury law is all we do. We understand the system you will have to navigate during the claims process better than most other personal injury lawyers because we have been involved on both sides of the claims fence. Prior to starting our firm, we worked as lawyers for the insurance companies to which you will have to present your claims. We understand what motivates the insurance companies better than other lawyers. We know from experience that the approach most other personal injury lawyers take often leads to unnecessary delays and sees claims resolve for less than they should. For more information or to schedule a time to speak with either lawyer, call 1-877-883-6171 or visit www.dyeandrussell.com. If you don’t get paid, we don’t get paid. The Medical Professional's Gateway to Health & Wellness | 17
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Rules of Nursing from the 19th Century I mproving the Life of the Emergenc y Room Healthcare Wor ker
Nursing is a tough job at any time, and these rules from more than 100 years ago offer an intriguing look into the history of the nursing profession. Sweep and mop the floors of your ward daily, and dust the patients'’ furniture and window sills. Maintain an even temperature in your ward by bringing in a scuttle of coal for the day'’ s business. Each day fill kerosene lamps, clean chimneys and trim wicks so there is enough light for the doctors to work. Nurse’ s ' notes are important in aiding your physician’ ' s work. Make your pens carefully; you may whittle nibs to your individual taste. Each nurse on day duty will report every day at 7 a.m. and leave at 8 p.m., except on the Sabbath, on which day she will be off from noon to 2 p.m. Graduate nurses in good standing with the director of nurses will be given an evening off each week for courting purposes, or two evenings a week if they go regularly to church. Each nurse should lay aside from each payday a goodly sum of her earnings for her benefits for her declining years so that she will not become a burden. For example, if you earn $30 a month, you should set aside $15. Any nurse who smokes, uses liquor in any form, gets her hair done at a beauty shop or frequents dance halls will give the director of nurses good reason to suspect her worth, intentions and integrity. The nurse who performs her labors and serves her patients and doctors faithfully and without fault for a period of fi fi five years will be given an increase by the hospital administration of fi five cents per day. 18 | www.navigatemag.com
healing from trauma: t h e i m p o rta n c e of t h e e m e r g e n cy d e part m e nt By Dr. Lori Triano-Antidormi Practice in Clinical and Rehabilitation Psychology As a psychologist in private practice who works with individuals impacted by a traumatic incident, and as an individual who has personally been impacted by a traumatic event, I am keenly aware of how the early moments or hours in the emergency department (ED) can potentially impact an individual's trauma response. Some individuals exposed to a traumatic event may, as a result, develop intense psychological symptoms, and their experience and interactions in the ED can impact both symptom development and recovery. Given that current literature suggests an individual’s experience at the time of a traumatic incident has a considerable impact on his or her recovery, it is important for those who work with trauma victims to have a clear understanding of the victim’s experience and his or her needs at the time of the traumatic event. Often, and understandably so, any physical trauma sustained by an individual requires immediate attention when he is brought into the ED. It is also important to remember, however, that individuals who have been exposed to a significant life-threatening traumatic event are also vulnerable to psychological injury following that trauma, including the possibility of developing post-traumatic stress disorder (PTSD). Further, it is important to remember that individuals who have suffered a trauma and are brought into the ED also have family members who may, at some point in time after the traumatic incident, be present in the ED as well. It is important to remember that this incident also represents a traumatic stressor for family members, putting them at risk of developing intense psychological symptoms as well. Not all individuals exposed to a traumatic event will develop a trauma reaction or PTSD, but some may, and, it is important to minimize the risk of PTSD. The development of PTSD has been linked to, among other factors, a lack of proper support at the time of the traumatic incident. Thus, proper support in the ED is critical. I can say from both my personal and professional experience that no one can ever be prepared for that traumatic event, which, by its very nature, will overwhelm their resources and change their life forever. My life was changed forever in 1997, when my two-and-a-half-year-old son was murdered and brought into the care of the ED trauma team. I know,
without a doubt, that my positive experience in the ED, specifically the support and compassion I received, were critical at that moment in time, and to my recovery. Imagine, if you can, your life as you now know it changed in an instant. Imagine learning of the significant injury, or death, of your beloved child, sibling, spouse or parent. I can tell you that those words – "He did not make it" – broke my heart in two and destroyed my equilibrium, my overall sense of well-being and my sense of safety. It all felt too unreal. I felt alone and very afraid. I felt lost and overwhelmed. I was helpless and speechless. I felt physically unwell, cold and weak. My mind was not working. Words could not, would not, register. I could not believe it. I was dazed and confused. This could not be happening! Individuals impacted by a traumatic incident experience a range of intense and varied emotional, cognitive and physical symptoms. Symptoms that are often foreign to them and very frightening. Symptoms that overwhelm and impair their coping resources. Symptoms that make simple tasks feel nearly impossible. Individuals impacted by trauma are fragile and vulnerable and, as such, they are in need of both practical and emotional support. They need kindness, care and compassion. They deserve and require respect. They need people to be present with them, to listen and assess their needs. They require empathy and understanding, and they require that those present understand the magnitude of their experience. They must neither be judged nor neglected. Their experience must not be minimized. I was well supported by those present in the ED after the murder of my son, and I now know that the support, compassion and understanding afforded to me by those present in the ED was critical to my long road of rebuilding. I clearly felt the presence and the compassion of those with me in the early aftermath of Zachary's death. I know, without a doubt, that the support shown to me at this most traumatic time laid a solid foundation from which the process of my rebuilding could begin.
Dr. Lori Triano-Antidormi is a registered psychologist with a practice in Clinical and Rehabilitation Psychology in Hamilton.
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By Virginie Markussen January. New Year. Diet. Here we go again. It’s the time of year when diet books come out promising the newest research in weight loss from experts in either white coats or tight spandex exercise clothes. Or magazines that in December promised that they had the best triple chocolate fudge cake recipe are now writing about the “quickest way to lose 20 pounds in 4 weeks.”
lose, I want you to say this sentence to yourself: “I want to create a new lifestyle for myself.” By saying this mantra you give yourself permission to do more for yourself than just watching a number on a scale go down. This is about creating pleasure in food, activities and new experiences. You have heard it so many times before, but it is so true: everything in balance.
Everybody does it. It’s as if it’s a mandatory activity every Jan. 1. Celebrities swear by their newest diets and office buildings are yet again filled with people bringing in their super salads and powerful protein shakes, bars or powders. Don’t get me wrong, there are people who, because of medical reasons, need to go on diets. But the average person who ate a second (or sometimes third) helping of turkey or snacked on Grandma’s cookies because it’s a Christmas tradition doesn’t have to panic on the first day of the New Year.
When it comes to food, the first thing I want you to do is look at your portions when you eat. This is very important no matter what you prepare for yourself. Eating three apples in one sitting is not good for you even though the food itself is high in fibre and many vital vitamins. Get to know what a portion size is and you will be on your way to losing weight but not losing pleasure. Remember, a portion of steak or chicken is the size of a deck of cards. Most people are always surprised when they see how little it is. Could that be because we are so used to the Fred Flintstone size steak?
Personally, I have a problem with the word diet. Not only for what the word represents (starvation, boredom, mood swings) but also because who wants to willingly do something that starts with the word die? How many times have you said to yourself, “I have to go on a diet”? This sentence in itself has a negative ring to it. The word have already puts you in a bad mood. We always want to do the opposite when we “have” to do something. Diets are a well-known journey that always ends the same way. We start with extreme enthusiasm, and then as we head into our second or third week, the enthusiasm is replaced with doubts, boredom or days wanting to cheat so bad that it is the only thing you can think of. Then, the ultimate ending to this story: throwing in the towel and just giving up altogether. Realistically, we live in a country that in January can have days with blizzards and temperatures dipping down to - 25 C, so the new year may not the best time to put yourself through starvation.
Enjoy your journey to a healthier and happier you. You should not dread or feel guilty about food. Food is there to fuel your body and to keep you vital no matter what your age. Learn to enjoy quality over quantity, eat as fresh and nonprocessed as possible and take your time eating in a relaxed environment. Use new experiences or even new hobbies to keep you from eating out of boredom or dealing with emotional eating. When doing something you love, whether it is painting a picture or going for a walk, knitting or building models, swimming or hang gliding, it is very hard to eat at the same time. And if you are to fall off the wagon and reach for that extra piece of chocolate cake or that burger that’s calling out your name, just know that all isn’t lost. Simply get back on track and continue on your way.
Instead, this is a time to take care of your health and look out for yourself both physically and mentally. Winter is a time when the flu goes around, we have shorter days and our everyday struggles seem harder to handle.
There are always challenges when trying to lose weight. Take one day at a time, and enjoy the journey toward a healthier life.
This year I challenge you not to try another diet on Jan. 1, but a new way of thinking. Instead of worrying about how many pounds you want to
Virginie Markussen is a nutritional consultant and freelance health writer. For more information, contact vmarkussen1@outlook.com.
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The Law & You By Ryan A. Murray
CALCULATING FUTURE INCOME LOSS In most cases, a person or company who causes an injury in Ontario is legally required to put the injured person back in the financial position that they would have been in if the injury had never happened. This means that, among other things, damages are payable to replace the income that the injured person would have made and will now fail to earn because of their By Ryan A. Murray injured state.
THE LAW AND YOU CALCULATING FUTURE INCOME LOSS
Future loss of income is calculated by determining what the injured person would have made most cases, person or company who causes injury in Ontario legally will required put the ifIn the injury hadanot occurred and reducing it byan any money that theisperson still betoable to injured person backthey in the financial position that they would have been in if the injury had never make even though have been hurt. happened. This means that, among other things, damages are payable to replace the income that the person would have made now fail to earn because of their injured state. Giveninjured the uncertainty of proving whatand willwill happen in the future, the injured person must only establish thatofthere is a isreasonable of the future loss occurring. Future loss income calculated chance by determining whateconomic the injured person would have made if the injury had not occurred and reducing it by any money that the person will still be able to though have been Atmake trial,even evidence is they led about whathurt. the injured person would likely have done for work if they had not been hurt. This includes evidence anyinpotential promotions, retirement or Given the uncertainty of proving what willabout happen the future, the injuredearly person must only career changes. Theis amount of future income is then calculated using a mathematical establish that there a reasonable chance of theloss future economic loss occurring. factor set out in the Rules of Civil Procedure. This factor takes into account issues like future At trial, evidence is led about what the injured person would likely have done for work if they inflation, interest rates and the chance that the injured person may pass away earlier than his had not been hurt. This includes evidence about any potential promotions, early retirement ororher expected life The span. career changes. amount of future income loss is then calculated using a mathematical
factor set out in the Rules of Civil Procedure. This factor takes into account issues like future Proving future income no chance easy task. usually requires a combination of expert inflation, interest ratesloss andisthe thatItthe injured person may pass away earlier evidence, than his or evidence fromlife thespan. injured person’s employer and/or co-workers as well as specific evidence her expected from the injured person about their career plans. If you or someone you know has suffered Proving future income loss is no easy task. It usually requires a combination of expert evidence, an injury that has caused them to suffer an income loss, it is important to consult with an evidence from the injured person’s employer and/or co-workers as well as specific evidence from experienced personal injury lawyer as plans. soon as possible. the injured person about their career If you or someone you know has suffered an injury that has caused them to suffer an income loss, it is important to consult with an experienced personal injury lawyer as soon as possible. Oatley Vigmond represents injured individuals in their claims against insurance Oatley Vigmond represents injured individuals in their claims against insurance companies. companies. Oatley Vigmond can be reached at (705) 726-9021 or 1-888-662-2481. Oatley Vigmond can be reached at (705) 726-9021 or 1-888-662-2481.
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STREET DRUGS By Karen Sheviak
Kids seem to be growing up faster all the time, and there are few things that parents worry more about than illicit drug use among teens – or even tweens. New drugs are often more dangerous than what kids used in past generations, so parents need to make sure that they have all the facts, know where to turn if their teen needs help, and develop a solid relationship with their kids so they can talk openly and honestly.
access to more information.” He adds that if your teen does say that they have been around drugs before, make sure you follow up with another non-confrontational question, such as “How did marijuana being present make you feel?” “This type of communication invites the child to be involved in a conversation rather than being bombarded with accusatory questions that are easily answered with one word,” says Thomson.
Detective Constable Gary Thomson, a 13-year veteran of the Durham Regional Police Service with nine years of experience in drug enforcement, spoke with Navigate magazine about preventing kids from using drugs – and where to turn if they do.
WHAT IF YOU SUSPECT YOUR CHILD IS DOING DRUGS?
START WITH COMMUNICATION Talking to your kids is the best way to help them avoid the dangers of drugs – and that starts long before you may suspect any drug use. “Initiating conversations about the child’s school day, friends and after school activities will allow parents to get an understanding of what a normal day looks like for their child,” says Thomson. That way, if the child’s behaviour begins to change, you will notice it early on before the problems get more severe.
If you have communicated with your child as outlined above, he may be willing to talk to you about his exposure to or use of drugs. However, there are certain signs to watch for that kids often exhibit when they begin using drugs. According to Thomson, “General drug use by young people can be associated with changes in mood or behaviour; reduced memory; an increase in problems at school related to attentiveness, finishing assignments and attendance; a decrease in motivation; changes in sleep patterns or oversleeping; paranoia; an increase in experiencing depression; and/or a change in circle of friends.” But, he adds, many of these symptoms can be normal during the teen years so they are not a definite indicator of drug use.
THE CONSEQUENCES When parents speak to their kids about drugs, they need to make sure their language is non-judgmental so kids feel comfortable talking to them. “For example ‘Do you smoke marijuana?’ could be replaced with ‘How often do you find yourself in a situation where marijuana is present?’” says Thomson. “The first question can be easily answered with a ‘no’ to avoid the topic, whereas the second question invites the child to answer using a sentence and allows the parent 22 | www.navigatemag.com
In addition to the physical and mental effects of drug addiction, teens could face serious legal consequences if they get caught using drugs. “Young people could face criminal charges or be placed on a diversion contract (in which case they might have to submit to regular drug testing or go to counselling) if caught using illegal drugs,” says Thomson. “If caught during school hours or on school property kids could also face suspension.”
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When parents speak to their kids about drugs, they need to make sure their language is non-judgmental. Plus, being convicted of a criminal offence for drug use could impact the young person later in life when seeking employment or attempting to travel out of the country for a family vacation.
DRUG AND ADDICTION RESOURCES Parents may feel a wide range of emotions if they discover their child is using drugs, from denial and anger to sadness and anxiety. Parents should access any resources they can as quickly as possible, both for their child’s benefit and their own. Thomson recommends websites such as www.canadadrugfree.org, which is a charitable organization that provides information for parents and teens and tells you where you can go for help. “The Durham Regional Police website www.drps.ca also has a drug abuse section with information and resources listed; there are links for the Centre for Addiction and Mental Health, Canadian Centre on Substance Abuse and the Public Health Agency of Canada,” says Thomson. “And, if a parent would like to speak to an officer in person, each division of the DRP has a Youth Officer and School Officers available.”
PRESCRIPTION MEDICATIONS/ADDERALL/PERCOCET/ OXYCODONE The use of prescription medications by young people is a growing trend. Medications are obtained from friends and family members (with or without consent) or can start with the young person’s own prescription. Medications abused include opioids (pain drugs) such as Oxycodone which is an ingredient in Percocet, and stimulants or amphetamines such as Adderall, which is used to treat hyperactivity disorders such as ADHD. Adderall is known to be abused by young adults in college or university for its ability to increase concentration and focus. Adderall has been given nicknames such as “the study drug” or “smart drug.” Signs of prescription drug abuse include: • Weight loss • Constipation • Nausea • Headaches • Loss of appetite • Financial loss to support habit • Requesting increase in doctor prescriptions or double doctoring
For more information, visit www.drps.ca.
COMMON DRUGS: SIGNS AND SYMPTOMS By Detective Constable Gary Thomson
MDMA/ECSTASY/MOLLY/E/X
MARIJUANA/WEED/GREEN The most common drug used by young people. Fairly easy to access for young people through friends, school mates and older siblings. Marijuana can be perceived by young people as a “natural” drug and therefore viewed as low risk. Signs of marijuana use include: • Dry mouth • Red, bloodshot eyes • Hunger • Coughing • Decreased memory and reaction time • Paranoia and anxiety
MDMA is a psychoactive drug that can cause a euphoric effect for the user. MDMA is most often consumed during a party setting or when attending dances or music festivals. MDMA is found in powder, capsule or pill form. Pills are often not labeled and are stamped with symbols attractive to young people. MDMA can cause the user to have feelings of love for someone they recently met. This can lead to an increase in sexual activity by young people. Young people may consume MDMA as a way of dealing with anxiety or feeling awkward during social gatherings/parties. Signs of MDMA use include: • Increased body temperature and sweating • Teeth clenching or chewing • Dilated pupils • Vision problems • Fainting • Panic attacks and anxiety • Increase pleasure for touch • Abnormally friendly behaviour The Medical Professional's Gateway to Health & Wellness | 23
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Wish
you had an
Avon Lady? Love your morning face! Visit avon.ca to find out more.
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With over 40 years of litigation experience, Oatley Vigmond knows personal injury law. We’ve argued hundreds of cases, secured record settlements and have helped shape Canadian law. Yet for all our success in the courtroom, we have never lost sight of the fact that people come first. We are dedicated to serving clients across Ontario. Contact us at 1.844.487.9036 or oatleyvigmond.com.
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