Connecting Care - Summer 2014

Craving Change™ In Calgary Eating better

Labour Of Love

Surviving morning sickness

LOSING

WEIGHT to

WIN

A road to good health

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Labour of Love

Ways to survive “all-day sickness”

cover story

LOSING TO WIN

4

On the path to good health

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9

Craving Change™ in Calgary Challenging the emotions behind what you eat

2

Medical Director’s message

9

Serve and return

11

Pulse and barley salad

12

Caring team brings peace of mind

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Calgary Foothills PCN programs and clinics

www.boehringer-ingelheim.com

VOLUME 6 • NO. 1 • 2014

Calgary Foothills Primary Care Network would like to thank Boehringer Ingelheim (Canada) Ltd. for their assistance in printing this medical communication publication.

Medical Director’s message Editor

Paula Beauchamp Primary Care Networks in Alberta are built to improve the access and delivery of primary health care in the community. Calgary Foothills Primary Care Network in north Calgary and Cochrane is working with your doctor to provide you with quality primary health care.

For example, our Access 365 Clinic is there for your urgent after-hours needs and our dietitians are there to help you with your weight management issues. Our team of health care professionals is committed to making sure you are connected to the care that you need.

Enjoy this issue of Connecting Care with some wonderful examples of an organization that is there for you and your family 365 days of the year.

Art Director

Alexandra Harle Graphic Design Cover Photograph

Linh Ly Photography Publisher

Jim Thornton

Sincerely,

Dr. Linda M. Slocombe Medical Director Calgary Foothills Primary Care Network

Calgary Foothills Primary Care Network

500, 1716 - 16th Avenue NW Calgary, AB T2M 0L7 P 403.284.FPCN (3726) F 403.284.9518 communications@cfpcn.ca cfpcn.ca

Published for CFPCN by

Paragon Publishing Inc.

Calgary, Alberta P 403.287.9818 ads@paragonpublish.com paragonpublish.com

Background Calgary Foothills Primary Care Network (PCN) is an arrangement between a group of family physicians and Alberta Health Services to provide primary care services to patients living in north Calgary and Cochrane. Created in 2006, the Calgary Foothills PCN’s mission is to enhance access and co-ordination of primary care for patients while improving the quality of professional life for community family physicians and allied health care professionals.

Primary care is the care patients receive at their first point of contact with the health care system, usually provided by family physicians or allied health care providers. Patients receive care for their everyday health needs, including health promotion and prevention, diagnosis and treatment of health conditions.

Connecting Care is a PCN publication aimed at educating patients of member physicians on new programs and initiatives available to them and their families.

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CONNECTING CARE

•

SUMMER 2014

Connecting Care Magazine is made available free of charge to the 350,000+ north Calgary and Cochrane patients of 392 PCN member physicians at more than 80 clinics in 54 communities.

The e-magazine version is available at cfpn.ca and by free subscription at connectingcare@paragonpublish.com All rights reserved ©2014. Printed in Canada. Member of the Canadian Federation of Independent Business.

BY PAULA BEAUCHAMP

Photo courtesy of Andras Schram Photography

RACHEL Vanderveen’s children were a true labour of love. Despite crippling morning sickness that lasted well into her second trimester, the Calgary realtor endured four pregnancies in five years. “At the time, my whole life was consumed by feeling sick and there were times when I thought I couldn’t face tomorrow,” she said.

While most pregnant women experience some symptoms of morning sickness, the Duchess of Cambridge Kate Middleton’s treatment for hyperemesis gravidarum, the most severe form of morning sickness, cast new light on the condition.

Family physician Dr. Heather Wrigley, who is based at Riley Park Maternity Clinic, says the condition can be hugely stressful, especially for people who are working or have other children.

“The nausea and vomiting in pregnancy is very similar to what people experience when they have chemotherapy,” she said.

Physical and emotional support Wrigley recommends talking with family and friends and asking for support. “Get as much help as you can. If someone is willing to help look after your other kids, cook meals or do the laundry, that is very helpful,” she said.

The timing can be difficult, though, because often the pregnancy hasn’t been announced early on. A partner’s help, therefore, can be vital. Wrigley says if the support isn’t there, it can threaten a marriage.

Vanderveen, a working homeschooling mom, says her husband Clint was her rock. “I talked to him about my needs and asked him to encourage me,” she says with a laugh. “I had scripts for him: ‘You’re 13 weeks now, you can do this.’ It made me feel better to hear him say that.”

Clint also barbecued outside a lot in the middle of winter because cooking smells triggered Vanderveen’s seemingly never-ending nausea.

Eating and other aids Experts say getting enough sleep is crucial because nausea is worse when you’re tired. Eat small frequent snacks, rather than three big meals, to avoid the empty stomach feeling that triggers nausea.

Each day Vanderveen imagined the food that seemed least offensive to her — usually almonds — and ate that gradually throughout the day. “I’d visualize quite a lot of different foods,” she said.

Wrigley tells pregnant women not to stress about maintaining the perfect diet if they are struggling to keep food down. “You have to eat what you can manage and when your condition improves, you can focus on getting a more balanced diet,” she said.

Wrigley says Gravol, which is typically used to treat motion sickness, can help ease symptoms and is safe. Diclectin — a combination of antihistamine and vitamin B6 — is also safe, she says. It is taken daily and works to prevent the onset of symptoms.

Pregnant women may need to temporarily stop taking prenatal vitamins that contain iron if they trigger morning sickness, but it is important to start taking them again after recovery. Folic acid remains essential throughout.

Most importantly, the condition is not harmful to your baby — and it can’t go on forever. For Vanderveen, the 22-week mark of each pregnancy provided longed-for deliverance. “You’re just so grateful when it ends.”

Pregnancy care at Riley Park Maternity Clinic can be accessed either by referral from your family physician or by self-referral. cfpcn.ca

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CONNECTING CARE

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SUMMER 2014

LOSING TO WIN BUILD UP: Kevan Austen in 2010.

h t l a e h d o o On the path to g

OVER the past year, Kevan Austen has lost four pant sizes, four shirt sizes and more than 110 pounds. The self-confessed one-time couch potato has shed his sedentary life and unhealthy eating habits, tackling a workout on 362 of the past 365 days.

“There’s no more sitting around eating bags of chips and watching movies or looking for excuses to sit around,” Austen says. “This is my new life and the goal is simple: to live and be healthy.”

Tackling Unhealthy Habits Flash back to February 2013 and the IT manager, who had been feeling increasingly unwell, faced a shock diabetes diagnosis. Blood tests ordered by family physician Patrick Lai revealed high blood glucose levels.

“It shouldn’t have come as a shock,” Austen, 47, says. “I had no attitude to my health.”

By Paula Beauchamp

In fact, the before and after story of Austen’s lifestyle change is staggering. Take his 2010 holiday to Seattle and Portland, for example, where the goal was to hit as many diners, drive-ins and dives — à la The Food Network — as he could. “The whole vacation revolved around eating,” says Austen, a trained chef.

“This year our holiday to the Oregon coast revolved around where we wanted to go for a hike. It’s a radical shift in how you think.”

Friends and colleagues who’ve watched Austen’s transformation often ask, “How do you do it?” and “How are you so successful?”

The answer is simple and it is always the same.

“There’s no secret,” says the health-food junkie, who recently took up running. "It’s all of the things your doctor has probably been telling you over the past 30 years — eat properly and exercise,” he says. “It took 20 years to put this weight on. It’s hard work to take it off.” cfpcn.ca

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Austen’s TOP TIPS

'Health home’ help Keys to Austen’s early success were appointments with a nurse and a pharmacist, who is also a trained diabetes educator, at his health home: Dr. Lai’s clinic. The Calgary Foothills Primary Care Network has 21 certified diabetic educators — pharmacists, nurses and dietitians who have additional training — working in member clinics.

1

“They were strong motivators and they asked the tough questions,” Austen says.

Go public: Tell everyone about what you are doing.

Talk about your goals.

“Amy helped me understand the physical process of diabetes and the medications.

Through those discussions, I knew what my body was doing.”

Pharmacist Amy Yu says people like

2

meeting face-to-face with a health care

Try an app to track calories via your phone.

Good in the early days to get a sense of the energy found in different foods.

Austen used Lose It.

professional. “There is a lot of stuff on the Internet that isn’t correct,” she said.

Appointments also give the health care team a good opportunity to more regularly assess the mood of diabetic patients, Yu said.

“The diagnosis can be overwhelming and depression can be high in people with diabetes,” she said.

to a daily hour-long walk with a neighbour.

Shedding the kilos little by little, Austen also shed four consecutive wardrobes of clothing as the weight dropped away.

Austen can now jog at 8.9 kilometres an hour for 20 minutes. A year ago he was huffing and puffing just to make it around the block.

His dietary changes would fit well into a lifestyle handbook. While dinner parties at the Austen home continue in elaborate style, the foodie now focuses on his guest’s hips as well as their hearts.

Typical fare pre-2013 could include homemade pasta with a heavy cream sauce and a mushroom ragout - heavy on the butter.

“You’re talking 1200 to 1500 calories a dish and then there’d be dessert,” Austen said. “I wanted to wow.”

Today visitors experience Kevan’s Cooking 2.0. The home-cooked Vietnamese noodle soup offered to extended family last month, for example, was a hit. “There were fresh vegetables, bean sprouts, grilled tofu,” he says. “Everyone added their own ingredients, even the

Dr. Lai believes

3

kids, and it was a lot of

embedded health

Move every day.

Get walking.

fun.”

teams are popular

While a few

because patients

goals remain,

like to receive a

Austen is

range of health

4

confident about

services in the

If you work in an office, eat lunch in the lunchroom. It makes you more accountable for what you eat.

the future —

one place,

and grateful for

where they are

all the help he’s

familiar with the

received. “I want

surroundings and

to get off my meds

staff. “The longer

and get the rest of

appointments (with

the weight off,” he says.

the health team) help,” he said.

5

“Patients are sophisticated and they

Buy quality food: For example, whole wheat tortillas, lots of salads.

know we have a limited amount of time.

They enjoy hearing different perspectives of the medical condition from other health professionals, such as a pharmacist and a nurse.” Dr. Lai says he appreciates the

6

additional services because ultimately they

Build exercise into your vacations. Buy a gym membership on holidays.

benefit his patients.

A new life Austen, who played football in his youth, has joined twice-weekly sessions at the University of Calgary’s TrymGym. And he’s committed

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CONNECTING CARE

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SUMMER 2014

Losing another 45 pounds will take Austen to his goal weight of 180 pounds.

“My beta receptor cells were damaged by my lifestyle, so it may not be possible to get off all the meds,” he says. “But I’m already down 30 per cent. I’m going to try.”

To register for TrymGym call 403-220-4374 and identify yourself as a patient of a member physician. To find out about your health team, please speak with your family doctor.

Craving

Change™ in Calgary

By Paula Beauchamp

DID you ever return home from school feeling sad as a child, only to be given a cookie to cheer you up? Do you feel angry with yourself when you binge on junk food in front of the television, night after night?

While hundreds of diets and fads tell us what to eat and when, few help us grasp why we make poor food choices and what emotions and habits drive us there.

Craving Change™, a program designed by two Calgarians, is the first to answer these questions and give us tools to build a healthier relationship with food. The program — offered as a four-session group workshop for adults — is open to patients of doctors in the Calgary Foothills Primary Care Network.

TOWARDS HEALTHY HABITS: Your eating habits change when your thinking does.

cfpcn.ca

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Eating Quiz Why am I eating?

Is it stomach, mouth or heart hunger?

CRAVING COLLABORATION: Craving Change™ co-founders Colleen Cannon, left, and Wendy Shah, right.

Facilitator Shirley Sullivan, a health

genealogy project to distract herself from her

management nurse, says the feedback from

decades-old routine of a post-school treat.

participants has been overwhelming. “There’s

Another participant, Karen Carlson, says

a sense of ‘wow, I’ve really learned something

she’s crocheted more blankets than usual

new here,’” she says.

this past month. “Yes, I’ve tried distraction,”

“People come feeling there is something wrong with them, that they can’t overcome their eating challenges and they learn they aren’t alone. They feel they’ve tried everything, but here they discover new strategies to try.”

she laughs. She’s also taken to eating her meals more slowly and savouring every bite.

“It gives your brain time to connect with your stomach and let you know you are full.”

Other tips include the 80/20 rule —

Why we eat

making good choices 80 per cent of the

Wendy Shah, the registered dietitian who co-

for the rest. “All or nothing thinking can be

created the program, says the key is changing

a real barrier,” program co-creator Colleen

your thinking habits to change your eating habits. “As people become more aware of their personal eating triggers, they are better able to control their food cravings,” she

time and eating less healthy food guilt-free

Cannon, a psychologist, says.

Time for change

said. “We have all learned, particularly in our

Cannon says people underestimate how

childhood, to associate foods with something

much time and energy it actually takes

other than satisfying hunger.”

to make and maintain a change. She

Take the stomach hunger, mouth hunger,

developed “slipping towards success”

heart hunger quiz opposite to find out more.

to help keep participants positive and

Food can be used as a treat, a distraction or a

motivated.

“See slips as an opportunity to be strategic

soothing tool.

And here’s the good news: You can break

behaviour,” she said. “It is absolutely

and your eating habits. But you do need to

normal to have lapses. Look at them with

stop and think before you eat.

curiosity and you’ll get valuable information

The program’s “change buffet” of strategies offers tools to alter the way you think

Participants are encouraged to set goals and

HEART HUNGER Eating in response to your emotions or how you feel mentally, not physically.

REASON FOR EATING

TYPE OF HUNGER

I’M BORED I’M STRESSED I’M HUNGRY BECAUSE IT’S TIME SOMETHING SMELLS GOOD I’M UPSET

be forgiving when they fall short.

Sullivan says it is wonderful to see people gain a sense of hope. “Many have struggled

yourself — taking a bubble bath to feel good

for decades and this program gives them

instead of munching on a bag of chips — or

the confidence to move forward and make

distraction. Doing a different activity can shift

realistic changes,” she said.

A former teacher started an afternoon

MOUTH HUNGER You want to eat something because it has a certain taste, texture, or smell.

Salty? Creamy? You crave the pleasure of food.

about what to try differently next time.”

and behave. Techniques include nurturing

your thoughts away from food cravings.

STOMACH HUNGER The physical need for food.

It’s been five to six hours since you ate and your stomach is growling.

and learn more about yourself and your

the link between your personal eating triggers

Strategies for change

Insert one of the following symbols:

To register for this free program call 403-284-3726 ext 206.

WE’RE CELEBRATING I DESERVE A TREAT I SAW AN AD ON TV I’M TIRED

To check your answers, go to page 12.

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SUMMER 2014

EARLY RESPONSE: Lindsay Berg enjoying time with the kids at her day home.

SERVE AND RETURN

BY PAULA BEAUCHAMP

Early childhood matters, enormously. The foundation for healthy development depends on stable, responsive relationships with adult caregivers in a safe, supportive environment.

- Alberta Family Wellness Initiative

Towards building better brains LINDSAY Berg smiles warmly at the waiting three-year-old. “Did you want to ask a question, Jasper?” she says.

The mother-of-two, who is also a day home mom to four other small children, spends much of her day playing on the floor and thinking up fun activities to share. “They are so special,” she says.

Important early years New research shows that ages zero to six are even more crucial in the development of the human brain than first thought.

Interactions during this stage actually affect how the brain is physically built.

Healthy exchanges between young children and their caregivers, dubbed “serve and return,” are needed to build a solid foundation for the brain to support future development.

You can see it in action when young children reach out and adults respond

through simple eye contact, cuddles, singing songs, reading books and playing games like peek-a-boo. Many such interactions are needed each day to build a healthy brain, according to the Alberta Family Wellness Initiative (AFWI).

“Serve and return, similar to hitting a ball back and forth in a game of tennis, sets the stage for learning of all kinds that takes place in early childhood.” It affects language learning, cognitive learning and the ability to regulate emotions.

Dr. June Bergman, physician with the Calgary Foothills Primary Care Network, says it is important to support parents and children in their health journeys, particularly during this earliest stage. “I would say to parents in general, spending time with your child is very important,” she said.

“You can’t respond every time they serve, but it is good to be aware of children’s

needs. If there were parts of your own childhood that you didn’t like, you don’t have to perpetuate that parenting.”

Getting help Calgary child, adolescent and family psychiatrist Dr. Joan Besant says it is really important for parents to get their own therapy if they have anger management problems, depression or anxiety.

She likens it to asking parents on an airplane to don their own oxygen masks first. “You have to be the best you can be in order to be useful to somebody else,” she said. If you have difficulty soothing yourself and managing your own stress, seeking personal help can be a good first step to better parenting.

Parents may have access to a behavioural health consultant (BHC) through their family doctor’s office. cfpcn.ca

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These images illustrate the negative impact of neglect on the developing brain. The CT scans on the left are from healthy three-year-old children with an average head size (50th percentile). The image on the right is from a series of three, three-year-old children following severe sensory-deprivation neglect in early childhood. Each child’s brain is significantly smaller than average and each has abnormal development of cortex and other abnormalities suggesting abnormal development of the brain.

Courtesy: Dr Bruce Perry and the ChildTrauma Academy.

Behavioural health consultants address a wide range of mental health concerns. Private therapists and work-based Employee Assistance Programs are other options.

In its Parenting Programs for Everyone, Alberta Health Services outlines parenting programs available locally, for example, through the Boys and Girls Club.

The goal of these programs is to increase parental confidence and capacity.

Toxic stress and later life Toxic stress in childhood can also adversely shape a child’s brain. While positive stress, such as meeting new people or preparing for a test, can help develop useful skills for later life, toxic stress is always harmful.

“Toxic stress is intense, long-lasting and uncontrollable, and occurs in the absence of supportive relationships,” according to AFWI. “For children, it can occur as a result of abuse, neglect, or living with a parent who is unable to provide appropriate care due to mental illness or addiction.”

If toxic stress is experienced in early life, it takes root in a child’s biological system and may lead to a range of disorders and chronic illnesses in later life.

Examples include hypertension, Type 2 diabetes, obesity, asthma, cardiovascular disease, mental illness and addiction.

One study has found a correlation between maltreatment in childhood and elevated inflammation in later years. “We need to stop asking, ‘What is wrong with you?’ and start asking ‘What happened to you?’” Dr. Bergman says.

Dr. Bergman hopes the new research will lead to greater support for challenged families. “My hope is that we can give families the support they need to create healthy children and that we see less chronic disease down the way,” she said. If you believe a child you know is experiencing toxic stress, please contact Alberta Human Services on 1-800-387-KIDS (5437).

To watch the short AFWI video, How Brains are Built: The Core Story of Brain Development, visit the Calgary Foothills Primary Care website at cfpcn.ca.

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CONNECTING CARE

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SUMMER 2014

Thinking About Quitting Smoking?

We can help you.

Let one of our trained Tobacco Reduction Educators help you develop a personalized: assessment to understand your triggers and improve your motivation quit plan follow-up strategy Contact a Calgary Co-op Pharmacy for more information about our Tobacco Reduction Program and to book your one-on-one consultaion.

Co-op Pharmacies are located in all Co-op Food Centres.

calgarycoop.com

ON THE PULSE: Chickpeas and lentils are among the best foods for your health.

Healthy Eating I really like pulses, such as chickpeas, beans and lentils. They are an underrated food.

In fact, if I could advertise the best foods out there, this would be one of them. Pulses are rich in soluble fibre, which helps balance blood cholesterol levels and blood sugars – and they don’t need to taste bland to be healthy. Pulses are also inexpensive and serve as a good meat alternative, because they are high in protein and they won’t add unwanted saturated fat. This salad is a great option for dinner or lunches and can be prepared ahead of time in big batches. And since the vegetables are cooked, it can also be stored in the freezer. Enjoy!

Pulse & Barley Salad

Andrea Kroeker, a registered dietitian with the Calgary Foothills Primary Care Network (PCN), talks pulses and why they are good for you.

Serving Size 1½ cups • Recipe by Pulse Canada.

Ingredients

Directions

1 tbsp olive oil

Over medium-high heat, sauté onion and garlic in olive oil in a large saucepan for about 2 minutes. Add barley and cook additional 2 minutes.

1 medium sweet onion, chopped 1 garlic clove, minced 1 ½ cups pearl barley 4 cups reduced sodium vegetable broth (good alternatives: homemade stock or reduced sodium chicken broth) 1 medium zucchini, chopped 2 cups halved cherry tomatoes 19 fl. oz. can chickpeas, rinsed and drained 19 fl. oz. can lentils, rinsed and drained ¼ tsp salt and pepper, optional (skip the salt to reduce your sodium intake) ¼ tsp or 10 sprigs dill, dried or chopped

Stir in soup stock and bring to a boil. Cover pan and reduce heat. Let simmer for 30-35 minutes or until barley has soaked up most liquid.

Stir in zucchini, tomatoes, lentils, chickpeas, salt and pepper. Cover and cook 5 minutes. Stir in dill. Serve with optional sprinkling of feta, lemon, thyme or fresh parsley on top. This dish is also delicious cold!

To learn more about healthy eating, register for a free Ask a Dietitian group appointment by calling 403-284-3726 ext 206. You can ask personal nutrition questions and book a one-on-one follow-up appointment with a dietitian. For more pulse recipes, visit Pulse Canada’s website at pulsecanada.ca.

(Optional) feta cheese (rinse feta to remove excess brine and salt), lemon, thyme or fresh parsley cfpcn.ca

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Caring team brings peace of mind

By Kelly Parks

SUPPORT TEAM: Cochrane Bethany Care Centre residents Harold, far left, and wife Mary, with son Lyle and Tammy Rogers.

IT is not just the residents who value Tammy

account each health team member’s expertise,

Rogers, nurse practitioner at the Bethany Care

whether that is pharmacy or psychology —

and his family feel valued by Rogers and the

Centre in Cochrane. Their families say she

we are able to look at the whole picture and

team. “There is an open door policy here,”

gives them peace of mind. “Tammy listens

provide care holistically.”

he says.

Lyle, the son of one resident couple, says he

to our concerns,” says the daughter of one Since 2007, a Calgary Foothills Primary Care Network (PCN) nurse practitioner has worked within Bethany Cochrane with the aim of increasing residents’ access to primary health care.

A team effort Day-to-day, Rogers works closely with each resident’s family physician. She also collaborates with other health care professionals, including a clinical pharmacist and an occupational therapist, to offer longterm care.

"Trust is part of providing quality care" Families in the loop

“With the help of the team, I provide on-

Year-round support is extended to residents’

site medical care,” says Rogers, who explains

families, helping to build a sense of rapport.

her nurse practitioner role as an advanced

The team also meets formally with residents

form of nursing. “Because of my extended

and their families once a year. “This is a

education, I’m able to assess and treat many

chance for the family to ask questions and be

issues, order tests and prescribe medications.”

involved,” Rogers says.

Many residents at Bethany Cochrane have

It is also an opportunity for everyone to

more than one health concern, which adds

hear all of the team members speak about

to the complexity — and the value — of

their care plans and assessments.

the nurse practitioner role and the diversity

“It’s important for us to build a relationship

of skills required from the whole team.

with the families,” Rogers says. “Trust is part

“By tackling these as a team — taking into

of providing quality care.”

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SUMMER 2014

Five nurse practitioners work within Calgary Foothills PCN. They help patients in a range of maternity, aged care and general practice settings.

Eating Quiz Answer Guide

resident. “We have a rapport with her.”

REASON FOR EATING

TYPE OF HUNGER

I’M BORED I’M STRESSED I’M HUNGRY BECAUSE IT’S TIME SOMETHING SMELLS GOOD I’M UPSET WE’RE CELEBRATING I DESERVE A TREAT I SAW AN AD ON TV I’M TIRED See quiz on page 8.

Calgary Foothills PCN

Programs & Clinics Clinics and Services Access 365 Clinic

Crowfoot Primary Care Centre

The Access 365 Clinic runs 365 days a year. It offers after-hours appointments for non-emergency medical care. Access the clinic by calling Health link Alberta: 403-943-5465.

Do you live with a chronic condition? Don’t have a family doctor?

This clinic may be able to help you. See Need-A-Doctor below.

Riley Park Maternity Clinics

Pain Management Clinic (PMC) Chronic pain? A team of health specialists at PMC helps patients with chronic pain. Ask your doctor if this service is right for you.

Care is available to pregnant women who do not have a family doctor or by referral from your family physician.

Programs Ask a Dietitian

Need-A-Doctor Website

Meet with a registered dietitian to learn label reading and more.

This group appointment is free to patients of PCN member physicians. To register, call 403-284-3726 ext 206.

Need a family doctor?

Register at www.needadoctorcalgaryandarea.ca or call Health Link Alberta at 403-943-5465.

Craving Change™

Navigation Team

Join this free four-session workshop for adults and change your thinking to change your eating habits. To register, call 403-284-3726 ext 206.

The Navigation Team cares for frail patients with complex health care needs. Ask your physician for a referral.

TrymGym Meet with a personal trainer and dietitian as part of a structured exercise program. Patients of member physicians get a $200 discount when they join. To register, call 403-220-4374.

Tobacco Cessation Join this free group session if you are ready to quit or just thinking about it. Ask your doctor for a referral.

Walking Programs calgary Join Walk with a Doc to exercise monthly with a group that includes a family doctor. Or, join a walking group weekday mornings in North Hill Mall or at Confederation Park in the summer. Register at 403-284-3726 ext 206.

cochrane Join men’s and women’s walking groups at Mitford Park year round. Call 403-851-2534 for information.

cfpcn.ca

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