People First Magazine PDM 214 Vol. 12 No. 6

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PeopleFirst pleFi Helping People Live Better Lives

How to Age Gracefully

Sun Safety Dr. Hister On

Age-Related Macular Degeneration Support The ALS Society of BC

ALS Stars Of Hope Company’s Coming Recipe

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PDM 214 Vol. 12 No. 6

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People15 First

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Eye Insurance

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Dr. Hister looks at two different conditions - shingles and AMD the leading cause of blindness among adults.

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Protect Yourself

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Sun Safety Peoples Pharmacist Ian Lloyd provides useful tips on how to be safe and healthy in the summer sun.

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Healthy Buys Great selection of quality health and wellness products from Peoples Pharmacy.

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Sunburns can really hurt, and too much sun can lead to skin cancers. Be safe this summer.

Healthy Choices For Vision Save on supplements that can help delay the progression of AMD.

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Choose from a selection of vision supplements that can help delay age-related macular degeneration.

Shingles and Age-Related Macular Degeneration

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Pharmacist Recommended What you need to know about eczema. Health news on how vitamin D may help mobility with seniors.

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Aging Gracefully Darlene Booth looks at aging, and provides tips on how to age gracefully.

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Shingles And

Managing Menopause Age-Related Macular Degeneration Part of the price I pay for being involved in the terrifically enjoyable work I do is that I get huge volumes of emails, and unfortunately, some of those emails are indeed volumes. In fact, some of the lengthier emails should more rightly be considered tomes or even epics for the rather obvious reason that nearly everyone is utterly fascinated by their own medical story P be honest, aren’t you completely enthralled by the workings of your own body and mind, and don’t you just love to share the details of its occasional sometimes frequent malfunctions with just about anyone you can cajole into listening to you? P although as nearly all of us have learned at a dinner or a party where one or more of the guests has decided to air their most current medical stories, most listeners to someone else’s medical history are not nearly as thrilled to hear about another person’s battles with P or conquests over - hemorrhoids or hernias or hysterectomies as the story-teller of said battles feels the listeners surely must be. At least that’s what my wife always lets me know whenever I try to get her to pay attention to some new ailment I imagine I’m coming down with. Anyway, the point I want to raise here is that in the very many emails I get, two pretty common conditions stand out for the amount of frustration they are associated with. Number one is shingles. Shingles is the name we give to the re-activation of an old chicken pox infection that has stayed latent

in the body for 40 or 0 or even 70 years, but which can come back, particularly when immunity is low as in old age or in someone with a malignancy. And very sadly, when shingles strikes suddenly (in the form of a pretty telltale rash in one delineated part of the body), it can unfortunately result in terrific pain that can go on for months, even years after the rash has disappeared, and which even more unfortunately is nearly impossible to treat well, although doctors, as always, have to do something to try to alleviate the pain, so we dispense all sorts of medications to dull post-shingles pain, none of which, if we are to be honest, are very effective. Here, for example, is a very typical story I received while writing this article: “Dr. Art, I got shingles 3 years ago, and despite the use of several medications, I still suffer from ongoing stabbing, burning and sharp pain and I am still very sensitive to light touch as the skin feels like a sunburn - and often, especially during the mornings and evenings hours I cannot bear even the touch of clothing on the skin.” In other words, this is a condition you want to avoid as best you can and to that end, I see it as my urgent public duty to let everyone know that there is a shingles vaccine available in Canada that offers an estimated 0-60% chance of preventing this infection. So I strongly recommend that everyone who qualifies get this vaccine, although it is both costly (anywhere from 200- 300), and it can also be very hard to find because it t has to be stored under restrictive (very cold) conditions which so many pharContinued On Page 11

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Ian Lloyd

Pharmacist, Peoples Pharmacy

Sun Safety Thank goodness the sun is finally here Time to get outside and soak up some rays what could possibly be wrong with this picture? If done right, nothing. While sun exposure is great for plants and people alike, being in the sun can pose a few dangers. Heat exhaustion, sunburns and even skin cancer can be some of the drawbacks from too much sun worshiping. I am not advocating staying indoors all summer, but just be aware of all the pleasures and pains that summer can bring. Sunlight is good for you, it helps your body make vitamin D. Vitamin D has been in the news recently for its ability to help prevent certain forms of cancer. There is also some evidence that it might play a role in preventing type 2 diabetes and multiple sclerosis. This important nutrient is also essential for the proper development of strong teeth and bones. People thought that vitamin D deficiency was a thing of the past, after they started fortifying milk with this vitamin. But the more I read about vitamin D, the more I think everyone should take a little extra. Recently, I read one study which found that approximately 2 % of people who lived in Southern Arizona were considered to be vitamin D deficient. This is quite shocking because Arizona is considered to be in the 'sun belt.’ Why is too much sunlight bad for us? The main reason is that, over time, excessive exposure to sunlight can lead to skin cancer. In the short term, too much exposure to sunlight can lead to sunburns, heat stroke or heat exhaustion. So what should one do? Sunlight is just like everything else in life, enjoy it in moderation and follow these tips: Q Try to limit your exposure to the sun during its most intense times, between 10am and 4pm. Q Seek out shade whenever possible. Some people use an umbrella to make their own shade. Q Wear light-coloured, long-sleeved clothes and a broad brimmed hat to protect your face. Q Wear your sunglasses. Q Apply sunscreen at least 30 minutes before going out into

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the sun. Use a sunscreen that has a sun protection factor (SPF) of at least 1 . Don’t forget to apply it to the exposed, sensitive area(s) of your body, such as your nose, ears, neck and lips. Q Reapply your sunscreen every 2 hours while in the sun and after swimming or excessive sweating. Infants and toddlers should not be exposed to direct sunlight. Sunscreen use is not recommended for little ones under the age of 6 months. The next major problem with getting too much sun is an increased risk of developing skin cancer. There are about 13,000 new cases of non-melanoma skin cancers discovered in BC every year. Much of the sun exposure and skin damage is thought to occur before the age of 20 this is why it is best to teach children to be 3sun-safe.’ What does skin cancer look like? Contact your physician if you notice any growths or skin changes and remember the “ABCD’s” of skin cancer. Watch for lesions that are asymmetrical-one half is not a mirror image of the other. Border irregularity: The edges are blurry or ragged. Colour is not uniform: the lesion is not the same colouring throughout. Diameter: watch for lesions that are larger than a pencil eraser. If you notice any of these signs, or wounds that bleed and won’t heal properly, contact your physician promptly. Early diagnosis and treatment lead to better outcomes. So what else should one think about when out in the sun? The first thing I always tell people is to wear proper sunglasses. Sunlight can play a role in the development of various eye disorders including cataracts, cancer of the skin around the eye, and may contribute to age-related macular degeneration. Whenever you are out in the sun, you should be wearing sunglasses, especially your children. My little one has been wearing sunglasses since she was 6 months old. Some eye care experts believe that 0% of our lifetime sunlight exposure occurs before age 18. This does make sense kids are told to go outside and play. When choosing a pair of sunglasses, look for a pair that states that it blocks 100% of Continued On Page 8


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both UV-A and UV-B light. It is very hard to find sunglasses in Canada that do not block both kinds of UV light. For maximum protection look for the kind that 'wrap around,’ this will prevent light from getting in from the sides. Basically, if you are outside and squinting, you should be wearing sunglasses. You don't need to get an expensive pair of sunglasses for them to be effective. More expensive pairs might be a little more fashionable or use better quality glass or plastic for the lenses. I am still using the same 30 pair of sunglasses that I bought 10 years ago. To all the grandparents out there: if you can't think of a good gift to give your little treasures, why not give a pair of cool-looking sunglasses? Another concern about summertime is sunstroke. What normally happens when we get too hot is that our bodies produce sweat in an attempt to cool off. This works just fine, but if this system is overwhelmed it can cause the body's core temperature to rise. This rise in core temperature can be quite serious. Mild increases in temperature can cause symptoms of confusion, dizziness, fainting or headaches. The blood vessels become dilated in an attempt to lower body temperature, thus giving the skin a bright red colour. As the body's temperature rises further, dehydration may occur and symptoms of chills, shivering, nausea, vomiting and loss of consciousness may be seen. At this point medical attention is essential. Prevention of heat exhaustion is easily done. Make sure

you drink plenty of water if you are outside in the heat. The key word here is 'water,3 not coffee, beer or sports drinks. Wear light, loose fitting clothing, which will allow sweat to evaporate. During the hottest times of the day try to stay cool and avoid strenuous activities or exercise. One major cause of heat stroke is being trapped inside a car during a sunny day. On days where the temperature is 32C outside, the interior of car can reach 1C in 20 minutes. At these temperatures, heat stroke can occur within minutes. This can prove to be fatal for young children and pets. On average, 38 children die every year from being trapped inside cars on hot days. The same is true for the family pet, usually dogs. Never leave children or pets unattended in a car leaving the windows slightly rolled down will not help. I hope this article was not too worrisome. I still plan to enjoy the sun this summer, but will be safe about it. My big hat will be on I will stay in the shade when possible and try to avoid being in the sun between 10am and 4pm. I will also wear my sunscreen with 30SPF, especially on my feet, the back of my hands and neck. These are very common places to get sun burnt. But don’t forget to get some sun exposure, it can keep your spirits up and help your body make vitamin D. Whenever you are in the sun just remember to 3Slip, Slap, Slop.’ Slip on your long sleeved T-shirt, slip into the shade, slap on your hat, and slop on your sunscreen.

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pharmacist recommended Health & Wellness Information From Your Peoples Pharmacist

Eczema Eczema or atopic dermatitis is due to a hypersensitivity reaction (similar to an allergy) in the skin, which leads to long-term swelling and redness (inflammation) of the skin. People with atopic dermatitis may lack certain proteins in the skin, which leads to greater sensitivity. If you have eczema, you're probably not the only person you know who has it. Eczema isn't contagious like a cold, but most people with eczema have family members with the condition. Researchers believe it is inherited or passed through the genes. People with eczema also may have asthma and certain allergies, such as hay fever. For some, food allergies may bring on or worsen eczema. Allergies to animal dander, rough fabrics, and dust can also trigger the condition in some people. If you're diagnosed with eczema, your doctor might: prescribe medications to soothe the redness and irritation, such as creams or ointments

that contain corticosteroids, or antihistamine pills. If the eczema is really severe, ultraviolet light therapy can help clear up the condition. Newer medications that change the way the skin's immune system reacts also may help. Moisturizers are one of the main treatments for eczema, both to prevent and treat eczema flares. People with eczema need a good moisturizer that replenishes the loss of natural oils from the skin. It is also important to have a moisturizer that doesn't irritate the skin and is free of fragrances and preservatives. After showering or bathing, it is important to immediately apply moisturizers on the skin. This will help trap moisture in the skin. Talk you to your Peoples Pharmacist about medications and moisturizers to help manage and control eczema.

health news Vitamin D May Help Seniors Stay Active Too little vitamin D has been linked to a host of health problems, including diabetes, obesity, and hypertension, and recent research now suggests that a lack of this important nutrient may also contribute to mobility problems in old age. The researchers followed more than 3,000 people between the ages of 70 and 79 for six years, and found that those with the lowest vitamin D levels at the start of the study had nearly a 30 percent increased risk of a mobility limitation at the end of the study and almost twice the risk of a mobility disability as people with the highest levels of vitamin D. The body produces vitamin D naturally when exposed to the sun's rays. However, because sun exposure increases the risk of skin cancer, many people limit their sun exposure or use sunscreen to protect their skin from the sun's potentially

damaging light. As people get older, the skin doesn't absorb and process the sun's ultraviolet light as effectively as it does in younger folks. Vitamin D plays an important role in muscle function, as it's needed to get calcium into the muscles, which is needed for muscle contraction. The study recommends that it would be premature to recommend vitamin D solely for preventing mobility issues. But, many people take vitamin D supplements for other reasons. It's difficult to get enough vitamin D through diet alone and the current recommendations are for 800 international units a day for people over 70 years old. Vitamin D is also found in fortified milks and juices, fatty fish (such as salmon or tuna), egg yolks, cheese and mushrooms. NEW! - peoplesdrugmart.com People First 9


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PEOPLES PHARMACISTS

Dr. Hister...Continued From Page 4

macies have chosen not to stock it. But if you can find it, get it. You won’t regret it. Which brings me now to the number two entrant on that list of most-frustrating conditions I get emails about and which is actually the real topic I’m supposed to cover this month, namely, age-related macular degeneration or more mercifully, AMD. AMD is the name we give to that problem in which “deposits” called drusen accumulate in the central part of the retina or the macula, and as the number of deposits expands, there is further damage in the central visual field, and eventually that leads to atrophy of the retinal lining, which can result in blindness. Indeed, AMD is the leading cause of blindness in seniors. Unfortunately, I don’t have the space here to discuss treatment options for the two varieties of AMD knows as “wet” AMD (for which, happily, we now have a few treatment options and more options on the way) and the more common “dry” AMD (for which, unhappily, we still have few effective therapies), because what I really want to focus on here is what we know about preventing this difficult-totreat problem that can rob the elderly of a well-deserved happy last third of life by adversely affecting their ability to read, drive, recognize faces, even to be mobile and independent. So to that end, some of the well-known risk factors for AMD include: Age: you can’t do much about that, I’m afraid, at least not much if you want to live to perhaps see the Canucks win the Stanley Cup one day (it will happen, you know, although not maybe in your lifetime). Genes: having a first-degree relative with AMD substantially raises your own risk of developing AMD, so the important point to draw from that is that if, for example, you have a sibling with AMD, you should try to make your ophthalmologist into your BFF, that is, get your eyes checked often. Previous cataract surgery: which means that you should try to prevent developing a cataract in the first place by, for example, wearing sunglasses outdoors as much as possible. High blood pressure and cardiovascular disease,

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Dr. Hister...Continued on Page 13

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Help Support The ALS Society of BC June is ALS Month - Buy A Star Of Hope At Peoples Drug Mart or Peoples Pharmacy Amyotrophic lateral sclerosis (also known as Lou Gehrig's disease) is a devastating neurodegenerative disease. Those living with the disease become progressively paralyzed due to degeneration of the upper and lower motor neurons in the brain and spinal cord. Eighty percent of people with ALS die within two to five years of diagnosis - unable to breathe or swallow. Along with ALS, neurodegenerative diseases include Alzheimer's disease, Huntington's disease and Parkinson's disease. According to the World Health Organization, neurodegenerative diseases are predicted to surpass cancer as the second leading cause of death in Canada by 2040.

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Dr. Hister...Continued From Page 11

meaning as usual, that if you lower your risk of heart disease and stroke, you also lower your risk of AMD, so to prevent AMD, you should do lots of exercise, eat well, watch your weight, and follow all those other blah-blah-blah rules for heart disease I always harangue you about. Poor diet, and to that end, a recent review determined that several nutrients including zinc, vitamin C, fish oils and lutein play a key role in overall eye health including lowering the risk of ending up with AMD, although it’s less likely that taking vitamin supplements has the same powerful positive effect on eye health in well-nourished individuals and (no surprise) smoking. Those are the simple, non-contentious prevention strategies for AMD. More disputatious, based on a recent large study from Europe, is what to do about ASA, because on that study people who were taking ASA regularly had more than double the risk of the “wet” form of AMD compared to people who didn’t take ASA every day, so if you’re one of the millions and millions of people currently taking ASA every day in large part because you’ve become convinced by those ubiquitous TV ads that the benefits of the regular use of ASA are potentially huge, so “Hey, why not, Wilma?”, here’s yet another reminder that ASA is indeed a very powerful drug with, yes, some clear benefits for some people, but ASA can also lead to some very unwanted complications in some people. So before starting on an ASA regime (and even if you’ve already begun to take ASA regularly), I strongly advise that you sit down with your family doc to work out whether for you, as an individual, those potential benefits of ASA do indeed outweigh the risks. Got to go now, by the way. I feel a powerful symptom coming on and I have to find my wife to tell her about it, although that may be a bit tricky because she left the house (“stormed out,” my son said sarcastically) as soon as she heard me say that I was nearing the end of writing this article. I’m sure she’s just going to shop for dinner.

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Dr. Art Hister can be heard on CKNW and other Corus Radio Network stations on House Calls on Saturdays at 10 AM, as well as seen on Global TV news on Saturday mornings at 9:20.

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Aging Gracefully When I grow up, I want to be just like $eanne Calment, an energetic French woman who rode a bicycle until she was 100, loved chocolate, olive oil and cigarettes and lived long enough to look back on her 122nd birthday. She set the longevity bar higher than most and is testament to the wonders of the human mystery. Some attribute her longevity to genetic inheritance, but there is speculation that the trump card lay in her attitude and resistance to stress. Calment was once quoted as saying, “If you can’t do anything about it, don’t worry about it.” With so much focus these days on preventing the aging process, I find great wisdom in these words. We have yet to find the eternal fountain of youth so aging is a probable future for most of us we can either accelerate the process by fear and denial, or embrace it with enough awareness and information to maximize the benefits of this precious life. When we look outside the window and study nature, we observe that the only sure things in this world are change and transformation. We are not separate from nature and no matter how hard we try, we cannot remain static. Successful aging requires desire and a dash of creativity to constantly reinvent ourselves while adapting to changing bodies, social circles and environments. It helps to focus on the things we have a degree of control over, while finding a way to make peace with those that we don’t. The ability to retain a sense of humour in this process is essential. Too often we attribute the effects of bad dietary habits and lifestyle choices to the “normal” process of aging. We expect pain and disability to be companions in the aging process and don’t realize that by taking care to eat well, exercise and get adequate rest, we can actually minimize overall discomfort while enhancing vitality. The by products of a healthy lifestyle are increased energy, enhanced immunity, sharper cognitive functions and an increased sense of physical and mental well being. It is never too late to make small lifestyle adjustments on the road to optimal wellness. By gradually adopting some of the following new habits you may find yourself with more energy or perhaps able to emulate $eanne Calment who is reported to have taken up fencing at the young age of 8 : 1. As we age, our relationship to food shifts into a somewhat lower

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gear as metabolism and digestion slow down. Fibre rich fruits, vegetables and whole grains will supply energy and fibre to keep the digestive processes moving along. Fresh fruits, berries and vegetables also contain phytonutrients and antioxidants to help boost immunity and fight inflammation. Inflammation not only makes us feel older it also contributes to the outward appearance of aging. 3. Adding a broad-spectrum digestive enzyme with meals can help with sluggish digestion and optimize assimilation of nutrients. 4. Our senses may not be as sharp as they once were so use fresh herbs and spices rather than salt to tantalize your taste buds too much sodium can quickly rob you of your health. 5. Watch the waistline. As metabolism slows and activity wanes, we need to adjust our caloric intake. Choose nutrient dense foods over empty calories reduce consumption of processed foods and sugary treats. 6. Avoid dehydration. Mild dehydration can be a real energy zap and contribute to brain fog, dry skin, random aches and pains and constipation. 7. Daily moderate exercise helps retain muscle mass and agility. If you have been sedentary it is always best to consult with your doctor before embarking on a new exercise regime. Find one that fits your lifestyle, start slow and build up endurance gradually. Walking and swimming are beneficial low impact options. 8. Exercise your brain. Learning something new or solving word and number puzzles helps prevent cognitive decline and memory problems. 9. Reach out and connect with friends and family. Loneliness can lead to depression and isolation. Volunteering is a great way to make new friends and connect with people of all ages. 10. Laugh often Laughter is an important remedy for pain, stress and conflict it is also a perfect antidote for the absurdities often associated with the aging process. Aging well is all about the attitude. Focus on the gains instead of the losses you may have run your last marathon but you now have the wisdom to appreciate that you have better things to do than running nowhere fast Good Health to You


Seafood Garden Dip

y low-fat dip gets This delightfully tang gurt instead of its creaminess from yo of fresh vegfull cream cheese. Chockt the shrimp and gies that complemen crabmeat. 41⁄4 oz. 120 g ed, Can of crabmeat, drain ked cartilage removed, fla 113 g and , 4 oz. led ee (p p rim sh Cooked deveined) chopped 2 150 mL e yogurt ⁄3 cup Low-fat plain Balkan-styl 1 cumber ⁄3 cup 75 mL Finely diced English cu (with peel) 1 60 mL ⁄4 cup Finely diced radish 1 60 mL ⁄4 cup Grated carrot 1 60 mL ⁄4 cup Mayonnaise 1 tbsp. 15 mL Chopped fresh dill ) (or 3⁄4 tsp., 4 mL, dried 10 mL 2 tsp. ce jui Lemon 1 ⁄2 tsp. 2 mL lek) Chili paste (sambal oe 1 ⁄2 tsp. 2 mL Grated lemon zest

Recipes For Good Health

Seafood Garden Dip

wl. ients in medium bo 1 Combine all 11 ingred ps g. Makes about 2 ⁄3 cu Chill. Stir before servin (575 mL). ; cup (60 mL): 274 Calories BEFORE MAKEOVER: 1/4 624 mg Sodium Sat); 25.2 g Total Fat (10.2 g (0 g 77 Calories; 5 g Total Fat ): mL (60 cup AFTER: 1/4 rCa g 2 ; 35 mg Cholesterol Mono, 0 g Poly, 1 g Sat); m diu So Protein; 140 mg bohydrate; 0 g Fibre; 5 g

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PEOPLES DRUG MART & PEOPLES PHARMACY Reprinted from Healthy Recipe Makeovers © Company's Coming Publishing Limited”

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The articles published in People First are for the general information of the reader. While effort is made to reflect accepted medical practice and knowledge, articles should not be relied upon for the treatment or management of any specific medical concern or problem and People First accepts no liability for reliance on the articles. For proper diagnosis and medical care, you should always consult your family physician promptly. Opinions expressed in sponsored articles by, Dr. Art Hister, Ian Lloyd, and Darlene Booth are paid editorials and are not necessarily shared by Peoples Drug Mart stores or Peoples Drug Mart (B.C.) Ltd. Some advertised products are not available in all stores. We reserve the right to substitute products or limit quantities. Prices effective while quantities last. Sale in retail quantities only.


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