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People First

Dr. Hister looks at head injuries and their effect on the teenage brain.

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Teenage Brains And Concussions Managing Menopause Whenever she thinks I’m erring, which is nearly every time I do anything at all, my mom generally shakes her head and mutters that “It’s those hits to the head you had as a young boy, Arthur. They ruined you,” and to give you an idea what my mom means by “ruined me,” she used that phrase the last time I ordered a Chinese food dish she wouldn’t eat but which I enjoy (chicken feet it was. Yum ) Coincidentally, by the way, my sons use the same reasoning to explain why like all baby boomers, I too, am so caught up in romanticizing my early days and why I bore my kids (and now even my grand-daughter) with endless not-always-identical versions of how much better everything used to be back when I was growing up. Now, it is true that I – and most of the kids I knew - suffered several very hard hits to the head when I was younger – although I doubt that they’re the reason for my love for the hockey of Jean Beliveau and Rocket Richard and Doug Harvey and cars with fins and summer evenings at the Orange Julep - including a couple of hits that left me seeing stars, and since I grew up in the working-class northeast end of Montreal, those were not Hollywood stars I was gazing at after getting knocked on the noggin. In my day, though, we sloughed off such hits to the head as a normal part of growing up, especially for boys, but that’s at least one thing that I am forced to admit was clearly not better in my day because we now know for sure that when a head is hit, even when it’s not hit especially hard, there are consequences, sometimes subtle ones that are very hard to

detect, sometimes severe ones that linger for months, even years, and which seem to be unamenable to any treatment beyond the very frustrating age-old “wait and wait and wait till it goes” approach. Now part of the reason we still know so little about head injuries is that it’s really only over the last few years that we’ve started researching them properly, in large part – a warning: editorial rant approaching - because the Neanderthals who govern professional sports organizations like the National Football League, and most especially the no-brainers who run the National Hockey League have done very little to determine the true cost of these consequences of playing those sports which entail endless hits to the head to “finish the check,” etc.. So although we’ve had concussions in hockey, for example, since the days of Joe Malone and Cyclone Taylor (and no, cynics, I didn’t see them play live), we still know very little about so many of the key issues involved in head injuries such as how hard a head injury has to be to produce an acute or recurrent problem, how many head injuries a person can take without developing symptoms that linger, whether some people are more vulnerable to certain types of hits to the head than others are, whether hits to particular parts of the head are more problematic than others, whether helmets offer any real long-term protection, and on and on. One vital thing we do finally understand, though, is that young heads and brains are more vulnerable to damage than more developed heads and brains, Continued On Page 11

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Ian Lloyd

Pharmacist, Peoples Pharmacy

Women's Supplements I like women.. that didn't sound right, perhaps I should rewrite my first sentence. Women are great patients they tend to be proactive about their health and ask a lot of questions. There, that sounded better. It is true that women tend to make most of the health care decisions in the household. Perhaps it is the mothering instinct that drives them to make informed choices which enable them to care for themselves and their family. This month, I will discuss some of the health issues and supplements that I feel are the most helpful for women. One health concern expressed by women is varicose veins. Varicose veins are twisted, enlarged veins (blood vessels) close to the skin's surface. For many people the problem is simply cosmetic, but for others these veins can cause an aching pain and discomfort. The condition referred to as “spider veins” is actually a mild form of varicose veins. To help prevent varicose veins and reduce the discomfort from existing varicose veins: protect your skin from the sun, get regular exercise, control your weight, avoid prolonged sitting and standing, don't cross your legs while sitting and wear elastic support hose. The most effective supplement to help with varicose veins is a standardized form of horse chestnut. Studies which have shown the effectiveness of horse chestnut have used 300 mg of an extract containing 50mg of aescin taken twice daily. The most common side effect seen was stomach upset. People who are taking blood thinning medication should talk to their Doctor before taking horse chestnut products. This kind of chestnut is 6 People First peoplesdrugmart.com - NEW!

not to be confused with other forms of chestnuts, either the eating or ornamental kinds. Many of the ornamental kinds of chestnut can be toxic. I hear this question at least once a month, “What really works for weight loss?” Sadly, I have to tell you the truth. There is no miracle pill for weight loss. It is believed that 4 of our population is overweight. We all know that carrying a few extra pounds can cause health problems including: heart disease, diabetes, joint problems, sleep apnea and more. -nfortunately, the primary reason people try to lose weight is purely cosmetic. Any reason to attain your ideal weight is a good reason, but solutions that are focused on by the cosmetically minded usually involve shortcuts and don't result in long term 'results.' It seems everyone loves to watch the Dr. Oz TV show. He seems to be a down to earth person and has a tendency to use dramatic demonstrations to prove a point. One product he promoted recently for weight loss was raspberry ketones. I will be brief: there is NO human evidence that raspberry ketones will help with weight loss. In one study, mice fed a high fat diet and raspberry ketone still managed to lose weight. However, there is some concern that this product might actually be harmful. It has similar properties to the stimulant synephrine and could cause shakiness and heart palpitations. There is also a case report about this supplement interacting with the blood thinning medication warfarin. Perhaps until more research is done, one should avoid this product. Continued On Page 8

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o d...Continued From Page

One supplement on the market that claims to be helpful for weight loss is called PG0. PG0 is essentially a very fancy fiber capsule. Fiber is not a new supplement for weight loss, but it can be very helpful. Added fiber can create the sensation that your stomach is full which causes you to eat less. Fiber also slows the absorption of food from your intestines which can help keep your energy (blood sugar) levels up. When your blood sugar levels drop, your body sends a signal that it is time to start eating again. PG0 is formulated to be a little more stable, than regular dietary fiber, in the harsh conditions of your digestive tract. There is some evidence to suggest that when taken before a meal, PG0 can reduce the amount of food needed to feel full. There have been a few studies which have shown taking PG0 can help with weight loss. Keep in mind one important fact most positive weight loss studies have included instruction on exercise and calorie intake reduction. I'm certain that most people could lose weight if they were to

get more exercise and watch what they eat. I don't think I have discussed the supplement calcium in a while. This is a very important supplement for women of all ages. It is helpful to maintain bone health, nerve function and can be helpful for treating PMS symptoms. I often get asked which form of calcium is best. The best form of calcium is the kind that you remember to take. It is true that calcium citrate is slightly better absorbed than calcium carbonate, but the difference is not very significant. Magnesium is sometimes added to calcium supplements for a couple of reasons. It can offset the constipating side effects of calcium and your body also uses it to make bone. The minerals zinc, copper and manganese also play a role in bone health. A good multivitamin has adequate amounts of all of these minerals, except magnesium. There has been recent news that calcium supplements might increase your risk of heart disease. While this is partially true, one must not forget that Continued On Page 10

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pharmacist recommended Health & Wellness Information From Your Peoples Pharmacist

Heartburn Prevention There are simple lifestyle changes you can make and tips you can follow that will help you prevent heartburn. • Eat smaller meals to reduce stomach pressure. • Avoid foods and beverages such as chocolate, tomato-based foods, fried or fatty foods, nuts, citrus, alcohol, tea, coffee, and cola which can aggravate heartburn. • Take a moderately paced walk after eating to help digestion. • Avoid going to bed or lying down within two hours after eating. • Elevate your head while you sleep. You can place bricks, or anything that's sturdy securely under the legs at the head of your bed. You can also use an extra pillow, to elevate your head. • Avoid tight clothing around the waist. • Develop effective ways to handle stress. • Stop smoking. The chemicals in cigarette smoke weaken the lower esophageal sphincter as they pass from the lungs into the blood. • If you're overweight, lose the extra pounds. Obesity increases abdominal pressure, which

can then push stomach contents up into the esophagus. Your doctor may suggest medications to reduce heartburn and/or acid reflux. Antacids - neutralize excess stomach acid. H2 Blockers – taken as oral dose pills, work systemically (absorbed into the bloodstream) to reduce the amount of acid that is released into the stomach. Available OTC or by prescription. Alginates – work non-systemically (not in the bloodstream) to form a protective barrier in the stomach that helps block acid from splashing up into your esophagus. PPIs (proton pump inhibitors) - taken as oral dose pills, work systemically (absorbed into the bloodstream) to reduce the amount of acid that is released into the stomach. Available by prescription only. Talk to a Peoples Pharmacist for more information on heartburn medications.

health news Moderate Exercise May Reduce Breast Cancer Risk Women who exercise may cut their risk of breast cancer by as much as 30 percent, a recent study suggests. The study showed that moderate recreational physical activity may reduce breast cancer risk. The study also found a reduced risk of breast cancer for women who engaged in exercise after menopause. The study team collected data on more than 1,500 women with breast cancer and a similar number of women without the disease. All the women had taken part in the Long Island Breast Cancer Study Project. They found women who exercised before or after menopause had a reduced risk of breast cancer. Women who exercised 10 to 19 hours a week had the largest benefit -- about a 30 percent reduced risk. The risk of breast cancer was cut with any amount of exercise, the study found. The risk reduction was seen mostly for hormone receptor-positive breast cancer, which is the most com-

monly diagnosed type among American women. Even among active women, however, gaining a significant amount of weight, particularly after menopause, increased the risk of breast cancer, negating the beneficial effect of exercise, the researchers found. The reasons that exercise is linked with a reduced risk of breast cancer aren't known. Yet it is known that maintaining a normal body weight is associated with reduced breast cancer risk. It is thought that a reduction in body fat results in less exposure to circulating hormones, growth factors and proinflammatory markers, all of which have been shown to be related to breast cancer risk. Many experts believe the way to reduce the risk for breast cancer means living a healthy lifestyle overall. Women who exercise most likely lead a healthier lifestyle -- they watch what they eat, they don't smoke, they don't drink.

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o d...Continued From Page

calcium is foremost in the prevention of osteoporosis. The study in question found that people who took high doses of calcium ( 1000mg/day) experienced more heart attacks than those who did not take calcium. The real increase in risk was not that great, however it did cause health care professionals to recommend that people reduce their supplemental use of calcium. Health Canada recommends that an adequate intake of calcium is 1000mg to 1200mg from all sources. We generally get about 300-400mg of calcium in our diet without really trying, so we only need a slight top-up to meet our daily requirements. A discussion about calcium, must be followed by a brief mention of the important bone building supplement vitamin D. It is important to ensure that you are taking enough vitamin D to absorb and use the calcium you are taking. Many calcium supplements will have vitamin D added. Your body needs vitamin D to make bone. Some people ask me if they still need to take vitamin D, since the body can make its own supply from sunlight. While this is true, do you

get at least 15 minutes of direct sunlight every single day of the year? This might not be the case for everyone, especially during the winter months or for those who are shut-ins. I recommend about 10002000I- of vitamin D a day just to be sure. No matter who you are, man or women, general health care advice is usually the same. Get plenty of rest, eat well and enjoy life. There are special concerns for women that should be watched for. Women tend to be at greater risk for osteoporosis, varicose veins and certain forms of cancer. Feel free to gather health care information from all sources. Just be aware that this information might be biased. That is why it is important to see your Doctor and Peoples Pharmacist and ask questions about your health. The more questions you ask, the more you are able to use the information to age gracefully. Written By Ian Lloyd, Pharmacist & Chartered Herbalist, Peoples Pharmacy

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Dr. Hister...Continued From Page 4

meaning that kids and teenagers seem to be significantly more susceptible to brain injury than adult brains. For example, a recent American study concluded that some kids who suffer a concussion (“concussion” is an inexact term that is likely to fade from use pretty soon to be replaced with the more accurate “traumatic brain injury”) can continue to have detectable symptoms such as memory problems and attention difficulties for up to a year following the head trauma. And please note, this study just looked at easily-measurable symptoms and was not designed to detect more subtle symptoms of head injury that require sophisticated analysis to detect. Another study I ran across in researching this article found that traumatic head injuries occur in way more kids’ sports than most would think. So although most of us would immediately list football and hockey as sports with a particularly large risk for concussion, this Canadian study found that basketball, gymnastics, even cheerleading are also associated with a high risk of brain injury. And of course, the fact that cheer-leading is linked to concussions means in turn that head injuries are increasing in young girls as well as young boys. Yet another important study found that as with adults, the effect of concussions is cumulative, so according to this analysis, a significant number of high school kids who suffer two or more concussions have symptoms of “post-concussion” problems. Post-concussion symptoms can include obvious cognitive difficulties (memory, attention, etc) but also symptoms like the feeling of walking around in a constant fog, headaches, mood fluctuations, depression, balance difficulties, and sleep disturbances. In fact, if you really want to worry as a parent of a sports-playing child, according to the authors of this study, what they saw in some of these kids who’d suffered a couple of concussions was akin to what one would see in a professional athlete who’d suffered a few concussions. (If you want a great read about what postconcussion symptoms (PCS) can do to a person and his family, go to the New York Times archive to dig up an interview from a few months back with Chris Pronger, the future Hall-of-Famer who has been out

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Dr. Hister...Continued From Page 11

of hockey for about a year now with PCS, and his wife, who talks about what that can do to a family. (It’s riveting – and sobering - reading). Finally, one other study I want to flag for you looked at high school football players and concluded that a “concussion” is often not the result of one particularly hard hit to the head but rather results from a number of smaller but repeated blows to the head, which means, of course, that the longer a football or hockey season goes on, the greater the risk to the athlete. (Warning: 2nd editorial rant: Wouldn’t you, too, love it, if the NHL went back to playing for the Stanley Cup not in mid-June but rather when it should be played, namely early April, when the play-offs could also, rather importantly, coincide with Passover, like it used to back when we . . . . After all, Passover is just not Passover if the father doesn’t rush through the service to make it to the TV for the opening face-off). Now before every parent who has read this far runs off to instantly remove their child from his or her chosen sport and hide them in a basement until they promise to give up soccer or hockey to focus only on playing the piano and Grand Theft Auto, please note this very important point: playing sports is not just an important part of growing for kids, it’s actually an essential aspect of growing up. Participation in sports builds social skills, confidence, co-ordination, fitness, and provides many other potential life-lasting benefits. Also, take into account that head injuries are still not common, especially now that we’ve finally begun to take measures to reduce the potential of suffering such an injury and its consequences. In fact, in the first study I cited, the authors concluded that “the majority of kids who sustain mild traumatic brain injuries actually do quite well and don’t have persistent symptoms after their injury.” Still, some do, and our urgent job is to find ways to make sure that traumatic brain injuries in kids become as rare as, well, as a smart comment from Don Cherry or Gary Bettman. 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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Have a Safe Summer Sometimes it seems like spring just wants to hang around forever and summer has gone on an extended leave One thing for sure though, when summer finally does bestow its grace upon us, we want to engage with it and take full advantage of the long glorious days of sunshine and warmer temperatures. The great outdoors becomes our playground and to get the most out of these few short months, we want to use common sense and exercise some caution to stay safe. As the mercury rises, one should be mindful to stay hydrated and minimize the risk of heat exhaustion and heat stroke. Be aware that alcohol and caffeine can act as diuretics and increase your risk of dehydration. It is important that you modify the intensity of your outdoor activities appropriately and avoid strenuous activity midday when the sun is at its hottest. Perspiration is the body’s natural cooling system keeping a water bottle or sports drink nearby is the key to staying hydrated as moisture and valuable electrolytes are quickly lost in sweat. Symptoms of heat exhaustion include heavy sweating, feeling tired and weak, nausea, vomiting, headache, muscle cramps and feeling lightheaded. It can progress to life threatening heat stroke when the body can no longer regulate the temperature at this point there is an absence of perspiration and an individual is likely pale, confused and lethargic. It is imperative one seeks emergency medical attention immediately at this point. And while long summer days can be full of fun, paying the price for all that pleasure with a sunburn is not Being a fairhaired girl of Celtic roots, I know only too well the hazards of burning so sunscreen is an essential ingredient in my sun survival kit. I look for natural sunscreens that don’t have a lot of chemicals in them they usually contain zinc oxide or titanium dioxide. Studies are finding that while the sunscreens can decrease the incidence of sunburn, we are not necessarily protecting ourselves from skin cancer we may still be exposing ourselves to harmful amounts of damaging radiation. While skin cancer is certainly on the rise, the upside is that about 90 of skin cancers are curable with early detection. Regular check ups are advisable especially if you notice any of the following:

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1. Any open sore that that will not heal over properly. 2. A reddish irritated spot that may itch, hurt or cause no discomfort at all. These usually appear on the chest, shoulder, arm or leg. 3. Any smooth growth with an elevated border and an indented centre. 4. A shiny scar-like area that may be white, yellow or waxy with a shiny, taut appearance. 5. An enlarging, irregular lesion on the face, lips or ears. 6. Any mole that changes in shape, appearance or texture. My next line of defence is to become a shade dweller and to wear -V protective clothing. Seek out shade between the hours of 10:00 am to 2:00 pm this is when the -V rays are at their peak strength. These days, protective clothing options are becoming more available and they offer an alternative to sunscreen. I have also developed a newfound affinity for sunglasses and hats a wide brimmed hat is an essential addition to the summer survival wardrobe. Protect your eyes from sun damage with sunglasses that block both -V-A and -V-B rays. So you have got your water bottle, sunscreen, hat and shades – now what? Chances are that the lure of the great outdoors will have you packing up a picnic or barbequing on the back deck with friends and family. Harmful bacteria thrive in warmer temperatures so proper outdoor food handling can greatly reduce your risk of foodborne illness. Keep animal products separated from other foods to avoid cross contamination don’t chop fruit or veggies on a cutting board that has hosted raw meat, poultry or fish. Make sure food is chilling until ready to eat or cook use plenty of ice packs in a cooler and keep it out of direct sunlight. When barbequing, it is good practice to buy a food thermometer to check the internal temperature of your animal proteins E. coli, Salmonella and Listeria may be present but are killed by heat. And lastly make sure hands, all cooking surfaces and utensils are clean and uncontaminated. I am quite certain you would much rather be remembered for being a great party host rather than hosting the party to remember because everyone got sick Have a safe summer and Good Health to You

lad ch to er Ricadeds aSsumame Sumnbm ry tou ow of veggies

A chic rai rice. Wild rice is high in the nutty flavour of wild e diet. suitable for a gluten-fre protein, low in fat and . zen fro n the oked and Wild rice can also be co

1.5 L 6 cups Water 1 0.5 mL ⁄8 tsp. Salt 3 175 mL ⁄4 cup Wild rice 540 mL . 19 oz rbanzo Can of chickpeas (ga ined beans), rinsed and dra 11⁄2 cups 375 mL es ato tom pe gra Halved 250 mL 1 cup mber Chopped English cucu ces 1 mm) pie (with peel), ⁄2 inch (12 250 mL 1 cup er pp pe w llo ye d pe Chop 1 60 mL 4 cup ⁄ Chopped fresh basil 1 60 mL 4 cup ⁄ Sliced green onion TTE RED WINE VINAIGRE 1 60 mL ⁄4 cup ar eg Red wine vin p. 15 mL tbs 1 Granulated sugar 5 mL 1 tsp. Dried oregano 1 2 mL ⁄2 tsp. Salt 1 1 mL ⁄4 tsp. Pepper 3 tbsp. 50 mL Olive oil to a boil. in small saucepan. Bring Combine water and salt ered, for cov ly tial par l, Boi medium. er to Add rice. Reduce heat to nsf Tra ll. we is tender. Drain asionabout 30 minutes until rice occ ring stir s, ute min about 20 large bowl. Let stand for ally, until cool. . Add next 6 ingredients. Stir 5 ingredients in small bowl until first Red Wine Vinaigrette: Stir cup e oil. Stir. Makes about 1/2 cups 7 sugar is dissolved. Add oliv ut abo kes mixture. Toss. Ma (125 mL). Drizzle over rice (1.75 mL). To tal Fat ): 27 0 Ca lor ies ; 12 g BEFORE: 1 cu p (25 0 mL ium Sod g (3 g Sat ); 1 g Fibre; 824 g Total (250 mL): 167 Calories; 7 26 g AFTER MAKEOVER: 1 cup rol; ste y, 1 g Sat); 0 mg Chole Fat (4.5 g Mono, 1 g Pol ium Sod mg 256 6 g Protein; Carbohydrate; 4 g Fibre;

Recipes For Good Health

Summer Rice Salad Healthy Recipe Makeovers Cookbooks are available at participating

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