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SLEEP
A PHARMACIST'S GUIDE TO DR. HISTER ON
INFLAMMATORY BOWEL SYNDROME SENIOR’S AND HEALTHY EATING COMPANY’S COMING RECIPE
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People15 First
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Dr. Hister looks at a group of disorders in which the intestines become inflamed and cause severe symptoms.
contents
Good For Your Gut
5 9
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Probiotic supplement that contributes to a natural healthy gut flora. Dairy and gluten free.
Sleep Well Page 7
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Vitamins & Supplements Great selection of sale priced vitamins and supplements from Peoples Pharmacy.
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99to 99
Inflammatory Bowel Disease
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A Pharmacist's Guide to Sleep Peoples Pharmacist Ian Lloyd with helpful tips on getting a good night’s sleep.
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Healthy & Wellness A selection of sleep aids to help you break the ongoing cycle of sleeplessness.
Melatonin is a natural supplement that will help restore your natural sleep pattern and reset your sleep-wake cycle.
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Pharmacist Recommended Advice on the common cold and helpful tips on how to fight the symptoms.
14
Healthy Eating for Seniors Darlene Booth with advice on the proper nutrition required for seniors.
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Blue Chicken Wings Brand new feature recipe From Company’s Coming Healthy Recipe Makeovers.
Lest We Forget
Remembrance Day Nov 11th
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INFLAMMATORY BOWEL DISEASE For the first 4 or 5 weeks that I spent going through my initial bout with celiac disease back in 19 5, I refused to go into the hospital to get tested even though by the 4th week I was suffering with severe watery diarrhea 24/ , and if you want to know how bad diarrhea can get (if you don’t want to know, stop reading now), it was this bad: I wasn’t able to work, of course, but I also couldn’t even sleep for more than 20-30 minutes without having to visit the toilet (and if I was stupid enough to try to sleep through the sudden spasms, well, just use your imagination – it was not pretty). That severe diarrhea went on for about -10 days, until I finally collapsed, unable to support myself heading down some stairs, a situation that was not helped at all by my wife’s insistent shrieking that I was being a stubborn idiot by refusing a hospital admission. That collapse, however, forced me to admit defeat and to very reluctantly allow my overly-patient doctor to admit me to VGH to be “worked up” (a loathsome term we use to refer to how we’re going to try to find out what’s wrong with a sick person; no wonder patients are so often wary of their health providers). So why was I so reluctant to be admitted to the hospital? Two reasons. First, I didn’t then, and I still now don’t, entirely trust hospitals to offer many sick persons their best chance to get well. For example, on the first night after I’d been admitted with a diagnosis of “probable celiac disease” clearly written in my chart, I was offered a dinner
Dr. Art Hister
consisting of a breaded cutlet (I think it was a cutlet – it was hard to tell under all that gluey stuff they had drowned it in) along with a bread roll, and for dessert, something I believe was cake, or at least it resembled cake. “See why I didn’t want to come here? They’re trying to kill me,” I told my wife when she came by. And I meant it. The other reason I had so adamantly refused admission to hospital, though, was because I was and I still am a confident “self-diagnoser,” someone obnoxiously certain that he knows exactly what’s wrong with himself no matter what his family members or caregivers may be telling him, a trait, by the way, that is shared by most Jewish male doctors, which is why they – we, actually – make the worst patients possible. And as a self-diagnoser, I had convinced myself that I was suffering from inflammatory bowel disease (IBD), either Crohn’s disease or ulcerative colitis (UC), for which the hallmark symptoms are diarrhea, often bloody, and abdominal pain, and I really didn’t want to have that diagnosis confirmed. I’m happy to say, however, that some quick albeit uncomfortable testing revealed that I was actually suffering from celiac disease, and although I thought at first that the diagnosis/disease was an even worse condition to end up with than IBD, I was wrong in that, too. In fact, my celiac disease, although linked to a higher risk of many other crummy auto-immune disorders such as MS, Type 1 diabetes, as well as various neurological and even some types of cancer, has Continued On Page 11
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A PHARMACIST'S GUIDE TO SLEEP Sometimes we think of sleep as a trivial matter. However, a lack of quality sleep, and its consequences (such as daytime sedation),has a great impact on society. It has been reported that sleepy and/or fatigued drivers are responsible for 4 of the fatal car crashes and about 20 of the non-fatal car crashes. One of the reasons for the Exxon-Valdez oil spill was thought to be the sleepiness of the bridge staff. Many Canadians have reported experiencing sleeping problems. In one phone survey, 40 of people mentioned that they experienced more than one of the symptoms of insomnia three times a week. A further 13 , were unlucky enough to meet the criteria for an insomnia disorder. There are many non-prescription and herbal options to help with sleep at your Peoples Drug Mart Pharmacy. This month, I hope to explain why sleep is so complex and find some options to help you get more. The information available about sleep is extensive because it is very important to our survival. During sleep, the mind and body rests and regenerates. Without it, our bodies and minds are unable to function well. What exactly is sleep? Sleep is divided up into five parts; stages 1-4 and REM sleep. Our bodies move between these five stages of sleep at various times during the night. It is thought that your body needs REM sleep to rejuvenate. Any disruption in your sleep might cause you to get less REM sleep. One important part of a good night sleep is sleep hygiene; this has nothing to do with cleanliness. These tips can be very helpful for people who have difficulty sleeping. •Try to have a fixed bedtime and wake-up time. This will help your body get into a regular sleep routine. •Try to avoid daytime naps. Some people do have a 6 People First
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Ian Lloyd Peoples Pharmacist
rest in the afternoon. If you must rest, try and limit it to 30- 45 minutes. •Avoid alcohol in the evening. It is true that alcohol can make you drowsy, but it can also interfere with your sleep as it leaves you body. •Avoid caffeinated beverages. Sometimes it is best to just avoid them altogether, especially in the afternoon and evening. •Get some exercise, but not in the evening. Regular exercise is great for your body and can wear you out. Although, rigorous exercise in the evening can have a stimulating effect. •Create a comfortable sleeping environment. The bedroom should be dark, cool (not cold) and free of any odd sounds. •Clear you mind before bed. Do not engage in activities that activate the mind before bed. DonLt plan your vacation in bed. Avoid thought provoking books before bed. If you cannot fall asleep within 30 minutes, get out of bed. If you have problems falling asleep, get up and leave the bedroom. Go elsewhere and have a light snack and read a light novel. Do not watch television. Speaking of television, kids are especially susceptible to sleep disturbances with electronic devices. One study found that kids with access to electronic devices in their bedrooms slept less. These children also had excess body weight, ate a poorer diet and got less physical exercise than other kids. The researchers went on to say that limiting electronic devices in the bedroom might be an option to help treat childhood obesity. The same advice is good for parents too: put the smartphone away and go to bed. What if all of this hygiene does not help? What about Continued On Page 8
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sleep medications? There are essentially three kinds of over the counter sleep aids; Dimenhydrinate (Gravol), Diphenhydramine (Benadryl, Sleepeze, etc) and other antihistamines. For some people, these work fine for the occasional bout of insomnia. There is the possibility that they can increase your blood pressure, interfere with glaucoma therapy, aggravate an enlarged prostate and/or cause daytime sedation. Ask your Peoples Drug Mart Pharmacist if these medications would be right for you. If you do use these medications, use them for only a short period of time, perhaps for only 5- days in a row. There is the possibility that they might loose their effectiveness if used for a longer period of time. Valerian is the most widely recognized herbal product for sleeping problems. Valerian seems to be more effective when used for longer periods of time (2 weeks), rather than for occasional problems. One study demonstrated that people who took a Valerian/Lemon Balm product T hour before bed, reported a 33 improvement in sleep quality. The researchers found this point interesting because the volunteers were healthy and did not complain of insomnia at the start of the study. Valer-
ian is generally safe and well tolerated. Mild side effects of headache, morning sedation and stomach upset are sometimes seen. Paradoxically, valerian has been known to cause a slight stimulatory effect in rare occurrences. One complaint about valerian root is its unpleasant odour. I mention to my patients that this odour does not come out on the skin and is thought to be related to the product’s potency. While no drug interactions have been reported, be cautious of using valerian concurrently with products that have a similar action (sedatives, alcohol, narcotics, etc.) It is common to find valerian mixed with other herbs used for sleep; such as passionflower, skullcap and hops. I thought this might perk menLs interest. Supplements that contain hops might also help with sleep. In fact, one study found that drinking beer might actually help you sleep better. A group of female nurses were given nonalcoholic beer to determine if it would help them sleep better. In case you were wondering, the beer was San Miguel 0.0 S. One group of nurses was given a bottle to drink in the evening after a stressful shift, while another group got nothing. After only two weeks, the Continued On Page 10
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pharmacist recommended Health & Wellness Information From Your Peoples Pharmacist
Fighting The Common Cold What is the common cold? The common cold is a contagious viral infection of the upper respiratory tract. Colds are not caused by the same viruses that cause influenza (the flu). What are the symptoms? The first symptom of a cold is usually a sore throat that may feel dry or scratchy. This is usually followed by a runny or plugged nose and a cough. Symptoms usually peak on day two or three and typically last five to seven days. Children’s colds usually last slightly longer. Although it is fairly rare, some colds include a low-grade fever. How can I avoid colds? Cold viruses typically spread through the air (by coughing and sneezing) or through physical contact (by touching). You may be able to avoid getting (and spreading) colds by washing your hands often and avoiding crowded areas. You do not have more chance of getting a cold as a result of drafts, cold weather, or going outside with wet hair. How can I treat colds? There is no cure for the common cold. Antibiotics do not relieve or cure colds. If you catch a cold, however, you can treat the symptoms while your body fights off the virus. Non-medication treatments The most basic part of treating your cold is to take good care of yourself — get plenty of sleep, stay comfortable, and drink lots of fluids (for example, hot drinks such as tea with lemon and honey). Non-prescription products Peoples Pharmacy offers many products that may help relieve your cold symptoms. Don’t expect to get rid of all your symptoms. Instead, try to find a product that will ease your worst symptoms. Each product may have possible side effects, so it is important to read the product instructions and talk to your Peoples Pharmacist before you use any non-prescription product. Acetaminophen Acetaminophen may provide relief for pain, sore throats, and fevers. Talk to your Peoples pharmacist
about the appropriate dosages for your family members. Decongestant sprays and drops Decongestant sprays and drops may help relieve stuffed-up noses. They should be used as directed and are best limited to three days of continuous use. If you don’t like nasal spray or drops, try using oral decongestants. Cough suppressants Cough suppressants such as dextromethorphan, or DM, may help you get a good night’s sleep by relieving dry, hacking coughs that can interfere with your sleep or daily activities. A dry, hacking cough is a cough that does not produce mucus. Expectorants Expectorants such as guaifenesin may help relieve wet, “productive” coughs with phlegm caused by chest congestion. Natural Supplements Echinacea may shorten the duration of a cold by one or two days and also reduce the severity of the cold symptoms. Supplements like COLD-A-TAK from webber naturals (a patented form of Echinacea) is clinically proven to stimulate the immune system in order to get rid of your cold up to 3 times faster. These supplements are most effective at the onset of a cold. Treating children There has not been much research into the effectiveness of oral cold and cough remedies for children under the age of six. Ask your Peoples Pharmacist which products are safest and best for young children. A product that only has one active ingredient may be the best option. Talk to your Peoples Pharmacist for advice on the best possible medications to help you fight the common cold.
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nurses who drank the near-beer experienced a better quality of sleep than the other group. The total length of sleep did not change. However, sleep latency (the time needed to fall asleep) was reduced in the beer group. This improved sleep had other measurable benefits. Improved sleep also reduced the level of anxiety experienced by nurses in the beer group compared to their abstaining counterparts. Sadly, a toast at night might not be the best idea for a restful slumber. Alcohol can interfere with your bodyLs ability to get a good nights rest. One of the most popular and effective natural sleep remedies is melatonin. Melatonin is a hormone that is produced by the pineal gland as the evening approaches. This hormone is produced as light decreases, but is blocked when things become brighter. This is another reason why TV might not be helpful for sleeping. The role of melatonin is to lower body temperature and chemically produce sleepiness. For some people, melatonin can be very helpful to produce a good night’s rest. Melatonin
might not be for everyone. You should talk to your Doctor or Peoples Drug Mart Pharmacist before starting melatonin. This supplement can interfere with blood thinners, sedatives, antidepressants, and immunosuppressants. One should not overlook the value of a regular nighttime ritual. This is thought to be helpful because it gives your body cues that it is time to fall asleep. My night ritual begins with reading a story to my daughter. Often just sitting in her chair makes me sleepy. After this, I brush my teeth, wash my face then sit in bed and read a newspaper (only the lifestyle section) until I become drowsy. No matter what works for you, it is important to get plenty of rest. Hopefully, it is not my articles that put you to sleep. Written By Ian Lloyd, Pharmacist & Chartered Herbalist, Peoples Pharmacy
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PEOPLES PHARMACISTS
Dr. Hister...Continued From Page 4
been a sort of blessing in that it’s made me adhere to a much more sensible diet than I otherwise would be following if I were allowed to ingest as much white bread, cake, pasta, and beer as I would ordinarily choose to eat, and happily, the relatively simple adjustment of sticking to a gluten-free diet has also kept my celiac disease under good control for nearly 40 years now. Unfortunately, however, IBD is often not nearly as easy to control as celiac disease is, in large part because unlike celiac disease, in which the trigger is well-known – the protein gluten, found in wheat, rye and barley - the triggers for IBD, which has increased sharply in incidence in western countries over the last 50 years, are still largely unknown. That said, it’s likely, as it is with so many other problems, that the root causes of the increasing prevalence of IBS lie in a combination of genetic and environmental factors, that is, it’s most likely that IBD happens in a genetically susceptible person when something in that person’s environment – a food, a toxin they take in, an infection – most likely a combination of such things, sets off an inflammatory cascade in the bowel. Along those lines, in a recent study, researchers from the University of Chicago working with a mouse model found that certain dietary fats – saturated fats but not polyunsaturated fats - can produce changes in the type of bacteria that are normally housed in the gut, changes that could, the researchers speculate, trigger inflammatory changes that become IBD. And it’s a theory that has relevance in the real world because lots of experts now believe – and nearly all IBD patients do as well – that in many cases of IBD, particularly UC, ingesting probiotics, that is, healthy bacteria that supplement or even replace the “unhealthy” bacteria already resident in the gut – can produce improvement in the symptoms of that condition. To that end, a few studies have determined that a very high-potency probiotic preparation called VSL#3 can in fact produce remissions and improvement in some patients with UC. Another intriguing study based on a similar premise (presented as a paper at a recent Digestive Dis-
Helping People Live Better Lives
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Dr. Hister...Continued on Page 13
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Are your medications working effectively for you? Medication Review Service The Peoples Drug Mart medication review service was created to ensure medication therapy is appropriate and effective for those taking multiple medications. Your Peoples Pharmacist will ensure all your medications are compatible with each other and working optimally. Medication review includes: O Detailed analysis of all medications (prescription and over-the-counter), vitamins and supplements, to ensure safe and effective use. O In-depth consultation to improve health outcomes by helping resolve any issues that may have arisen due to your medications. A Peoples Drug Mart medication review provides an opportunity for you to sit down one-on-one with your Peoples Pharmacist to help identify and resolve common medication-related issues, so you can get the most benefit from your medication. This medication review can help you better understand your medication therapy, and ensure that medications are being taken as prescribed. Speak to a Peoples Pharmacist about scheduling a free medication review.
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The best way to protect against influenza is to get immunized every year.
FLU VACCINATION SERVICES Most Peoples Drug Mart and Peoples Pharmacy locations offer on site flu vaccination services. Talk to your local Peoples Pharmacist about this convenient health service. A fee may apply for non-eligible B.C. residents
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Dr. Hister...Continued From Page 11
ease Week meeting in San Diego) involved cells grown in the lab, and In this study, the researchers determined that the food additive maltrodextrin, a component of some sweeteners, might change what happens to otherwise normal bacteria in the gut which might in turn, the researchers speculate, worsen symptoms in some people with Crohn’s disease, but it’s important to note that because that study wasn’t done on real patients in the real world (and because it hasn’t been published yet either), it’s still way too soon to say how to interpret the findings. But, of course, the way we eat is not the only thing that’s changed in how we now live our lives compared to a half-century ago, and to that end, another interesting study (from Swiss researchers) that was presented at that same meeting in San Diego claimed that people with IBD may have more frequent flareups of their condition if they fly or spend time in high altitudes (for example, skiing, an activity that is more important to most Swiss than even eating). What would be the connection between high altitude and IBD flare-ups? Well, obviously, the researchers don’t know yet but they guess that the oxygen change related to altitude might trigger an immune response in susceptible individuals. All in all, then, we clearly still have a long, long way to go yet in figuring out why some people get IBD and others in the same circumstances do not, why some people with IBD respond to some provoking agents while others do not, etc. etc. But until we make those breakthroughs, the bottom line for anyone with IBD is pretty simple: try to determine if there are certain foods (or even avoidable food additives such as sweeteners, for example) or other manageable “environmental” or situational changes (it’s hard to eliminate stress, for example, but it’s not impossible to try to lower stress levels) that may have a triggering effect on your condition, and if you can, work on avoiding or at least minimizing your exposure to those variables. And make sure to stay in touch with your doctors, because IBD is a set of problems that’s very happily finally drawing a lot more research attention. 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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HEALTHY EATING FOR SENIORS
Darlene Booth
Having just celebrated my 54th birthday and bearing witness to the changes in my own body over these past couple years really has me thinking ahead. I eat well and exercise regularly and yet each day I find a new and often quite comical way in which my outer body informs me that I will indeed slide into my role as an elder in this society in the very near future. And still I am extremely grateful; the outer packaging may be wrinkled and faded but I do cherish my good health and still have the energy to run, bike and climb the stairs instead of taking the elevator. All of this has me thinking ahead to my senior years with the knowledge that the outer manifestations taking place on the surface of my body are a by-product of an internal environment that is also shifting into a lower gear. Eating well and regular exercise are important at every age but our needs do change with the passing of years. A teenager’s nutritional requirements are going to be vastly different from someone who remembers having to actually get up off the couch to switch the channels on the television. Age related changes in our emotions and overall health could affect our appetite, digestion and proper assimilation of important nutrients. This may lead to nutritional deficiencies and increase our risk of developing degenerative disorders, such as osteoporosis, eye and vision problems, joint and mobility issues, inflammatory conditions, heart disease and various other conditions generally associated with the aging process. Inevitably, our metabolism is going to shift into a lower gear and this means that you will likely need fewer calories for maintenance than you used to. If you still eat like a 20 year old and you are not running marathons, you are going to gain weight. You will also increase your risk of obesity related health issues. Fewer calories per day means less wiggle room for junk food; make sure that your food choices are as nutrient rich as possible. Maintaining your muscle mass by staying active and finding an exercise routine that works well for your body will also keep your metabolism revved up. Digestive health is also important. As we age our digestive juices wane and it becomes harder for the body to actually break down and utilize the food that we are eating. A diges-
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R.H.N
tive enzyme supplement designed for seniors can greatly improve this process. Eating some raw food daily if you can tolerate it is also a good practice. Sometimes it is hard for seniors to chew raw food so that is when a blender can really be your best friend. You can load smoothies up with kale, fresh or frozen fruit, yogurt, protein powders, essential fatty acids, raw nuts and seeds and last night’s dinner if you see fit Here are some nutritional tips that will guide you in building and maintaining a healthy diet: Fibre is essential - Eat your fresh fruit and veggies. These fibre rich essentials are loaded with a wide variety of vitamins and minerals. If budgets do not allow for fresh produce, frozen is the next best thing. Opt for whole grains over processed and refined carbohydrates. These fibre rich foods along with plenty of water are going to keep your bowels moving and happy. Some people also benefit from a fibre supplement. 2. Healthy fats feed the brain and the body – Eat nuts, seeds, avocados, cold water fish and use cold pressed vegetable oils. Coconut oil in particular is showing promise in improving cognitive function for seniors. 3. Protein is power – Seniors need between .4 and .5 grams per body weight of quality protein daily. Choose beans, eggs, poultry, lean meat, fish, dairy and nuts. 4. Calcium is crucial - If you can tolerate dairy products you will also be benefitting from the calcium to protect bones and teeth. You may also want to add a good quality calcium supplement to your diet. 5. B12 for mind and body – Aging impacts our ability to absorb B12 which is needed for healthy mind and body. This little supplement can be one of your best investments. Opt for a sublingual version that dissolves under the tongue. It is sad that food security is not a priority in our society and often seniors are living on a fixed income. Poverty can present challenges in shopping and budgeting for nutritious foods. Taking advantage of the senior’s discount days and shopping the sales can ensure your best advantage for your grocery dollars. Good Health to You
People First Master 224_Layout 1 12-10-17 8:55 AM Page 15
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pot. Bring to ts in Dutch oven or large Combine first 5 ingredien m. Simmer, uncovered, for about diu a boil. Reduce heat to me are no longer pink inside. Strain 20 minutes until drumettes bowl. Reserve for another use. Rem cooking liquid into mediu on and bay leaf. oni , rot car ard disc and ttes. Toss move large bowl. Add hot drume Stir next 3 ingredients in mettes are coated. Transfer to until jam is melted and dru et with sides, reserving apricot mixshe greased foil-lined baking (230ºC) oven for about 20 minutes, ºF 450 in e Bak l. bow in remaining ture in il browned. Toss drumettes turning occasionally, unt ut 28 chicken wings. apricot mixture. Makes abo 4 ingredients in small bowl. Makes all Light Blue Dip: Combine . Serve with wings. dip ) mL 0 (15 cup 2/3 about ories; 18 g 1 tsp. (5 mL) dip: 230 Cal BEFORE: 1 drumette and Sodium Total Fat (5 g Sat); 430 mgtsp. (5 mL) dip: 120 Calories; 8 g 1 AFTER: 1 drumette and Poly, 2.5 g Sat); 39 mg Cholesterol; g Sodium Total Fat (3 g Mono, 1.5 re; 10 g Protein; 114 mg 2 g Carbohydrate; 0 g Fib
Recipes For Good Health
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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.
People First Master 224_Layout 1 12-10-17 8:55 AM Page 16
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