A Healthier You by Prince George Citizen

A Healthier You July 2013

Presented by Northern Health and Glacier Media

Recovering from heart conditions Ways to improve your heart

Symptoms of a heart attack Heart health hikes | Fitness for heart health | Heart health & tips

A HEALTHIER YOU — 2 — July ‘13

Inside A Healthier You

Welcome to Healthier You Welcome to the seventh edition of A Healthier You magazine! The heart is one of the most important organs in our bodies. It pumps blood with oxygen and other nutrients to other parts of the body.The heart needs to be looked after properly.This edition of A Healthier You magazine will focus on the heart, how to take care of it, and potential complications you could face if you don’t take care of yourself. One of this edition’s stories will look at the Network of Rural to Tertiary Healthcare (NORTH) NORTH clinic, which includes a heart failure centre in Prince George, B.C. that officially opened earlier this year.The NORTH network has many unique features, such as access to clinicians who focus on heart failure. We will speak with physicians from across the region who assess and treat the signs and symptoms of heart failure conditions and provide tips regarding preventive methods for heart failure conditions. The cover story for this edition explores the lives of two northern B.C. residents.The first had heart challenges as a baby and the second has suffered a heart attack. Both

of these strong survivors now enjoy a high standard of living, despite having had to live through these health challenges. Prevention of potential heart problems is the best defense against suffering heart failure. We know that a healthy lifestyle can help prevent heart complications.To give you an idea of how best to avoid these types of challenges, we will share an article from a NH staff member about ways to get moving at work and a story from an employed student nurse from Smithers about healthy foods for your heart.The Northern B.C. Tourism Association contributes an article highlighting local trails to explore, for all skill levels, to get your heart pumping. In addition, there is a discussion from two pharmacists from Northern Health about how medication that lowers cholesterol can help reduce the risk of having a heart attack or other complications.They point out that these types of medications cannot work in isolation and it’s important to make a plan with your physicians and pharmacists. This is a great edition of A Healthier You, filled with information focused on the health of your heart. I hope you enjoy! n

Cathy Ulrich, Northern Health chief executive officer and president Cathy has held her position of president and CEO since 2007. From 2002 to 2007, she was the organization’s vice president, clinical services and chief nursing officer. Before the formation of Northern Health, Ulrich worked in a variety of nursing and management positions in northern B.C., Manitoba, and Alberta. Most of her career has been in rural and northern communities, giving her a solid understanding of their unique health needs.

Inside... ON THE COVER: Dan Paxton and Drayden Schultz Photo by Trevor Moore

page 18

CEO welcome

Symptoms of a heart attack

Heart health hikes

Health tip : heart health

Ways to improve your heart

Heart health and tips

Feature: Recovering from heart conditions

Fitness for heart health

How much do you do it?

Staff profile: Christa Keating

Recovering from a heart attack

NORTH Clinic

Understanding cholesterol medication THE PRINCE GEORGE

Health care foundations CITIZEN

THE

PRINCE GEORGE

Visit the Northern Health Matters Blog for more healthy living tips at blog.northernhealth.ca Photo by Trevor Moore

CITIZEN A Healthier You is published by THE CITIZEN and PRINCE GEORGE

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A HEALTHIER YOU – 3 – July A HEALTHIER YOU‘13 — 3 — July ‘13

Symptoms of a heart attack

Peter James | Prince George Citizen

Symptoms of a heart attack Dr. Firas Mansour speaks about signs of a heart attack.

henever an actor on screen grabs his chest with a pained expression and a bright red face, the audience is conditioned to know he’s suffering a heart attack.

Citizen photo by Brent Braaten

Hollywood’s portrayal of the condition isn’t totally off base many people who suffer a sudden heart attack feel a crushing pain in their chest, neck and arm. Unfortunately, some people who don’t have the classic symptoms of the condition fail to recognize they’re also experiencing a heart attack. “With a heart attack, it’s critical that a patient is seen as soon as possible to receive the appropriate care,” Prince George internal medicine specialist Dr. Firas Mansour said.“A delay in care generally causes more damage to the heart muscle.” Among the less common heart attack symptoms are a shortness of breath and a sudden feeling of weakness, which Mansour said some people attribute to having a cold or the flu. Occasionally people will take a few days to rest, waiting for the symptoms to clear up, not knowing they had a heart attack. Mansour said people should be particularly concerned if the less typical symptoms occur when someone is exerting themselves - even lightly - and the symptoms go away when the person is at rest. Cont’d on page 5

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Symptoms of a heart attack Cont’d from page 4 “Any symptom related to exertion is alarming,” he said.“If you have heartburn when you walk and the heartburn resolves when you stop walking or when you’re resting, then that’s not related to the stomach illness - that’s something most likely related to the heart.” Some people dismiss heart attack symptoms due to the lack of a severe pain in their chest. “Sometimes people think of pain as something that has to really hurt, but any type of discomfort in the chest [can be a sign],” Mansour said.“Sometimes people just feel tightness in the chest, they don’t feel any pain.” In rare cases, heart attacks are discovered well after the fact because there was no one incident the patient identifies. “In some individuals we discover that they’ve had heart attacks when we’re doing tests,” Mansour said.“But you can’t find an incident that could explain the signs and the results of the heart test.” People with elevated risk factors, like high blood pressure, high cholesterol or diabetes should be even more aware of the subtle symptoms and act when they occur. “They should seek immediate medical attention if they feel unwell for no clear reason,” he said. In addition to atypical symptoms, Mansour said there are also warning signs that a heart attack could be imminent. Fatigue, dizziness, palpitations in the chest and unexplained shortness of

breath which don’t last very long are indications people should at the very least arrange an appointment with a family physician or call 8-1-1 and speak to a nurse. “Most people would have some warning signs in the days and weeks leading to the heart attack,” Mansour said.“Most patients would have mild symptoms related to a heart attack for a short duration, but [the symptoms] come back often.” There is no such thing as an insignificant heart attack, according to Mansour, and he said people should get checked out if they’re at all concerned. “Most patients, if they arrive at the hospital, they survive,” he said.“But some people don’t have a chance at the time of their heart attack and that’s where we really need to emphasize that people need to be aware of the warning signs before a heart attack.” Most of the time physicians are able to sort through the symptoms a patient is describing and determine they’re having a heart attack; Mansour said it’s only when the symptoms are very obscure that a diagnosis gets missed. “I think most physicians are able to identify [heart attacks] in most patients,” he said.“We have ways of evaluating the severity of symptoms and the likelihood the symptoms are related to a heart attack.” n

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Heart health hikes

Susan Clarke Hubbard | Northern BC Tourism

Heart health hikes

This is a great time to get out walking or hiking, and northern BC has a plenty of trails, both short and long, to keep you busy. If you’re starting out, go easy, carry some water and invite a friend! Ask at your local visitor centre about more options – you might be surprised how many trails there are in your own community!

Events for the runners! Emperor’s Challenge Half Marathon Mountain Run – August 10, 2013, Tumbler Ridge Mad Moose Ultra-Marathon, Marathon & Half Marathon – September 22, 2013, Prince George Photo credit Susan Clarke

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Heart health hikes

Scenic city escapes Often overlooked, but ever present, your community has trails right within its limits, which are scenic and easily accessible. Ferry Island Campground & Nature Park, Terrace: This 2.8-kilometer trail outlines Ferry Island, and is punctuated by branched off shorter trails and tree carvings.Take a break to watch anglers fish the Skeena River. Heritage River Trail system, Prince George: The Nechako and Fraser Rivers are the star of this trail system, which takes walkers and joggers for a trip along the banks and to some of Prince George’s most charming established areas. With many access points, your can pick your favourite section, or use adjoining trails to make an 11-kilometer loop. Tumbler Ridge takes community spirit and health to a new level, with a volunteer-run, timed walk or hike each Monday night at Flatbed Loops. Running May through August, getting out to walk the 2-kilometer loop is a lovely way to stretch your legs and meet the neighbors. Cont’d on page 8

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Heart health hikes

Day trips

Photo credit Susan Clarke

Ancient Forest

Take in fresh air while enjoying some of the spectacles that our region has to offer: Prince George or McBride: Ancient Forest – Just 113 kilometers east of Prince George live 800- to 2000-year-old Western Redcedars, accessible by a short but moderate trail. Good news for all users – the accessible boardwalk is almost ready! From Terrace: Nisga’a Memorial Lavabed - Take the 6-kilometer guided roundtrip tour through old-growth forest to a viewpoint that overlooks the Tseax Cone that erupted in the mid-1700s. (Arrange your trip with Split Mountain Adventures in Terrace.)

From Prince Rupert: Metlakatla Wilderness Trail: This new trail promises fun for the whole family, with 20km (10km in and 10km out) of views, beaches, viewing towers and two village sites.Take the ferry across and pack a lunch. Haida Gwaii: Naikoon Provincial Park/Pesuta: Feeling like a wreck? Hike the beach to the wreck of the Pesuta, a log barge that crashed in 1928. From the Tlell River day use site, the trail is 5 kilometers each way.

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Heart health hikes

Multiday hikes The Cascades: Near Tumbler Ridge, are a series of ten waterfalls on Monkman Creek, separated by small lakes. Described as sublime by Charles Helm in his book, Exploring Tumbler Ridge, some of these falls are so rarely seen that they do not actually have names! Allow three days, for this 50-kilometer experience, and pack for wilderness camping.

Photo credit-SianJames

When you’re ready to take your walking to the woods, look for your local hiking club. Just a few in the area are Bulkley Valley Backpackers, Caledonia Ramblers and Alpine Club of Canada (Prince George), and Wolverine Nordic Mountain Society (Tumbler Ridge).

Kitselas Canyon Wokkpash Trail

Wokkpash Trail: This 65-kilometer trail is for the fit and wilderness savvy! Witness the Wokkpash Hoodoos towering over you, the wide, sweeping valleys of the Muskwa Range and pure wilderness. In fact, your only company may be caribou, mountain goats, Stone’s Sheep and moose.

Other hiking resources: • Trailpeak.com • Northern BC App Ask your local Visitor Information Centre! Books: • The Outsider’s Guide to Prince Rupert, Matt J. Simmons • Hiking North Central BC, Rob Bryce • Central Interior Trail Guide(s), Caledonia Ramblers • Exploring Tumbler Ridge, Charles Helm • Hiking & Motorized Trail Guide, Tourism Northern Rockies

Photo credit JF Bergeron EnviroFoto

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Health tip: Heart health

Health Tip By Dr. David Bowering, Northern Health chief medical health officer

Dr. David Bowering is Northern Health’s chief medical health officer.. In November 2010, he released the report “Where are the Men? Chief Medical Health Officer’s report on the Wellbeing of Men and Boys in Northern BC” and has been heavily involved with the men’s health program since then. To stay active, Dr. Bowering walks or bikes to work, walks his dog daily, boycotts elevators, hikes or cross-country skis most weekends and plays with his grandchildren.

Heart Health: What you need to know!

Our hearts are central to who we are, physically, emotionally, and spiritually.The heart has been written about and studied more than any other organ.When I “Googled” the word “heart” I got 1,540,000,000 hits! If I hope to provide any insight into how to have a healthy heart and prevent heart disease in 500 words or less, I need to get right down to basics. A healthy heart is important! Heart disease in one form or another is the leading cause of death. Makes sense. Generally speaking, when our heart stops, so do we. Your heart is a thick muscular part of your system of blood vessels specifically adapted to pump blood. The job of that system of vessels from the largest artery to the smallest capillary is to take oxygen to all the cells in your body. If any cell doesn’t get oxygen, it dies. Insufficient circulation to the brain leads to stroke, and dementia. Insufficient circulation to the heart muscle itself leads to heart attack and heart failure. Insufficient circulation to other tissues in the body leads to poor wound healing, pain and muscle fatigue. It all boils down to the health of your blood vessels and circulatory system. So what keeps blood vessels healthy? Good genes! There isn’t too much any of us can do about that at the moment, so on to the next important factor. Good nutrition! Green leafy vegetables and fruit. Nuts, seeds and fish containing essential fatty acids are good for the heart, as is avoidance of too much salt, sugar, and unhealthy fats like trans fats, all of which stress and inflame the walls of our blood vessels and cause our blood to form clots and clumps instead of flowing smoothly. Cont’d on page 11

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Health tip: Heart health

Health Tip Cont’d from page 10 Avoiding poisons! Tobacco.Too much alcohol. Drugs like cocaine that irritate the heart and make it work harder.‘Nuff said. Managing stress! Stress generates a hormonal response in our body which leads to even more inflammation and more damage to those vital blood vessels. Good relationships, a balanced life that includes recreation, especially outdoors, and enough sleep all help protect our hearts. Movement and exercise! Exercise expands our blood vessels

and increases blood flow to everywhere it needs to go… both to deliver oxygen and remove toxins. It can have a powerful protective effect on our hearts. Good primary health care.Two common medically treatable conditions – high blood pressure and type 2 diabetes – can cause a great deal of damage to blood vessels and other organs. Both can be avoided and treated effectively once they are identified through appropriate screening. Oxygen is the best drug there is. When your muscles and brain get lots of it you feel great.You need your heart for that, so why wouldn’t you take good care of it? n

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Dr. Haider Hadi , on heart tips.

Ways to improve your heart

Citizen photo by Brent Braaten

Ways to improve your heart Peter James |Prince George Citizen

or Prince George cardiologist Dr. Haidar Hadi, maintaining a healthy heart is a lifelong pursuit. From diet to exercise to cutting down on stress, Hadi said there’s no shortage of ways to improve the functioning of your heart and reduce your risk for cardiac problems down the road. Hadi has identified five practical things people can do to help their heart, but rather than tackling them all at once he suggested people work on them one at a time. “Don’t try to do everything together, it doesn’t work,” Hadi said. “Concentrate on one thing. If you’re quitting smoking, do that first, then look to other things like diet and exercise.”

1. Stop smoking Chemicals in cigarettes are known to cause hardening of arteries, which can lead to heart attacks. Hadi said it’s never too late to quit smoking, but also said those who quit even after having a heart attack will see benefits. Hadi said people can access government resources, which cover the initial cost of some smoking cessation aides and provide one-on-one counselling to help people overcome the mental side of the addiction. To help avoid peer pressure which can make it more difficult to quit, Hadi suggested finding a partner to quit with. One incentive is to save up the money otherwise spent on cigarettes and use it to celebrate being smoke-free for a year. “Put it in a bank account called ‘kick the bad habit’ and reward yourself because it’s a big achievement,” he said.

2. Exercise Like any muscle, the heart gets stronger after it gets worked out. A stronger heart expends less energy to push blood through the body, which means it generally beats at a slower rate when at rest. Exercise also helps reduce stress by releasing endorphins into the body.

Hadi recommends at least 30 minutes of brisk exercise at least five days a week. Integrating exercise into a daily routine and involving family will make it easier for people to keep up with their fitness goals. “In the summer, cycle to work,” he said. “In the winter, obviously it’s not as easy to cycle, but you can shovel the snow. We have no shortage of snow in the north and shoveling snow for half an hour is good aerobic exercise.” For people with joint problems or back pain, Hadi said swimming is a good alternative.

3. Ditch the table salt Western food is typically high in sodium to begin with due to processing, so Hadi said there’s no reason for people to put table salt on their food on top of that. The body requires sodium, one of the elements of table salt, but only in small doses. Hadi said one gram of the element a day is enough, which works out to about 2.5 grams (or one teaspoon) of table salt. Too much sodium can lead to higher blood pressure, which is a risk factor for heart attacks. Other diet tips Hadi offered were to eat more Greek salad – or other meals using olive oil, which contains more unsaturated fat - and cut down on red meat. A HEALTHIER 12 – July ‘13 A HEALTHIER YOU — 12 —YOU July–‘13

4. Early screening Conventional wisdom is to begin screening for heart risk factors when patients reach 40 years of age, but Hadi suggests it could be beneficial to start sooner. “We’re less active so we’ve noticed over the recent years people will have diabetes at a much younger age,” Hadi said, noting diabetes is also a risk factor for heart disease. Since he’s seen patients in their 20s and 30s who have had heart attacks, he recommends people as young as 20 get their blood sugar, cholesterol and blood pressure checked. He also said it’s important for people to know the specifics of their family medical history because genetics also play a big role in determining risks for heart attacks.

5. Have a laugh Too much stress is a risk factor for heart disease and Hadi offered a simple solution. “It’s shown that laughing is a stress reliever,” he said.“When you have stress it increases your adrenaline and when you have adrenaline it increases your heart rate.” An additional benefit to having a good laugh is a strengthened immune system. n

A HEALTHIER YOU — 13 — July ‘13

Heart health and tips Michelle Bolen

Michelle is a student at UBCO in the BSN program, working as an employed student nurse in her hometown Smithers, entering her fourth year of the program. She is intending to become a registered nurse, gain experience in the nursing field while traveling, and apply to become a nurse practitioner. Her anticipated extracurricular accomplishments include traveling to Ghana, Africa on her fourth year nursing trip. She is the Global Gala Chair involved with the GNC (Global Nursing Citizens).

Heart health and tips to keep your heart healthy Keeping your heart healthy means learning what heart disease is, and learning how to prevent it. Heart disease is any condition that affects the functioning or structure of the heart and the most common type of heart disease is coronary artery disease.1 The coronary arteries supply the heart with the oxygen and nutrients necessary to give it the means to pump blood

to the brain and the rest of the body.The build-up of hard, fatty materials on the lining of these arteries causes decreased blood flow and an inadequate supply of nutrition to properly propel the heart.This is called coronary artery disease (CAD). The good news is that this disease is manageable and even preventable.2 Cont’d on page 15

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Heart health and tips – KEEP YOUR HEART HEALTHY

Cont’d from page 14 High blood pressure and high cholesterol are two main risk factors of coronary artery disease and can be controlled to some extent by diet and exercise. Sodium (in very small amounts) is a vital part of our diet, but too much can lead to high blood pressure.2,3 The Canadian diet has so much sodium that adding extra most likely means you are consuming too much. Large quantities of sodium are added to processed and manufactured foods in North America, increasing the incidence of high blood pressure.3,4 To the right are some tips from the Heart and Stroke Foundation to keep your blood pressure down, reduce your cholesterol, and keep your heart healthy. n

Look at the words associated with how your food is cooked. These words can tell you if it’s a healthier choice. Some healthier words are: stir-fried, poached, grilled, baked, barbequed, broiled, steamed, roasted and charbroiled.5 Terms to watch out for are cream/cheese sauce, batter, breaded, creamed, deep-fried, crispy, pan-fried, sautéed, thick sauce, gravy, mayonnaise, and pastry.6

Consider portion size. A good tool to help you choose the correct portion is Canada’s Food Guide, which can be found on the Heart and Stroke Foundation’s website, or Health Canada’s website. Additionally, the Canadian Physical Activity Guidelines indicate how much exercise a person should be getting.

Keep healthy snacks in reach. In addition, reduce the packaged and processed snacks lying around.7 Just because it’s healthy doesn’t mean it has to taste bad.The Heart and Stroke Foundation of B.C. contains many easy, healthy recipes, and surprisingly, the social website Pinterest is a great resource for healthy recipes too. And if that’s too much work you can always turn to Google.There are many resources available online to give you tips and hints on heart health, but it is your responsibility to access them. Get yourself informed, and start making some good decisions for your heart. Cont’d on page 16

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Heart health and tips R001413886

– KEEP YOUR HEART HEALTHY

Cont’d from page 15 References Campbell, N., Czernichow, S., Dunford, E., Jacobson, M., Jenner, K., Mhurchu, C. N., Neal, B., Webster, J., Woodward, M., Yuan, W. (2012). The variability of reported salt levels in fast foods across six countries: opportunities for salt reduction. Canadian Medical Association. 184: 1023-1028. DOI:10.1503/cmaj.111895 Health Canada (2013). Retrieved from: http://hc-sc.gc.ca/index_e.html (accessed June 19, 2013). Heart and Stroke Foundation (2012). Retrieved from: http://www. heartandstroke.com/site/c.ikIQLcMWJtE/b.3484021/k.7C85/Heart_ Disease.htm (accessed June 19, 2013).

1Heart and Stroke Foundation (2012). Retrieved from: http://www. heartandstroke.com/site/c.ikIQLcMWJtE/b.3484021/k.7C85/Heart_ Disease.htm (accessed June 19, 2013). 2,5,6,7 2,3 Health Canada (2013). Retrieved from: http://hc-sc.gc.ca/index_e. html (accessed June 19, 2013). 3,4 Campbell, N., Czernichow, S., Dunford, E., Jacobson, M., Jenner, K., Mhurchu, C. N., Neal, B., Webster, J., Woodward, M., Yuan, W. (2012). The variability of reported salt levels in fast foods across six countries: opportunities for salt reduction. Canadian Medical Association. 184: 1023-1028. DOI:10.1503/cmaj.111895

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Feature

Recovering from heart conditions Peter James | Prince George Citizen

either Dan Paxton nor Drayden Schultz have fully functioning hearts, but that doesn’t stop them from continuing to live life to its fullest. Paxton, 68, has had two heart attacks in recent years but still stays as active has he possibly can. Drayden, 10, was born with a congenital heart defect and needed three open-heart surgeries in his first three years of life, yet he still takes part in the same activities as all of his friends. Both understand their conditions do come with some limitations, but they’ve found ways to work around those challenges without compromising their quality of life. “The doctors have been fantastic,” Paxton said. “They always say you don’t stop living, you just have to be smarter.” For Paxton that has meant some diet modification - he’s eating less red meat now and is having smaller portions of food - and he’s tweaked his exercise regime to focus less on heavy lifting. He can still do everyday yard work, but he no longer does his own snow removal. In Drayden’s case, he knows that he doesn’t have the same endurance as some of his friends so he takes breaks when he needs to and is sure to get enough sleep each night. Cold weather poses a challenge for Drayden as his condition means his lips sometimes turn a shade of purple in the winter, a sign that it’s

time to come inside and warm up. “I don’t even notice it,” he said. “Sometimes my lips will turn purple and I don’t even feel cold.” Drayden was born with hypoplastic left heart syndrome. He had his first heart surgery when he was just three days old. Along with subsequent procedures at three months and three years of age, he still goes in for annual checkups, but his prognosis is great. “He’s done better than what they ever expected,” Drayden’s mother Ronda said. “They said from the beginning, since he was born, that he doesn’t fit the mold as a typical hypoplastic kid.” Children born with Drayden’s condition don’t have a fully functional left ventricle. When people ask him about what that means, he matter of factly replies that he has half a heart. While it’s possible he could require a heart transplant one day, doctors have told Drayden it’s not likely at this point because he’s doing so well. “[The doctors] said never to hold him back from doing anything, so I’ve never treated him any differently,” Ronda said. “He knows his own limits. He knows he can’t run as long as the other kids, he can run but he just doesn’t have the same endurance.” Drayden swims, bikes, skateboards and is as active as any other child his age. He even lists gym class as one of his favourite subjects in school.

A HEALTHIER 18 – July ‘13 A HEALTHIER YOU — 18 —YOU July–‘13

Photo

Recovering from heart conditions

He’s done better than what they ever expected. They said from the beginning, since he was born, that he doesn’t fit the mold as a typical hypoplastic kid. – Drayden’s mother Ronda

him to go the hospital where doctors diagOf course, there have been times when nosed a mild heart attack. Drayden’s heart condition has prevented The heart attack kept him from coachhim from doing something he wanted to do. ing the Grade 7 girls’ team from Immaculate During an otherwise great trip to California Conception in a tournament later that day. two years ago, sponsored by the Children’s “The kids went on to win the tournament Wish Foundation, he was prevented from and came to the hospital and gave me my going on all the attractions. gold medal,” Paxton recalled. “I became at big “The rides I was wanting to go on, star at the hospital - the greatest coach alive the kids with half a heart couldn’t go according to the nurses - it was one of the on,” he said. Paxton’s first brush with a heart prob- most touching things I’ve ever experienced in my life.” lem came six years ago when he was He was at the University Hospital of living in Vancouver. First he felt sick Northern B.C. for a week before getting transto his stomach, then his face started to turn an odd, gray-like colour. He quickly ferred to Vancouver to have another stent put in and has been recovering ever since. decided he should go to the hospital to Paxton has learned his lesget checked out. son from the basketball game Paxton had an angioand has vowed to stay off the plasty procedure to court in the future, but with widen his arteries and A person who is stubborn his physician’s permission had two stents placed to he’s hoping to get back into help his heart function about stuff like this is a total the gym soon to get back into more effectively. fool. It’s not fair to your family, shape. After retiring from Drayden doesn’t remember his job as a customs it’s not fair to your friends and but when he was a baby, docofficer, Paxton moved it’s not even fair to yourself. tors asked his family to bring to Prince George with his wife Dianne in – Dan Paxton him in so a group of medical students could try to diag2008. He was doing nose his condition as part of well with his recovery a classroom exercise. Since until he decided to moving to Prince George, play in a fun teachers Drayden has also used his condition to help and coaches versus students basketstudents in the Northern Medical Program. ball game at Immaculate Conception Educating others about heart health is school in March. important to both of them. In Paxton’s case, “I probably exerted more energy he’s been vocal to friends and colleagues that I should have and by the end of about getting checked out and following docthe game I was aching right up the tors’ directions. middle of my chest,” he said, noting “A person who is stubborn about stuff like in hindsight it was probably a poor this is a total fool,” Paxton said. “It’s not fair decision to suit up. to your family, it’s not fair to your friends and Despite the chest pain, Paxton first went home and had a shower, but when it’s not even fair to yourself. A heart attack can seriously slow you right down.” n the pain persisted Dianne encouraged

by Trevor Moore

A HEALTHIER YOU – 19 –YOU July — ‘13 19 — July ‘13 A HEALTHIER

Fitness for heart health

Fitness for heart health Have you seen this sign in your doctor’s office: “Eating healthy and regular exercise will do more for you than I ever can”? Sage words of advice that ring true especially when it comes to the hardworking human heart. Beating 100,000 times per day, the human heart is the hardest working organ in our bodies. Its performance, or lack thereof, can determine your quality of life in one short moment. The statistics on the sedentary lifestyles led by many Canadians may seem grim but there are some easy steps you can take to get your heart active.You will see results such as improved circulation, more energy and lower blood pressure. “I recommend that you start small to avoid being discouraged or causing injury,” says Shannon Johnson, Coordinator of Fitness Programs at the YMCA of Northern BC.“You don’t need to run out and buy expensive equipment or clothing - make use of what you have around you. Have a dog? Take him for a walk! Shopping? Don’t drive around searching out the closest parking spot – park further away and walk. By incorporating little changes into your daily life they will become habit and motivate you to take on even more challenging fitness activities.” Exercise will build a healthy heart – but make sure it’s exercise that matches your current fitness level and interest. Stretching, aerobic and strengthening are offered in programs such as yoga, Zumba and weights, respectively. Each is different but all will get your heart rate up.“Ask yourself if you prefer to work out as part of a group or on your own. Maybe games and sports are more your style,” says Johnson.“Physical limitations will also play a role, so increase your intensity as you progress.” Be realistic. If you haven’t exercised in ten years, don’t expect to run a marathon next week.“Being active should reflect the weather and seasons.Winter is no excuse for being sedentary – especially in northern BC,” adds Johnson.The Canadian Society for Exercise Physiology (CSEP) recommends thirty minutes of exercise per day that can be broken out in ten minute sessions of vigorous housework or a quick walk around the block! For beginners to determine their target heart rate, use the formula below: 220 minus your age, x 60% = target heart rate. For a 42-year–old, their target heart rate would be 107 beats per minute. Setting a goal no matter how big or small can provide extra motivation.Want to run a 5k? Planning a walking tour of Scotland? A healthy heart will get you there but not without some love and attention.“Physical results are often felt very soon after getting active,” says Johnson.“But is the most rewarding for me in my two decades as a Fitness Instructor is the change in personality as individuals build confidence and gain energy. It’s not just the heart that gets healthy – it’s the mind and spirit too.” n A HEALTHIER 20 – July ‘13 A HEALTHIER YOU — 20 —YOU July–‘13

A HEALTHIER YOU — 21 — July ‘13

Healthy eating, active living Christine Glennic-Visser Christine is the regional coordinator for the HEAL (Healthy Eating, Active Living) Network in northern B.C. Christine loves to share good healthy local food with family, friends and co-workers and is passionate about making the healthy choice the easier choice for everyone. Although she is currently limited in her physical activity choices for medical reasons, she has become creative at fitting in activity and spends many happy hours deep water running and using gentle resistance training and stretching to maintain muscle strength. Christine can often be found in her kitchen, developing or testing recipes, and conspiring with her six grandchildren to encourage their parents to eat more fruits and vegetables!

How much do you do it?

How much do you sit each day? Most people very simply:“SIT LESS and MOVE MORE.” What can you do? How do you move away sit to get to and from work, sit at work, sit to from a culture where sitting is normal? meet, sit to eat and sit to be entertained.The The first step is to look sitting list goes on and on. at how much you are We sit too much. actually sitting and where Did you know getting We’ve become so sedentary that you can begin to make the recommended 30 minutes of exercise every day 30 minutes a day at the gym may some changes. For most of us the bulk of our day might not be enough? Did not counteract the detrimental is spent in the workplace, you know that in addition sitting.To give you to that 30 minutes a day effects of 8, 9 or 10 hours of sitting. often an idea of how much you you should also be thinking about what your body – Genevieve Healy, PhD really sit, you can find a sitting calculator at juststand. is doing for the other 23 ½ org. hours. Research shows that The second step, once if you are sedentary for you know how much you actually sit, is to most of the day, it can actually outweigh the slowly begin to create changes. benefits you gain from the time you set aside Cont’d on page 23 to exercise. What does this mean? It means

A HEALTHIER YOU — 22 — July ‘13

Healthy eating, active living – HOW MUCH DO YOU DO IT?

Cont’d from page 22 This is challenging if your work is mostly sedentary and you feel desk-bound, but it is not impossible. The real danger in sitting comes from long periods without movement. Begin making small changes that get you up out of chairs. Make the choice to stand easier. Here are some ideas to get you started: • Stand up when you read. • Stand up when you are talking on the phone. • Stand up during meetings. • Stand up when talking to co-workers. • Move your wastebasket, stapler, three-hole punch, recycling to a centralized location. • Request counter height tables in your meeting and lunch rooms. • Take a quick ‘shake break’ at least once an hour. • Take walking meetings during good weather. • Walk around during your coffee and lunch breaks. The third step happens when standing becomes normal for you. Enjoy your new habits. Enjoy knowing that you are doing the best you can to be active throughout your day. Will it be easy? No, it won’t. Sitting is normal, standing is not. The idea isn’t to immediately go from hours of sitting to hours of standing.Think about changing the culture around sitting and making it easier and more acceptable to stand.Your body is made to move, so for your health and well-being, start now to… “SIT LESS and MOVE MORE.” n

A HEALTHIER YOU — 23 — July ‘13

Staff profile: Christa Keating

Christa

Keating

What is your position with Northern Health? Chronic Disease Nurse Educator, in the Health Promotion Program at Prince Rupert Regional Hospital. I teach people who have diabetes or heart disease about their condition and how to manage it. I also teach staff and physicians about the newest guidelines and research in patient management of these conditions as well. My work takes me often out in the community to present information about chronic disease prevention, or to screen for early detection of them. I often travel to remote communities surrounding Prince Rupert to provide this work as well.

Describe your family life. I am a mom of two amazing teenagers. My son William is 17 and just graduated high school and has a great sense of humour. My daughter Hayden is 13, in grade 8 and is so full of sweetness. As with most parents, your children become your world. It has been just the three of us for a while but I am very lucky that most of my family lives in Prince Rupert as well and in nearby Hartley Bay, so I am able to see them and we are able to be part of each other’s lives. They have given me and my children tremendous love and support.

What brought you to your community? My family brought me back to Prince Rupert. Well that and a job! When I graduated nursing school from UBC it was difficult to get a permanent full time job. I moved home and my first job was as a casual nurse on the medical/pediatric ward of Prince Rupert Regional Hospital! I stayed because soon after that I married and started a family, and wanted my children to grow up knowing their grandparents and aunts and uncles and cousins, and I wanted that connection and support as well.

Where did you grow up? I am of the Tsimshian Nation, my name is Kamdamax, from the community of Gitaga’at (Hartley Bay) of the eagle clan andfrom the house of Sinnaxeet. I was born in Kitimat, but grew up right here in Prince Rupert and spent most of my summers growing up with my grandparents and uncle and aunt in Hartley Bay.

Where do you currently live? Prince Rupert A HEALTHIER 24 – July ‘13 A HEALTHIER YOU — 24 —YOU July–‘13

A HEALTHIER YOU — 25 — July ‘13

Staff profile: Christa Keating What’s the most rewarding part about living where you do? Here in Prince Rupert, I am able to remain an active part of my family and culture. My job also enables me to help make a positive impact on the health of family and community, which is what supported me to get to where I am in my life. Now I can give something back, and that is rewarding.

What made you want to enter your field? I have always known since I was a little girl that I was going to be a nurse, even before I really even knew what that was! When I was in high school it became a toss-up between becoming a

teacher or a nurse. Nursing won obviously, and now I am a nurse who teaches!

What is the most challenging part of your job? What is challenging about my job, is similar to all health positions, that sometimes no matter how hard we work and try and no matter how hard the patient works and tries sometimes, complications happen. I am lucky that in my job I get to know people well and often for many years, but when they suffer, I suffer too.

What is the most rewarding part of your job? The most rewarding part of my job is making a difference in someone’s life. When providing some information, or teaching a skill, or screening for something, which then leads to that person making a positive change in their life that makes them healthier or prevents something unhealthy, it makes my job and my life meaningful. Knowledge is power, so to pass knowledge on to others empowers others, and we all become healthier and stronger.

What is your favourite part of northern B.C.? My favorite part of northern B.C. is the ocean. Hands down. I grew up beside it and on it and still spend most of my time there. There are many amazing mountains, valleys, lakes and other landscapes that are stunning in the north, but they would never be enough to get me to leave the ocean. The ocean is beautiful and sometimes treacherous; it is rich with food that we harvest, and full of life that I have been lucky enough to see. My family has always lived off of what the ocean provides in food, fun and work. Much of my family have been fishermen, or worked other marine jobs on the ocean. It is part of who I am.

A HEALTHIER 26 – July ‘13 A HEALTHIER YOU — 26 —YOU July–‘13

Staff profile: Christa Keating

Where do you see yourself in five years? Probably right here. Just maybe doing things a little differently, a little better, a little easier, with a community at a healthier level.

What do you do to live a healthy lifestyle? For me one of my essential routines for staying healthy is running on the Butze Rapids trail. There I am able to run, and release and burn off any stress, I am able to be outside and connected to nature. There is a spot where I stop to look at the ocean and meditate. I often run with friends and it is our time to share and connect with each other. It isn’t just a physical activity for me - I am also able to “exercise” the mental, emotional and spiritual parts of me too. I also try to eat what gives my body nourishment (and avoid what doesn’t) and enjoy it too!

What benefits does living a healthy lifestyle have for a person’s heart? Living a healthy life –- as in eating foods that nourish your body and moving your body to keep it strong -- keeps our heart strong. But living a healthy life is much more than diet and exercise. Spending time with family and friends keeps us connected and our emotional heart nourished. Growing and learning, and doing what is meaningful for you keeps your mental and spiritual heart open to inspiration and energized with creativity.

Who has been the most influential person in your life? There have been too many to just name one. My parents and grandparents, and siblings have been there to teach, ground me and support me. My mom has and still is there as one of my biggest supports and I am so thankful for it. I have an amazing circle of friends who have laughed and cried with me. I have had nursing mentors and spiritual teachers who have helped me get to where I am in my life today. Sometimes even the smallest interaction can make a big difference in your life path. I am so grateful for all of them. n A HEALTHIER YOU — 27 — July ‘13

Recovering from a heart attack

Peter James | Prince George Citizen

Recovering from a heart attack

A heart attack can be a scary experience and that fear can linger long after the symptoms subside. Nurse Melanie Starzyk said ensuring that patients have the tools to recover from both the physical as well as the psychological impacts of a cardiac condition are central to the teachings at Northern Health’s Network of Rural to Tertiary Healthcare (NORTH). “It can be such an overwhelming experience for people both psychologically and emotionally and cardiac rehab provides a means to address both of those areas,” Starzyk, a clinic RN at NORTH said. Heart-attack patients in northern B.C. are often referred to NORTH, although some patients also self-refer to access the services. Facilitators are located throughout the region and are available to help walk patients through a self-guided program which usually takes six to 12 weeks to complete, depending on the needs of the patient. The goal of the four-booklet set is to teach patients about their heart condition and provide information on what life changes are needed. One booklet is a diary used by the patient to record important information like their medication schedule or weight-loss progress and it doubles as a place to record feelings and emotions through their recovery journey. “We often encourage them to include their thoughts, their feelings and their beliefs at this time, it’s good because at a later time they can refer back to it and see how they were feeling at a certain time,” Starzyk said. Another book includes information for close family members to help them cope with having a loved one with cardiac health problems. Starzyk said the clinic recommends having spouses or other close family members come to some of the appointments at NORTH so they can have their questions answered as well. Cont’d on page 29 A HEALTHIER YOU — 28 — July ‘13

Recovering from a heart attack – RECOVERING FROM A HEART ATTACK

Cont’d from page 28 Part of the program is dealing with misconceptions that exist around post-heart attack care. Starzyk said the most common questions surround the medication regiment people are put on by their physicians. “For example [they ask]:‘Am I going to have to be on these medications for the rest of my life? Or, can I just cut back on the number of pills I’m taking to this many?” Starzyk said.“We discuss the importance of the medication, the reason they’re on them and the importance of not stopping them altogether.” Often patients are encouraged to make lifestyle changes to reduce the risk of a future heart attack and the staff at the NORTH clinic help people through what can be a challenging process of quitting smoking, changing their diet or losing weight. “Many people live a certain way up until that point - but everything changes once they have a heart attack,” Starzyk said.“It’s not just their body that’s going through something, they themselves are and so are their families.” Getting people talking about their heart condition and providing a resource for their questions helps ease some of the uncertainty people feel, according to Starzyk. “I think once people have had a heart attack, the fear that surrounds having another heart attack is very common,” she said.“They’ve gone through it and they’re scared to go through it again.” n

A HEALTHIER YOU — 29 — July ‘13

NORTH Clinic

Peter James | Prince George Citizen

North Clinic providing care for patients with heart failure

Dr. Colleen Hennessy and CCVS Regional Coordinator Barbara Hennessy at the NORTH clinic in the Victoria Medical building with telehealth equipment. Citizen photo by Brent Braaten

he learning curve from a heart condition can be steep, but education and ongoing care programs make the transition easier. The new Network of Rural to Tertiary Healthcare (NORTH) clinic gives people living with heart failure a dedicated resource centre staffed by nurses specially trained in cardiac conditions and five heart specialists who are able to help patients optimize their medication. Northern Health’s Heart Function medical lead Dr. Colleen Hennessy said one of the big benefits of NORTH is that staff can dedicate a lot of time to

patients to fully explain the dietary, exercise and other life changes which are required to reduce the risk and improve their quality of life. “It takes a lot of time, it takes a lot of reinforcement,” she said.“So in a busy general practitioner’s office or the hardto-get-into specialist’s office, the time to spend with the patient is not there.” At NORTH, patients with heart failure receive an hour-long introductory visit plus follow-up visits which can focus on different aspects of cardiac care.There are also group sessions available either in-person in Prince George or via videoA HEALTHIER YOU — 30 — July ‘13

link around the region. “You’re repeating things a lot, because you really want to ingrain it,” Dr. Hennessy said. Between 2009 and 2012, there were 1,600 hospital admissions for heart failure across Northern Health. Even more patients were admitted with another condition and a heart condition was considered a secondary cause. Meanwhile, half a million Canadians live with heart failure issues, with another 50,000 being diagnosed each year. Cont’d on page 32

A HEALTHIER YOU — 31 — July ‘13

NORTH Clinic – PROVIDING CARE FOR PATIENTS WITH HEART FAILURE

Cont’d from page 30 Since officially opening in February, NORTH clinicians have seen more than 120 patients and that number will grow as more communities in Northern Health sign on. By providing in-depth education and support, NORTH aims to both reduce the number of hospital admissions, which will save the healthcare system money, while at the same time improving the quality of life of patients. “We know that for these types of conditions, these are not going to be cured,” Dr. Hennessy said.“There has to be everyone engaged in the caring of this individual. Not only the person caring for the individual, but their GP, the referring physicians, the attending physicians, everyone has to be in the loop.” As its name suggests, NORTH is a network that connects the specialists with patients around Northern Health. Videoconference technology allows patients to access specialist care without leaving their home community and electronic stethoscopes even allow the cardiologists to monitor heart rates remotely. Nurses are trained in most communities that are part of the NORTH network to deliver the educational components face-to-face.“If there is a nurse in that area then that nurse gets utilized,” Northern Health Regional Coordinator for Cardiac & Cerebrovascular Services Barbara Hennessy said.“If there isn’t a nurse [patients] still have an opportunity to get education in their local area because they can do it through video conference.” Prince Rupert,Terrace and Kitimat were the first to connect into the system, with Valemount expected to come online shortly. Vanderhoof is next on the list, with staff training planned for later this summer and four other communities have expressed interest in joining the network. Dr. Colleen Hennessy hopes many more communities will join the network in the coming months and years, but it’s dependent on staff and infrastructure resources available in those locations. She cautioned that growth needs to happen in a manageable way to ensure high-quality care standards are upheld. “Each one of them requires an individual assessment because it’s entirely dependent on what resources they currently have at their site,” Dr. Hennessy said. In addition to providing care to heart failure patients, the NORTH clinic also provided educational support to heart attack survivors. Patients are often referred by their family physicians, who can ask the staff at NORTH to provide a variety of care options, from education to helping patients get on the ideal medication.The length of time someone is assigned to the clinic varies from a few months to much longer, depending on the complexity of the case. “Adjusting the medications, if the family doctors want us to do it, that’s something we can do,” Dr. Hennessy said.“If they’re comfortable with it, they can carry on with it.” n

A HEALTHIER YOU — 32 — July ‘13

Cholesterol medication Jonathon Dyck, Marketing and Communications Officer Northern Health

Understanding cholesterol medication

rescribing medication to help lower cholesterol is a method used by physicians and other medical professionals to decrease the likelihood of developing a heart attack or other signs of worsening coronary artery disease. In fact, cholesterol-lowering drugs are the number one medication sold in Canada and the United States of America.Typically, this drug is used by those who are at high risk of a coronary event due to cardiac risk factors including family history or who have already suffered a heart attack. “There is a family of drugs called Statins that are the primary family of cholesterol-lowering drugs prescribed,” said Aron Nenninger, a pharmacist based in Terrace, B.C.“The goal of having people that have had heart attacks or are at high risk take these medications is to reduce risk of future coronary events and hopefully improve their standard of living along with prolonging their life.” In studies of patients who have taken Statins, it has been seen that the medication has had a positive impact, not only on reducing cholesterol levels, but on the number of heart attacks, hospitalizations, heart surgeries and deaths that occur. People with health and/or cholesterol issues need to ensure that they completely understand their situation by having the conversation with a medical professional.This can include talking about other drugs they may be taking and other lifestyle changes they could make for their health. “People cannot just look at the medication as the only factor in helping reduce risk for heart conditions,” said Rachelle Miller, a pharmacist based in Dawson Creek, B.C.“They also need to evaluate lifestyle pieces such as diet and exercise as well.There is no one solution that can work in isolation to improve heart condition; instead it needs to be a comprehensive appro ach.” The side effects of Statins are uncommon, but may include muscle cramping, and in rare cases, kidney and liver failure. Compared to the potential drawbacks, the drug’s benefits can help people with certain heart conditions.That said, while on any medication, it’s crucial to keep a conversation going with your physician so changes can be made if necessary. “If you are one of the people who are suffering reduced quality of life as a result of taking a statin, you need to talk to your pharmacist or physician as it could be as simple as drug interaction.The alternative is that the person cannot tolerate the medication and that does need to be addressed,” said Rachelle. n A HEALTHIER YOU — 33 — July ‘13

Health care foundations

Health care foundations Throughout northern B.C., health care foundations work with the communities and donors on a variety of fundraising programs and the money they raise helps improve health care for local residents. It’s often used to buy specialized equipment for hospitals and clinics, like the warmers for premature babies that the Dawson Creek and District Hospital Foundation bought in 2012 (see the April 2012 issue of A Healthier You).

History of the Max Lange Foundation Max Christian Lange was born on August 17, 1905 in Kiel, Germany. Max was a professional engineer who started work for Al scan in Kitimat as a Millwright in the machine shop in 1953, where he worked until his retirement aged 65 on September 01, 1970, aged 65. He lived with his wife Irmgard, and the couple had no children. Max resided in the Kitimat residential care unit of the old Kitimat General Hospital site towards the end of his life, and died on May 23, 1996. Upon his death, Max had bequeathed $2,007,782.00 to a charitable fund the Kitimat General Hospital & Health Centre. This became the Max Lange Fund, managed by two executors, Mr. Feldhoff and Mr. Doering, who have generously given their time to administering the Max Lange Fund in honor of Max within the spirit of his wishes to contribute to health care within the community of Kitimat. Mr. Doering died in 2012. Mr. Feldoff continues to work to manage the legacy of Max Lange in his role of executor of the Max Lange Fund. The working philosophy of the Max Lange Fund is to consider opportunities for financial support, through donation, towards proposals to enhance and improve health care equipment for the Kitimat General Hospital & Health Centre site. Proposals relating directly to health care services and patient care are presented and determined through collaborative discussion between physicians, clinicians, Northern Health administration with the Max Lange Fund representative. Since inception, the Max Lange Fund continues to make significant donations to health care service equipment to augment annual capital equipment funding provided by Northern Health. Cont’d on page 35 A HEALTHIER YOU — 34 — July ‘13

Health care foundations Cont’d from page 34

New name for the foundation in Fort Nelson We are excited to announce that the Fort Nelson Hospital Foundation has changed its name. The organization will now be known as the Fort Nelson Hospital & Healthcare Foundation. The organization has now expanded its mandate to allow the foundation to take on funding of new health related programs and services for Fort Nelson. “It will allow us to continue to make enhancements to the healthcare in Fort Nelson. As a community, we all know that there are issues with recruiting doctors, medivacs, maternity, addiction and other services.The Foundation would like to be part of the solution to some of these concerns,” says President Laurie Dolan. Our organization is currently working with the Northern Rockies Regional Municipality and Northern Health as part of the development study of a Primary Care Home.The Board of Directors is looking forward to investigating other opportunities to enhance health care in our community and at the hospital.

Dr. R.E.M. Lee Hospital Foundation 25th Anniversary It was the dream of Dr. Robert Lee to have a medical referral center in the Pacific Northwest. He discussed the

changes in technology and the need for a CT scanner and stated there could be no modern medicine without it. A group of Terrace businessmen got together who wanted to help upgrade some of the equipment in use at the hospital and pursue the purchase of a CT scanner. They concluded that the best way to solicit and accept donations would be through a hospital foundation. The Dr. R.E.M. Lee Hospital Foundation was formed as a non-profit society dedicated to achieving a higher level of health care in the region and administered by a volunteer Board of Directors. Its registered date of Incorporation was February 11, 1988.

Fort St. John Hospital Foundation At the heart of a growing community are its people.The FSJ Hospital Foundation is fortunate to see the heart and caring of our residents on a daily basis.Their generosity has helped us to raise over $9 million since our start in 1998, all of which has stayed right here in our community.The most recent demonstration was the 14th annual Bluey Day which supports local cancer patients.The event saw 47 individuals “Be Brave & Shave” raising over $97,000! Amazing! Thank you to everyone who supports us and our goal of improving patient care and comfort here at home. n

Your health matters to Northern Health Did you know adults need to get at least 150 minutes of physical activity a week? Find fun, accessible methods to get moving on the Northern Health Matters Blog at blog.northernhealth.ca

the northern way of caring

northernhealth.ca A HEALTHIER YOU — 35 — July ‘13