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Back-to-school – What you need to know about head lice, pink eye, and the common cold

Every year, back-to-school can be an exciting, as well as stressful, period for both parents and children. Kids will see their friends again after a couple of months of summer vacation and are about to spend a lot of time together back in the classroom. It remains important to understand how the common back-to-school illnesses that can be transmitted and prevented. Head lice, pink eye and the common cold are some of those common illnesses. What are they? What are the symptoms? How do we treat them? Here is what you need to know.

What are head lice?

Head lice are visible tiny insects that can live on the human scalp and feed themselves with blood. They are about the size of a sesame seed and they can multiply themselves by producing lice eggs. As opposed to what some people think, head lice are not a sign of poor hygiene or an unclean living environment. They commonly spread from direct or indirect head-to-head contact making children more subject to this type of common illness. Children heads often touch when they play together and share accessories in places such as schools, day cares, or at the park. Shareable items such as hats, gloves, scarves, hairbrushes, pillows and headphones may lead to the spread of head lice. It is important to note that lice transmission is possible through direct and indirect contact, but that lice cannot jump from one person to another. 1, 2, 3, 5

What are the symptoms?

Symptoms associated with head lice are numerous. Here are some of the most important ones:

  • Itching on the scalp, neck and ears which can start a couple days/weeks after lice transmission
  • Visible but hard to see head lice and/or eggs 1, 2

How can head lice be prevented and treated?

Even though it is hard to prevent children from getting head lice, parents can work with them on good habits to follow in order to reduce the chances of transmission like hanging their garments on a separate hook from other children's garments and not to share hair bands, barrettes, towels, combs, brushes, hats and scarves. 1, 3, 4, 5

Fortunately, they are multiple products to treat head lice. There is a broad range of treatments available. It is always recommended to consult your Walmart Pharmacist prior to starting a treatment. Remember to always read and follow the product label carefully for an effective treatment.

What is pink eye?

Children can also be exposed to pink eye when they return to school – also referred to as conjunctivitis. Conjunctivitis is when the transparent membrane (conjunctiva) layer covering the white part of the eyeball and lines the inside of the eyelid is infected or subject to inflammation. 6, 7 There are many types of conjunctivitis. It can be caused by a virus or bacteria (infectious conjunctivitis), by seasonal allergies like pollen and grass (allergic conjunctivitis), or by irritants, such as when children play in a pool full of chlorine (chemical conjunctivitis). 7, 8, 9

Pink eye is a common eye condition. Pink eye can be contagious if it is caused by a virus or bacteria, and this is one of the reasons why children can be infected at school or any other place where direct contact with another infected person can occur. Conjunctivitis can also be spread through indirect contact – such as when children share items together like towels and washcloths. However, it is rarely dangerous for the vision of the person to be affected when treated and diagnosed properly.

What are the symptoms?

There are multiple symptoms with pink eye, including:

  • Redness of the eye(s) – eyeball or eyelid
  • Swollen conjunctiva
  • Itchy eyes
  • Blurred vision
  • Tears
  • Sensitivity to light
  • Sandy or scratchy feeling in the eye(s)
  • A discharge that forms a crust that keeps the eyes from opening after sleep

How can pink eye be treated?

There are many conjunctivitis treatments available in the pharmacy such as antibiotic eye drops, eye ointments, and antihistamine medications. Your Walmart Pharmacist can help you with the proper treatment depending on the type of conjunctivitis you may have. 6, 7, 8, 9

What is a common cold?

Common cold is a viral infection of the nose and throat and can be one of the reasons why your children may miss school this year. It is caused by a virus that infect the nose, throat and sinuses. There are many types of common colds. Children are also subject to be infected at school or day care, as it can be transmitted through direct contact with others who have a cold as well as through items that are contaminated. Children are likely to have five to seven colds per year.14

What are the symptoms?

Here are some of the symptoms your children can experience when having a common cold: 10, 11, 12

  • Runny nose
  • Stuffy nose
  • Sneezing
  • Mucus
  • Sore throat
  • Congestion

How can the common cold be prevented or symptoms be treated?

The chances of getting common cold can be reduced in several ways such as by washing your hands often with soap and water, not touching your face with unwashed hands, and by staying away from people who are sick. It is always important to take time to explain and show good prevention practices to your children. Your Walmart pharmacist can advise on what products for relief of cold symptoms may be right for you or your family. If symptoms do not go away after a few days or if the common cold seems to cause serious problems such as high fever and vomiting, you should consult a doctor. 10, 12, 13



Resources

1Mayo Clinic. Head lice. https://www.mayoclinic.org/diseases-conditions/head-lice/symptoms-causes/syc-20356180
2WebMD. Slideshow: treating and preventing a head lice infestation. https://www.webmd.com/children/ss/slideshow-lice-overview
3Health Link BC. Head Lice. https://www.healthlinkbc.ca/health-topics/hw51114
4Ottawa Public Health. Head Lice Fact Sheet. https://www.ottawapublichealth.ca/en/professionals-and-partners/resources/Documents/Educators/head_lice_en.pdf
5Canadian Paediatric Society. A home for paediatricians. A voice for children and youth. https://www.cps.ca/en/documents/position/head-lice
6WebMD. Conjunctivitis (Pinkeye). https://www.webmd.com/eye-health/eye-health-conjunctivitis#1
7Mayo Clinic. Pink eye (conjunctivitis). https://www.mayoclinic.org/diseases-conditions/pink-eye/symptoms-causes/syc-20376355
8National Eye Institute. Facts about Pink Eye. https://nei.nih.gov/health/pinkeye/pink_facts
9Ontario Association of optometrists. Pink eye (conjunctivitis). https://www.optom.on.ca/OAO/Patients/Library/Pink_eye_conjuctivitis_.aspx
10Mayo Clinic. Common cold. https://www.mayoclinic.org/diseases-conditions/common-cold/symptoms-causes/syc-20351605
11WebMD. Understanding the common cold – the basics. https://www.webmd.com/cold-and-flu/cold-guide/understanding-common-cold-basics#1
12Caring for kids. Cold in children. https://www.caringforkids.cps.ca/handouts/colds_in_children
13WebMD. Children and colds. https://www.webmd.com/cold-and-flu/cold-guide/children_colds#2
14WebMD. Why do children get sick so often? https://www.webmd.com/cold-and-flu/qa/why-do-children-get-sick-so-often

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Pharma Science

SNEEZE, COUGH, ITCH: A NEW ALLERGY SEASON IS UNDER WAY
If you have an allergy, your Walmart Pharmacist can help you find relief

Allergies often occur in the spring. And in the summer, fall, and winter. In your home or outdoors. In other words, anywhere and anytime you encounter one of your allergy triggers. Fortunately, there are a number of effective ways to manage allergies, and relief may be just a pharmacy away.

What exactly is allergy?

Allergy is an immune reaction to a substance your body views as a threat (called an allergen), even though it’s usually something harmless like dust or tree pollen.1 Your immune system overreacts to such allergens and produces histamine, a chemical that causes the allergy symptoms familiar to so many of us.1 In a sense, allergy means your immune system is being too careful.

Allergy affects about 30% of adults and 40% of children, so there’s a good chance that you or someone close to you lives with at least one allergy.1 And while they often begin in childhood, allergies can pop up at any point in life.2 One day you hug your cat without any problem, and the next month your eyes start watering when the cat enters the room. To make things even more confusing, a food allergy may disappear as you step out of your teens, only to resurface two decades later.2

That time of year: seasonal allergies

Of all the different types of allergies, seasonal allergies affect the greatest number of people—up to a quarter of all Canadians.3 Known as “hay fever” to most people and as “seasonal allergic rhinitis” to doctors, these allergies come and go with each change of season.

April brings not only showers but pollen from trees and flowers. An extremely common allergen, pollen has millions sneezing and sniffling until the end of May.4 (Pollen is a fine powder produced by plants to fertilize other plants of the same species.5) Next comes grass pollen, which peaks in June and July.4 Sneeze season doesn’t end there: between August and October, ragweed fills the air and tickles allergic noses.4 Depending on your specific triggers, your own allergic symptoms may come and go throughout these months.

Springing forward into allergy

It’s no surprise that hay fever symptoms peak in April and May, when tree pollen reaches the highest levels.1 Trees that can trigger allergies include maple, elm, pine, willow, and birch, among many others.6,7 The pollen can travel for several kilometres, so you may find yourself sneezing even if you live in a concrete jungle or towering condo.6

While rarely an emergency, spring allergies can put a serious dent in your quality of life. Anyone who’s sniffled through a spring allergy season will recognize the symptoms, which include sneezing, runny or stuffy nose, scratchy throat, cough, watery eyes, itching, and swollen sinuses.8

This year, prepare for the season by talking to your Walmart Pharmacist, who can suggest treatments that work and steer you away from those that don’t.9 Your pharmacist can also point out behaviours that could be making your symptoms worse, such as using aerosol sprays or perfume.9

Watch that weather report

Your allergy symptoms don’t just depend on the time of year: daily weather conditions also play a role. Warm, dry days tend to have the highest pollen counts, especially in the mornings.8 Pollen travels by air, so it’s no surprise that wind can make symptoms worse.8 Damp, rainy days, which tend to have a lower pollen count, may give you a break.8 A local allergy forecast (available online) will tell you which types of pollen are running high that day.



Allergic around the clock

Not all allergies depend on the season. Allergens from pets, dust, mould, chemicals, and foods can cross your path at any time of year. About one in 10 people has an allergy to household pets, more often cats than dogs.10 Contrary to popular belief, most people with cat allergies react not to the fur, but to a protein on the animal’s skin.10 Over 2.6 million Canadians, meanwhile, live with food allergies that need to be managed every day—including a half a million children.11 Allergies to some foods and chemicals can turn serious, requiring the use of an epinephrine injector (such as EpiPen®) to treat emergencies.

If you have year-round allergies, your Walmart Pharmacist can advise you on how to avoid triggers, prevent anaphylaxis (life-threatening allergic reactions), and use epinephrine injectors correctly.12,13

Detective work

Allergy symptoms look a lot like cold symptoms, so you may wonder if your runny nose comes from allergies or a simple cold. It’s probably due to allergies if:14

  1. Your mucus is clear and stays clear.
  2. Your eyes itch or water.
  3. You’ve had symptoms for more than a week, and they don’t change from day to day.
  4. You only get symptoms in certain situations (such as visiting your friend with three cats).

Symptoms can give you clues, but not proof. Even if you know for sure that budding elm trees make you sneeze, other allergens may fly under your radar. Indeed, more than two-thirds of spring allergy sufferers have symptoms that persist year-round—proof that their misery comes from more than tree pollen.15 In some people, substances that trigger allergies may also bring on an asthma attack.16

The only way to diagnose allergies is through medical testing. A blood test can measure your overall immune response, while skin prick tests can reveal how your body reacts to specific allergens such as pollen, tree nuts, or cats.1 While you’ll need to see an allergist to get tested, your Walmart Pharmacist can help you prepare—for instance, by stopping certain medications a few days in advance.17

Allergic or just sensitive?

If a food gives you “a pain in the gut,” you may have an intolerance (or sensitivity) to that food, rather than an allergy. This happens when your body can’t properly digest the food, either because you lack an enzyme or react to certain chemicals in the food.18 Lactose intolerance falls under this umbrella. Perhaps you can get away with eating a teaspoon of the food, but larger quantities bring on symptoms such as vomiting or diarrhea.18 A true food allergy, on the other hand, tends to cause skin symptoms such as hives, itchiness and swelling.18



Reducing the discomfort

Pharmacies stock a variety of over-the-counter and prescription medicines that can provide relief to seasonal allergy sufferers. Here’s the breakdown:

  1. Antihistamines block the action of histamine, making allergy symptoms more manageable.1 For an extra dose of protection, start taking antihistamines before symptoms start—and continue taking them throughout allergy season.8
  2. Decongestants help unblock stuffed noses that can result from pollen, pet or dust allergy.1
  3. Steroid sprays (applied to the inside of the nose) also clear a blocked nose.1
  4. Leukotriene antagonists (available by prescription only) block the effects of leukotrienes, substances that cause the airways to tighten during an allergic reaction.19

Your Walmart Pharmacist can help you choose the right products and advise you on how to use them properly. Patients who select products on their own, without advice from the pharmacist, tend to make poorer choices and get less relief.20 [Note: before starting any new medical treatment, always check with a healthcare provider.]

One of the best ways to minimize allergic reactions is to reduce contact with allergens. If you suffer from seasonal allergies, the tips below can help you reduce your exposure to pollen:8

  1. Place HEPA filters, which remove pollen and other allergens from the air, in the rooms where you spend the most time.
  2. Remove outdoor clothing when you enter your home and wash it before wearing it again.
  3. Use a damp towel to wipe pollen off your outdoor pets.
  4. Shut your windows, especially in the morning when pollen counts are at their highest.

Getting to the source

While the measures discussed above may relieve your allergy symptoms, they won’t make you less allergic. Immune therapy offers this possibility. You’ll need to take a series of shots or tablets, with each dose slightly larger than the previous one.8 This helps your body adapt to the allergen so your immune system no longer seeks to fight it off.8 The process can take up to five years,8 but your patience will likely pay off: immune therapy helps reduce symptoms in about 85% of people with hay fever.21

Have questions about immune therapy? Your Walmart Pharmacist can fill you in on the details. In the meantime, keep tissues at hand and stock up on strategies to keep you comfortable.



Resources

1Medical News Today—everything about allergies: https://www.medicalnewstoday.com/articles/264419.php
2WebMD—adult-onset allergies: https://www.webmd.com/allergies/features/adult-onset-allergies#2
3International Journal of Environmental Research and Public Health – prevalence of environmental allergies in Canada: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6121311/
4Weather Network—seasonal allergies: https://www.theweathernetwork.com/news/articles/canadas-10-most-common-seasonal-allergies/81059
5Healthline—pollen allergies: https://www.healthline.com/health/allergies/pollen
6WebMD—spring allergies: https://www.webmd.com/allergies/spring-allergies#1
7Healthline—seasonal allergies: https://www.healthline.com/health/allergies/seasonal-allergies
8Healthline—spring allergies: https://www.healthline.com/health/spring-allergies
9Pharmacy Times—counselling tips for allergies: https://www.pharmacytimes.com/publications/issue/2011/April2011/Top-10-Counseling-Tips-for-Allergies
10LiveScience—pet allergies: https://www.livescience.com/36578-cat-worse-dogs-allergies-pets.html
11Allergy Canada—facts on food allergies: https://foodallergycanada.ca/wp-content/uploads/FAC-Fact-sheet_April2019.pdf
12National Community Pharmacists Association—pharmacist role in managing anaphylaxis: http://www.cecity.com/ncpa/2012_projects/anaphylaxis/index.htm
13Pharmacy Times—pharmacist role in food allergies: https://www.pharmacytimes.com/contributor/karen-berger/2018/02/pharmacists-can-play-an-important-role-in-food-allergy-education
14WebMD—cold or allergies: https://www.webmd.com/allergies/sinus-nose-tool/allergies-or-cold
15Mayo Clinic—allergy and asthma: https://www.mayoclinic.org/diseases-conditions/asthma/in-depth/allergies-and-asthma/art-20047458
16ACAAI—seasonal allergies: https://acaai.org/allergies/seasonal-allergies
17ACAAI—allergy skin testing: https://acaai.org/allergies/treatment/allergy-testing/skin-test
18AAAAI—food allergy vs intolerance: https://www.aaaai.org/conditions-and-treatments/library/allergy-library/food-intolerance
19WebMD—leukotriene modifiers and allergies: https://www.webmd.com/allergies/leukotriene#1
20Pharmacypractice.org—pharmacist role in managing allergic rhinitis: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6207357/pdf/pharmpract-16-1332.pdf
21AAAAI—effectiveness of immune therapy: https://www.aaaai.org/conditions-and-treatments/library/allergy-library/immunotherapy-can-provide-lasting-relief

This health information is provided to you by Pharma Science

Pharma Science

Allergy and Asthma: How are they related?

Introduction1,2,3,4

Many Canadians suffer from allergies and asthma. Both conditions affect the respiratory system – the breathing airways and lungs. Asthma and allergy can be related, but they are not the same thing.

Incidence of allergy1,5

  • Respiratory allergies such as hay fever (allergic rhinitis) affect about 20% of Canadians.
  • About 7.5% of Canadians say they have at least one food allergy – 7.6% of adults and 6.9% of children under 18 years.

Incidence of asthma6

  • About 3.8 million Canadians have asthma and of those, about 850,000 are children under the age of 14.

Incidence of and relationship between allergies AND asthma1,2,4,6,7,8,9

There is a relationship between asthma and allergy, and there are similarities between asthma and allergy symptoms. They both affect the airways. Asthma and allergies both cause problems with breathing that begin with breathing in air through the nose (where allergy symptoms are often present) and continue along the airway to the lungs (where asthma symptoms are present).

  • More than 80% of Canadians with asthma also have allergies.
  • 75% of people with asthma have seasonal allergies.
  • Some allergens (things that cause an allergic reaction) can also trigger asthma symptoms.
  • Seasonal allergies may be a risk factor for developing asthma or making asthma worse.
  • People with serious food or other anaphylactic allergies and asthma may be prescribed emergency medications. If you’ve been prescribed emergency medicine – certain asthma medicine and/or an epinephrine auto-injector (such as EpiPen®) – to manage anaphylaxis, you should always carry it with you.
  • Skin allergy, for example eczema, may also be related to asthma.

What is an Allergy?8,10

An allergy is caused by your body mistaking a normally harmless thing (allergen) – such as pet hair or pollen – in the environment as something that is “attacking” the body and the body overreacts. This results in an allergic response. Allergens can be inhaled, swallowed, touched, or injected. Your Walmart Pharmacist can answer any questions you may have about allergies.

Type of allergies

Seasonal allergies are more common than other allergies and usually occur during certain times of the year – often spring, summer, and fall – in northern climates.10

  • Things that may cause seasonal allergies include tree, grass and weed pollen, and outdoor mold that develops in rainy, humid weather where water collects, and in piles of leaves and freshly mown grass.

With hay fever (allergic rhinitis), symptoms may include:10

  • Runny nose
  • Itchy eyes, nose, roof of mouth
  • Sneezing
  • Red, watery eyes
  • Stuffy nose and congestion
  • Headache that may happen because of congestion

Perennial allergies are present all year. These are often caused by things such as:10

  • Mold that forms in bathrooms and kitchens
  • Animal dander and hair
  • Dust and dust mites
  • Cockroaches

A food allergy may occur with any food, but some food allergies are more common than others. Health Canada considers the following foods “priority allergens”.8

  • Eggs
  • Milk
  • Peanuts
  • Seafood – including fish and shellfish
  • Mustard
  • Sesame
  • Soy
  • Sulphites – a food additive
  • Tree nuts
  • Wheat

The most dangerous allergies are anaphylactic allergies, including serious food allergies. Anaphylactic allergies cause very serious symptoms:8

  • Trouble breathing caused by airway swelling.
    • This can include a severe asthma attack for people who also have asthma (If you have been prescribed emergency medication for your asthma, always carry it with you).
  • Drop in blood pressure that causes dizziness, feeling faint or light-headed, or passing out.

These very serious symptoms may lead to death if not treated right away. It is important to always carry an epinephrine auto-injector (such as EpiPen®) with you if you suffer from anaphylaxis.

Your Walmart Pharmacist can provide information about allergies including avoiding your allergens and advice for managing your symptoms. Ask your Walmart Pharmacist about allergy medications and how to use them correctly and safely – including prescribed epinephrine auto-injectors.

What is asthma?7,11

Asthma is a chronic condition that affects the way air moves through the airway and makes breathing harder. This happens when you are exposed to an asthma trigger and either the lining of the airway becomes swollen and/or the muscles around the airway become sensitive and narrow. Remember that your Walmart Pharmacist can answer any questions you may have about asthma!

Possible symptoms

Symptoms of asthma may include:7,11

  • Shortness of breath
  • Chest tightness
  • Coughing
  • Wheezing
  • Increased mucous production

Symptoms will be different from person-to-person and will also differ in how serious they are – from mild to moderate to severe – and in how often they happen. Different episodes of asthma may also be different in how serious they are.

Types of asthma

There are two types of asthma:11

  • Allergic asthma – happens when exposed to allergens such as pollen, mold, dust mites, or pet dander.
  • Non-allergic asthma – happens when exposed to triggers like smoke, exercise, stress, or very hot and humid or very cold weather.

Is asthma an allergy?11

While asthma and allergy can be related, they are NOT the same thing. An allergy is a reaction to an allergen that causes swelling and irritation in a certain part of the body, for example the nose, eyes, lungs, or skin. An allergic reaction in the lungs produces symptoms of asthma. Allergens are common asthma triggers.

Diagnosing asthma6

Asthma is diagnosed by a doctor. A medical history will be taken. The nose, throat and upper airway will be checked. And the doctor will listen to the chest for wheezing in the lungs. The doctor will also look for signs of allergic conditions like eczema of the skin.

Spirometry is a test used to measure how well the lungs work and is used to test for asthma. Allergy testing may also be done to look for allergen triggers.

Just ask your Walmart Pharmacist for help if you think you or someone you know may have asthma.

Asthma triggers12,13,14

Asthma triggers lead to asthma attacks by causing swelling of the airways. Triggers are different from person-to-person. It is very important to avoid triggers and to keep airways from the swelling that causes asthma symptoms.

Allergic triggers cause airway swelling and include many of the allergy triggers mentioned above:12,13

  • Dust mites
  • Animals
  • Cockroaches
  • Pollens
  • Mold
  • Viral infections
  • Some kinds of air pollution

Symptom triggers are nonallergic triggers that do not cause swelling but do cause the muscles around the airway to become sensitive and narrow. These triggers include:14

  • Smoke
  • Exercise
  • Cold air
  • Chemical fumes, perfumes
  • Sulphites (food additive)
  • Some kinds of air pollution
  • Intense emotion

Managing and monitoring asthma

An important way to manage asthma is to avoid asthma triggers. Since each person’s triggers may be different, try to avoid those triggers that affect you.

Indoor/outdoor trigger management12,13,14,15,16

Here are some recommendations:

  • Remove carpeting from floors wherever possible.
  • Use a HEPA filter. These filters trap very small particles from the air (air filters) or floors and furniture (vacuum filters), including dust mite feces, pollen, animal hair/dander.
  • Keep pets off furniture and beds, and out of bedrooms.
  • Try to keep dust mites to a minimum. Wash linens in hot water.
  • Keep windows closed during hot weather, in your home and car, and use an air conditioner.
  • Be sure to eliminate mold from the kitchen and bathroom.
  • Choose personal hygiene, laundry, and cleaning products that are scent-free
  • There are a variety of asthma- and allergy-friendly products that are endorsed by Asthma Canada’s asthma & allergy friendly™ Certification Program. Visit https://asthma.ca/what-we-do/resources/certifiedproducts/ for more information.
  • If you are allergic to pollen, check pollen counts and avoid being outside for long periods of time during high pollen times.
  • Remove piles of leaves and mown grass, as well as stagnant water.
  • Avoid wood smoke and second-hand smoke.
  • Exercise indoors on very warm and very cold days.
  • On very cold days, breathe through your nose to warm air before it reaches your lungs.

Viral illness and allergic rhinitis14

Avoid catching viral illnesses, such as the cold or flu, that may worsen asthma symptoms. Wash your hands often. Get the flu shot. If you have allergies and asthma, treat your allergies to reduce symptoms that may worsen asthma symptoms. Talk to your Walmart Pharmacist about the best way to manage your cold, flu, and allergy symptoms and about getting your flu shot each year.

Food and/or other anaphylactic allergy management8,17

Anyone with asthma who also has food and/or other anaphylactic allergies must be very careful to avoid allergens that cause this reaction and may be prescribed emergency medications. If you have been prescribed emergency medicine for allergy and/ or asthma, you should always carry it with you. This medicine may include an epinephrine auto-injector (such as EpiPen®) to manage anaphylaxis and your rescue asthma medicine.

Asthma action plan18

An asthma action plan can help you and your doctor ensure you are managing your asthma effectively. By keeping track of when and why your asthma control changes, you and your doctor and pharmacist can develop ways to manage these changes for better asthma control.

The action plan from Asthma Canada will give you an idea of how to create a plan that you can share with your doctor, your pharmacist and other healthcare providers. Visit https://asthma.ca/wp-content/uploads/2018/06/AAP-FINAL.pdf for more information.

Monitoring asthma19

Your doctor may ask you to monitor your asthma using a peak flow meter. The meter measures how quickly you can breathe out all the air from your lungs, after breathing in a big breath. The measurement will show how well air is moving through your airways. Higher readings mean better asthma control; lower readings mean poorer control. Good control will be different for each person. There are both mechanical and digital peak flow meters available. Your Walmart Pharmacist can help you decide which meter may be best for you.

Medications19

People with asthma usually use two types of medicine; one to manage swelling and one to relieve symptoms like wheezing and shortness of breath, when they happen.

  • Controller medications help manage the underlying swelling to help reduce the risk of symptoms and attacks. They do not immediately relieve these symptoms and should not be used to treat a severe asthma attack. Controller medications must be used regularly. Ask your Walmart Pharmacist if you have any questions.20
  • Reliever or “rescue” medications are short-acting medications that provide fast, but temporary relief of symptoms. Carry this medication with you at all times. If you have exercise-induced asthma, you may take the medication 10 to 15 minutes before exercise. Side effects of these medications include shaky hands, fast heartbeat, and nervousness. Ask your Walmart Pharmacist if you have any questions about your reliever medication.21
  • Oral steroids that are taken by mouth are sometimes prescribed to manage very troublesome symptoms. You and your doctor can decide if these medications may be necessary for you22
  • Allergy medications may help because good management of allergies may improve asthma control.23

Always take your asthma medication(s) exactly the way your doctor and/or pharmacist told you to take it/them. Ask your Walmart Pharmacist if you are not sure which medication to use when. Remember to tell your doctor and your pharmacist about any new medications you may be using, including over-the-counter and natural health products to be sure they are safe to use with your asthma medication(s).

Your Walmart Pharmacist can provide information about managing asthma and allergies, avoiding triggers, managing symptoms, and asthma and allergy medications and how to use them correctly and safely. To learn more about allergies and asthma, please visit Asthma Canada: https://asthma.ca/.



Resources

1Asthma Canada. Allergies. https://asthma.ca/allergies. Copyright 2009-2019. Accessed March 2, 2019.
2Asthma Canada. Allergies and Asthma. https://asthma.ca/allergies/allergies-and-asthma/. Copyright 2009-2019. Accessed March 2, 2019.
3Asthma Canada. Is asthma an allergy? https://asthma.ca/get-help/asthma-3/aboutasthma/ask-asc-expert/ Copyright 2009-2019. Accessed March 7, 2019.
4American College of Asthma, Allergy & Immunology. What does asthma have to do with your allergies? Probably a lot. https://acaai.org/news/what-does-asthma-have-do-your-allergies-probably-lot. Published April 10, 2018. Accessed March 6, 2019.
5Allergy, genes and environment network. New estimates of food allergy prevalence in Canada. http://allergen-nce.ca/wp-content/uploads/SPAACE_prevalence_data.pdf. Published October 29, 2015. Accessed March 6, 2019.
6Asthma Canada. Asthma facts and statistics. https://asthma.ca/wp-content/uploads/2019/02/Asthma-101.pdf. Accessed March 6. 2019
7Asthma Canada. What is Asthma? https://asthma.ca/what-is-asthma/. Copyright 2009-2019. Accessed March 2, 2019.
8Food Allergy Canada (formerly Anaphylaxis Canada). Asthma and food allergies. https://foodallergycanada.ca/about-allergies/related-conditions/asthma/. Copyright 2019. Accessed March 2, 2019; Anaphylaxis. https://foodallergycanada.ca/about-allergies/food-allergens/ Copyright 2019. Accessed March 19, 2019.
9Canadian Dermatology Association. Common types pf eczema.https://dermatology.ca/public-patients/skin/eczema/. Copyright 2019. Accessed March 19, 2019.
10American College of Asthma, Allergy & Immunology. Allergic rhinitis. https://acaai.org/allergies/types/hay-fever-rhinitis. Copyright 2014. Accessed March 6, 2019.
11American College of Asthma, Allergy & Immunology. What is asthma? https://acaai.org/asthma/asthma-101. Copyright 2014. Accessed March 6, 2019.
12Asthma Canada. Indoor triggers – home & work. https://asthma.ca/lifestyle/indoor-triggers-home-work/. Accessed March 2, 2019.
13Asthma Canada. Outdoor triggers. https://asthma.ca/lifestyle/outdoor-triggers/. Copyright 2009-2019. Accessed March 2, 2019.
14The Lung Association. Avoid your asthma inducers. https://www.lung.ca/lung-health/lung-disease/asthma/treatment#asthma%20inducers. Updated April 26, 2016. Accessed March 2, 2019.
15Explain that stuff. HEPA filters. https://www.explainthatstuff.com/hepafilters.html. Updated 2018. Accessed March 11, 2019.
16Asthma Canada. Asthma & allergy friendly ™ certification program. https://asthma.ca/what-we-do/resources/certifiedproducts/. Copyright 2009-2019. Accessed March 2, 2019.
17Food Allergy Canada (formerly Anaphylaxis Canada). Be allergy-aware. https://foodallergycanada.ca/about-allergies/food-allergens/eggs/. Copyright 2019. Accessed March 7, 2019.
18Asthma Canada. Asthma action plan. https://asthma.ca/get-help/asthma-3/control/asthma-action-plan/. Copyright 2009-2019. Accessed March 2, 2019.
19Asthma Canada. Peak flow meters. https://asthma.ca/get-help/asthma-3/control/how-to-monitor/. Copyright 2009-2019. Accessed March 2, 2019.
20Asthma Canada. Controllers. https://asthma.ca/get-help/asthma-3/treatment/controllers/. Copyright 2009-2019. Accessed March 2, 2019.
21Asthma Canada. Relievers. https://asthma.ca/get-help/asthma-3/treatment/relievers/. Copyright 2009-2019. Accessed March 2, 2019.
22Asthma Canada. Medicines & treatment. https://asthma.ca/get-help/asthma-3/treatment/. Copyright 2009-2019. Accessed March 2, 2019; Oral corticosteroids. https://asthma.ca/get-help/asthma-3/treatment/oral/ Copyright 2009-2019. Accessed March 19, 2019.
23Asthma Canada. Will allergy medicine help my asthma? https://asthma.ca/get-help/asthma-3/aboutasthma/ask-asc-expert/. Copyright 2009-2019. Accessed March 7, 2019.

This health information is provided to you by Sun Pharma

Sun Pharma

Alzheimer's Disease
It's time to think about this disease

It’s not Alzheimer’s disease, it’s just normal forgetfulness. Everyone misplaces their keys once in a while. Sounds like a senior moment. While we often make light of our memory problems, the brain changes of Alzheimer’s disease are no joke. So how do you know if the disease may be sneaking up on a loved one—or on you?

What it is—and isn’t

Alzheimer’s disease is not a normal part of aging. First identified in 1906, it is a brain disorder that causes problems with memory and thinking. People with Alzheimer’s disease have protein deposits called plaques and fibrous clumps called tangles scattered throughout the brain.1 Over time, these plaques and tangles shrink the brain and cause brain cells to die.

Many people do not know the difference between the terms “dementia” and “Alzheimer’s disease.” Dementia is a general word that means decreased brain function, while Alzheimer’s disease is one type of dementia (the most common type).1

The older you are, the more likely you are to develop Alzheimer’s disease and other types of dementia. In Canada, more than 400,000 people over 65 (7.1% of the older adult population) live with dementia,2 and a quarter of people over 85 are affected.3 More women than men get the disease, and the gender gap increases with age.3

But age doesn’t tell the whole story: obesity, high cholesterol, and diabetes all increase the risk of Alzheimer’s disease.4 If you smoke, your risk goes up by 45%.4 (The good news: quitting brings the risk down again.) With alcohol, the risk is more complicated: drinking moderate amounts actually brings the risk down a little, but heavy drinkers face the highest risk.4 While Alzheimer’s disease doesn’t usually “run in families,”4 having a parent or sibling with the disease does put you at slightly higher risk.5 Ask your Walmart Pharmacist if you have any questions about possible risk factors.

Nobody has a perfect memory—even young, healthy people misplace their keys or forget what someone just told them—but a pattern of forgetfulness may signal a drop in brain function.6 Perhaps you (or your loved one) misplace things more often, or stumble over words that used to come easily. Perhaps other people have begun noticing such changes.

Below is a table that discusses some of the differences between normal aging and Alzheimer’s disease.

Normal Aging vs. Alzheimer’s Disease7
Normal age-related changes Possible signs of Alzheimer’s disease

Sometimes forgetting names or appointments, but remembering them later

A pattern of forgetting names, dates, and recently learned information

Occasionally needing help to use a familiar appliance

Difficulty completing daily tasks such as driving to work or using a familiar electronic appliance

Mistaking the day of the week but figuring it out later

Losing track of dates, seasons, and the passage of time

Sometimes having trouble finding the right word

Trouble remembering words and following conversations

Vision changes related to cataracts

Trouble understanding visual and spatial information (reading, how far things are)

The symptoms of Alzheimer’s disease generally get worse over time, though each person progresses at a different pace. In the early stage of the disease, people can still work, drive, and live independently.8 In the moderate stage, which can last for years, people may have more trouble performing daily tasks, but still remember important details about their lives.8 In the final stage, people lose the ability to carry out daily activities, to communicate, to recognize family or friends, and eventually to control movement.7 Their personalities may also change.

Detecting it early

If you’re concerned that you or a loved one may be developing Alzheimer’s disease, don’t wait: the earlier you detect it, the better you can treat it. Start by talking to your Walmart Pharmacist, who can help you find specialists and clinics that diagnose the condition. Some pharmacists may even be able to conduct quick screening tests and recommend a visit with a doctor if they suspect a problem.9

To diagnose Alzheimer’s disease, doctors evaluate memory, thinking, and ability to function. During the appointment, the doctor will likely:10

  • Run simple memory and thinking tests
  • Ask questions to find out how the brain changes are affecting daily life
  • Look for changes in personality or behaviour

The doctor may also order lab tests to find out if other medical conditions could be causing the symptoms.10

Treatments to improve or delay symptoms

Health Canada has approved several medications for Alzheimer’s disease. Most of them improve the ability of brain cells to “talk to each other” and can make a noticeable difference in quality of life, sometimes for years.11 While none of these medications stop the disease from progressing, this may soon change. Researchers are now studying treatments that reduce the amount of plaque formed in the brain, direct the immune system to attack plaques, and prevent the formation of tangles.12

Before getting approved, a new medication needs to prove its value in clinical trials—studies that examine how a treatment works on a group of people. Participating in a clinical trial gives you the opportunity to try brand-new treatments and to contribute to medical research.13 Your Walmart Pharmacist can help you understand what a clinical trial involves and may know about clinical trials going on in your part of the country.

Overall, research doesn’t support the use of “alternative” health products to treat Alzheimer’s disease, though a few studies have found that coconut oil and omega-3 fatty acids can give brain power a boost.14 And what about cannabis? For the time being, it’s not recommended for Alzheimer’s disease because of limited evidence that it can improve symptoms.15 If anything, research suggests a link between long-term cannabis use and memory problems.15

Finally, don’t discount good old-fashioned physical activity. Not only does exercise preserve mental function in healthy people, but regular exercise can improve memory and thinking skills in people with early Alzheimer’s disease.16 Aim for 30 to 60 minutes, several times a week. Finally, there’s the direct approach: exercising the brain. Games, puzzles, or challenging yourself with a new language or musical instrument can help slow down memory loss and other mental problems.17

A pillar of support

As you begin the journey toward treatment, look to your Walmart Pharmacist for guidance and support. Alzheimer’s disease researchers are making new discoveries every day, and the pharmacist may know about new treatments that could help you or your loved one.

Once treatment has begun, your Walmart Pharmacist can monitor the side effects of medications and make sure you aren’t taking any drugs that interfere with each other.17 Staying in regular touch with your Walmart Pharmacist during treatment will help ensure that problems are caught early.

As further support, your Walmart Pharmacist may suggest ways to make Alzheimer’s disease more manageable, such as written schedules and other memory aids.18 Finally, the pharmacist can steer you toward resources in your community, including support for caregivers.

Coping strategies

Below are some strategies that can help people with Alzheimer’s disease and their caregivers cope with the condition.

For people with Alzheimer’s disease19 For caregivers20

Develop a daily routine

Modify the home environment to limit exposure to potential dangers

Approach one task at a time

Write down the steps for challenging tasks

Make a list of tasks that have become more challenging

Recognize that the person you are caring for may misinterpret your words or actions

Simplify the tasks when possible (such as easier recipes for meals)

Encourage the person to talk about familiar people and events

Identify people who can help you (for instance, to pay bills)

Enjoy the good times

Talking about it

Alzheimer’s disease is nobody’s fault—and is nothing to hide. A conversation with your Walmart Pharmacist can get you started on solutions. And keep talking to your family, friends, doctor, and pharmacist as the disease progresses. As key members of your support team, these team members can help lighten your load.



Resources

1Alzheimer’s definition: https://alzheimer.ca/en/Home/About-dementia/Alzheimers-disease?gclid=EAIaIQobChMI-KmfwqTJ4wIVjI3ICh2_QAULEAAYASAAEgIVb_D_BwE
2Alzheimer’s stats: https://www.canada.ca/en/public-health/services/publications/diseases-conditions/dementia-highlights-canadian-chronic-disease-surveillance.html
3Alzheimer’s stats: https://www.cihi.ca/en/dementia-in-canada/dementia-in-canada-summary
4Risk factors: https://alzheimer.ca/en/Home/About-dementia/Alzheimer-s-disease/Risk-factors
5Familial risk: https://www.healthline.com/health/alzheimers-hereditary#genetic-mutations
6Symptoms: https://www.torontomemoryprogram.com/symptoms-of-dementia/
7Alzheimer’s vs normal aging: https://www.alz.org/alzheimers-dementia/10_signs
8Stages of disease: https://www.alz.org/alzheimers-dementia/stages
9Pharmacist screening tests: https://www.pharmacists.ca/news-events/news/pharmacists-doing-more-to-support-patients-with-dementia-their-families-and-caregivers/
10Diagnosis: https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/alzheimers/art-20048075
11Treatments: https://alzheimer.ca/en/Home/About-dementia/Treatment-options/Drugs-approved-for-Alzheimers-disease?gclid=EAIaIQobChMI8bj13K_J4wIVBZ-fCh1RJwW9EAAYBCAAEgLSoPD_BwE
12Emerging treatments: https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/alzheimers-treatments/art-20047780
13Clinical trials: https://www.torontomemoryprogram.com/dementia-research-program/
14Alternative therapies: https://www.healthline.com/health/alzheimers-disease/alternative-treatments#the-takeaway
15Cannabis and dementia treatment: https://alzheimer.ca/en/Home/About-dementia/Treatment-options/cannabis-and-treatment-dementia
16Physical exercise: https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/expert-answers/alzheimers-disease/faq-20057881
17Brain exercises: https://www.webmd.com/alzheimers/guide/preventing-dementia-brain-exercises#1
18Pharmacist’s role: https://www.pharmacytimes.com/publications/issue/2007/2007-01/2007-01-6235
19Patient coping strategies: https://www.alz.org/help-support/i-have-alz/live-well/tips-for-daily-life
20Caregiver coping strategies: https://www.ucsfhealth.org/education/coping_strategies_for_alzheimers_disease_caregivers/

This health information is provided to you by Apotex

Sandoz

Over 75% of Canadians have been touched by cancer, whether it is through their own personal diagnosis or that of a close loved one.1 With the latest research suggesting almost 1 in 2 Canadians will be diagnosed with cancer during their life, those numbers will increase.2 Although cancer mainly affects Canadians over the age of 50, it can occur at any age so it’s important for everyone to understand what they can do to reduce their risk and know the common signs and symptoms.3


Tips to Reduce Cancer Risk

Lifestyle choices can impact your chance of developing cancer. Follow these tips to reduce your overall risk:


  • Be smoke-free – Smoking is the most preventable cause of cancer and it accounts for about 1/3 of all cancer deaths.4 Smoking, chewing tobacco and second-hand smoke have been linked to a variety of cancers such as lung, mouth, throat, kidney, bladder, pancreas etc.5 If you’re a smoker and thinking of quitting, talk to your Walmart Pharmacist about how they can help. If you’re not a smoker, make sure to limit your exposure to second-hand smoke as much as possible.
  • Maintain a healthy lifestyle – Approximately 1/3 of the most common cancers can be prevented with lifestyle changes that includes a healthy diet, maintaining a healthy weight and being more active.6
    • Healthy diet – Follow Canada’s Food Guide and have a diet that is high in a variety of fruits and vegetables, limits red meat and processed meats (i.e. bacon, hot dogs and deli meats), contains whole grains and limits sugary drinks such as soft drinks, sports drinks and fruit-flavoured drinks.7
    • Achieve and maintain a healthy weight – Ask your Walmart Pharmacist how to calculate your body mass index (BMI) which will give you a healthy weight range specific to your height and weight. BMI for healthy adults between the ages of 20 to 65 should be between 18.5 to 24.9.7
    • Be physically active – Guidelines recommend 150 minutes of moderate to vigorous physical activity per week in bouts of 10 minutes or more. Moderate intensity means activities like biking or brisk walking that cause you to sweat a little and breathe harder. Vigorous intensity means activities like jogging or cross-country skiing that cause you to sweat and be out of breath.8
    • Get immunized – Talk to your doctor and/or Walmart Pharmacist about whether the hepatitis B vaccine or human papillomavirus (HPV) vaccine is right for you. The hepatitis B virus is associated with some liver cancers and HPV can lead to cervical and other genital cancers.5
    • Protect yourself from the sun – Skin cancer is one of the more common cancers and can be prevented by avoiding the sun when it’s the strongest (between 10-4pm), staying in the shade as much as possible or covering exposed areas, using lots of sun screen and avoiding tanning beds.5
    • Regular screenings and being aware of the common signs and symptoms – Awareness can increase your chances of discovering potential cancers earlier, which is when treatments are the most successful.5

Cancer Signs & Symptoms

The signs and symptoms (below) on their own are not enough to diagnose cancer but can help your doctor determine what’s wrong.9 Some of these symptoms can be caused by other medical issues, but still should be checked out by your doctor.

  • Pain – Some cancers cause pain from the start but it can also be a late sign of cancer. With some brain tumours, there can be headaches that last for days and don’t get any better with treatment. If you have pain that can’t be explained or doesn’t go away, it’s always good to check with your doctor and/or Walmart Pharmacist.9
  • Unplanned weight loss – Almost 50% of people with cancer will have had lost weight without trying by the time they are diagnosed. It is one of the more common and earlier cancer symptoms.9
  • Fatigue – Tell your doctor and/or Walmart Pharmacist if you are constantly tired and rest doesn’t help. Leukemia can leave you exhausted as can blood loss from colon or stomach cancers. It may also be due to cancer-related weight loss.9
  • Fever – If it’s high or lasts for more than 3 days, check with your doctor and/or Walmart Pharmacist as some blood cancers can cause a fever that lasts for days or even weeks.9
  • Skin Changes – If you find any new or unusual moles, bumps or marks on your body, have them checked in case of skin cancer. If your skin darkens, looks red or yellow, itches, grows more hair or has an unexplained rash then have it checked as it could be a sign of liver, kidney or ovarian cancer.9
  • Sores that don’t heal – Spots on your skin that bleed and aren’t going away can be another sign of skin cancer. Oral cancers sometimes start as mouth sores.9
  • For Men – The more common cancers in men are prostate, colorectal and lung.9 Signs of these cancers can be:
    • Pain, change in size or shape, lump or redness in the penis or testicles.9
    • Coughing or hoarseness that lasts more than 3 weeks, is severe or produces blood when you cough.9
    • Diarrhea or constipation for more than 4 weeks can be a sign of colorectal cancer. Talk to your doctor if there is blood in your bowel movements.9
    • Trouble peeing, burning or pain when peeing and going a lot more than usual especially at night can be caused by an enlarged prostate. See the doctor if you have painful ejaculations or blood in your pee or semen.10 Prostate cancer is the most common cancer to affect men in Canada. 1 in 7 men will be diagnosed in their lifetime. It can be slow growing and some men will go years without having it detected, which is why regular screening and letting your doctor know if you have any of the signs or symptoms is very important.11
  • For Women – The more common cancers in women are breast, lung and colorectal. Women can also get cancer in the uterus, endometrium, cervix, vagina or vulva.9 Signs of these cancers can be:
    • Bleeding or discharge in between periods or after menopause. Endometrial cancer can cause bleeding when you shouldn’t be.9
    • Changes in appetite that lasts 2 weeks or longer. Ovarian cancer can make you feel full or make it hard to eat.9
    • Gas, indigestion and pressure can all be signs of ovarian cancer as can bloating and cramps not linked to PMS. Pain and pressure in the pelvic area could be a sign of endometrial cancer.9
    • Breast changes that include breasts feeling different, finding lumps, size changes, discharge from nipples and spots or changes in the skin around nipples.9 It’s important to know your breast tissue by looking and feeling the entire breast area up to collar bone and under the armpits as well as nipple so you can detect any changes. There’s no right or wrong way to do this and any changes should be discussed with your doctor. Screening for breast cancer with mammograms is recommended for women between 50-69 years of age. Talk to your doctor and/or Walmart Pharmacist about the guidelines in your province. 12

For more information on the different types of cancer and resources to help you or a loved one with a cancer diagnosis, visit the Canadian Cancer Society website at www.cancer.ca.



Resources

1http://www.cancer.ca/en/about-us/for-media/media-releases/national/2015/daffodil-month-survey-shows-need-for-increased-awareness/?region=onAccessed: March 5, 2018
2http://www.cancer.ca/en/about-us/for-media/media-releases/national/2017/canadian-cancer-statistics/?region=bc Accessed: March 5, 2018
3http://www.cancer.ca/en/cancer-information/cancer-101/cancer-statistics-at-a-glance/?region=on Accessed: March 5, 2018
4http://www.lungcancercanada.ca/lung-cancer.aspx Accessed: March 5, 2018
5https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/cancer-prevention/art-20044816 Accessed: March 5, 2018
6https://www.wcrf.org/int/cancer-facts-figures/link-between-lifestyle-and-cancer-risk Accessed: March 5, 2018
7https://www.cancer.org/cancer/cancer-causes/diet-physical-activity/diet-and-physical-activity Accessed: March 5, 2018
8http://www.csep.ca/CMFiles/Guidelines/CSEP_PAGuidelines_adults_en. Accessed: March 5, 2018
9https://www.webmd.com/cancer/understanding-cancer-symptoms#1 Accessed: March 6, 2018
10http://www.prostatecancer.ca/Prostate-Cancer/About-Prostate-Cancer/Signs-and-Symptoms Accessed: March 6, 2018
11https://www.prostatecancer.ca/Prostate-Cancer/About-Prostate-Cancer/Prostate-Cancer Accessed: March 6, 2018
12http://www.cancer.ca/en/cancer-information/cancer-type/breast/screening/?region=on Accessed: March 6, 2018

This health information is provided to you by Apotex

Sandoz

NOTHING TO SNEEZE AT
The flu is common, but not harmless. Your Walmart Pharmacist can help you avoid the flu this season—or get through it more comfortably

Fever. Chills. Aching joints. Monster cough. Everyone agrees that influenza (“the flu”) is one big nuisance. But the illness does more than annoy: for some people, the flu can lead to serious and even life-threatening complications. Fortunately, you can take steps to avoid it this season.

Who, when, what, and why

A contagious upper airway disease caused by Influenza viruses, the flu affects between five and 20 percent of the general population every year.1 Although it is possible to get aflu in the summer (especially if you have been travelling),2 you have a far greater chance of catching it during “flu season”—from late fall to early spring.3

The flu spreads from person to person through droplets that are coughed or sneezed out by affected individuals.4 You can catch the flu if you inhale or touch a droplet—which can live on hard surfaces for up to 48 hours5—and then touch your eyes, nose or mouth before washing your hands.4 The illness is thought to be most contagious during the first three to fourdays, when people tend to cough and sneeze the most, but patients can remain contagious for up to a week.5

Young or old, healthy or sick—the illnessdoesn’t spare any group of people. Not surprisingly, your risk goes up if you have been in recent contact with an affected family member.6Having a child under 18 living in your house also bumps up your own risk.6

Flu symptoms may include fever, chills, cough, sore throat, runny eyes and stuffy nose, headache and muscle aches, extreme weakness and fatigue, and loss of appetite.7The flu may also lead to diarrhea or vomiting, though this happens more often in children than in adults.7

Is it a cold or the flu?8

Here’s a tell-tale difference: cold symptoms tend to sneak up on you over several hours or days, while the flu often comes on abruptly: one minute you feel well, and the next minute you want nothing more than to dive into bed. More clues:

Symtom Cold Flu
Fever Rare Usual
Aches Slight (mild) Usual
Chills Uncommon Fairly common
Weakness & fatigue Sometimes Usual
Sneezing & stuffy nose Common Sometimes
Sore throat Common Sometimes
Chest discomfort, cough Mild to moderate Common
Headache Rare Common


It gets complicated

While most healthy people recover from the flu without any problems, typically within seven to 10 days,7 certain groups have higher odds of developing flu complications. These include:9,10

  • Babies under sixmonths old (too young to get the flu shot)
  • Children under five years old, who have small airways that can get blocked easily
  • People aged 65 years and older, who tend to have weaker immune systems
  • People aged 65 years and older, who tend to have weaker immune systems
  • People with asthma, heart disease, diabetes, or any illness that weakens the immune system

Common flu complications include ear and sinus infections, dehydration, and pneumonia.9 In vulnerable people, the flu may also lead to muscle inflammation, heart problems, and problems with your central nervous system.10 All told, the flu leads to over 12,200 hospitalizations and 3,500 deaths in Canada every year.11 Such figures leave no doubt: the disease needs to be taken seriously.

Outsmarting the flu virus

If you want to avoid the flu this season (and who doesn’t?), start with the most powerful weapon against the illness: vaccination.12 Recommended by Health Canada for everyone aged six months or older,12 the vaccine lowers your seasonal risk of getting the flu by up to 60 percent—and also protects the people around you.13 Even if you do end up catching a flu, your symptoms will likely be milder.13 And don’t forget to vaccinate your children: a 2017 study showed that the flu shot can significantly reduce a child’s risk of dying from the flu.13

Best of all, you don’t need a doctor’s appointment to get the vaccine: in most parts of the country, trained pharmacists offer it free of charge to walk-in clients14 and can also give advice about immunization. Along with standard injections, a spray form of the vaccine is now available in Canada—a welcome piece of news for people who dislike needles.15 Your Walmart Pharmacist can tell you more about this option.

Remember: last year’s shot won’t protect you against this year’s flu. Flu viruses come in several varieties and keep changing over time, so every year experts develop a new vaccine to deal with the upcoming season’s new “crop.” Unsure about the vaccine’s safety for you or your child? Talk to your doctor and your Walmart Pharmacist.

Shots on the rise16

If you decide to get vaccinated, you will join the increasing number of Canadians who take this annual step. Between the 2015-16 and 2017-18 seasons, the rates of flu vaccination have risen slowly and steadily in all groups of adults, including healthy people between 18 and 64 years, seniors (age 65+), and people with chronic conditions. In total, 38% of Canadian adults got vaccinated in 2017-18; about a third of them in pharmacies.

Along with the vaccine, you can reduce your risk of catching or spreading the flu with these simple behaviours17,18:

  • Wash your hands regularly, especially before or after touching your eyes, nose or mouth. This prevents the virus from spreading when you touch your face or objects such as desks and doorknobs.
  • Clean and disinfect objects and surfaces touched by a lot of people. Soap and water will remove the virus, though you can also use a bleach-and-water solution approved for killing germs.
  • Cough and sneeze into your shirt sleeve, to prevent the virus from spreading through the air or your hands.
  • Dispose of used tissues right away so other people don’t touch them.
  • Avoid close contact with other people who have the flu. If possible, stay at least three feet away.
  • Stay home when you have the flu (especially the first three to four days) to avoid spreading germs to other people. If you have a fever, stay home at least 24 hours after the fever goes down, as resting will help you recover faster.

Flu symptom S.O.S.

If you end up getting the flu, a range of over-the-counter pharmacy products can help make the experience less miserable. Pain relief medications can help reduce fever and headache, cough suppressants can help make you cough less, and decongestants can help clear up congested sinuses and ear tubes.19 These products come in a variety of brands, formats, and doses. If you find yourself confused or overwhelmed by all the choices, your Walmart Pharmacist can point you in the right direction.

You also have the option of taking prescription antiviral medications. By slowing down the replication of the flu virus in your body, these medications allow your immune system to fight the virus more effectively.20 Beginning antiviral treatment within 48 hours of the start of flu symptoms will give you the greatest relief—and may also help shorten the duration of the illness.20 Your Walmart Pharmacist can advise you on whether these medications are right for you.

Finally, don’t ignore the old-fashioned counsel to “rest and drink a lot of fluids,” as sleep helps your immune system fight infection and fluids prevent dehydration.21

A word about antibiotics22,23

Antibiotics kill bacteria, not viruses, so they won’t do anything for the flu. And why risk experiencing such antibiotic side effects as nausea, diarrhea, bloating, and stomach pain if the medication doesn’t make you feel better? Something else to consider: unneeded antibiotics increase your risk of getting a future infection that may not respond to antibiotic treatment.

Become flu-ent this year

Make this the year you develop a flu shot habit. If you have any doubts about how the vaccine works or how safe it is, your Walmart Pharmacist can address your concerns. Here’s to a cough- and sneeze-free flu season!



Resources

1.Flu prevalence statistics: https://www.healthline.com/health/influenza/facts-and-statistics#5
2.Summer flu: https://www.verywellhealth.com/can-you-get-the-flu-in-the-summer-770307
3.Flu season: https://www.verywellhealth.com/flu-season-from-start-to-peak-and-end-2633835
4.How the flu spreads: https://immunizebc.ca/influenza
5.Flu contagion facts: https://www.webmd.com/cold-and-flu/how-long-flu-contagious
6.Children living in the home as risk factor: https://wwwnc.cdc.gov/eid/article/19/4/pdfs/11-1812.pdf
7.Flu symptoms and course: https://www.ontario.ca/page/flu-facts#section-4
8.Cold vs. flu chart: https://www.cdc.gov/flu/symptoms/coldflu.htm
9.Risk factors for flu complications: https://www.ontario.ca/page/flu-facts#section-3
10.Flu complications: https://www.webmd.com/cold-and-flu/flu-complications#1
11.Hospitalization & mortality stats: https://www.canada.ca/en/public-health/services/diseases/flu-influenza/health-professionals.html
12.Flu vaccine: https://www.canada.ca/en/public-health/services/diseases/flu-influenza/prevention-risks.html
13. Flu shot benefits: https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm
14.Pharmacy role in flu vaccination: https://www.pharmacists.ca/education-practice-resources/patient-care/influenza-resources/pharmacists-role-in-flu-vaccination/
15. Spray form of the vaccine: https://www.healthlinkbc.ca/medications/ue5492
16. Flu vaccination rates in Canada: https://www.canada.ca/en/public-health/services/publications/healthy-living/2017-2018-seasonal-influenza-flu-vaccine-coverage-survey-results.html
17. Non-drug flu prevention strategies 1: https://www.healthlinkbc.ca/healthlinkbc-files/facts-about-influenza
18. Non-drug flu prevention strategies 2: https://www.cdc.gov/nonpharmaceutical-interventions/home/index.html
19. OTC flu treatments: https://www.pharmacytimes.com/publications/issue/2017/november2017/safe-and-proper-use-of-nonprescription-products-for-cold-and-flu-season
20. Antivirals flu medication: https://www.healthline.com/health/flu-treatments#antiviral-drugs
21. Lifestyle measures to manage the flu: https://www.mayoclinic.org/diseases-conditions/flu/diagnosis-treatment/drc-20351725
22. Flu and antibiotics: https://www.webmd.com/cold-and-flu/flu-treatment-antibiotics-or-not#1
23. Antibiotic side effects: https://www.medicalnewstoday.com/articles/322850.php

This health information is provided to you by Apotex

Apotex

The flu season runs from late fall to early spring and causes about 12,200 hospitalizations and 3,500 deaths in Canada each year.1 Although a cold is a milder respiratory infection, it can still leave you feeling sick for a few days and can occur year round.2,3

Use this chart to help determine whether you have the cold or flu.2

Symtoms Cold Flu
Fever Sometimes, usually mild Common, usually for 3-4 days and is usually higher (100-102°F or 37.8-38.9°C)
Headache Rarely Common
Aches and pains Slight Common, can be severe
Fatigue Sometimes Common, can last 2 to 3 weeks
Sneezing Common Sometimes
Stuffy Nose Common Sometimes
Sore Throat Common Common
Cough Mild to moderate; hacking cough Common, can be severe


Regardless of whether you are suffering from the cold or flu, the key to staying healthy is prevention. Follow these tips to keep yourself protected and to prevent spreading viruses to others:

  • Get vaccinated. Getting your annual flu shot is one of the best ways to prevent the flu. In fact, the flu shot has been shown to reduce the number of doctor visits, hospitalizations and deaths related to the flu.1Recent studies also show the vaccine reduces the risk of flu illness by about 40% to 60% among the overall population during seasons when the flu vaccine is well matched to circulating flu viruses.4The National Advisory Committee on Immunization (NACI) recommends that all Canadians 6 months of age and older should get the flu shot unless there is a reason they can’t receive the vaccine.5And because the virus changes frequently, important to get your flu shot each fall.1-Check with your Walmart Pharmacist to see if you a good candidate for the flu shot and then book an appointment to get your flu shot at the pharmacy.
  • Wash your hands. Did you know viruses can live on your hands for up to 3 hours? Properly washing your hands often and thoroughly (for at least 15 seconds with soap and water) helps prevent the spread of illness.1
  • Use alcohol based hand sanitizer. When soap and water are not available, hand sanitizer with at least 60% alcohol is a good alternative.1
  • Avoid touching your face or rubbing your eyes. Viruses enter the body when we touch infected surfaces and then touch our eyes, nose and/or mouth.1
  • Cover your cough or sneeze. Use a tissue and throw it out right away rather than keeping it in your pocket, on a desk or table. Cough into your upper sleeve, and not your hands, when you don’t have tissues available.1
  • Stay at home when you are sick. Viruses spread more easily when you are around other people. It’s better to stay home from work, school, nursing homes etc. to prevent getting other people sick.1
  • Clean and disinfect surfaces.Viruses can live on hard surfaces like countertops, door handles, computer keyboards and phones for up to 8 hours. This makes it important to regularly clean and disinfect these areas.1
  • Stick to a healthy lifestyle. Even with exposure to the cold or flu virus, it doesn’t mean you have to get sick. Keep your immune system working at its best with a balanced diet, regular exercise (at least 4 times a week) and enough sleep (7 to 9 hours/night).6
  • Quit Smoking.Smokers are more likely to get flus and colds and when they do get sick, the symptoms are worse and last longer.6,7 If you are a smoker and thinking of quitting, talk to your Walmart Pharmacist about how they can help.

If you do end up getting sick, always talk to your Walmart Pharmacist before taking any over-the-counter medications. They can advise you on what is the best product for your symptoms, ensure it does not interact with any other medications you may be taking or cause any issues with any medical conditions you may have. Children less than 6 years of age should not be given any over-the-counter cough and cold medicines8If they have a fever and/or aches and pains, you can give acetaminophen or ibuprofen (as long as they are over 6 months old).8 Do not give acetylsalicylic acid (e.g. Aspirin) or any medicine containing it to children or teenagers.8Ask you Walmart Pharmacist for help!

Use the following measures to help yourself or your child be more comfortable while sick:

  • Drink plenty of fluids and small nutritious meals.8
  • Use saline drops or sprays to help thin out thick mucus, making it easier to clear. For babies and toddlers, a suction bulb can be used to clear mucus from nose.8
  • Use a cold mist humidifier (as long as it is cleaned regularly to prevent bacteria or mold growth).8
  • Get plenty of rest.1

You should see your doctor if your symptoms get worse or you don’t start to feel a better in a few days.1



Resources

1https://www.ontario.ca/page/flu-factsAccessed July 10, 2018.
2 https://www.webmd.com/cold-and-flu/flu-cold-symptoms#1Accessed July 10, 2018.
3 http://www.cfp.ca/content/57/11/1289Accessed July 10, 2018.
4http://www.cdc.gov/flu/about/qa/vaccineeffect.htm Accessed July 11, 2018.
5https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-statement-seasonal-influenza-vaccine-2017-2018.html#rec Accessed July 27, 2018.
6https://www.webmd.com/cold-and-flu/cold_flu_stopping_germs_work#1 Accessed July 11, 2018.
7https://www.webmd.com/cold-and-flu/what-makes-colds-worse Accessed July 11, 2018.
8https://www.caringforkids.cps.ca/handouts/colds_in_children Accessed July 27, 2018.

This health information is provided to you by Auropharma

Auropharma

What is type 2 diabetes?

Type 2 diabetes is a condition in which your body does not effectively use the insulin it produces or does not produce enough insulin. Insulin is used by your body to turn the sugar (glucose) in your blood into energy. Type 2 diabetes occurs when this system doesn’t work properly and sugar levels in your blood are too high.1,2Sugar in your blood comes from consuming foods that contain carbohydrates such as breads, rice, pasta, fruit, and milk.

Screening for type 2 diabetes

Generally, if you are over 40 years old, you should be tested for diabetes every three years. If you have one or more risk factors, you should be tested more often and/or start regular screening earlier.3,4

Some common risk factors for type 2 diabetes:4

  • Having a parent, brother, or sister with diabetes
  • Being a member of a high-risk group (e.g., African, Arab, Asian, Hispanic, Indigenous, or South Asian descent)
  • Having health complications that are associated with diabetes
  • Having given birth to a baby that weighed more than four kilograms (nine pounds) at birth or having had gestational diabetes (diabetes during pregnancy)
  • Having been diagnosed with prediabetes
  • Having high blood pressure
  • Having high cholesterol
  • Being overweight, especially if that weight is mostly carried around the stomach

Diagnosing type 2 diabetes

Your doctor will take a medical history and do a physical examination (to screen for risk factors). You will need to take a blood test or tests to measure the sugar in your blood.

Two blood tests are typically used to diagnose type 2 diabetes:

  1.   Fasting blood glucose: You cannot eat for at least eight hours before taking this blood test. A result of 7.0 mmol/L or higher suggests you have diabetes.5
  2.   A1C: You do not need to fast for this test; it may be done at any time. If your result is 6.5% or higher and if there are no factors that might affect the accuracy of the test, this result suggests you have diabetes.5

Prediabetes6

Prediabetes is diagnosed if your blood sugar level is higher than normal – an A1C of 6.0% to 6.4% – but not high enough to be diagnosed with type 2 diabetes. Your Walmart Pharmacist can answer questions you may have about prediabetes and help you develop a healthy lifestyle management plan to reduce your risk of developing type 2 diabetes.

Managing type 2 diabetes

If you have been diagnosed with type 2 diabetes, you and your healthcare team will develop an individualized management plan that meets your needs and wants. The plan may include healthy lifestyle recommendations (including healthy eating, physical activity, and weight management), medication, and blood sugar monitoring.7,8

Healthy eating9,10,11,12

Following a healthy diet is important for everyone and will help you to better manage your blood sugar levels if you have type 2 diabetes. Your Walmart Pharmacist may be helpful in providing information about healthy eating and making good food choices, including eating a variety of foods – vegetables, fruit, low-fat dairy products, whole grains, and meats and alternatives. Following Eating Well with Canada’s Food Guide is a good place to start. It may be found at:https://www.canada.ca/en/health-canada/services/canada-food-guides.html
  • Carbohydrate counting11 is an important way to help you prepare healthy meals and snacks. Grains, starches, fruit, milk and milk products, legumes, sugary and prepared foods, and some vegetables contain carbohydrates. You will need to manage the amounts of these foods that you consume at each meal or snack. Meat and alternatives and fats contain small amounts of carbohydrate. You and your healthcare team can determine how many grams of carbohydrate you may consume at each meal/snack. Try to stay close to that amount to help keep your blood sugar level in your target range.
  • Food labels (see below)13may help you make sure you are within the range for carbohydrates for each of your meals and snacks. Pay attention to both serving size and the amount of carbohydrate on the label.
  • “Plate Method” is another way to help you manage your meal planning and food choices. Generally, you should fill half of your plate with vegetables, a quarter of your plate with grains and starches, and a quarter of your plate with meat and alternatives.13 The image below shows how it works.14
  • For more information about meal planning and food choices, visit: https://www.diabetes.ca/diabetes-and-you/healthy-living-resources/diet-nutrition/basic-meal-planning

Physical activity15

A healthy lifestyle is the first step in managing type 2 diabetes. Participating in regular physical activity is as important as following a nutrition plan. Check with your doctor before starting any physical activity routine, especially if you haven’t been physically active for a while. Start slowly – 10 minutes of walking each day – with the goal of increasing your time being active to 150 minutes each week. Even raking leaves and gardening can be included. Gradually build up the intensity of your activity. Your Walmart Pharmacist can help you with a personalized exercise plan.

Weight management6

Achieving and maintaining a healthy weight is an important part of your management plan. If you are overweight, you should aim to lose between 5% and 10% of your weight.16 Your nutrition and physical activity plans will help you achieve this goal. Your Walmart Pharmacist can help you with tips on how to safely lose and keep off extra weight.

Medication6

Depending on your blood sugar level, healthy living routines, and other health-related factors, your doctor may recommend that you take medication to help you better manage your blood sugar level. Your Walmart Pharmacist can answer any questions you have about your medication, including how to take it, avoiding and managing side effects, and possible drug interactions.

Monitoring your blood sugar

Self-monitoring blood sugar16

If you have type 2 diabetes and you are meeting your individualized blood sugar targets with a healthy lifestyle regimen (healthy eating, physical activity, weight management) or healthy lifestyle and oral medication, you may be asked to check your blood sugar one to two times per week. Your Walmart Pharmacist can help you get started by recommending a blood glucose meter and helping you feel comfortable self-testing.

A1C

A1C is usually measured every three months in people with type 2 diabetes. Recommended target levels appear in the table below.8
A1C Fasting blood sugar/blood sugar before eating (mmol/L) Blood sugar 2 hours after eating (mmol/L)
Target for most people with diabetes* 7.0% or less 4.0 to 7.0 5.0 to 10.0
5.0 to 8.0 if A1C targets are not being met

Managing diabetes-related health and wellness concerns

Self-management goals6

In addition to your nutrition, physical activity, and weight-management goals, there are other important ways you may help manage your health and wellness with diabetes.
  • Foot care, eye care, and dental care:It should be a regular part of your health maintenance routine. Check your feet often (e.g., for blisters, sores, redness, calluses) and have foot-care issues dealt with by a professional. See your eye specialist for checkups, see your dentist regularly, and practice good oral hygiene.
  • Smoking cessation:If you smoke tobacco, your pharmacist can help you quit. Talk to your Walmart Pharmacist about strategies to quit smoking.
  • Emotional wellness:It is important to try to manage your stress. Your Walmart Pharmacist can recommend ways to achieve this goal.

Heart health17,18

People with type 2 diabetes may also have heart health issues. Diabetes is a significant risk factor for heart disease; in fact, 65% to 80% of people with diabetes die from heart disease. Help reduce your risk for heart disease by following your diabetes management regimen. Your Walmart Pharmacist can answer questions you may have about heart health and type 2 diabetes, and how to best manage both for better health and wellness.



References

1Diabetes Canada. Diabetes and you: Living with type 2 diabetes.https://www.diabetes.ca/diabetes-and-you/living-with-type-2-diabetesPublished March 2018. Accessed September 15, 2018.
2 Government of Canada. Type 2 diabetes. https://www.canada.ca/en/public-health/services/diseases/type-2-diabetes.htmlUpdated July 5, 2018. Accessed September 15, 2018.
3Ekoe JM, Goldenberg R, Katz P. Clinical practice guidelines: screening for diabetes in adults. Can J Diabetes. 2018;42(Suppl 1):S88-S103.
4Diabetes Canada. Are you at risk? https://www.diabetes.ca/about-diabetes/risk-factors/are-you-at-riskPublished March 2018. Accessed September 15, 2018.
5Diabetes Canada. Signs and symptoms.https://www.diabetes.ca/about-diabetes/signs-and-symptomsPublished March 2018. Accessed September 15, 2018.
6Diabetes Canada. Diabetes Canada 2018 clinical practice guidelines: quick reference guide. http://guidelines.diabetes.ca/docs/CPG-quick-reference-guide-web-EN.pdfPublished March 2018. Accessed September 17, 2018.
7Diabetes Canada. Staying healthy with diabetes. https://www.diabetes.ca/diabetes-and-you/healthy-living-resources/general-tips/staying-healthy-with-diabetesPublished March 2018. Accessed September 15, 2018.
8Diabetes Canada. Managing your blood sugar. https://www.diabetes.ca/diabetes-and-you/healthy-living-resources/blood-glucose-insulin/managing-your-blood-sugarPublished March 2018. Accessed September 15, 2018.
9Government of Canada. Canada’s food guides. https://www.canada.ca/en/health-canada/services/canada-food-guides.htmlUpdated September 1, 2016. Accessed September 15, 2018.
1010. Diabetes Canada. Diet and nutrition. https://www.diabetes.ca/diabetes-and-you/healthy-living-resources/diet-nutritionPublished March 2018. Accessed September 15, 2018.
11Diabetes Canada. Carbohydrate counting. https://www.diabetes.ca/diabetes-and-you/healthy-living-resources/diet-nutrition/carbohydrate-counting Published March 2018. Accessed September 15, 2018.
12Government of Canada. Make wise choices. https://www.canada.ca/en/health-canada/services/food-nutrition/canada-food-guide/food-guide-basics/make-wise-choices.htmlPublished February 2007. Accessed September 15, 2018.
13Diabetes Canada. Understanding the nutrition label. https://www.diabetes.ca/diabetes-and-you/healthy-living-resources/diet-nutrition/understanding-the-nutrition-labelPublished March 2018. Accessed September 15, 2018.
14Diabetes Canada. Basic meal planning. https://www.diabetes.ca/diabetes-and-you/healthy-living-resources/diet-nutrition/basic-meal-planningPublished March 2018. Accessed September 25, 2018.
15Government of Canada. How can physical activity help people with type 2 diabetes? Published August 6, 2011. Accessed September 17, 2018.
16Diabetes Canada. Diabetes Canada 2018 clinical practice guidelines: self-monitoring blood glucose (SMBG) frequency and pattern tool. http://guidelines.diabetes.ca/docs/resources/SMBG-pattern_K.pdfPublished March 2018. Accessed September 17, 2018.
17 Heart Research Institute of Canada. Facts about heart disease. http://www.hricanada.org/about-heart-disease/facts-about-heart-diseaseCopyright 2018. Accessed October 2, 2018.
18Diabetes Canada. Diabetes Canada 2018 clinical practice guidelines: screening for the presence of cardiovascular disease. http://guidelines.diabetes.ca/cpg/chapter24. Published March 2018. Accessed October 11, 2018.

This health information is provided to you by AuroPharma

AuroPharma

What is Epilepsy?1,2,3

Brain cells communicate using electrical signals. Epilepsy is a condition in which abnormal electrical activity in the brain changes the way the brain works, for short periods of time. These changes may affect consciousness, movement, and/or actions. When this happens, a person experiences a seizure.

In Canada, epilepsy affects about 300,000 people. New cases of epilepsy are diagnosed in about 1 in 2,000 people each year. About 75% to 80% of people with epilepsy are diagnosed before the age of 18.

What causes epilepsy?1,3,4

In more than 50% of cases, the cause of epilepsy is unknown. In other cases, causes may include:

  • brain tumour, severe head injury, brain injury during birth, problems with brain structure
  • poisoning due to alcoholism or street drugs

Screening and diagnosis5,6

If you or your child experience(s) a seizure, it is important to see a doctor as soon as possible. The doctor will take a medical history, ask questions about what happened during the seizure, and do a physical examination to see if:

  • the seizure is related to a short-term problem (e.g., a fever, infection)
  • there is a physical problem with the brain or a continuing problem with the way the brain works
  • the seizure was an isolated incident or perhaps suggests epilepsy

In addition, the doctor may order:

  • blood tests and other lab tests
  • an electroencephalogram (EEG) recording:7An EEG is a safe and painless test that allows your doctor to see if there is unusual electrical activity happening in your brain that may cause seizures.
  • computerized (axial) tomography (CAT) scan:8 A CAT scan of the head is a safe, low-radiation x-ray that produces three dimensional (3-D) images that may show if there are problems in the skull or the brain that may be causing seizures.
  • magnetic resonance imaging (MRI):9The MRI provides very detailed images of the brain’s structures and provides valuable information that helps find the source of seizures, diagnose epilepsy, and determine appropriate treatment of epilepsy.

It is important to remember that a single seizure does not mean a person has epilepsy.

What are the different types of seizures?1,6,10

There are many different types of seizures. Most seizures can be categorized as “focal” also known as “partial,” or “generalized.”

Focal/partial seizure activity happens in a limited area of the brain. There are two types of focal seizures:

    • In focal/partial seizures with retained awareness a person is aware and can communicate during/after the seizure. The person may have jerking movements in parts of the body, physical symptoms such as stomach pain, and sensory changes such as hearing things that are not there
    • In focal/partial seizures with a loss of awareness a person may lose consciousness and may appear dazed. The person may not be able to communicate during the seizure.

Generalized seizure involves the entire brain. There are six types of generalized seizures:

  • In absence seizures a person may lose consciousness and muscle control without convulsions. The person will not remember the experience.11 These seizures usually last from two to 10 seconds.
  • In tonic-clonic or convulsive seizures a person first loses consciousness and may fall to the ground due to muscle stiffness. The person may lose bladder and bowel control, bite the tongue, and his/her hands and feet will jerk.12 These usually last from one to three minutes but may last up to five minutes.
  • In atonic seizures (drop attacks) a person will suddenly lose consciousness and collapse and may hit his/her head when falling.13There are no convulsions. These seizures do not occur very often. This type of seizure is more common in children.
  • In clonic seizures a person may lose bladder/bowel control and begin to jerk in various parts of the body.14The person may temporarily lose consciousness and experience confusion afterwards. This may progress to tonic-clonic seizures over time.
  • In tonic seizures (very uncommon) muscles in the face, arms, legs, and trunk may spasm and tense.15
  • In myoclonic seizures (may occur one at a time or in a series) a person will experience muscle jerks in parts or all of the body.16.

As a person ages, the frequency, intensity, and duration of seizures may change. In some people seizures may disappear over time. Your doctor and Walmart pharmacist can help you understand what type of seizures you or your child may be experiencing and help you manage them.

Common seizure triggers3

There are some seizure triggers that are more common, but each person’s triggers may be different. Common triggers may include:

  • stress
  • tiredness
  • skipping meals
  • flickering lights
  • fever or illness
  • feeling angry, worried, or scared
  • weather conditions such as heat and/or humidity

Managing epilepsy

Medication17,18

Epilepsy cannot be cured, but medication can help control and/or prevent seizures. In the majority of cases medication is helpful in controlling seizures. It may be necessary to take more than one medication for treatment to be successful.

It is very important to take antiepileptic medications (also known as antiseizure or anticonvulsant medications) exactly as they have been prescribed by your doctor.

  • This means taking the dose prescribed at the time(s) prescribed and not missing doses. If you or your child miss(es) a dose, speak with your doctor or Walmart Pharmacist.
  • You should never stop taking medication for epilepsy without telling your doctor.l
  • If you or your child switch(es) from a brand name to a generic drug (with the same ingredients that help control seizures) or to another form of the brand name drug, it is very important to speak with your doctor and/or Walmart Pharmacist to be certain that the dosing for the new drug is correct.

Common side effects from antiepileptic medications may include:

  • drowsiness
  • drowsiness
  • rash
  • loss of muscular coordination
  • nausea
  • hyperactivity (in children)
  • irritability
  • behaviour changes

All side effects, including those that are not on this list, should be discussed with your doctor and/or Walmart Pharmacist as soon as they occur.

Medication cautions1

  • In order to avoid unpleasant or dangerous drug interactions, tell your doctor and your Walmart Pharmacist about any other medications, even over-the-counter medications and natural health products, you or your child may be taking.
  • Avoid drinking alcohol.
  • Never take someone else’s seizure medication.

Surgery1,5,19

Surgery is a treatment that may be considered if seizures do not respond to medication.

  • People who may be considered good candidates for surgery are those with focal/partial seizures that are limited to one part of the brain.
  • You and your doctor may discuss the pros and cons of surgery if seizures are not controlled with medication.

You and your healthcare team20

Ask your questions1,5,19

Your doctor and your Walmart Pharmacist are important members of your healthcare team. They can help you better understand epilepsy and how to carefully manage the condition. If you have questions about any aspect of this condition, ask your doctor or Walmart Pharmacist.

Journalling20Journalling is a helpful way to keep track of the nature, frequency, and intensity of seizures, possible seizure triggers, medication(s) and side effects, and any other information that may be helpful to you and your healthcare team.

Managing relationships and daily living1,21,22

Your relationships with your family, friends, colleagues, and teachers are an important part of your life.

  • Sharing information about epilepsy with family, friends, and caregivers will help them understand the condition and how they may help you or your child manage seizures.
  • It is important to have a colleague (or colleagues) know about your condition and how to help you if you have a seizure at work.
  • Teachers (and other school staff) of children/teens should be advised of what to do in case of a seizure.

You may have questions about many things including: watching television and playing video games (the light may be a trigger), alcohol consumption, smoking (cigarettes, cannabis), street drugs, sex, travel tips, driving, safety in your home and in your workplace, and more.

  • Record your questions in your journal and share them at your next visit with your doctor.
  • Your healthcare team may be able to answer many of these questions, but you may also find answers at http://epilepsy.ca

First aid23The following information about how best to help during and after a seizure should be shared with loved ones, friends, caregivers, colleagues, and teachers.

  • Remain calm, stay close by, and provide reassurance after the seizure ends and the person is fully conscious.
  • Keep the person having a seizure safe:
    • Remove things from the environment that may cause harm.
    • Place something soft under the person’s head if he/she falls, and if you can, gently roll him/her onto his/her side.
    • If the person wanders, stay close by.
  • Try to note the time the seizure started and the time it ended.
  • Do not put anything in the person’s mouth or restrain him/her.
  • Call 911 if:
    • the seizure lasts more than five minutes or a second seizure begins right after the first
    • full consciousness and regular breathing do not resume after the seizure ends
    • the person is injured, pregnant, or has diabetes

Healthy lifestyle21,24

Emotional wellnes is important for everyone. This means paying attention to feelings, behaviours, and moods, and finding ways to enjoy life even when faced with challenges, like epilepsy. Reach out to your healthcare team if you or your child are/is having trouble managing your emotional health and wellness.

Physical activity is important for overall health. When participating in any physical activity be sure that there is someone with you who is able to recognize your seizure pattern and knows what to do to keep you safe. If you or your child participate(s) in team sports, make sure the coach knows about your/your child’s epilepsy and how to take care of you/your child. Wear a helmet when appropriate and wear a life vest when in or on the water.



References

1Epilepsy Canada. Answers to your questions. http://www.epilepsy.ca/uploads/7/0/8/6/70868839/epilepsy_answers2011.pdf. Revised 2010. Accessed September 25, 2018.
2Government of Canada. Epilepsy in Canada. https://www.canada.ca/en/public-health/services/publications/diseases-conditions/epilepsy.html. Modified April 13,2018. Accessed September 25, 2018.
3Epilepsy Canada. Epilepsy facts. http://www.epilepsy.ca/epilepsy-facts.html. Copyright 2016. Accessed September 25, 2018.
4Epilepsy Ontario. Causes. http://epilepsyontario.org/about-epilepsy/causes/. Copyright 2018. Accessed September 30, 2018.
5Epilepsy Canada. Understanding your diagnosis. http://www.epilepsy.ca/diagnosis-and-treatment.html. Copyright 2016. Accessed September 25, 2018.
6Epilepsy Ontario. Diagnosis. http://epilepsyontario.org/about-epilepsy/diagnosis/. Copyright 2018. Accessed September 30, 2018.
7Epilepsy Ontario. Electroencephalogram (EEG).http://epilepsyontario.org/about-epilepsy/treatments/eeg/. Copyright 2018. Accessed September 30, 2018.
8Epilepsy Ontario. CT or CAT Scan [computerized (axial) tomography scan].http://epilepsyontario.org/cat/. Printed August 8, 2011. Accessed September 30, 2018.
9Epilepsy Ontario. Magnetic resonance imaging (MRI).http://epilepsyontario.org/mri/. Printed August 8, 2011. Accessed September 30, 2018.
10Epilepsy Ontario. Types of seizures.http://epilepsyontario.org/about-epilepsy/types-of-seizures/. Copyright 2018. Accessed September 30, 2018.
11Epilepsy Ontario. Absence seizures.http://epilepsyontario.org/about-epilepsy/types-of-seizures/absence-seizures/. Copyright 2018. Accessed September 30, 2018.
12Epilepsy Ontario. Tonic-clonic seizures. http://epilepsyontario.org/about-epilepsy/types-of-seizures/tonic-clonic-seizures/. Copyright 2018. Accessed September 30, 2018.
13Epilepsy Ontario. Clonic seizures.http://epilepsyontario.org/about-epilepsy/types-of-seizures/clonic-seizures/. Copyright 2018. Accessed September 30, 2018.
14Epilepsy Ontario. Atonic (drop) seizures.http://epilepsyontario.org/about-epilepsy/types-of-seizures/atonic-drop-seizures/. Copyright 2018. Accessed September 30, 2018.
15Epilepsy Ontario. Tonic seizures.http://epilepsyontario.org/about-epilepsy/types-of-seizures/tonic-seizures/. Copyright 2018. Accessed September 30, 2018.
16Epilepsy Ontario. Myoclonic seizures. http://epilepsyontario.org/about-epilepsy/types-of-seizures/myoclonic-seizures/. Copyright 2018. Accessed September 30, 2018.
17Epilepsy Canada. Your medication for epilepsy.http://www.epilepsy.ca/uploads/7/0/8/6/70868839/medication-new.pdf. Revised 2009. Accessed September 30, 2018.
18Epilepsy Ontario. Medications. http://epilepsyontario.org/about-epilepsy/treatments/medications/. Copyright 2018. Accessed September 30, 2018.

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Family and Diabetes

Family health history and contributing factors

It is important to know your family’s health history in order to be aware of your predisposition to having certain diseases. Diabetes is one of many diseases that could be passed down from generation to generation. Your risk of having type 2 diabetes or prediabetes increases if a member of your family has the diagnosis, if you have a sedentary lifestyle or if you have an unhealthy eating regimen1.

What is prediabetes?

Prediabetes can be diagnosed if your levels of blood sugar are higher than normal, but they are not high enough to be diagnosed as a type 2 diabetes. Prediabetes can develop into type 2 diabetes if the person does not make changes to maintain a healthy lifestyle1.

It is important to inform your doctor if you have a family history or a relative who has diabetes, as you are more likely to have prediabetes and develop diabetes. Your doctor can recommend earlier screening for diabetes for you4.

Lifestyle

Lifestyle can influence the onset of diabetes as well as the progression and management of the disease after diagnosis.

Parents can help their kids prevent type 2 diabetes by setting healthy habits for the whole family. It is easier to transform healthy changes into habits if the whole family does the changes together. Here are some tips to help your kids with healthier habits11;

  • Get kids involved in making healthier meals.
  • Shop for food together.
  • Teach your kids to read food labels to understand which foods are healthiest.
  • Have meals together as a family as often as you can.
  • Do not insist kids clean their plates.
  • Reward kids with praise instead of food11.

Physical activities are also another component to a healthy lifestyle. Here are some tips11;

  • Aim for your child to get 60 minutes of physical activity a day, in several 10- or 15-minute sessions or all at once.
  • Take parent and kid fitness classes together.
  • Encourage kids to join a sports team.
  • Plan active outings, like hiking or biking.
  • Take walks together.
  • Move more in and outside of the house—vacuuming, raking leaves, gardening11.

Diabetes and pregnancy

A lack of control of the blood sugar for a pregnant woman with diabetes can lead to problems for the mother and the baby. Since the organs of a baby form during the first two months of the pregnancy, the organs can be affected by uncontrolled blood sugar resulting in possible birth defects.

Uncontrolled diabetes can cause the baby’s blood sugar to be high and may cause the baby to grow extra-large. This can cause complications during the delivery and a C-section could be needed to deliver the baby2.

To prevent complications during the pregnancy, women with diabetes should first consult their physician to get and keep control of their blood sugar before and during their pregnancy5.

Living with a diagnosis of diabetes

When a person is diagnosed as having diabetes, it can take them some time to accept their diagnosis. Some people will go through different stages before accepting their diagnosis. One of these stages may be depression, where the person has a feeling of helplessness and powerlessness over their life. People with diabetes are more prone to suffer from depression and anxiety disorders. In fact, 20% (compared to 5-10% in the general population) of diabetics are suffering from depression and 30% (compared to 5% in the general population) of diabetics are suffering from anxiety disorder5. Depression and anxiety can have a significant impact on the control of blood glucose.

For teenagers, diabetes can be even more difficult to live with at times due to the hormonal changes that affect behavior and blood sugar. If the teenager has a rebellious period, it can be difficult to maintain a good control of their diabetes and may extend into early adulthood3.

Therefore, it is very important that those with diabetes have a better understanding of the disease as this is a vital step in the journey towards acceptance of the disease. Having the right information on diabetes will help individuals take concrete and positive actions to live long, active, healthy and satisfying lives5.

Addressing a diabetes diagnosis with your family

It is important to address a diagnosis of diabetes with your family by explaining to them your situation, your lifestyle regimen and general information about diabetes. Often, families and friends want to help but have a difficult time due to a poor understanding of diabetes and what it entails. Communicating your needs and expectations will provide them with the information they need to help and support you in the right way5.

Family dynamic and impact on the disease

Diabetes is not like other chronic illnesses, it requires more than just taking a medication on a regular basis. Diabetes can require regular blood sugar monitoring along with insulin and/or medication management influenced by diet, activity and stress. Therefore, it is essential to have the help and support of your family3.

Sometimes a spouse or caregiver may ask the diabetic to check their blood sugar level because they suspect there may be an instance of low blood sugar. This involvement could cause the person with diabetes to become angry or show signs of irritability. It is important to note that low blood glucose levels can cause a person to be irritable and argumentative3. It is these types of situations that can bring frustration to both the patient and the spouse/caregiver. Therefore, both sides need to understand each other’s circumstance3.

When a parent learns that their child is diagnosed with diabetes, it can bring fear, confusion and sometimes anger. Here are three key elements if your child has diabetes3;

  • This diagnosis may mean a change in diet for your entire family.
  • At first, it will feel like a moment-to-moment battle between high blood glucose and low blood glucose.
  • It may become difficult for a sibling without diabetes, as the child with diabetes will get more attention because of the disease.

Prevention and actions

How can we be proactive with prevention?

A familial history of type 2 diabetes has been shown to be a contributing factor to increased risk of having diabetes. Your familial risk of having diabetes and obesity are two important determinants to predict diabetes. The combination of these two factors increases the ability to predict the disease to almost 40%7. Therefore, it is important to screen your familial risk and your health condition with the help of your doctor.

You can help prevent or delay type 2 diabetes by making lasting lifestyle changes9:

  • Discover how to eat healthy and add more physical activity into your day.
  • Find out how to manage stress, stay motivated, and solve problems that can slow your progress9.

What are some concrete actions to take if you have an elderly relative with diabetes?

An elderly diabetic person may need some help; here are some elements for you to consider3;
  • Elderly persons with diabetes may need help with their diet or remembering to take medications.
  • Elderly persons with diabetes may also have complications from their diabetes that can limit their ability to take care of daily activities.
  • Assisted living centers and nursing homes may not be equipped or properly educated to take care of patients with insulin pumps or complex insulin plans. This is a time where the person with diabetes needs an advocate, which more than likely will be a spouse or family member3.

If you have a relative with diabetes, you should seek to learn more about diabetes and its implications. Remember that not everyone with diabetes will have the same needs or disease management requirements, therefore, it is important to ask questions and listen to what they say8.

For more information about diabetes, risk factors or managing your medications, ask your Walmart pharmacist.



References

1.Mayo Clinic Health System. Speaking of Health: Types of diabetes. https://mayoclinichealthsystem.org/hometown-health/speaking-of-health/types-of-diabetes. Reviewed October 18, 2016. Accessed on October 24, 2019.
2.CDC. Type 1 or Type 2 Diabetes and Pregnancy. https://www.cdc.gov/pregnancy/diabetes-types.html. Reviewed October 22, 2019. Accessed on October 24, 2019.
3.Mayo Clinic Health System. A New Me: Lifestyle management helps La Crosse woman make changes inside and out. https://mayoclinichealthsystem.org/hometown-health/speaking-of-health/caring-for-a-loved-one-with-diabetes. Reviewed July 14, 2014. Accessed on October 24, 2019.
4.CDC. Family Health History and Diabetes. https://www.cdc.gov/genomics/famhistory/famhist_diabetes.htm. Reviewed on July 18, 2017. Accessed on October 1, 2019.
5.Diabetes Day-Care Unit in collaboration with Dr. Robert G. Josse, Dr. R. G. J. (2005). Understand your diabetes... and live a healthy life (3rd Ed.). Montreal, Canada: Rogers Media.
6.Laffel, L. M., Connell, A., Vangsness, L., Goebel-Fabbri, A., Mansfield, A., & Anderson, B. J. (2003). General quality of life in youth with type 1 diabetes: relationship to patient management and diabetes-specific family conflict. Diabetes care, 26(11), 3067-3073.
7.Hariri, S., Yoon, P. W., Qureshi, N., Valdez, R., Scheuner, M. T., & Khoury, M. J. (2006). Family history of type 2 diabetes: a population-based screening tool for prevention?. Genetics in Medicine, 8(2), 102.
8.CDC. Friends, Family & Diabetes. https://www.cdc.gov/diabetes/library/features/family-friends-diabetes.html. Reviewed on August 7, 2018. Accessed on October 2, 2019.
9.CDC. Prevent Type 2 Diabetes. https://www.cdc.gov/diabetes/prevent-type-2/. Reviewed on August 12, 2019. Accessed on October 1, 2019.
10.Mayo Clinic Health System. Diabetes Education. https://mayoclinichealthsystem.org/locations/la-crosse/services-and-treatments/diabetes-education. Accessed on October 29, 2019.
11.CDC. Prevent Type 2 Diabetes in Kids. https://www.cdc.gov/features/prevent-diabetes-kids/index.html. Reviewed on June 29, 2017. Accessed on October 29, 2019.

This health information is provided to you by Pharma Science

Pharma Science

Healthy Living: Achieving Maintainable Health Goals

Introduction1

Healthy living … whether you’ve been motivated by a New Year’s resolution or had a wake-up call due to a health concern, it will take commitment, effort, encouragement, and support to achieve that goal. Healthy living can start with making healthy lifestyle changes.
  • Start small.
  • Build on your successes.
  • Ask for support.

SMART is an acronym often used for goal setting. It may help you decide if you can and will achieve and maintain each of the healthy lifestyle goals you set.

  • S:   Specific – How and when will I do what I mean to do?
  • M:   Measurable – How will I keep track of what I am doing (how much, how often)?
  • A:   Attainable – Will I be able to do this (is it too much at one time, should I cut back)?
  • R:   Rewarding – Is this something that I want to do? (Note: The “R” often refers to Realistic)
  • T:   Timely – When will I start and for how long will I do this (try to choose goals that you can maintain over the long term)?

Your healthcare team, including your Walmart Pharmacist, can help you choose a few lifestyle goals to start with. You may find the SMART goals worksheet helpful in keeping you on track. It can be found at: https://myhealth.alberta.ca/Alberta/AlbertaDocuments/smart-goal-worksheet.pdf.

Healthy Eating2,3,4

Making healthy food choices may help you to feel and look well. There are tools available to help you make the food choices you prefer. Make meal planning more interesting by choosing foods from other cultures that meet your personal daily nutrition requirements e.g., naan instead of sliced bread or couscous instead of rice.

Eating Well with Canada’s Food Guide2

This guide provides information on the varieties of foods in each of the four food groups, serving sizes and numbers of servings per day, and other information for different ages and stages of life. You will also find information on how to read and use food labels based on serving size to help you make healthy choices at the grocery store. Canada’s Food Guide can be found at: https://www.canada.ca/content/dam/hc-sc/migration/hc-sc/fn-an/alt_formats/hpfb-dgpsa/pdf/food-guide-aliment/print_eatwell_bienmang-eng.pdf.

Eat Well Plate

This infographic can help you visualize how much food from each food group you should include at a meal. You can find it at: http://www.healthycanadians.gc.ca/eating-nutrition/healthy-eating-saine-alimentation/food-guide-aliment/my-guide-mon-guide/index-eng.php.

My Food Guide

You may also want to create a personal food guide through a customizable tool from Canada’s Food Guide. Find out more at: http://www.healthycanadians.gc.ca/eating-nutrition/healthy-eating-saine-alimentation/food-guide-aliment/my-guide-mon-guide/index-eng.php.

It is helpful to know how many calories you may need each day, based on your activity level.

Estimated energy (calories) requirements3^
Male Age 19 to 30 Age 31 to 50 Age 51 to 70 Age 71+
Sedentary* 2500 2350 2150 2200
Low active** 2700 2600 2350 2000
Active*** 3000 2900 2650 2500
Female Age 19 to 30 Age 31 to 50 Age 51 to 70 Age 71+
Sedentary* 1900 1800 1650 1550
Low active** 2100 2600 1850 1750
Active*** 2350 2250 2100 2000

^ The calories calculations are estimated based on median height and weight, age and activity level.

*Sedentary: little daily physical activity even during leisure time (e.g., sitting for long periods, relying mostly on motorized transportation).

**Low active: some physical activity daily (e.g., walking to the bus, shovelling snow, mowing the lawn).

***Active: at least 150 minutes of moderate-to-vigorous physical activity (you breathe harder and your heart beats faster; you will sweat during vigorous activity) each week.

You’ll find more information in Canada’s Food Guide and at: https://www.canada.ca/en/health-canada/services/food-nutrition/canada-food-guide/food-guide-basics/estimated-energy-requirements.html.

Popular diets4

Popular diets promise to help you lose weight fast, often by restricting the types of foods you may consume (e.g., carbohydrates). These diets may work in the short term, but keeping the weight off after you stop the diet may be very difficult.

Diets that may be more helpful for you in achieving your weight loss goals and maintaining your healthy weight include those that encourage healthy eating – making healthy choices from the four food groups – teach portion control, and recommend physical activity.

Your healthcare team, including your Walmart Pharmacist, can help you with a nutrition plan that will help you achieve and maintain your healthy eating/healthy weight goals.

Active Living5,6,7

An active lifestyle has many health benefits including maintaining a healthy weight, helping prevent disease, and reducing stress. It is important to incorporate a variety of activities that you enjoy, including endurance activities (e.g., walking, cycling, jogging, dancing, swimming), flexibility activities (e.g., gardening, stretching exercises, bowling, yoga), and strength activities (e.g., lifting and carrying groceries, climbing stairs, abdominal exercises, light weight/strength training), into your daily routine. More information may be found at: https://www.physicalactivityplan.org/resources/CPAG.pdf.

In all cases, before you start a new physical activity routine, check with your doctor. You should first learn the proper technique to perform the activity to avoid injury, and if you feel excessively breathless or tired, or if you are in pain, stop the activity.

For adults aged 18 to 64, it is recommended to get 150 minutes of moderate (e.g., brisk walking, bike riding) to vigorous (e.g., jogging, cross country skiing) physical activity each week. This may be achieved in sessions of 10 minutes or more throughout the week. Try to include activities that target your muscles and bones (strength and weight-bearing activities) at least two times per week.

Responsible Choices8,9,10,11,12,13,14

Part of a healthy lifestyle includes making responsible choices.

Alcohol consumption8

To reduce health risks, injury and/or harm:

  • Women: no more than 10 drinks per week, with no more than two drinks per day most days.
  • Men: no more than 15 drinks per week, with no more than three drinks per day most days.

Plan “no alcohol” days every week to reduce the risk of developing a habit. Drink slowly and have no more than two drinks in a three-hour period. On special occasions, you may add one drink, based on the limits above.

Drink responsibly to avoid injury and/or harm:

  • NEVER drink and drive.
  • NEVER drink when pregnant.

For more information, see:http://www.ccdus.ca/Resource%20Library/2012-Canada-Low-Risk-Alcohol-Drinking-Guidelines-Brochure-en.pdf.

Caffeine consumption9

Health Canada recommends that most adults consume no more than 400 mg of caffeine per day. This is equivalent to two to three cups of coffee per day. Pregnant women should reduce their consumption to 300 mg or less per day. For more information, including caffeine amounts in tea and cocoa products, see: https://www.canada.ca/en/health-canada/services/food-nutrition/food-safety/food-additives/caffeine-foods/foods.html.

Cannabis and recreational drug use10,11

There are no current guidelines regarding cannabis use, despite legalization. As with any recreational drug, it is important to be responsible: use cannabis in moderation, get cannabis from a legal distributor, and be aware of potential overdose risks/signs.

Be safe and avoid injury and/or harm

  • NEVER smoke cannabis/use recreational drugs and drive.
  • NEVER use these drugs when pregnant.

For information about the affects of cannabis on cognitive functioning and mental health, see: http://www.ccdus.ca/Resource%20Library/CCSA-Clearing-the-Smoke-on-Cannabis-Highlights-2016-en.pdf.

Note:There is evidence that suggests that the use of alcohol and cannabis together will have a more harmful effect than the use of either alone, including effect on cognitive, psychomotor, and impaired driving.

Screen time12,13

Adults and children of all ages are drawn to screens. For a variety of reasons, limiting screen time, especially for younger children, is advised. Evidence suggests that screen time has an influence on children’s physical and mental health – how they feel and what they do. Too much screen time may interfere with good nutrition, physical activity, and sleep time.

The Canadian Paediatric Society recommends two hours or less of screen time per day for children, and that those under the age of two have as little exposure as possible. Be a good role model. Children will learn from what they see of your own screen time habits.

Sleep hygiene14

Getting a good night’s sleep is important for your physical and mental health. Here are some tips to help you have a restful night:
  • Make your bedroom as comfortable as possible.
  • Try to relax before you get into bed.
  • Engage in regular physical activity at least three times per week.
  • Establish a bedtime routine and stick to it every night – even on the weekend – this includes a regular bedtime and awakening time.
  • Avoid screen time before bed and especially in bed.
  • Avoid caffeine and alcohol before bed.
  • Avoid napping during the day.

Disease prevention/immunization15,16

One of the most important things you can do for your and your family’s health is for all of you to get immunized. Your doctor or Walmart Pharmacist can advise you about what vaccines you and your family members need for optimal health and disease prevention. The Public Health Agency of Canada recommends using the CANImmunize app to learn more about, and keep track of, immunizations. Find out more at: https://www.canimmunize.ca/en/home.

Stress Management17

We live in stressful times. Competing priorities – family, friends, jobs – can be very stressful. It is often not easy to juggle your priorities. To maintain overall wellness, it is helpful to try to reduce stress. A few suggestions include:
  • Participate in yoga, meditation, and/or mindfulness activities.
  • Try to maintain work/life balance – ask for help from trusted family members/friends when you need help meeting your personal responsibilities because of professional demands.
  • Participate in activities you enjoy with people you enjoy spending time with.
  • Talk about your stressors with trusted family members/friends.

Your healthcare team, including your Walmart Pharmacist, can provide information and strategies to help you to manage your stress. They may also be able to suggest other health professionals who can help you.

What you should know about your medications15,16

Caring for yourself and your family members – both children and older parents – often involves the use of medications. It is important to know the questions to ask so that you may be confident that you are treating your loved ones safely and effectively. Your Walmart Pharmacist is your medication expert. He/she is available to answer your questions about your/your family’s medications and conditions. Don’t guess; Just Ask to get the information you need to provide the best possible care to your loved ones.



References

1MyHealth.Alberta.ca Network. Setting SMART goals. https://myhealth.alberta.ca/Alberta/Pages/Setting-smart-goals.aspx. Current as of December 12, 2016; https://myhealth.alberta.ca/Alberta/AlbertaDocuments/smart-goal-worksheet.pdf Accessed November 6, 2018.
2Government of Canada. Eating Well with Canada’s Food Guide. https://www.canada.ca/content/dam/hc-sc/migration/hc-sc/fn-an/alt_formats/hpfb-dgpsa/pdf/food-guide-aliment/print_eatwell_bienmang-eng.pdf.Published 2011; My Food Guide.http://www.healthycanadians.gc.ca/eating-nutrition/healthy-eating-saine-alimentation/food-guide-aliment/my-guide-mon-guide/index-eng.php.Updated July 6, 2018; Eat Well Plate.http://www.healthycanadians.gc.ca/eating-nutrition/healthy-eating-saine-alimentation/tips-conseils/interactive-tools-outils-interactifs/eat-well-bien-manger-eng.php.Updated September 1, 2016. All accessed November 6, 2018.
3Government of Canada. How much food you need every day.https://www.canada.ca/en/health-canada/services/food-nutrition/canada-food-guide/food-guide-basics/much-food-you-need-every-day.html.Modified February 7, 2018; Estimated energy requirements.https://www.canada.ca/en/health-canada/services/food-nutrition/canada-food-guide/food-guide-basics/estimated-energy-requirements.html.Published November 8, 2011. Both accessed November 6, 2018.
4Huffington Post (CA). The most popular weight loss diets ranked by whether or not they work. https://www.huffingtonpost.ca/2015/04/07/weight-loss-diets_n_7017562.html. Published April 7, 2015. Accessed November 6, 2018.
5Public Health Agency of Canada. Canada’s Physical Activity Guide. https://www.physicalactivityplan.org/resources/CPAG.pdf.Accessed November 6, 2018.
6 Government of Canada. Physical activity tips for adults (18-64 years). https://www.canada.ca/en/public-health/services/publications/healthy-living/physical-activity-tips-adults-18-64-years.html.Modified October 1, 2018. Accessed November 6, 2018.
7Canadian Society for Exercise Physiology. Canadian physical activity guidelines for adults (18-64). http://csepguidelines.ca/adults-18-64/. Copyright 2018. Accessed November 6, 2018.
8Canadian Centre on Substance Abuse and Addiction. 2012 Low-risk alcohol drinking guidelines. http://www.ccdus.ca/Resource%20Library/2012-Canada-Low-Risk-Alcohol-Drinking-Guidelines-Brochure-en.pdf. Copyright 2018. Accessed November 6, 2018.
9Government of Canada. Canada’s food guides. https://www.canada.ca/en/health-canada/services/food-nutrition/food-safety/food-additives/caffeine-foods/foods.html. February 16, 2012. Accessed November 6, 2018.
10Canadian Centre on Substance Abuse and Addiction. Health impacts of cannabis. http://www.ccdus.ca/Eng/topics/Cannabis/Health-Impacts-of-Cannabis/Pages/default.aspx. Copyright 2016; Clearing the smoke on cannabis.http://www.ccdus.ca/Resource%20Library/CCSA-Clearing-the-Smoke-on-Cannabis-Highlights-2016-en.pdf. Copyright 2016. Both accessed November 6, 2018.
11Public health Ontario. Evidence brief: Risk factors for simultaneous use of alcohol and cannabis. https://www.publichealthontario.ca/en/eRepository/Evidence_Brief_Risk_factors_alcohol_cannabis.pdf.Published August 2018. Accessed December 4, 2018.
12Screen Smart. Screens & health. http://www.screensmart.ca/screens_health. Copyright 2010. Accessed November 10, 2018.
13Canadian Paediatric Society. Caring for kids: screen time at home: healthy habits. https://www.caringforkids.cps.ca/handouts/screen-time-at-home-healthy-habits. Updated June 2017. Accessed November 10, 2018.
14Anxiety BC. Getting a good night’s sleep. https://www.anxietycanada.com/sites/default/files/SleepHygiene.pdf.. Accessed November 10, 2018.
15Government of Canada. Get immunized. https://www.canada.ca/en/public-health/services/immunization/get-immunized.html. Modified April 6, 2018. Accessed November 10, 2018.
16CANImmunize. https://www.canimmunize.ca/en/home.Published 2018. Accessed November 10, 2018.
17Canadian Mental Health Association. Stress. . https://cmha.ca/documents/stressCopyright 2018. Accessed November 10, 2018.
18Canadian Pharmacists Association. Medication management. https://www.pharmacists.ca/education-practice-resources/professional-development/medication-management/.Copyright 2018. Accessed November 10, 2018.

This health information is provided to you by Taro

Taro

HEALTHY – AND SATISFYING – HOLIDAY EATING
Enlist your Walmart Pharmacist to help you eat smarter this holiday season

It’s the holidays! Time for celebrating, reconnecting with relatives, and eating. And eating. And eating.

For many of us, the holidays mean a chance to relax our usual dietary habits. There’s nothing wrong with a special day of indulgence, of course, but in today’s world the holiday season starts weeks before the big day (think holiday parties) and takes an extra week or two to wind down (think leftovers and boxes of chocolates).

How then to handle the challenge of eating healthily over the holidays without feeling like you’re missing all the fun?

Treats and consequences

The connection between celebration and food is stitched deep into most cultures. Many of us carry memories of long tables heaped with holiday foods, and we all have that well-meaning relative who insists you need another cookie.

While a bite of an oven-fresh cookie counts as one of life’s purest pleasures, we rarely stop at just one bite—or five, for that matter. As a result, the average North American adult gains a pound or more between November and January.1,2 This may not sound like a lot, but research has shown that people don’t shed the weight after the holidays.3 The long-term outcome? Weight creep.

The consequences of holiday binging don’t stop at the scale. After just five days of eating a high-fat diet, according to one study, the muscles change the way they process nutrients, which can derail the body’s response to insulin and raise the risk of diabetes and other diseases over time.4 Another study found that an unusually heavy meal quadruples the risk of a heart attack within two hours of consuming the food—an especially important tip-off for people with heart disease or previous heart attacks.5

So how do you resist that sixth bite of the cookie?

Support where you least expect it

If you haven’t yet turned to your Walmart Pharmacist for holiday eating support, now is your chance to tap into this resource. For one thing, the pharmacist can introduce you to products (such as supplements) that support healthy holiday eating. If you are taking medications, the pharmacist can warn you about foods that could weaken the effectiveness of these drugs.

Along with advice on products, your Walmart Pharmacist can suggest strategies to help you manage your eating over the holidays, explain the recommendations from Canada’s Food Guide, and refer you to a dietitian if needed.

If you have a health condition

While healthy holiday eating benefits everyone, people with health conditions need to make it a priority. If you have diabetes, for example, binging on holiday cookies or skipping a meal in preparation for a big dinner could throw your blood sugar off balance.7 Eating sugar also increases inflammation—an important consideration for people with arthritis.8 Same goes for alcohol, which is why experts advise people with arthritis to drink moderately or not at all.8

Things can get especially tricky when you attend a holiday party, where you have no control over the food being served. Bringing your own “emergency kit” (i.e., a handbag with healthy snacks) can help you sail through such scenarios. If you have diabetes, you may also need to check your blood sugar more often while out and about.7

Ask your Walmart Pharmacist for advice on meeting your nutritional needs during the holidays.



Planning your strategy

Many of us approach the holiday season with the healthiest of intentions, but good intentions rarely survive without a strategy. The following tips can help you manage the buffet tables and cookie trays you’ll face this holiday season.9,10

  1.   Eat something before the event. With a healthy snack like an apple and cheese slices in your belly, the party food table won’t call to you so loudly.
  2.   Don’t stand next to the food table all night. No reason to dangle temptation in your face—step away and focus on the conversation.
  3.   Take your time. Look over all the options on the table (or tables) before deciding what to put on your plate. Also take your time before serving yourself a second helping, as it takes up to 20 minutes for your stomach to register fullness.
  4.   Splurge only on foods you truly love. If you love pumpkin pie, by all means have a slice, but take a pass on the stale-looking pound cake.
  5.   Be picky with portions. Remember that the first few bites always taste the best, so a spoonful of that sweet potato dip will satisfy as much as a bowlful.11
  6.   Go greener. Make room for some vegetables on your plate. They will fill you up and keep you feeling light on your feet.
  7.   Go easy on the alcohol. Aside from being rich in sugar, alcoholic drinks lower your resistance to overeating. Think of holiday drinks as a rich dessert: something to sample, rather than devour.
  8.   Give yourself an ending cue. When you feel satisfied (or know it’s time to stop eating), pop a mint or piece of gum into your mouth to signal “the end” to your mind and body.

Once the holidays have begun, let your Walmart Pharmacist know how they’re going, as support from a trusted health professional will help you stay motivated.

How to refuse offers of food – politely12,13

There’s a term for that dear old aunt who insists you try her home-baked cookies: food pusher. Although food pushers may have the best of intentions, they can weaken your resolve in an instant. While a polite “no, thanks” is all you need to tell a food pusher, it may feel kinder and more polite to say something like, “I’m full right now, but I’d love to take one of your cookies home with me and try it later” or “I’m trying to save my appetite for all the other wonderful food at this party.”



Tools in the toolbox

If you still worry about managing the holiday food temptations, and especially if you live with obesity, your Walmart Pharmacist can advise you on healthy lifestyle approaches to help manage your weight. Everyone is unique, so don’t skip the professional advice. Your Walmart Pharmacist can also give you balanced information about questionable treatments, like that “miracle fat-melting shake” you heard about.

Most pharmacies carry numerous dietary supplements that, when paired with healthy behaviours, may assist with weight management. If you are interested in trying one, talk to your Walmart Pharmacist first. Be open about your health status so the pharmacist can make sure the supplement doesn’t interfere with any of your medical conditions or medications. Your Walmart Pharmacist can also help you manage side effects (such as nervousness, bloating, or gas) from these products.14

Dieting during the holidays?

Think again. Many doctors advise against starting a diet right before the holidays, which can lead to excess hunger at a time when temptation is greatest.15 Also, humans are biologically wired to eat a little more during the colder months.16 Instead of “going on a diet” this holiday season, keep your focus on balanced nutrition and avoid skipping meals.15



An ounce of preparation

Don’t wait until the holiday cookie swap is upon you: advance planning will help you walk a healthier line this season. Get a jump on smart holiday eating by talking to your Walmart Pharmacist at your next visit.



Resources

1Holiday weight gain: https://www.healthline.com/nutrition/tips-to-avoid-holiday-weight-gain
2Range of holiday weight gain: https://www.healthline.com/health-news/what-happens-to-your-body-over-the-holidays#2
3Persistence of weight gain after the holidays: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4336296/
4Impact of 5 days of high-fat eating: https://vtnews.vt.edu/articles/2015/04/041315-cals-skeletal.html
5Heart attacks after heavy meals: https://www.sciencedaily.com/releases/2000/11/001120072759.htm
6Pharmacist-hosted nutrition classes: https://www.pbahealth.com/how-to-promote-nutrition-and-diet-at-your-pharmacy/
7Holiday eating with diabetes: https://www.healthline.com/health/diabetes/navigating-holiday
8Holiday eating with arthritis: http://blog.arthritis.org/living-with-arthritis/holidays-arthritis-diet/?_ga=2.253901901.493519856.1565614015-1902765479.1565614015
9Harvard Health Publishing holiday eating tips: https://www.health.harvard.edu/blog/12-tips-for-holiday-eating-201212245718
10Northwestern Medicine holiday eating tips: https://www.nm.org/healthbeat/healthy-tips/nutrition/healthy-holiday-eating-habits
11First few bites and portion control: https://www.apa.org/monitor/2012/11/bite-chew
12How to say ‘no’ to food pushers: https://www.webmd.com/diet/obesity/features/how-say-no-food-pushers#1
13How to decline food at parties: https://www.rachaelrayshow.com/articles/how-to-politely-decline-food-during-the-holidays-or-any-dinner-party-without-insulting-the
14Medical News Today review of weight control supplements: https://www.medicalnewstoday.com/articles/320646.php
15Dieting before the holidays: https://globalnews.ca/news/3883552/diet-before-holidays/
16Eating more during the colder months: https://www.everydayhealth.com/diet-nutrition/why-do-we-eat-more-in-winter.aspx

This health information is provided to you by Sandoz

Sandoz

Hypertension: What to know about high blood pressure

Hypertension affects 7.5 million Canadians1 and is among the leading cause of death and disability worldwide2. Hypertension (high blood pressure) is a chronic disease that affects many people, not just the elderly. Approximately 2% of children and adolescents4, 7% of pregnant women4, and 25% of adults have hypertension.4 The number of people with high blood pressure continues to rise, as there are better screening tools, increased awareness, increased obesity and an aging population. High blood pressure control in Canada is estimated to be nearly 70%. However, this still means that approximately 30% of Canadians with hypertension still do not have adequate blood pressure control. As well, nearly 20% of Canadian adults are either unaware of their high blood pressure or are aware but are not being treated with high blood pressure medication.2 Your Walmart Pharmacist can help you check your blood pressure and partner with you to help keep your blood pressure under control.

What is hypertension?

Hypertension or high blood pressure is a condition in which blood pressure is consistently higher than normal. Blood pressure is the force of blood against your blood vessel walls. Hypertension means that there is too much pressure pushing against your blood vessels walls, which, over time, increases your risk of heart attack and stroke.9 Some risk factors for hypertension cannot be changed such as family history, age and gender. Other factors are controllable like diet, physical activity, alcohol intake, smoking and stress management.4, 5, 9, 10

Is hypertension serious?

Hypertension is often called the "silent killer"6 because it has no obvious symptoms and develops slowly over time. High blood pressure can only be diagnosed through blood pressure measurement. If left untreated, chronic (or long-term) hypertension can lead to serious heart outcomes, such as heart failure, stroke, heart attack, kidney disease, vision loss, and erectile dysfunction.8,9,10

What is normal blood pressure?

Blood pressure readings have two numbers, such as 112/78 mm Hg. The top (systolic) number is the pressure when the heart beats. The bottom (diastolic) number is the pressure when the heart rests between beats. Normal blood pressure is below 120/80 mm Hg. If you’re an adult and your systolic pressure is 120 to 129, and your diastolic pressure is less than 80, you have elevated blood pressure. High blood pressure is a systolic pressure of 130 or higher or a diastolic pressure of 80 or higher, that stays high over time.9 If you have questions about your blood pressure readings, just ask your Walmart Pharmacist.

How is blood pressure measured?

Blood pressure is measured on your upper arm using a device with an inflatable cuff.4, 5 When taking your blood pressure, try to be in a sitting position with your back supported if possible. Your legs should be uncrossed with both feet flat on the floor.4, 5

If you suspect your blood pressure is high, your doctor will likely determine if you have high blood pressure based on the average of two or more blood pressure readings, at two or more visits. The evaluation should also include one reading taken outside of your doctor’s office5 – for example with your Walmart Pharmacist, at home, or by wearing a device. Your Walmart Pharmacist can advise you what is the best blood pressure monitoring device and method for you.

What are the blood pressure targets?

Most people should ideally aim to reduce their blood pressure below 120/80 mmHg to maintain good health and reduce the risk of stroke, heart disease, and other conditions. But your specific blood pressure targets will depend on many factors, including your age, health conditions such as known cardiovascular risk.4 Your health care professional will determine your blood pressure targets



Systolic mm Hg (upper number) Diastolic mm Hg (lower number) Blood Pressure Category
Below 120 Below 80 Normal
120-129 Below 80 Elevated
130-139 80-89 High Blood Pressure (Hypertension) Stage 1
140 or higher or 90 or higher High Blood Pressure (Hypertension) Stage 2
Higher than 180 and/or Higher than 120 Hypertension Crisis - Consult your doctor immediately

Adapted from https://www.heart.org/-/media/data-import/downloadables/f/9/8/pe-abh-what-is-high-blood-pressure-ucm_300310.pdf

Blood pressure target ranges may be lower for children and teenagers.4 (520) Always talk with your health care professional for more information.

How is hypertension controlled?

Blood pressure responds well to healthy behaviors, and some people may be able to improve their blood pressure with a healthy lifestyle alone. However, other people may need extra help from drug therapy to lower their blood pressure to a safe range.4

Healthy behaviors

  • Limit salt intake: Adults should restrict salt intake to less than 2,000mg/day.4 Favor unprocessed foods as some processed foods may contain a significant amount of salt. Reading labels should help you identify food that contains less salt. 4,7
  • Potassium supplementation:Increased dietary intake of potassium can help reduce your blood pressure if you are not at risk of hyperkalemia such as if you have a kidney disease or use certain drugs that reduce the amount of potassium being eliminated from your body.4 See your Walmart pharmacist who can advise you on drug interactions and contraindications before starting any new supplements.
  • Maintain or reduce weight:When you are overweight, even moderate weight loss can have an impact and can help lower your blood pressure.4,11 Talk to your Walmart Pharmacist about what target weight is healthy for you.
  • Dietary Approach to Stop Hypertension (DASH) Diet: The Dash Diet has similarities to Canada’s Food Guide. It is high in vegetables, fruits, low-fat dairy products, and moderate amounts of whole grains, poultry, fish and nuts and low in sweets, fats, and red meats. The DASH diet with sodium restriction is a lifelong approach to healthy eating that's designed to help lower or prevent high blood pressure.4,11
  • Physical Activity:Aerobic exercise such as walking, cycling, jogging, swimming, of moderate intensity, and possibly resistance training can decrease systolic and diastolic pressure. A reduction in blood pressure can be seen with 4 to 7 sessions per week of moderate-intensity exercise lasting 30-60 minutes. Discuss with your doctor the optimal exercise regimen for you.5
  • Limited alcohol intake: One to two standard drinks per day or less is recommended and consumption should not exceed 14 standard drinks per week for men and 9 standard drinks per week for women.4, 5 One standard drink is considered to be equivalent of 13.6 g or 17.2 mL of ethanol or approximately 44 mL [1.5 oz] of 80 proof [40%] spirits, 355 mL [12 oz] of 5% beer, or 148 mL [5 oz] of 12% wine.4
  • Seek advice on smoking cessation.4
  • Manage stress levels. Implementing stress management strategies should be considered as part of your overall management to reduce your blood pressure4

Hypertension Medications

Hypertension can be controlled by medication.4,5 There are many types of drugs that lower blood pressure, often referred to as “antihypertensives”. People respond differently to these medications and may need to take a combination of two or more of them over time for the best effect.12

When you first start a high blood pressure medication, it may take several weeks before showing optimal effects. And it may take some time for you and your doctor to find the best dose and combination of medications to help control your blood pressure.12

Importance of taking your blood pressure medications

Blood pressure medications only help you control high blood pressure. They cannot cure it! Not taking or stopping your blood pressure medication will return your blood pressure to its previous state, which can cause it to rise again to dangerous levels. Take your medications as directed, and renew them on time. Do not stop taking your blood pressure medications because you feel fine. Report side effects to your doctor or pharmacist.12 Your Walmart pharmacist, with your doctor, will help you manage any drug side effects. Your Walmart Pharmacist can provide advice on different methods to help you to remember to take your medications. Just ask!



Resources

1 http://www.hypertensiontalk.com/wp-content/uploads/2016/05/HTN-Fact-Sheet-2016_FINAL.pdf
2Padwal et al. Epidemiology of Hypertension in Canada: An Update. Canadian Journal of Cardiology 32 (2016) 687-694.
3Statistics Canada. Blood pressure of children and youth 2012 to 2013
4Hypertension Canada’s 2018 Guidelines for Diagnosis, Risk Assessment, Prevention, and Treatment of Hypertension in Adults and Children
5Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A report of the ACC/AHA on Clinical Practice Guidelines. Hypertension (2018): 71
6https://www.heart.org/en/health-topics/high-blood-pressure/why-high-blood-pressure-is-a-silent-killer
7Whelton et al. Sodium reduction and weight loss in the treatment of hypertension in older persons: a randomized controlled trial of non pharmacological interventions in the elderly (TONE). JAMA (1998) 279: 839z
8https://www.heart.org/-/media/files/health-topics/high-blood-pressure/consequences-of-high-blood-pressure-infographic-pdf-ucm_464947.pdf.
9https://www.heart.org/-/media/data-import/downloadables/f/9/8/pe-abh-what-is-high-blood-pressure-ucm_300310.pdf
10Weight Loss and Blood Pressure Control (Pro). David W. Harsha and George A. Bray Originally published12 May 2008 https://doi.org/10.1161/HYPERTENSIONAHA.107.094011Hypertension. 2008; 51:1420–1425
11https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/dash-diet/art-20048456.
12https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure/managing-high-blood-pressure-medications

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TAKE CHARGE OF YOUR KIDNEYS
Your kidneys deserve your attention, just like the rest of you.
Your Walmart Pharmacist can help.

Let’s face it: kidneys aren’t sexy. They don’t make headlines as often as hearts, lungs, or brains. When they work well, we don’t talk or even think about them. It’s only when they stop doing their job that they get our attention. But we can do better: by knowing our risk of kidney disease and taking better care of our kidneys today, we can prevent or delay serious problems in the years to come.

Why kidneys matter

You have two kidneys, located on either side of your spine at the bottom of your ribcage. These fist-sized organs have a filtering function, meaning they flush out excess water and waste products, which leave your body through urine.1 They work nonstop, filtering a half-cup of blood every minute to maintain the right balance of salt, potassium, and other minerals in your body.1,2

But healthy kidneys do a lot more than balance your chemicals: they release a hormone that helps the body make red blood cells and other hormones that keep blood pressure under control.3 As if that weren’t enough, kidneys produce a form of vitamin D that keeps your bones strong and healthy.2,3

Kidney Health.

When kidneys go bad

With such a complicated job description, it’s hardly surprising that kidneys sometimes trip up. When they become damaged and no longer filter blood properly, wastes build up in your body, which causes other problems that can interfere with your health.4

Chronic kidney disease (CKD) is by no means rare: about 1 in 10 Canadians has CKD.5 And the worst part? Most people don’t even know they have it.6

Kidneys do their job so well that you may not realize you have CKD until the disease is quite advanced. Even if you do have symptoms, you may not suspect kidney disease, because CKD symptoms tend to be “nonspecific,” meaning that other diseases can cause the same signs and symptoms.7 Watch for nausea, vomiting, loss of appetite, sleep problems, changes in how much you urinate, muscle twitches or cramps, swollen ankles or feet, and persistent itching.7

As the disease progresses, your kidneys lose the ability to flush out excess fluids. This could cause your arms and legs to swell up as well as raise your blood pressure.7 That’s right: high blood pressure can lead to kidney disease, and kidney disease can lead to high blood pressure. A sudden rise in potassium levels, which the damaged kidneys can no longer handle, could affect your heart’s ability to function.

Chronic kidney disease may also affect other parts of your body, which could lead to anemia (low iron in the blood), weak bones that fracture more easily, or nerve damage that makes it harder to concentrate.7 Your immune system may be weakened and struggle to fight infections.7 If you’re pregnant, kidney disease may increase the risk of complications.7

Some good news: if you identify kidney disease early enough, you can prevent or delay its progression.8 If you have any questions or concerns about your kidneys, start by talking to your doctor or Walmart Pharmacist.

The endgame

If CKD continues unchecked, the kidneys eventually fail — what’s known as end-stage kidney disease.9 The two treatment options at this stage — dialysis or kidney transplant — allow many people to live long lives.9 Dialysis is a treatment that balances the minerals in your blood and gets rid of waste and extra fluids.10 Kidney transplant has a high success rate, and you only need to receive one healthy kidney.11



Know your risk

Kidneys never come with a lifetime guarantee, but some people have a higher risk of problems than others. Let’s start with the major risk factors: diabetes, heart disease, and high blood pressure.12 About one out of three people with diabetes and one out of five people with high blood pressure may have CKD.13 Having a family member with one of these conditions — or with actual kidney disease — also bumps up your risk.12

Age 60 or over? That alone will boost your risk.12 Obesity also carries extra risk, as does low birth weight.12 Your risk also creeps up if you’ve had bladder infections or kidney stones.12 Unfortunately, kidney disease doesn’t play fair when it comes to ethnic origins: the risk is higher in people of African, Hispanic, Asian, and First Nations heritage.12 While you can’t change your heritage or birth weight, knowing about such risk factors can motivate you to take better care of your kidneys.

Any medication you take ends up traveling through your kidneys. This usually doesn’t pose a problem, but heavy or long-term use of pain medications such as ASA (Aspirin®), naproxen (e.g., Aleve®), and ibuprofen (e.g., Advil®) can lead to kidney damage.14 This holds especially true for older people and those with health problems, but a large study has found that high doses of these medications can boost CKD risk even in young, healthy people.15

The warning labels on pain medications tell you how long you can safely use them. If you have pain or fever for a longer time, don’t keep taking them — see your doctor.14 If your doctor has prescribed a pain medication, be sure to follow the doctor’s instructions. In case you’re wondering about “baby aspirin” (81 to 162 mg daily), you don’t need to worry: research has found no added risk of CKD with regular use.14 Unsure about the over-the-counter pain medications you’re using? Your Walmart Pharmacist can help you choose a suitable product and use it safely.

Quick kidney check

Because kidney disease often goes unnoticed, the BC Renal Agency has developed an online quiz to help you assess your risk.16 This quiz lets you know if you should see a doctor about your kidneys. While no online tool can replace a medical visit, the test gives you a starting point. Take the test at http://www.bcrenalagency.ca/health-info/kidney-health-self-assessment.



Do you or don’t you?

Having a high risk of kidney disease doesn’t mean you actually have it or will develop it. To find out for sure, you need to get tested. Here’s what to expect:17

  1.   Blood tests: These tests measure the waste products (such as creatinine and urea) in your blood. When kidney function slows down, levels of these waste products go up.18
  2.   Urine tests: Analyzing a sample of your urine may reveal abnormalities that point to kidney disease.
  3.   Imaging tests: Ultrasound can uncover abnormalities in your kidneys’ size or shape.
  4.   Biopsy: If it looks like you have kidney damage, your doctor may recommend looking at a sample (biopsy) of your kidney tissue to find out what could be causing the problem.

Preserving your kidney health

Whether or not you have any signs of kidney disease, it pays to take good care of your kidneys. Fortunately, a lot of the recommended strategies line up with general advice for getting and staying healthier. No doubt you’ve heard it before, but the message is worth repeating: maintain as healthy a weight as you can — if overweight, even a small weight loss can help you control blood pressure and blood sugar.19 If you have diabetes, the best way to protect your kidneys is to control your blood sugar (high blood sugar clogs up the filters in kidneys19) and take all your medications as prescribed.20 Some blood pressure medications may even help protect your kidneys20 — talk to your Walmart Pharmacist to find out more. If you smoke, make this the time to quit.19 And you have one more reason to stay active: preserving your kidneys.19

A kidney-friendly diet can help your kidneys work properly and prevent them from wearing out. Start with water — your kidneys’ fuel. Drink it throughout the day.21 Limit your salt intake to avoid raising your blood pressure.22 The omega-3 fats in salmon and other fatty fish can slightly reduce blood pressure, while the pectin in apples may help reduce blood sugar and cholesterol levels.21

If your blood pressure runs high, don’t hesitate to enlist your Walmart Pharmacist’s help. The pharmacist can show you how to use the blood pressure machines at the pharmacy, recommend home-use devices, give you tips on how to bring your numbers down — and cheer you on as you take steps to protect your kidneys.

If you already have kidney disease

If you already have CKD, you’ll need to modify your lifestyle a little. Choosing low-potassium foods such as berries, broccoli, salmon, white rice, and white bread will prevent potassium from building up in your bloodstream.23 A dietitian can help you design an eating plan that meets your needs. To keep your creatinine levels down low, avoid vigorous exercise and supplements containing creatine.24 Review your supplements with your Walmart Pharmacist to make sure they are all safe. Your healthcare provider may also recommend calcium, iron, and/or vitamin D supplements,25 and your Walmart Pharmacist can help you select the right product for you.





Resources

1National Institute of Diabetes and Digestive and Kidney Diseases. Your kidneys & how they work. https://www.niddk.nih.gov/health-information/kidney-disease/kidneys-how-they-work
2Kidney Foundation. How kidneys work. https://kidney.ca/Kidney-Health/Your-Kidneys/How-Kidneys-Work
3Healthline. Kidney health. https://www.healthline.com/health/kidney-health
4MedlinePlus. Chronic kidney disease. https://medlineplus.gov/chronickidneydisease.html
5Kidney Foundation. Facing the facts. https://kidney.ca/CMSPages/GetFile.aspx?guid=4696a3a5-cfce-46bf-9c0e-1d127f16027f
6Arora P, Vasa P, Brenner D, et al. Prevalence estimates of chronic kidney disease in Canada. CMAJ 2013;185:E417. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3680588/pdf/185e417.pdf
7Mayo Clinic. Chronic kidney disease symptoms & causes. https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/symptoms-causes/syc-20354521
8National Kidney Foundation. About chronic kidney disease. https://www.kidney.org/atoz/content/about-chronic-kidney-disease
9Mayo Clinic. End-stage renal disease. https://www.mayoclinic.org/diseases-conditions/end-stage-renal-disease/symptoms-causes/syc-20354532
10National Kidney Foundation. Dialysis. https://www.kidney.org/atoz/content/dialysisinfo
11Nephcure Kidney International. Kidney transplant. https://nephcure.org/livingwithkidneydisease/kidney-failure/transplant/?gclid=CjwKCAiAsIDxBRAsEiwAV76N84PwRmFSJ7t3IeN4O-xpu2pysBShDPExjFb2n0Lbr7_V8tyAtllxeRoCVw8QAvD_BwE
12National Kidney Foundation. Six-step guide to protecting kidney health. https://www.kidney.org/atoz/content/sixstepshealthprimer
13Centers for Disease Control and Prevention. Take care of your kidneys and they will take care of you. https://www.cdc.gov/kidneydisease/prevention-risk/take-care.html
14National Kidney Foundation. Pain medicines (analgesics). https://www.kidney.org/atoz/content/painmeds_analgesics
15Kidney News Online. High dose of NSAIDs may increase kidney disease risk. https://www.kidneynews.org/kidney-news/findings/high-dose-of-nsaids-may-increase-kidney-disease-risk
16BC Renal Agency. Kidney health self-assessment. http://www.bcrenalagency.ca/health-info/kidney-health-self-assessment
17Mayo Clinic. Chronic kidney disease diagnosis. https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/diagnosis-treatment/drc-20354527
18National Kidney Foundation. Understanding your lab values. https://www.kidney.org/atoz/content/understanding-your-lab-values
19Kidney Foundation. Keeping your kidneys healthy. https://kidney.ca/Kidney-Health/Your-Kidneys/Keeping-Your-Kidneys-Healthy
20National Institute of Diabetes and Digestive and Kidney Diseases. Preventing chronic kidney disease. https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/prevention
21Medical News Today. What foods are good for kidneys? https://www.medicalnewstoday.com/articles/325390.php
22American Kidney Fund. Kidney-friendly diet for CKD. https://www.kidneyfund.org/kidney-disease/chronic-kidney-disease-ckd/kidney-friendly-diet-for-ckd.html
23Healthline. Kidney disease and potassium. https://www.healthline.com/health/kidney-health/kidney-disease-and-potassium
24Healthline. 8 home remedies to naturally lower your creatinine levels. https://www.healthline.com/health/how-to-lower-creatinine
25National Kidney Foundation. Vitamins and minerals in chronic kidney disease. https://www.kidney.org/atoz/content/vitamineral

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Mint Pharmaceutical

YOUR MENTAL HEALTH AND YOUR PHARMACIST

Help is available - and it's closer than you think

How is your mental health today? Are you relaxed or tense? Do you wake up with a smile or drag yourself out of bed? Do you feel like your usual self, or do things seem not quite right? If you’re concerned about your mental health, remember this: you’re not alone, and help is available.

Mental distress is all around us

Just how common are mental health issues? In any given year, one in five Canadians will face a mental health condition such as anxiety or depression.1These conditions don’t play favourites: they visit young and old, rich and poor, and people from all cultures. One year it may be your family member or friend, the next year it could be you.

What’s more, the problem appears to be increasing, especially in young people. Some research has blamed social media2(think of those beaming smiles on Facebook photos, which make other people’s lives seem picture perfect), while other researchers have pointed to “the rising stress of living.”3

On a more encouraging note, people today are more likely to talk about their mental health struggles than even five years ago. That said, shame and embarrassment continue to keep some people from getting the help they need. Many employees still keep their managers in the dark about their mental health issues, and 4 out of 10 respondents to a 2016 survey reported feeling depressed or anxious—but were not seeking help.4

In the table below, you’ll see a list of common mental health conditions. While it takes a trained health professional to make a diagnosis, the list can help you start a conversation.

Common Mental Health Conditions 5-8
Category Disorder Key symptoms
Mood issues

Major depression

Loss of enjoyment, low mood, fatigue or agitation, changes in appetite

Chronic mild depression

Same as above, but longer-lasting and not as intense

Bipolar disorder

Dramatic swings in mood, from extreme highs to crushing lows

Anxiety issues

eneralized anxiety

Excessive anxiety and worry about many things in everyday life.

Phobias

Excessive anxiety about specific things (such as flying, spiders, public speaking, etc.)

Panic disorder

Panic attacks in response to specific situations or for no clear reason.

Post-traumatic stress disorder

Distressing memories of, or “reliving,” a traumatic event.

Obsessive compulsive disorder

Unwanted thoughts and/or behaviours you feel compelled to carry out (e.g., worrying about germs, excessive hand-washing)

How do you know if you have a mental health issue?

What separates mental health conditions from life’s ups and downs? First of all, mental health conditions tend to last longer. While “the blues” come and go, depression may last for weeks, months, or years at a time.9 As shown in the table below, several other clues can help you distinguish true depression and anxiety from the expected challenges of everyday life.

Mental health conditions also interfere with your day-to-day functioning. It’s normal to get “stressed out” from time to time, but not to avoid cars, elevators or shopping malls because of fear. It’s normal to feel sad, but not to feel so hopeless you can’t get your work done—or get to your workplace at all. Bottom line: if your symptoms lead you to avoid activities you want or need to do, you may need professional help.

Normal life challengesMental Health Conditions
SadnessDepression9
  • You feel low, but can be comforted
  • Your sadness is linked to a specific trigger
  • Your low mood lasts less than two weeks
  • You can’t be comforted; all life seems bleak
  • Your low mood may or may not have a “reason”
  • Your low mood lasts two weeks or longer
Everyday anxietyAnxiety disorder10
  • Your anxiety has a reasonable source, such as an upcoming interview or exam
  • Your anxiety level matches the situation
  • You don’t have intense, bothersome physical symptoms
  • Even everyday responsibilities, like paying the bills, make you anxious
  • Your anxiety goes beyond expected levels (e.g., high anxiety for weeks before an interview)
  • You have physical symptoms such as pounding heart or headache

Help is closer than you think

If you’re facing mental health challenges, you may wonder where to turn. Family doctors are a definite possibility—if you have one—but they can’t always see you right away. Have you ever considered your pharmacist? Approachable, easily accessible, and someone you can trust,11 your Walmart Pharmacist is a logical place to start.

Your Walmart Pharmacist knows not only about drugs but about diseases and how they affect you. In some cases, they may use tools, such as the Patient Health Questionnaire (PHQ),12 to help screen for common mental health conditions. If your responses raise a red flag, your pharmacist can help steer you toward the right health services so you can get the treatment you need.

A watchful eye

Treatment for mental health conditions typically involves medication paired with psychotherapy (talk therapy). Antidepressant medications, a common treatment for both depression and anxiety, may cause side effects such as nausea or stomach upset.13 As an expert in medications, your Walmart Pharmacist can help you understand and manage these possible effects, which often subside over time.

Your Walmart Pharmacist also knows if you are taking other medications or supplements that could interfere with your mental health treatment—or actually worsen your mental state. For example, some prescription pain medications can cause changes in mood.14 In such a case, your Walmart Pharmacist can warn you to look out for mood changes and to see your doctor if your mood does worsen.14 The pharmacist can also share any concerns about your prescriptions with your doctor.

If you are juggling several medications, you may have trouble remembering when to take what. Your Walmart Pharmacist can make the process easier for you—for example, by providing you with compliance packaging (often called blister packs) to organize your medications and help you remember to take them. The pharmacist may also conduct a medication review to make sure the drugs you are taking work well together and to suggest changes if they don’t.15

Did you know?

Research has shown that pharmacists can improve mental health care. In one study, team meetings (arranged by pharmacists) to discuss patients’ medications led to more appropriate use of antidepressants and anti-anxiety medications—and the positive change lasted for three years.16 In another study, over half of patients whose pharmacists provided “comprehensive medication management” (reviewing drugs, monitoring patient status, and reinforcing treatment goals) saw an improvement in their mental health condition.17

Taking the first step

It’s never easy to take that first step, but your Walmart Pharmacist can help. Many Walmart Pharmacies have counselling areas or similar spaces where you can talk privately.18 And no matter where you have the discussion, you can trust your pharmacist to listen to you and to respect your boundaries.

Here are some questions you can ask your Walmart Pharmacist to start a conversation about your mental health treatment:19,20

  • May I speak to you about some of the struggles I’ve been having with my mood?
  • How will this medication help me, and when should it start working?
  • How do I store it and take it, and what do I do if I miss a dose?
  • Can I stop using it if I feel better?
  • Are there foods or other products I should avoid while taking it?
  • How do I recognize an allergic reaction and what should I do about it?

At the same time, be sure to tell your Walmart Pharmacist about all other medicines, vitamins, and other supplements you use.20 Also, let your Walmart Pharmacist know about any challenges that could affect your ability to take your medication as prescribed, such as trouble swallowing or memory problems.20 Are you pregnant or breastfeeding? Your Walmart Pharmacist needs to know that too, to make sure that none of the medications you take put the child at risk.20

Walmart Pharmacists are here to help you and have the expertise to support your mental health treatment. Take that first step toward better mental health: just ask your Walmart Pharmacist.



Resources

1CMHA—prevalence stats: https://cmha.ca/about-cmha/fast-facts-about-mental-illness.
2Forbes—social media as contributor: https://www.forbes.com/sites/alicegwalton/2018/11/16/new-research-shows-just-how-bad-social-media-can-be-for-mental-health/#18d5fe4f7af4
3Global News—rising stress as contributor: https://globalnews.ca/news/4138006/stress-causes-today/
4CAMH—prevalence & stigma info: https://www.camh.ca/en/driving-change/the-crisis-is-real/mental-health-statistics
5NIH—common mental health disorders: https://www.ncbi.nlm.nih.gov/books/NBK92266/pdf/Bookshelf_NBK92266.pdf
6Mayo Clinic—PTSD symptoms: https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967
7MDSC—bipolar disorder symptoms: https://mdsc.ca/edu/what-is-bipolar-disorder/?gclid=CjwKCAjw2cTmBRAVEiwA8YMgzeOs3dvd6dGR6YFeYHJO5rTAzghNbVCWe2TJdWq5Tsy4dQZIaKNaCRoCDRIQAvD_BwE
8WebMD—dysthymia symptoms: https://www.webmd.com/depression/guide/chronic-depression-dysthymia#1
9Medical news today—sadness vs depression: https://www.medicalnewstoday.com/articles/314418.php
10ULifeline—everyday anxiety vs anxiety disorders: http://www.ulifeline.org/articles/439-anxiety-vs-anxiety-disorders
11CPA—pharmacists are highly trusted: https://www.pharmacists.ca/cpha-ca/assets/File/news-events/PAM/PAM2017_CommunicationsToolkit.pdf
12The Translator—medication management by pharmacist improved outcomes in psychiatric patients: https://www.pharmacists.ca/cpha-ca/assets/File/education-practice-resources/Translator%20Winter_V9_Issue4_2015.pdf
13Harvard Health—antidepressant side effects: https://www.health.harvard.edu/mind-and-mood/what-are-the-real-risks-of-antidepressants
14Pharmacy Times—opioid pain medications and mood changes: https://www.pharmacytimes.com/publications/issue/2017/august2017/pharmacists-can-play-important-role-in-depression-screening
15CPA—pharmacist’s role in mental health: https://www.pharmacists.ca/news-events/cpha-blog/the-pharmacist-s-role-in-mental-health/
16Journal of the American Geriatric Society—impact of drug reviews on appropriate prescribing: https://www.ncbi.nlm.nih.gov/pubmed/9434669
17J Am Geriatric Society—team meetings led by pharmacists improved treatment outcomes: https://www.ncbi.nlm.nih.gov/pubmed/9434669
18Ontario College of Pharmacists—private counselling areas: http://www.ocpinfo.com/protecting-the-public/your-pharmacy/managing-care/
19Central Care Health—mental health services pharmacies may provide: https://www.centracare.com/for-the-health-of-it/your-health/mental-health-how-can-your-community-pharmacist-help/
20FDA—talking to your pharmacist: https://www.fda.gov/drugs/resources-you/stop-learn-go-tips-talking-your-pharmacist-learn-how-use-medicines-safely

This health information is provided to you by Pharma Science

Sponsored by Pharma Science

RING IN THE NEW YOU
Take advantage of the New Year to make some changes—but keep it simple and real

For many people, the words New Year’s resolutions bring up memories of past struggles. Perhaps you vowed to lose 20 pounds, but gained five instead. Perhaps you signed up for a gym membership in January—and let it expire in April. If that’s the case, you’re in good company. Fewer than 25 per cent of people stick with their New Year’s resolutions for more than 30 days, and just eight per cent actually accomplish what they set out to do.1

If you want to be part of that eight per cent, try something different this year. For starters, trade the harsh, intimidating word “resolution” for something friendlier, such as “goal” or “better self.” Next, aim for goals you can actually achieve. But how?

One foot forward

The secret to making lasting changes is to keep them small and specific. If the couch has been your best friend all year, “exercise for an hour every day” sets the bar too high. It’s neither small nor specific. “Walk around the block three times a week” gives you a much better shot at success. If you’re completely out of practice with exercise, consider starting with an even smaller goal, like climbing a flight of stairs after lunch.

Success with each small change gives you the confidence to manage more difficult tasks later on.2 For example, once you’ve mastered walking around the block, you can increase the distance or progress to a slow jog.

You may also want to stagger your goals: healthier eating in January, physical activity in March, and so on. It takes too much attention and energy to tackle several goals at the same time, which is why those long New Year’s lists so rarely work out.3 Once a new behaviour becomes a habit—which could take up to two months, according to new research4—you’ll have the energy to tackle the next one.

There’s no need to do all this alone: buddying up with people who share your goals can keep you motivated.3 Invite a friend or neighbour to go to the gym with you, and consider joining—or creating—a more formal support system, such as a group of co-workers with an interest in healthy eating. Your cheering squad also includes your Walmart Pharmacist, who can share strategies and tools (such as healthy eating tips) to help you make positive changes.

SMART Goals5-7

Want goals that stick? Make sure they’re S.M.A.R.T. Here’s how:

  1.   S for Specific: The more specific your destination, the more easily you can reach it. Think of the difference between “accumulate wealth” and “increase income by $500 per month.”
  2.   M for Measurable: This means you have a way to track your progress and achievement. You can’t really measure a goal of “be friendlier,” but you’ll know whether you’ve smiled at a neighbour or shopkeeper every day.
  3.   A for Achievable: It doesn’t matter if your friend can shed weight like old clothes–the goal has to be achievable for you.
  4.   R for Relevant: Is the goal something you actually want, or is it your mother's or best friend’s idea? Choose goals that line up with your own vision and values.
  5.   T for Timely: A target date anchors your goal in the real world. Changing “read more this year” into “read one book a month” gives you a clear target and finish line.



Body check

Make this the year to treat your body as well as your car: tuned up and powered up. Screening tests can help detect health problems early on, allowing you to take action before they get worse. For your convenience, many Walmart pharmacies offer screening tests right on-site. Ask your Walmart Pharmacist which tests make sense for you. If you’re a 50-year-old woman, for example, Canadian guidelines recommend a cholesterol and blood pressure screen, as well as a colon cancer screen every two years.8

Your Walmart Pharmacist can also help you bring your immunizations up to date. Along with booster shots for some vaccines, the guidelines recommend vaccination against herpes zoster (shingles) for those 50 and over.8 As for the flu shot, your best bet is to get one every year. In fact, annual flu shots are recommended for everyone aged six months or older.9

While you’re at it, ask your Walmart Pharmacist to review your medications. Especially important for people taking several drugs at the same time, a medication review can uncover harmful interactions, dosing problems, or medications you no longer need.10 If you’re finding it hard to manage your medication schedule, your Walmart Pharmacist can suggest tips and tools (such as checklists, alarms, and pill boxes)11 to make the job easier.

All in the family

“Spend more time with loved ones” consistently shows up on New Year’s resolution lists.12 If you play it smart, you can combine this goal with your personal health goals. Instead of chopping vegetables by yourself on the cutting board, invite the rest of your family to join you: involving your kids in healthy meal preparation can increase their interest in eating the foods.13

The same goes for physical activity. When you make it a family affair, it becomes easier and more enjoyable for all of you.13 Build a snowman together, take the dog on a group walk after dinner, or put on some upbeat music and have a “silly dance” contest.

Family time also includes talking time, and you can’t go wrong if you make this a goal. Along with dinnertime debates and car-ride confessions, consider engaging your kids in “dialogic reading,” which simply means having two-way conversations with children during reading time.14 Such conversations stimulate young brains and increase the whole family’s well-being.14

The Short List12

Ever wonder what other people’s lists of New Year’s resolutions look like? Here are the 10 most popular items:

  1. Exercise more
  2. Lose weight
  3. Get organized
  4. Learn a new skill or hobby
  5. Live life to the fullest
  6. Save more money/spend less money
  7. Quit smoking
  8. Spend more time with family and friends
  9. Travel more
  10. Read more

Notice how broad and vague these goals are? Fortunately, you now know how to convert them to specific, achievable SMART goals.



Home health makeover

If your body deserves a New Year’s tune-up, why not your home? Start by checking your smoke and carbon monoxide detectors (you should have one on every floor) and replacing dead batteries.15,16 Take the time to read the labels on cleaning products and follow directions for safe use. To make handwashing less of a bother, install hand sanitizer or soap pumps in strategic locations throughout your home.

And don’t forget your medicine cabinet. Bring a list of its contents to your Walmart Pharmacist, who can refresh your memory if you’ve forgotten what a product is for and advise you on products that may not be right for you.17 Finally, check the expiry dates on all medications and safely dispose of expired products.17

Expect imperfection

I had a doughnut, may as well have five more. Who among us hasn’t given in to such sabotaging thoughts? Rather than abandoning your goals, take setbacks as an opportunity to learn. If you have one cigarette after going smoke-free for a month, ask yourself what triggered the behaviour and make a plan for a healthier response next time.18

Whatever you do, be kind to yourself. Far from motivating you to do better, self-blame and focusing on your “failure” drains your motivation and willpower.18 Instead, forgive yourself for your imperfections, adjust your goal if needed, and move on—with the help of your Walmart Pharmacist.



Resources

1Forbes: https://www.forbes.com/sites/ashiraprossack1/2018/12/31/goals-not-resolutions/#71b210d23879
2Harvard Health: https://www.health.harvard.edu/staying-healthy/seven-steps-for-making-your-new-years-resolutions-stick
3Entrepreneur: https://www.entrepreneur.com/article/286254
4ScienceAlert: https://www.sciencealert.com/how-long-it-takes-to-break-a-habit-according-to-science
5Brian Tracy: https://www.briantracy.com/blog/personal-success/smart-goals/
6Mind Tools: https://www.mindtools.com/pages/article/smart-goals.htm
7University of California: https://www.ucop.edu/local-human-resources/_files/performance-appraisal/How%20to%20write%20SMART%20Goals%20v2.pdf
8Canadian Family Physician: https://www.cfp.ca/content/cfp/62/2/131.full.pdf
9Government of Canada: https://www.canada.ca/en/public-health/services/publications/vaccines-immunization/canadian-immunization-guide-statement-seasonal-influenza-vaccine-2019-2020.html
10McMaster: https://www.mcmasteroptimalaging.org/blog/detail/blog/2017/04/10/is-it-time-for-a-medication-review-many-people-take-unnecessary-meds
11WebMD: https://www.webmd.com/a-to-z-guides/organize-medication#1
12GoSkills: https://www.goskills.com/Soft-Skills/Articles/Top-10-new-years-resolutions
13Family Education: https://www.familyeducation.com/life/new-years-resolutions/top-10-new-years-resolutions-families
14Getting Smart: https://www.gettingsmart.com/2019/10/small-talk-big-benefits-adding-conversations-to-reading-and-everyday-moments/
15Safety.com: https://www.safety.com/smoke-detector-placement/
16Safewise: https://www.safewise.com/home-security-faq/where-install-co-monitors
17Good Rx: https://www.goodrx.com/blog/how-to-organize-your-medicine-cabinet/
18The Guardian: https://www.theguardian.com/lifeandstyle/2019/jan/10/struggling-with-new-year-resolutions-willpower

This health information is provided to you by Mint

Mint

Seasonal Affective Disorder: Managing Winter Blues

Do you regularly find yourself feeling “blue” during the winter months?1,2,3

Like it or not, in Canada we can be sure that winter will arrive. As the days get shorter and hours of daylight are fewer, some people experience changes in mood and energy level because of the reduced amount of light. These mood changes may affect general wellbeing and may be due to:
  • Your biological clock – With less sunlight, your body’s natural wake-sleep cycle may be disrupted.
  • Serotonin level – The brain chemical serotonin affects mood. When this level drops because of less sunlight, you may experience mood changes.
  • Melatonin level – The brain chemical melatonin affects sleep and mood. As melatonin levels drop, this can disrupt sleep and impact mood.

If you experience changes in mood and energy levels seasonally – usually during late fall and winter – you may have a condition called seasonal affective disorder (SAD).

What is seasonal affective disorder (SAD)?1,2,3

SAD is a type of depression related to the changing seasons. In most people with SAD, symptoms begin in late fall, as the days get shorter, and end in late winter or early spring, as the days get longer. There are some people who experience SAD in the summer, but this is much less common.

About 2% to 3% of Canadians will experience SAD in their lifetime. About 10% of people who have depression have SAD. Some people (about 15% of Canadians) will experience a milder form of SAD that does not interfere with their daily routines but is still SAD.

What are the signs and symptoms of SAD?1,2,3

Signs and symptoms of SAD may include:

  • Wanting to sleep all the time (winter); not being able to get a good night’s sleep (summer)
  • Feeling sad, tired all the time, hopeless, irritable, tense, stressed, anti-social
  • Changes in appetite; food cravings such as sugar and starch
  • Low energy and motivation

It is important to know that while these symptoms are also general symptoms of depression, with SAD the symptoms will typically start and end at the same time each year.

Who is at risk of developing SAD?1,2,3

  • Adults (usually younger than 50 years old) are at greater risk of developing SAD.
  • Women may experience SAD more often than men.
  • People who live in countries further to the north or to the south of the equator, where daylight fluctuates seasonally.
  • People with a family history of SAD or other forms of depression.

How is SAD diagnosed?1,2,3

If you are concerned that you may have symptoms of SAD, speak with your doctor. He/she will take a history, perform a physical examination, and may recommend having some lab tests to rule out other conditions.

In addition to a physical examination, your doctor or a recommended mental health professional will do a psychological examination that will include questions about your symptoms, thoughts, feelings, and behaviours.

How is SAD treated?1,2,3

  • Light therapy- Light therapy is a common treatment for SAD. Your doctor or Walmart Pharmacist may recommend a light box that may be purchased for use at home. They can also advise you about when, how, and for how long to use the light box.

    The therapy requires that you sit a short distance from the light box to be exposed to bright light within the first hour of waking up. The light from the box is similar to natural, outdoor light and seems to cause changes in brain chemicals like serotonin and melatonin that are linked to mood. It may take a few days/weeks for the treatment to have an effect, but it seems to be effective for many people. You may experience some side effects including nausea, headache, and eye strain.

  • Counselling- Counselling (psychotherapy) may be helpful for some people, and in particular, some people may find cognitive behavioural therapy (CBT) helpful. Your doctor may be able to recommend therapists with expertise and experience treating people with SAD, and explain how and why counselling may be helpful.

  • Medication- Discuss with your doctor what medication may be most helpful. You may need to try more than one medication to see which one works best for you. Your doctor and Walmart Pharmacist can answer any questions you may have about what to expect with your medication, including how to take it, possible side effects, and how long it may take to relieve symptoms of SAD. Your doctor may recommend taking medication before your symptoms generally appear each year.

  • Self-help- There are many ways you may help reduce your symptoms:

    • Follow your treatment plan.
    • Practice yoga or meditation to relieve stress.
    • Consider art therapy or music therapy to help you relax.
    • Try to exercise regularly. Any physical activity helps to relieve some stress and anxiety, and may improve your mood and boost your energy level.
    • Practice good sleep habits.
    • Follow a healthful diet and try to avoid overeating sugary or starchy foods.
    • Make an effort to socialize and be with people you enjoy.
    • If your budget and vacation time allow, try to schedule a trip to a sunny destination during the winter.

Tips for making winter “brighter”2,3

  • Keep blinds and curtains open and up, and trim trees and high bushes in the yard to allow in more light.
  • If you are able, sit closer to windows at home and/or at work.
  • Get outside for a walk during the day, even on cloudy days. Any outdoor light will be helpful, especially within two hours of waking up, but any time during the day is a good time.

Support2,3

Your healthcare team, including your Walmart Pharmacist, may be supportive in several ways, such as answering questions you may have about SAD, your symptoms, and medications, and offering information and recommendations for counselling services, relaxation techniques, and more.

Let family and friends you trust and with whom you enjoy spending time know how you are feeling. Share a laugh or a tear with those you care for and who care for you. Stay connected!

References

1Centre for Addiction and Mental Health (CAMH). Seasonal Affective Disorder (SAD).https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/seasonal-affective-disorder. Accessed October 17, 2018.
2Canadian Mental Health Association (BC). Seasonal Affective Disorder. https://cmha.bc.ca/documents/seasonal-affective-disorder-2/Accessed October 17, 2018;http://www.heretohelp.bc.ca/sites/default/files/seasonal-affective-disorder_0.pdf. Accessed October 17, 2018.
3Mayo Clinic. Seasonal Affective Disorder. Symptoms & Causes.https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/symptoms-causes/syc-20364651.Accessed October 17, 2018.

This health information is provided to you by Pharma Science

Pharma Science

As spring begins to take hold, the familiar sneezing, itchy eyes and throat, and runny nose start to appear in people with seasonal allergies. An allergy is your body’s reaction to something in the environment that it becomes sensitive to – called an allergen – that typically doesn’t cause a reaction in most other people.1 It is estimated that more than one-in-six Canadians suffer from seasonal allergies.2 The allergy season in Canada typically begins in early spring and ends with the first real frost in late autumn.


What are seasonal allergies?3,4

Seasonal allergies, often called “hay fever,” are allergies people have to outdoor allergens, such as pollens that are in the air and mould spores that are stirred up into the air.


  • Allergies that appear in the spring (April-May) are usually due to tree pollen.
  • Allergies that appear in the summer (late May to mid-July) are usually due to grass and weed pollens and outdoor mould spores (mid-July) that may develop in rainy, humid weather on logs and rotting plants, in soil, and on grasses.
  • Allergies that appear in the fall (mid-August to October) are usually caused by weeds, especially ragweed.

What are the signs and symptoms of seasonal allergies?5

People with seasonal allergies may have some or all of these more common signs and symptoms:

  • Runny nose
  • Stuffy nose
  • Watery, red, itchy eyes
  • Sneezing
  • Coughing
  • Itchy nose, roof of mouth, or throat

Other symptoms may include blue-coloured skin under the eyes, postnasal drip, and fatigue.

Is it hay fever, or is it a cold?6

Symtoms Causes When do symptoms start? How long do symptoms last?
Hay Fever
  • No Fever
  • Runny or stuffy nose (clear, white, thin mucus)
  • Sneezing
  • Itchy nose, throat, and eyes
  • Cough is rare
  • Caused by exporsure to triggers: Pollen, Mould spores
  • Symptoms start quickly, upon exposure
  • Weeks or months
  • Symptoms last as long as you are exposed to the allergen
Common Cold
  • No fever
  • No aches and pains
  • Still have an appetite
  • Sore throat
  • Runny, stuffy nose
  • Sneezing
  • Most prominent symptoms are in the nose
  • Caused by one of more than 200 viruses
  • Symptoms usually come on gradually
  • Lasts about one week


How are seasonal allergies diagnosed?7,8,9

Both children and adults may have symptoms of seasonal allergies. A specialist doctor called an allergist can help you/your child determine the exact cause of the allergies, and learn more about seasonal allergies and how to best manage and treat them.

  • The doctor will ask if you have a family history of allergies and about you/your child’s allergy symptoms to see if there is a pattern to the symptoms.
  • If the symptoms and history suggest that you/your child may have seasonal allergies, the doctor may recommend allergy testing to confirm what allergens are causing you/your child’s symptoms.
  • Allergy testing is done by skin testing and/or blood testing.
  • The diagnosis of seasonal allergy is made when BOTH positive test results show a sensitivity to an allergen AND you/your child have symptoms when exposed to the allergen.
    • For example, if you/your child test positive to grass pollen and you/your child sneeze and have a runny nose when playing on the grass, you/your child would be diagnosed with an allergy to grass pollen.

Can outdoor seasonal allergy allergens be brought indoors?10

Even though your seasonal allergies are mainly triggered when you are outdoors, they may also be triggered indoors when allergens are brought in from the outside.

Allergens that may be brought indoors:

  • Pollen that comes into the house through open windows and doors
  • Pollen that comes indoors on your hands and in your hair
  • Pets may carry pollen in from outside on their coats

Indoor allergens that may trigger or make seasonal allergy symptoms worse:

  • Smoking
    • May not be a trigger for seasonal allergies, but it does make symptoms worse
  • Mould
    • May occur in damp bathrooms and basements

Preventing seasonal allergies10,11

Managing triggers

Avoiding your allergens is the best way to prevent symptoms. There are ways to manage your indoor environment, and when you are outdoors, there are ways you may avoid or reduce exposure to seasonal pollen.

Managing your indoor environment:

  • Keep bathrooms and basements dry and clean, especially if when it is humid in the summer.
  • Use a dehumidifier.
  • Avoid carpet in bathrooms and basements.
  • Keep windows and doors closed – as much as possible – during high-pollen seasons.
  • Use an air conditioner.
  • Change furnace filters regularly.
  • Avoid drying clothes outdoors when pollen levels are high.

Avoiding outdoor triggers:

  • Know the daily pollen count.
    • Pollen counts are highest when the weather is warm, dry, and breezy.
    • Your local weather forecast may include a pollen count during allergy season.
    • Pollen counts are often higher in the morning.
  • Wash your hands when you come indoors and shower or bathe in the evening to wash off pollen.
  • Wear gloves and a mask if you do a lot of gardening.
  • Keep your grass cut short.
  • Drive with the windows closed and the air conditioning on.

How are seasonal allergies treated?12

Medications

It is important to know what your allergens are and to try to avoid them if/when possible. If avoiding them is not always possible and symptoms are bothersome, medications may be used.

  • BEFORE taking any medication – even over-the-counter medications – to treat your allergy symptoms, speak with your doctor and/or pharmacist.
    • Always take your medication(s), or give your child his/her medication(s), exactly as you have been told to by your doctor and/or pharmacist.

These medications may help control symptoms:

  • Antihistamines help to manage symptoms including sneezing, runny nose, watery eyes, and itchy eyes and/or throat.
  • Decongestant nasal sprays, drops, or tablets may be used for stuffy nose.
    • They should only be used for a few days.
  • Inhaled steroids (nasal sprays) may be suggested if antihistamines are not controlling your symptoms, especially if your allergies are more severe.
    • These medications “prevent” symptoms, so they should be started BEFORE your seasonal allergy(ies) begin.

Allergy shots

If you are not able to manage your symptoms by avoiding triggers and taking medications, your doctor may recommend allergy shots.

  • These shots include small amounts of your allergen(s).
  • Allergy shots are usually given over a longer period of time.
    • Shots are given on a regular schedule to allow your body to get used to the allergen(s) and so that you no longer have the allergic reaction to it/them.
    • You may be asked to wait in your doctor’s office for about 30 minutes after each shot to be sure you don’t have a reaction to the shot.

Medications in pregnancy and breastfeeding13

  • Ask your doctor or pharmacist about which antihistamines are known to be safe in pregnancy.
  • Antihistamines are considered safe to use during breastfeeding.
    • Only very small amounts are excreted in the breast milk and would not cause any adverse effects on a breastfeeding infant. Talk to your healthcare practitioner if you have concerns.

Medications and allergy shots in children9

  • If it is not possible for your child to avoid seasonal allergy triggers, there are allergy medications, such as antihistamines, decongestants, and inhaled steroids (nasal sprays), that can help manage symptoms.
    • An allergist may evaluate your child and recommend allergy shots.
      • Always let your doctor know if your child is sick or experiencing asthma. The doctor may stop the shots until your child is better.
      • As with adults, your child will have to wait in the doctor’s office for about 30 minutes after each shot to be sure he/she doesn’t have a reaction to the shot.

Your doctor and/or pharmacist can help you make the right treatment choice(s) for your child’s symptoms and seasonal allergy history.

Seasonal allergies and asthma14

  • Approximately 75% of people with asthma also have seasonal allergies.
  • Some of the same allergens will trigger seasonal allergies and asthma.
  • Well-managed seasonal allergies may reduce asthma symptoms and may help prevent the development of asthma in children with seasonal allergies.


References

1American College of Allergy, Asthma & Immunology. Seasonal Allergies. https://acaai.org/allergies/seasonal-allergies.Reviewed and updated 12/28/2017. Accessed April 19, 2018.
2CBC News. Seasonal allergies: something to sneeze at. http://www.cbc.ca/news/health/seasonal-allergies-something-to-sneeze-at-1.930532. Posted March 19, 2010. Last updated May 13, 2011. Accessed April 18, 2018.
3Asthma Canada. Allergies. https://www.asthma.ca/allergies/about-allergies/. Accessed April 19, 2018.
4CBC News. The four seasons of hay fever. http://www.cbc.ca/news/health/the-four-seasons-of-hay-fever-1.1024941. Posted May 24, 2011. Accessed April 18, 2018.
5Mayo Clinic. Hay fever. https://www.mayoclinic.org/diseases-conditions/hay-fever/symptoms-causes/syc-20373039?p=1. Accessed April 19, 2018.
6Asthma.ca. Ah-choo! Is it a Cold, Hay Fever, Sinusitis or the Flu? https://asthma.ca/wp-content/uploads/2017/08/Sinusitis_Rhinitis_Comparison_Chart.pdf. Accessed April 18, 2018.
7Allergy/Asthma Information Association. Allergic Rhinitis. http://www.aaia.ca/en/allergic_rhinitis.htm. From Allergy & Asthma News 2008(2). Accessed April 20, 2018.
8Hospital for Sick Children. AboutKidsHealth: Allergies.https://www.aboutkidshealth.ca/Article?contentid=804&language=English. Updated December 18, 2014. Accessed April 18, 2018.
9KidsHealth®. About seasonal allergies. https://kidshealth.org/en/parents/seasonal-allergies.html. Reviewed October 2016. Accessed April 18, 2018.
10CHealth. Avoiding outdoor allergens. http://chealth.canoe.com/channel/allergy/allergy-prevention/avoiding-outdoor-allergens. Accessed April 18, 2018.
11Asthma Canada. Allergies: Taking control. https://www.asthma.ca/allergies/taking-control/. Accessed April 18, 2018.
12Asthma Canada. Allergies: Treatment. https://www.asthma.ca/allergies/treatment/. Accessed April 18, 2018.
13SickKids. Motherisk: Safety of antihistamines during pregnancy and lactation. http://www.motherisk.org/prof/updatesDetail.jsp?content_id=927. Published May 2010. Accessed April 19, 2018.
14Asthma Canada. Allergies. https://www.asthma.ca/allergies. Accessed April 19, 2018.

This health information is provided to you by Mint Pharmaceuticals, Inc.

Mint Pharmaceuticals



STROKE SMART


Not sure about your risk of stroke? Or what to do about it?
Your Walmart Pharmacist can help

Uncle Jim had a stroke. This sentence has a familiar ring to it, but many of us have only a hazy idea of what stroke means or why it happens. It’s information we can’t afford to ignore, though: stroke is surprisingly common—and often preventable.1 Read below for the must-have details.

What are strokes, and who gets them?

Strokes happen when blood stops flowing to any part of the brain and results in some brain cells being damaged.1 They come in two varieties: the most common type (called ischemic stroke) results from a blockage in a blood vessel in the brain, which can happen when a substance called plaque builds up inside your arteries.1 The other type (called hemorrhagic stroke) occurs when an artery in the brain breaks open, usually after becoming weaker from high blood pressure.1

More than 62,000 strokes occur in Canada each year.2 That’s a lot of strokes—about one every 10 minutes.3 What’s more, over 400,000 people in Canada live with the after-effects of stroke.2 The risk of stroke goes up as you get older, and about 10 per cent of people aged 65 years and older have had one.4 Stroke affects men and women to a similar extent, though women tend to have worse physical and mental outcomes.2

SIZE MATTERS

You may have heard of a mini-stroke, also known as a transient ischemic attack (TIA). TIAs last only a few minutes and don’t cause permanent damage.5 That said, one in three people who has a TIA will go on to have a stroke, so you can consider a TIA a warning—and a chance to take action to prevent a future stroke.5



Know your risk

Being older, having a close family member who had a stroke, or having an African, South Asian, or Indigenous heritage puts you at higher risk of stroke.6 While you can’t control your age or your origins, you do have the power to control many other risk factors, including an unhealthy weight or diet, lack of physical activity, smoking, and excessive alcohol use.6 Medical conditions that raise your risk of stroke, such as high blood pressure, high cholesterol, or diabetes,6 can also improve with a healthier lifestyle and the right treatment.6

If you’re serious about reducing your risk of stroke, start with your Walmart Pharmacist. A key player on your healthcare team, the pharmacist can help you evaluate your risk of stroke, offer strategies to improve your lifestyle, and work with your doctor to reduce your risk.7

READY, SET, SCORE8

One million people have used the Heart & Stroke Foundation’s risk assessment tool. Why not be one of them? It takes just seven minutes and provides visual feedback on your risk factors for heart disease and stroke—including the ones you can control. A bonus: the tool gives you a chance to set a healthy goal and receive personalized support. See the “Know Your Risk” box at https://www.heartandstroke.ca/stroke/risk-and-prevention.



Strike it down before it happens

You can begin reducing your risk of stroke today, starting right now. Your future self will thank you. Here’s what will help the most:9,10

  1.   Lose excess weight: As little as 10 pounds can reduce your risk.
  2.   Exercise moderately most days of the week. A walk around the block counts.
  3.   Have no more than one alcoholic drink per day.
  4.   Quit smoking. This step alone will make a big difference, as smoking doubles your risk.
  5.   Manage your medical conditions, such as diabetes or atrial fibrillation (irregular heartbeat).

The strategies for keeping strokes away will also reduce your risk of many other diseases and make you healthier overall. If you’re not sure where or how to start, your Walmart Pharmacist can offer support and suggestions, which could include monitoring your blood pressure, guidance on nutrition and exercise, and products to help you quit smoking.

Signs of a stroke

When you’re having a stroke and your brain lacks oxygen, your body gives you signals.11 These danger signs, which typically happen all of a sudden, include:11

  1.   Numbness or weakness in your face, arms, or legs, especially on one side of the body
  2.   Confusion or difficulty talking or understanding speech
  3.   Trouble seeing or double vision
  4.   Trouble walking, dizziness, or loss of balance or coordination
  5.   Severe headache without explanation
  6.   Nausea, vomiting, or drowsiness

If these symptoms last only a few moments, you may have had a mini-stroke.11 Whether or not the symptoms clear up, someone needs to call a doctor or 9-1-1 right away.11 When it comes to stroke, quick action can save lives.

FAST THINKING12

Not sure if it’s a stroke? Here’s a F.A.S.T. way to tell.
If your Face is drooping…
You can’t raise both Arms…
Or your Speech is jumbled…
It’s Time to call 9-1-1.



What happens after a stroke?

The great majority of people (about 85%) survive their stroke, and about 10% recover completely.13 For the remaining survivors, the after-effects will depend on the location of the blood shortage and how much brain tissue it affects.14 The muscles in your limbs may get weaker or stiffer, making it harder to get around independently.15 You may have trouble with your bladder and bowel control.15 Communication challenges, also common after a stroke, may include difficulty speaking, writing, and interpreting what others are saying.15

TAKING SIDES

While no two strokes are exactly the same, the outcomes tend to follow common patterns. If a stroke occurs on one side of the brain, it generally affects the other side of the body. Here’s what may happen:14

Effects of left-brain stroke
• Paralysis on the right side of the body
• Speech or language problems
• Slow, cautious behaviours
• Memory loss

Effects of right-brain stroke
• Paralysis on the left side of the body
• Vision problems
• Quicker behaviours
• Memory loss



When you have a stroke, a team of healthcare providers works with you to help you recover lost brain function and adapt to more permanent changes.16 Consider your Walmart Pharmacist a key member of your support team.

If you’ve already had a stroke

Once you’ve had a stroke, you’re at higher risk of having another one for the next five years, though you can bring down the risk by carefully following your treatment plan.17 If you had an ischemic stroke, blood thinners can help prevent more blockages.16 If you have high blood pressure, a number of medications can reduce it to safer levels. Of course, you should never take any of these medications without a doctor’s advice.

Your Walmart Pharmacist can teach you about your medications, help you manage side effects, and offer strategies to help you stick with your medication plan.15 For example, if you have trouble keeping track of your pills, your pharmacist can group them into blister packs.16 Blood thinners may carry their own risks, such as bleeding, and your pharmacist can give you tips to make using them as safe as possible.18

These supports make a real difference: studies show that stroke survivors who look to their pharmacist as a resource have better control of risk factors, better medical outcomes, and a better quality of life.19,20 So don’t hesitate to approach your Walmart Pharmacist to clear up your questions and ask for help, whether for yourself or for a loved one. When it comes to reducing your risk of stroke, every little bit counts.



Resources

1What is a stroke? https://www.heartandstroke.ca/stroke/what-is-stroke?gclsrc=aw.ds&&gclid=CjwKCAjwpqv0BRABEiwA-TySwR_1S2bQeAq8MhrwveZZP888zBqEc2k9LpefZLQq-nE3O_OqyLCfghoC8BMQAvD_BwE
2Stroke statistics in Canada: https://www.heartandstroke.ca/-/media/pdf-files/canada/stroke-report/strokereport2018.ashx?rev=8491d9c349f7404491f36be67f649c0b&hash=1BCC40A8A71C6EE5CBB3BEE2AD1941B7
3Stroke frequency in Canada: https://vghfoundation.ca/stroke-health/?gclid=CjwKCAjw7LX0BRBiEiwA__gNw6E0iCGt4tWndDZWoIGRFfOmh8sv-E625WwlzptUdSFHxMGZeC8ppRoCZtYQAvD_BwE
4Stroke statistics in Canada: https://www.canada.ca/en/public-health/services/publications/diseases-conditions/stroke-canada-fact-sheet.html
5Transient ischemic attacks: https://www.mayoclinic.org/diseases-conditions/transient-ischemic-attack/symptoms-causes/syc-20355679
6Stroke risk factors: https://www.heartandstroke.ca/stroke/risk-and-prevention
7Pharmacy-led stroke screening: https://www.albertahealthservices.ca/scns/Page10575.aspx
8Stroke risk assessment: https://ehealth.heartandstroke.ca/
9Steps to prevent a stroke: https://www.health.harvard.edu/womens-health/8-things-you-can-do-to-prevent-a-stroke
10How to prevent a stroke: https://www.webmd.com/stroke/guide/understanding-stroke-prevention#1
11Warning signs: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Preventing-Stroke#Warning%20Signs
12Signs of stroke (FAST acronym): https://www.heartandstroke.ca/stroke/signs-of-stroke
13Stroke mortality: https://bodyandhealth.canada.com/healthfeature/gethealthfeature/stroke
14Long-term effects of stroke: https://www.stroke.org/en/about-stroke/effects-of-stroke
15Stroke recovery & support: https://www.heartandstroke.ca/stroke/recovery-and-support
16Your Stroke Journey: https://www.heartandstroke.ca/-/media/pdf-files/canada/your-stroke-journey/en-your-stroke-journey-v20.ashx
17Risk of subsequent stroke: https://www.webmd.com/stroke/news/20170724/one-stroke-more-strokes-risk-remains-years-later#1
18Cautions with Aspirin: https://www.stroke.org/en/health-topics/heart-attack/treatment-of-a-heart-attack/aspirin-and-heart-disease
19Role of pharmacist in secondary stroke prevention: https://pubmed.ncbi.nlm.nih.gov/28929979/
20Impact of pharmacist interventions on stroke patients: https://www.researchgate.net/publication/309670977_Impact_of_clinical_pharmacist%27s_interventions_on_health_outcomes_in_post_stroke_patients

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Apotex



Summer Skin Care
Your Walmart Pharmacist can help



Did you know that 1 in 3 cancers diagnosed worldwide are skin cancers and 80 to 90% of those are caused by Ultraviolet (UV) rays?1 Although you can be exposed to UV rays throughout the year, the exposure is the highest in the summer.2 Follow these tips to protect your and your family’s skin and enjoy the outdoors safely:

  1. Check the UV Index: The UV index is a useful tool that tells you the strength of the sun’s daily UV rays, the higher the number the stronger the sun’s ray. When the UV index reaches 3 or more, it’s important to use extra protection. Spend less time outside between the hours of 11am and 3pm, when the sun’s rays are at their strongest or any time when the UV index is 3 or more.3
  2. Find Shade: If your shadow is shorter than you, it’s time to find some shade as this means the sun’s rays are at their strongest. Sit under a tree or an awning at a restaurant and bring an umbrella for protection when you can’t find shade.3
  3. Wear Sunglasses: Close-fitting sunglasses in a wrap-around style offer the best protection. Check the labels to ensure they are UV 400 or 100% UV protection.3
  4. Cover Up: Clothes can offer even better protection than sunscreen. Choose clothes that are made from tightly woven fabrics or that have UV Protection Factor (UPF). When choosing a hat, a wide-brimmed hat that covers your head, neck, ears and face is preferred.3 If wearing a baseball hat, don’t forget to apply sunscreen to your neck and ears.4
  5. Be Aware of Medications: Some medications can make your skin more sensitive to the sun.4 Check with your Walmart Pharmacist to find out if any of your medications can cause sun sensitivity.
  6. Sunscreen Properly: Sunscreen absorbs the UV rays and prevents them from getting into the skin.3 Keep these tips in mind when using sunscreen products:
    • Use a broad-spectrum sunscreen that is water resistant as this will protect you from UVA and UVB rays and stay on better in the water.5
    • Choose a sunscreen with an SPF of at least 30. SPF stands for Sun Protection Factor and tells you the ability of the sunscreen to block out UVB rays. A sunscreen with an SPF of 30 will block out 97% of the sun’s UVB rays.5
    • Remember to apply a generous amount (the average adult needs about 2 to 3 tablespoons to cover their body and another teaspoon for the face and neck).5
    • Reapply at least every 2 hours and sunscreen should be reapplied after swimming, toweling off or sweating.5
    • Sunscreen should be applied before insect repellant.5
    • Protect your lips with a SPF lip balm and make sure to reapply especially after eating or drinking.5
    • Apply sunscreen on cloudy days and during winter months as UV rays can pass through clouds and reflect off bright surfaces like snow.5
    • Don’t use sunscreen after they have expired as they contain chemicals that may not work as well after expiry. They can be affected by extreme changes in temperature so if it has been frozen or overheated or changed color or smell, it’s better to throw it out.5
    • Babies 6 months and younger cannot use sunscreen but should be protected by using clothing and being in the shade.4
    • If your overwhelmed by the number of choices of sunscreen products available, ask your Walmart Pharmacist for help in choosing which sunscreen would be best for you and your family.
  7. Don’t Use Tanning Beds: Tanning beds expose your skin to harmful UV rays that increase your risk of cancer. There is no evidence that using tanning beds to get a base tan will decrease your risk of sunburns.4
  8. Check Your Skin Regularly: Look for any skin changes or any changes to moles, freckles or birthmarks. If you notice anything different, let your health care provider know and have them provide regular skin evaluations as well.4

How to Treat Sunburns

It can take up to two days after being sunburned for the full severity of the sunburn to become apparent. Your skin won’t begin to heal for several more days.6 If the sunburn has blisters or the skin appears white or is numb, contact your health care professional as these are symptoms of a more serious sunburn.7 Treating a sunburn at home doesn’t help heal your skin but the following tips will help decrease the pain, swelling and any discomfort6:

  1. Take a Pain Reliever: If needed and if taken soon after sun exposure, over-the-counter pain relievers may help reduce the pain and swelling of a sunburn.6 Ask your Walmart pharmacist which pain reliever would be the best one for you to take.
  2. Rehydrate: Drink water, juice or sports drinks to replace fluids.
  3. Cool the skin: Apply a towel dampened with cool water or take a cool bath or shower to soothe the skin.6,7
  4. Apply Moisturizer, Lotion or Gel: Aloe Vera lotion or gel or a calamine lotion can be soothing to the skin.6
  5. Treat Peel Skinned Gently: Sometimes after a few days, the affected skin begins to peel. This is the body’s way to get rid of the damaged skin. Keep moisturizing your skin as it peels.6
  6. Protect Your Sunburn from Further Damage: Stay out of the sun until your skin heals and if you do go outside, protect yourself from the sunlight.6

Remember if you have any questions about sun protection or treating any sunburns, just ask your Walmart Pharmacist for help. They will be able to provide recommendations based on your specific needs.



Resources

1https://www.canadianskincancerfoundation.com/skin-cancer/ Accessed on May 1, 2020.
2https://www.canada.ca/en/environment-climate-change/services/weather-health/uv-index-sun-safety/seasons.html Accessed on May 1, 2020.
3https://www.cancer.ca/en/prevention-and-screening/reduce-cancer-risk/make-healthy-choices/be-sun-safe/the-6-best-ways-to-be-sun-safe/?region=on Accessed on May 1, 2020.
4https://newsnetwork.mayoclinic.org/discussion/9-tips-to-protect-your-skin-this-summer/ Accessed on May 1, 2020.
5https://www.cancer.ca/en/prevention-and-screening/reduce-cancer-risk/make-healthy-choices/be-sun-safe/sunscreen-101-quick-tips-on-using-sunscreen-products/?region=on Accessed on May 1, 2020.
6https://www.mayoclinic.org/diseases-conditions/sunburn/diagnosis-treatment/drc-20355928 Accessed on May 4, 2020.
7https://www.webmd.com/first-aid/sunburn-treatment Accessed on May 4, 2020.



This health information is provided to you by Apotex

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Travel Health

Canadians are travelling more and more each year, whether for work or pleasure. But whatever the reason, it’s important to make sure your travel planning includes taking measures for healthy travel.1 Being proactive, prepared and taking precautions will help ensure a healthy trip for you and those travelling with you.2 The following tips can help:

1. Consider Your Health Status: Check with your doctor to see if you should cancel or delay your travel plans if you are not feeling well, especially if you have a fever. This can help prevent spreading diseases to others as well as ensuring you don’t end up with a health emergency during your trip. If you’re pregnant, you can be at higher risk for certain conditions such as blood clots due to flying. Talk to your doctor about what specific precautions or health considerations to keep in mind for safe travelling while pregnant.3

2. Get Immunized: Book an appointment with a travel clinic (or your doctor or Walmart pharmacist if they offer travel services) a few months before any international travel. In certain Canadian provinces, pharmacists are permitted to inject travel vaccines. Some countries require specific immunizations prior to entry and may require more than 1 dose that needs to be separated by a few months. This is also a good time to get updated on routine immunizations as well. Ask your travel expert to review any other health precautions you may need to take based on your destination, such as malaria prevention.2

3. Learn About Your Destination: It’s a good idea to do research on where you will be visiting. Some precautions will be discussed at your travel health appointment but you should look into things, such as whether the tap water is safe to drink or if there are any specific customs or rules, especially if you plan on driving,. Motor vehicle accidents are the leading cause of injuries during travel. A good resource is www.travelhealth.gc.ca by the Public Health Agency of Canada. You can review by destination and get information on travel health notices, safety and security, natural health disasters etc. for your specific travel destination.4

4. Pack a Travel Health Kit: There are few essentials that all travel health kits should include. This includes:

  • Basic first aid items (bandages, gauze, tweezers, antiseptic etc.)
  • Insect repellant
  • Sunscreen
  • Antibacterial hand wipes
  • Thermometer
  • Oral rehydration solution packet

Over-the-counter travel medications should always be discussed with your Walmart Pharmacist or doctor before you leave on your trip. It is important to make sure medications such as pain/fever medications, travel diarrhea treatments, motion sickness medications, antihistamines, and laxatives etc. are appropriate for your specific needs and you need to understand when/how they should be taken.5

5. Travel Safe with Prescription Medications: When travelling with prescription medications, make sure to keep them in the original container and pack them in a waterproof container in your carry-on luggage. You should pack extra medication in checked luggage in case of loss or unexpected travel delays. A cooler might be needed for medications that need to be refrigerated, such as insulin. It’s also a good idea to travel with a copy of the prescriptions or letter from your doctor outlining your conditions and the medications you take.2 Talk to your Walmart Pharmacist to see if you are eligible for a medication review. Your Walmart Pharmacist can review all your medications and provide you with a detailed medication list that would provide the information you need for a trip.

6. Manage Jet Lag: Jet lag makes it hard for you to sleep at night or stay alert during the day, and it can also make you feel weak and affect your bowel movements. It occurs when you cross time zones; most people won’t feel the effects until they’ve crossed three time zones. The more time zones you cross, and if travelling east, the more you will feel the effects. Talk to your doctor and/or Walmart pharmacist to see if melatonin (hormone that helps regulate sleep/wake cycle) or sleeping pills would be appropriate. Other tips that can help:

  • Get plenty of rest before your trip
  • If your trip is 2 days or more: sleep 1 hour earlier each night for a few days before travel when travelling east and 1 hour later if travelling west
  • Set your watch to the new time zone on the plane and try to sleep/stay awake depending on what the time is at the destination
  • Stay hydrated by drinking lots of water and avoiding alcohol and caffeine on the plane
  • Adjust your schedule as soon as you arrive – go to sleep at your usual bedtime and try not to sleep in
  • If travelling for a big event, try and arrive a few days before to give your body time to adjust6

7. Learn what To Do If You Get Sick While Away: Contact the Canadian Consulate or Embassy if you become seriously ill as they can help you find medical care. For locations by destination, please refer to the Government of Canada website: https://travel.gc.ca/assistance/embassies-consulates. If travelling to a malaria-risk area, get medical help right away if you become ill with a fever or flu-like symptoms. Traveller’s diarrhea is the most common illness while away on a trip. If it lasts more than 7 days or if you have a fever, bloody or mucus in your stools, and/or signs of dehydration, make sure to see a doctor. 5 To help avoid traveller’s diarrhea watch what you eat:

  • Avoid eating food from street vendors
  • Make sure all milk and dairy products consumed are pasteurized
  • Don’t eat raw or undercooked meat and seafood
  • Stick to fruits and vegetables that are cooked and only eat raw ones if they can be washed and peeled by yourself
  • Avoid unsterilized water and ice in high-risk countries.7

8. Get Post Travel Care When Needed: If you were healthy while away and feel fine when you return, there is no need to see your doctor. But keep in mind that some diseases can take weeks to months to show any symptoms. If you were sick with fever or serious flu-like symptoms while away or within 6 months of returning, have diarrhea that won’t go away or keeps recurring, skin rash or sores, fatigue, unexplained weight loss, yellowing of the whites of the eyes or shortness of breath, be sure to see your doctor and mention which areas you travelled to.8



References

1https://www.statcan.gc.ca/daily-quotidien/170818/dq170818b-eng.htm Accessed May 4, 2018
2https://www.healthlinkbc.ca/health-topics/te7636#te7641 Accessed June 12, 2018
3https://travel.gc.ca/travelling/publications/well-on-your-way Accessed June 12, 2018
4https://www.healthlinkbc.ca/health-topics/te7636 Accessed May 14, 2018
5https://www.healthlinkbc.ca/health-topics/te7642#te7642-sec Accessed May 15, 2018
6https://www.healthlinkbc.ca/health-topics/ug4997#ug4998 Accessed May 15, 2018
7https://www.mayoclinic.org/diseases-conditions/travelers-diarrhea/symptoms-causes/syc-20352182 Accessed June 12, 2018
8https://www.healthlinkbc.ca/health-topics/te7636#te7647 Accessed May 16, 2018

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CONCERNED ABOUT TRAVELLER’S DIARRHEA?

Your pharmacist can help – before and after your trip

Montezuma’s revenge, Tut’s tummy… whatever you call it, traveller’s diarrhea does not make a pleasant travel companion. In fact, it can ruin a much-anticipated holiday.

However, it would be a shame to let concerns about traveller’s diarrhea keep you from exploring the world. Fortunately, you can take steps to make the experience less uncomfortable — or avoid it altogether. Consider your Walmart Pharmacist a valuable partner in this mission.

What is it, anyway?

Traveller’s diarrhea is the most common health issue that travellers face, striking up to 40% of people visiting less developed parts of the world.1 The risk tends to be highest in South Asia, the Middle East, tropical Africa, and Central America.2

Most people develop traveller’s diarrhea by eating foods or drinking beverages contaminated with bacteria (often E. coli), viruses, or parasites.3 These “bugs” can sneak into undercooked meat or fish, fresh salads, raw vegetables, unpeeled fruit, cold sauces, unpasteurized dairy products, and untreated water.3

Did you know?3

In a survey of about 500 Canadians, most respondents revealed they know very little about the possible sources of E. coli infection while on vacation:

  • 94% didn’t know contaminated ice cubes could contain E. coli.
  • 96% didn’t know raw fruits and uncooked vegetables could cause it.
  • 86% didn’t know that improperly cooked beef could lead to an E. coli infection.
  • 67% didn’t know they could get infected with E. coli from contaminated water.

All told, a whopping 98% of Canadians surveyed make a food or water mistake within their first three days of travel.4


If you have traveller’s diarrhea, you will probably know it. But here is a classic definition: three or more loose (and possibly bloody) stools in 24 hours along with at least one of the following symptoms: fever, nausea, vomiting, and/or cramps.5 While obviously unpleasant, the condition does not usually put healthy adults at serious risk. However, children and the elderly who get it can become dehydrated very quickly, so you need to watch them closely.6 When in doubt, always check it out! Seek advice from a healthcare professional if you have questions or concerns.

Which bug is to blame? What to expect7
Caused byHow commonCluesDuration

Bacteria

80-90% of cases

Starts suddenly Classic symptoms

3-5 days

Viruses

5-8% of cases

Starts suddenly Vomiting may be greater

2-3 days

Parasites

< 10% of cases

Starts gradually

Weeks to months if untreated

An ounce of preparation

Your Walmart Pharmacist can recommend products to help you prevent — or, in the worst-case scenario, handle — traveller’s diarrhea. Here are some options to discuss with your pharmacist:

  • Bismuth subsalicylate: Taking a medication containing bismuth (such as Pepto-Bismol®) before your trip can decrease your risk of getting traveller’s diarrhea by up to 50%.7 Your Walmart Pharmacist can let you know when and how to take it. Avoid bismuth if you’re pregnant, and don’t give it to a child under age 3.8
  • Dukoral® vaccine: This drinkable vaccine lowers your risk of getting traveller’s diarrhea caused by E. coli for about three months. Thus, you can take it before your vacation.3 You don’t need a prescription to get the vaccine; just ask your Walmart Pharmacist to help you. While Canada’s tropical medicine committee (called CATMAT) doesn’t recommend Dukoral for everyone, the precaution makes sense in people at higher risk.9 Just ask your Walmart Pharmacist to help you decide if the vaccine is right for you.
  • Loperamide: If you do get traveller’s diarrhea, this medication decreases how often and how urgently you need to go to the bathroom,8 which can make your scheduled train or plane ride a lot more bearable.
  • Antibiotics: If you’re travelling to a high-risk area, your doctor may prescribe antibiotics. Keeping the pills on “standby” during your trip can allow you to treat severe traveller’s diarrhea early. (Mild cases don’t require antibiotics at all.) Antibiotics shorten the duration of traveller’s diarrhea, especially when combined with loperamide.10 Be sure to discuss when to take the antibiotics with your doctor or Walmart Pharmacist before you leave. In very limited cases, a healthcare professional may suggest you take antibiotics before your trip as a preventive measure.10 Your Walmart Pharmacist can also advise you about the pros and cons of antibiotics for traveller’s diarrhea.
  • Oral rehydration: If you’re travelling with children or older people, or if you have a chronic illness, talk to your Walmart Pharmacist about oral rehydration products. They are available in powdered form so they can be packed easily and mixed with water later. These products help replenish essential vitamins and minerals that the diarrhea may have washed out of your body.11 In children, who have a much greater risk of getting dehydrated, oral rehydration is essential as long as the diarrhea continues.11 While most pharmacies around the world carry these products, packing some in your travel kit can give you extra peace of mind.

While on your trip

Spending the day exploring an exciting new place can bring on thirst, especially in the hot summer months. But don’t reach for the first liquid you see! If at all possible, stick to drinks from commercially sealed containers. (Water in a bottle could be tap water.3) If you’re unsure, don’t drink it! And remember that ice cubes may also come from water that is not clean.

When eating fruits or vegetables, follow the rule of “cook it, boil it, peel it, or leave it.”3 Wait until you have washed fruit in clean water and peeled it before you eat it.8 Your safest bet in a restaurant is to eat only items that are both cooked and served hot. The salad buffet that’s been sitting at room temperature since the morning? Give it a pass.

The most effective strategies are often the simplest, like washing your hands. Wash them often — not just before and after eating. Wash your hands several times throughout the day.7 Good hand hygiene keeps germs from spreading.

Street food smarts12

For many people, a big part of the travel experience includes sampling local foods on the street. Here’s how you can enjoy street foods without putting yourself at high risk of traveller’s diarrhea:

  • Give yourself a few days to adjust to the local cuisine before sampling street food.
  • Do as the locals do: If people are lining up to buy food at a kiosk (especially families), it’s usually safe.
  • Take time to watch the street vendor’s food hygiene – which means how they prepare the food.
  • Check the oil used to fry foods. If it’s cloudy or dirty, it’s probably being reused.
  • If it’s not thoroughly cooked, walk on.

If traveller’s diarrhea strikes

While prevention measures will greatly reduce your risk, traveller’s diarhhea can still find you. If your symptoms suggest traveller’s diarrhea, start treatment right away. There is no need to first get a formal diagnosis. Begin by drinking safe beverages, such as bottled water or bottled unsweetened fruit juice to replace the fluids you’ve lost. It’s important to know that alcohol and caffeine can make dehydration worse, not better, and that sugary drinks can worsen diarrhea.9

Now is the time to reach for the loperamide your Walmart Pharmacist advised you to pack. The bismuth subsalicylate-containing medication you took as prevention can also help shorten the duration of the illness.13 If you seem to have a more severe case, consider taking those antibiotics you brought with you and/or seeing a healthcare professional.

When to seek medical help6,14
For adultsFor children
  • Diarrhea lasts more than two days
  • You become dehydrated
  • You have severe pain
  • You have bloody or black stools
  • Your fever is higher than 39°C (102°F)
  • You are losing fluids faster than you can take them in
  • Persistent vomiting
  • Fever of 39°C (102°F) or higher
  • Bloody stools or severe diarrhea
  • Dry mouth or crying without tears
  • Peeing less often or fewer wet diapers
  • Unusually sleepy or nonresponsive
A local embassy or consulate may be able to help you find a healthcare professional.

Back on home soil

If you still have symptoms after you get home, a visit to your Walmart Pharmacist can help speed up your recovery. Your pharmacist will likely recommend some of the treatments listed above. Symptoms that will not go away or get worse require a doctor’s attention, of course. But in the great majority of cases, your traveller’s diarrhea will quickly resolve — making the memory of your trip one that you can share with family and friends, along with your souvenirs.



Resources

1UptoDate—prevalence: https://www.uptodate.com/contents/travelers-diarrhea-microbiology-epidemiology-and-prevention
2Journal of Travel Medicine—riskiest regions: https://academic.oup.com/jtm/article/24/suppl_1/S2/3782734
3Newswire Canada—causes of TD: https://www.newswire.ca/news-releases/canadians-widely-unaware-of-how-to-protect-against-travellers-diarrhea-caused-by-an-e-coli-infection-515800651.html
4Dukoral website—food/water mistake stat: https://www.dukoralcanada.com/high-risk-areas
5AAFP article—symptoms: https://www.aafp.org/afp/2005/0601/p2095.html
6Mayo clinic—risk in children, when to see a doctor: https://www.mayoclinic.org/diseases-conditions/travelers-diarrhea/diagnosis-treatment/drc-20352188
7U.S. Pharmacist—what to expect from different causative agents: https://www.uspharmacist.com/article/approach-to-treatment-and-prevention-of-travelers-diarrhea
8CDC advisory—safe eating and drinking practices, loperamide: https://wwwnc.cdc.gov/travel/page/travelers-diarrhea
9Canadian Family Physician—CATMAT vaccine recommendations: https://www.cfp.ca/content/61/11/976
10Medscape—antibiotics as treatment and prevention: https://www.medscape.com/viewarticle/887515_1
11HealthLink BC—oral rehydration: https://www.healthlinkbc.ca/health-topics/aa140669spec
12Travel insurance review—street food safety: https://www.travelinsurancereview.net/tips-and-advice/travel-safety-tips/tips-safe-street-food/
13WebMD—bismuth (Pepto-Bismol) as treatment: https://www.webmd.com/digestive-disorders/travelers-diarrhea#1
14MedicineNet—rapid fluid loss: https://www.medicinenet.com/travelers_diarrhea/article.htm#how_is_travelers_diarrhea_treated

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Understanding Blood Cholesterol

Every 7 minutes in Canada someone dies from heart disease or stroke. Understanding the risks of high blood cholesterol can help you beat the odds!1

How the heart works

Your heart is a muscle and its job is to pump blood around your body, to carry oxygen and other important nutrients needed by every cell in the body.

Did you know that:

  • the average size of a heart is about the size of your fist?
  • a heart pumps on average 2,000 gallons of blood per day?
  • a heart beats about 100,000 times a day?2,3

Why blood cholesterol matters

High blood cholesterol is one of the major controllable risk factors for heart disease and stroke. As your blood cholesterol rises, so does your risk.

Cholesterol is a lipid (fat) naturally found within the human body and is an essential building block for cell membranes, hormones and vitamin D.4 However, high blood levels of certain types of cholesterol can increase heart disease risk. Your Walmart Pharmacist can help answer any questions you may have about why controlling blood cholesterol is important to your health.

Who should take the test?

The only way to know if you have high cholesterol levels is to have a simple blood test. Everyone can take the test. The Canadian Guidelines5 recommends screening of cholesterol and heart disease risk if you:

  • are a male over 40 years of age
    are female over 50 years of age and/or post-menopausal
  • have heart disease, diabetes or high blood pressure
  • have a waist circumference greater than 94 cm (37 inches) for men and 80 cm (31.5 inches) for women
  • smoke or have smoked within the last year
  • have erectile dysfunction (ED)
  • have a family history of heart disease or stroke

Other risk factors:6,7

  • Ethnicity: Individuals of First Nations, African and Asian descent have greater risk
  • Physical inactivity

The more risk factors you have, the more important it is to keep your cholesterol in target range.8

The Good, the Bad and the Ugly

The blood test can measure the three following kinds of cholesterol (fat) in your blood :

  • HDL cholesterol
  • LDL cholesterol
  • Triglycerides

The Good: HDL cholesterol is often referred to as ‘good’ cholesterol because it helps to remove excess cholesterol from the body.

The Bad: LDL cholesterol is often referred to as ‘bad’ cholesterol because it can form plaque or fatty deposits on the walls of your arteries (blood vessels). If your LDL level is high, it can block blood flow to your heart and brain.

The Ugly: Although not considered a risk factor all by itself, high levels of triglycerides appear to be associated with greater risk of heart disease. Triglycerides are not a cholesterol, but are the most common form of fat in the body.9

Managing your cholesterol

You can take control of your health by making healthy lifestyle choices that can decrease your blood cholesterol and reduce your risk of developing heart disease and stroke. The Heart and Stroke Foundation10 recommends that you:

1. Eat a healthy balanced diet

  • Choose lower fat dairy products or alternatives with no added sugar. Select 1% or skim milk, plain yogurt and lower fat cheeses.
  • Plan healthy snacks with at least 2 different types of food. For example try: hummus and baby carrots; apple wedges and lower fat cheese or plain yogurt with berries.
  • Drink water or lower fat plain milk to satisfy thirst.
  • Avoid sugary drinks including soft drinks, sports drinks, sweetened milk or alternatives, fruit drinks, 100% fruit juice and ready-to-drink sweetened coffees and teas.

Note: If your blood cholesterol level is high, your physician or dietitian may recommend restricting your intake of foods high in cholesterol such as egg yolks, organ meats, full- fat dairy products and processed meats.

2. Cook and eat more meals at home

  • Cooking at home allows you to select whole and minimally processed foods.
  • Reduce the amount of sugar, salt and solid fats used in your favorite recipes.

3. Make eating out a special occasion

  • Eating out usually results in you consuming large amounts of food, and more fat, salt and sugar.
  • When you do eat out, choose restaurants that serve freshly made dishes using whole and minimally processed foods and provide nutrition information.

4. Achieve and maintain a healthy weight

  • Being overweight or obese increases your LDL or bad cholesterol level, lowers your HDL or good cholesterol level and raises your triglyceride levels. Reducing your weight is a positive way to reduce your blood cholesterol levels.

5. Be active

  • Being physically active will help improve your cholesterol levels and general heart health. Aim for 150 minutes a week. That is less than 25 minutes per day!
  • Choose activities you like. Cycling, swimming, gardening, walking are great ways to keep active.

6. Be smoke-free

  • Smoking is a risk factor for heart disease. It reduces the level of your HDL “good” cholesterol. Once you quit, within a few weeks your HDL levels may start to rise.

Consult your doctor or your Walmart Pharmacist for more information on lifestyle tips! Some people may need prescription cholesterol medication to help control their blood cholesterol. Just ask your doctor or Walmart Pharmacist for advice!



Resources

1http://www.hricanada.org/about-heart-disease/facts-about-heart-disease
2https://www.heartandstroke.ca/heart/what-is-heart-disease/how-a-healthy-heart-works
3https://www.healthline.com/health/fun-facts-about-the-heart#1
4https://www.heartuk.org.uk/cholesterol/what-is-cholesterol
5https://www.heartandstroke.ca/heart/risk-and-prevention/condition-risk-factors/high-cholesterol
6Genest J et al. Can J Cardiol Vol 25 No 10 October 2009, 2009 Canadian Cardiovascular Society/Canadian Guidelines for the diagnosis and treatment of dyslipidemia and prevention of cardiovascular disease in the adult- 2009 recommendation.
7https://pwc.ottawaheart.ca/education/heart-health-education/risk-factors/ethnicity
8https://www.nhlbi.nih.gov/files/docs/public/heart/wyntk.pdf, p.3
9https://my.clevelandclinic.org/health/articles/17583-triglycerides--heart-health
10https://www.heartandstroke.ca/heart/risk-and-prevention/condition-risk-factors/high-cholesterol

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