By Wendy Haaf
Find out what to do after treatment
Once you’re on the other side of a cancer treatment, how do you go about living as long and healthy a life as possible, both physically and emotionally? Since an estimated two in five Canadians will develop some form of the disease in their lifetimes and 63 per cent of all survivors—regardless of cancer type and grade—will live at least five years after diagnosis, that’s a question many of us will eventually face.
Thankfully, researchers have been working on finding answers, and a growing body of evidence suggests that the everyday choices people make after finishing chemotherapy and radiation treatment have the power to increase both longevity and the quality of life after cancer and may even help reduce the odds of encountering the disease again.
“There’s a lot people can do to improve their physical and psychological health,” says Dr. Gary Rodin, a professor of psychiatry at the University of Toronto and head of supportive care at Princess Margaret Hospital.
Dealing With Depression
“It’s completely normal to get depressed when you’re diagnosed, and there’s nothing harmful about that,” says Janine Giese-Davis, a researcher and adjunct associate professor in the department of psychology at the University of Calgary and the Tom Baker Cancer Centre’s Division of Psychosocial Oncology. “What’s harmful is if it becomes a chronic pattern, so that six months or a year later, you’re still at the same level of depression or even higher.
The evidence now for a link between depression and reduced survival is pretty strong—and increasing.” (Needless to say, depression also substantially diminishes quality of life.) For instance, the authors of a 2009 analysis of 25 studies found the premature mortality rate among cancer survivors who’d been diagnosed with depression was up to 39 per cent higher than in their nondepressed counterparts.
There are undoubtedly multiple factors behind this phenomenon, including that depression is known to impair the immune system’s disease fighting capabilities and reduce a person’s ability to consistently stick to the kind of healthy lifestyle that can mitigate the increased risk for other chronic diseases (such as heart disease and osteoporosis) that go hand-in-hand with a history of cancer.
While treating depression is worthwhile for the latter reason alone, there’s also some preliminary evidence that this also may improve the odds of long-term survival. Giese-Davis cites a study she authored, involving women with stage four (the most advanced stage) metastatic breast cancer. “Decreasing their depression levels in the first year after diagnosis predicted them living longer,” she says.
Interestingly, the specific strategies women used to tackle their depression— which ranged from participating in group psychotherapy to joining recreational groups—wasn’t important. “All that mattered is that they decreased that depression level,” Giese- Davis says. “I think that’s even more hopeful—that you don’t have to be the type of person who goes to psychotherapy; you can be the type of person who exercises or volunteers.” She adds that most practitioners would recommend a combination of medication and some form of therapy for moderate to severe depression. “Antidepressants help you put a floor under yourself and get enough energy to do the work to get you back into feeling some hope about your life.”
Living with the possibility of a cancer recurrence could leave the calmest, most unflappable person struggling with anxiety. “I think most people who’ve been diagnosed with cancer live between being on the edge of fear that the cancer will return and wanting to make the best of the time they have,” Giese- Davis says.
“And just as there are many ways to improve depression levels, there are similarly numerous ways to improve anxiety levels.” Such strategies include learning relaxation techniques and expressing your fears in a safe environment, she says, adding that often means talking to someone other than the people closest to you, who typically are grappling with their own fears and their worries for you.
“Expressing how you feel—fearful, sad, angry, or whatever—really goes a long way to diminishing depression and anxiety,” Giese-Davis says. And as counterintuitive as it may sound, confronting your fears directly and even delving into them more deeply, albeit in the right way, can also be beneficial. While at Stanford University in California, Giese-Davis was involved in a study for which women with metastatic breast cancer examined their worst fears. “We had them talk about exactly what their fears were about and what they imagined,” she says. Once participants had pinpointed the things that caused them the most anxiety, they actively took steps to prevent that worst-case scenario. For example, if the thought of friends and family having to provide personal care in the event that you lost your independence was what you found most disturbing, you might start saving money so you could hire a caregiver if necessary. “The remarkable thing was, instead of depressing people, it often released them back into their lives,” Giese- Davis says.
Something many people do naturally in the aftermath of a cancer diagnosis can also be a stepping stone to reducing anxiety. “Some people begin to think about how they’re spending their lives, what sort of work they want to do, their relationships, what’s really valuable to them,” Princess Margaret Hospital’s Dr. Rodin says. “Maybe they haven’t been spending as much time with their families as they might have wanted, and they realize that might be more important than all of the other things they were doing.”
Finding ways to channel your time and energy into the things that mean the most to you doesn’t just make you happier and more engaged, it may also wrestle your anxiety down to more manageable levels. “Whether it’s making some kind of legacy for your grandkids, making quilts, joining local politics, or volunteering for cancer research projects, when you’re doing something meaningful, it’s hard to be anxious,” Giese-Davis says.
Sure, you know that a healthy diet is linked with a lower risk for several types of first-time cancers, but if you’ve already been diagnosed, you might assume that the horse is already out of the barn. In fact, accumulating evidence strongly suggests that’s not the case at all.
For one thing, following treatment, cancer survivors face higherthan- average odds of developing several chronic health problems including heart disease, Type 2 diabetes, and osteoporosis; a healthy lifestyle, including excellent nutrition, can help cut those heightened risks down to size.
“We know that maintaining a healthy weight, consuming a nutrient- rich diet, and being physically active are all going to be important to a person’s long-term health,” says Christy Brissette, a registered dietitian with the Head & Neck Centre and the ELLICSR Health, Wellness, and Cancer Survivorship Centre at Toronto’s Princess Margaret Hospital. “We’re also getting more and more evidence indicating that by managing all of these things, we might see a lower risk for recurrence of certain cancers. And in some cancers, we’re seeing a trend such that there might be a lower risk for recurrence, as well as improvements in overall survival after treatment.”
So what kinds of dietary changes could improve your long-term prognosis? If your body weight is higher than what’s considered healthy, cutting nutritionally empty calories is a good place to start. “The number one thing we can do to lower our risk for cancer is to be as lean as possible without being underweight,” Brissette explains. “Carrying extra weight, especially around the midsection, is associated with higher insulin levels and all kinds of hormone cascades that are being linked to a higher risk for certain cancers.”
Cutting back on sugary drinks and foods high in added sugars and low in fibre (i.e., many processed foods) and focusing on whole foods serves a dual purpose. First, these changes improve your chances of shrinking a spare tire, but perhaps even more importantly, this type of eating pattern helps curb blood sugar levels and, by extension, the amount of insulin the body produces in response.
Fat is another nutrient that seems to play a key role in cancer prevention. “There have been a lot of studies looking at the impact of dietary fat, mainly on breast, prostate, and ovarian and other gynecological cancers,” Brissette says, “and basically, the type of fat seems to be just as important as overall fat.” The importance of the latter is likely because fat is relatively dense in calories. As far as type of fat goes, “higher saturated fat intakes are being linked to shorter survival, and greater monounsaturated fat intakes might predict longer survival in some cancers.”
Consequently, most experts now recommend replacing saturated fats from sources such as red meats and full-fat dairy products with monounsaturated fats from things such as olive oil, nuts, and avocados. Keep in mind that portion size is still important, since these healthy fats are equally high in calories.
That theme of de-emphasizing animal sources in favour of plants is echoed in the results of other studies aimed at pinpointing the best diet for cancer survivors. “So far, what we see is that the type of diet that’s linked to a lower risk for different types of cancer in some cases also reduces the risk for recurrence,” Brissette says. “Basically, that dietary pattern is high in vegetables, fruits, whole grains, and beans and legumes, and includes leaner foods that come from animals, such as chicken and fish, while it minimizes intakes of refined grains, processed and red meats, desserts, and full-fat dairy products.”
Consequently, organizations such as the World Cancer Research Fund and the American Institute for Cancer Research recommend that “cancer survivors, or really all of us who are trying to lower our risk, allow two-thirds or more of our plates for foods that come from plants and one-third or less for foods that come from animals,” Brissette says.
The same sets of recommendations suggest limiting red meat to 18 ounces (510 grams) or less each week and, if you consume alcohol, stopping at two drinks a day for men and one for women. Happily, this type of eating plan—which encompasses both the Mediterranean and DASH diets—is also linked with a reduction in the risk for other health problems, including high blood pressure, heart disease, and stroke.
Just how dramatic a difference can this type of eating plan make? While that probably depends on the type of cancer, Brissette says, “in one study looking at dietary patterns in breast cancer survivors, those who had the highest intakes of vegetables and whole grains saw a 43 per cent reduction in overall early mortality, versus those people with the lowest intakes.”
Of course, changing eating habits developed during a lifetime can be a struggle, but there are resources to help. “Here at Princess Margaret, I’m part of a program called the ELLICSR Kitchen,” Brissette says. “I work with a wellness chef, and we deliver nutrition education and cooking classes.” Participants also get to taste the wares from the classes. Shawn Hart, 54, of Toronto, a two-time breast cancer survivor, says the program has helped her completely change the way she eats. “I grew up in an Irish family, so it was meat and potatoes, and junk food was its own food group,” she says. “I don’t like much, and the treatment narrowed my tastes even more. I can’t even tolerate the smell of some things.”
However, after being gradually introduced to unfamiliar ingredients such as herbs and to template-type recipes that allow her to switch a loathed vegetable for one she likes, Hart has incorporated a host of healthy foods such as kale into her diet. Having once disliked berries due to their texture, she now incorporates them into foods such as smoothies. “My mom is amazed at what I’m eating,” she says. “I think each time I do something good for myself, I feel like I have a little bit of control over the cancer coming back. My wellness chef and dietitian are just as important to me as my doctors.”
Even if you’re not a patient of the Princess Margaret, or live outside of Toronto, you can access some of ELLICSR’s resources. “We have a big show once a month that we stream live on the Internet, so people can tune in and ask us questions, and we have a huge library of 500 recipes on our website [ellicsr.ca],” Brissette says. “We also have a YouTube channel where we post oneto two-minute videos on nutrition skills such as how to manage taste changes from treatment,” she says; other videos on the channel focus on basic kitchen tips. (Brissette is also one of the consulting dietitians for a magazine called Nourish— nourishonline.ca— which offers evidencebacked nutrition information and practical tips specifically for cancer survivors.)
Staying or Becoming Physically Active
About 20 years ago, the evidence that physical activity could improve quality of life and reduce symptoms such as fatigue began rolling in, followed by research pointing towards physical activity as a powerful tool for dealing with the mental and emotional challenges a cancer diagnosis often brings. Catherine Sabiston, the Canada Research Chair in Physical Activity and Mental Health and an associate professor of kinesiology and physical education at the University of Toronto, is involved in one of the latest of such studies, now currently under way.
She sums up the findings of the research that’s been done to date this way: “We see consistently, both cross-sectionally and over time, that physical activity helps to reduce symptoms of depression, reduces stress, reduces anxiety, and improves overall emotional wellbeing.” As evidence for the benefits of exercise grew stronger, scientists began to look into the question of how physical activity might affect longevity and the likelihood of cancer recurrence.
A landmark study of breast cancer survivors released in 2005 was the first to find that “physical activity in survivorship was linked with reduced risk for recurrence and lower premature mortality rates,” with roughly 30 per cent drops in each of these measures, says Jeff Vallance, a Tier 2 Canada Research Chair in Health Promotion and Chronic Disease Management and a health solutions population investigator at Athabasca University in Alberta. “Three to five hours a week of moderate intensity walking had the greatest benefit,” he adds.
Now, after 10 years and roughly as many studies, research has shown fairly consistent associations between physical activity and reductions in premature mortality and cancer recurrence, he says. And perhaps the best news of all to emerge from all this research is that people can reap the benefits even if they’ve never exercised. “Some of our colleagues have done work that shows that change in physical activity at any point following a cancer diagnosis is important,” Sabiston says. “It’s as if starting today helps you regardless.” Sabiston also emphasizes that simply choosing an activity you enjoy and moving more today than you did yesterday is more crucial than the specific type of exercise or aiming for a particular amount of activity per week.
For one thing, she says, “light activity is beneficial for a number of mental health facets.” Light activity also reduces sedentary time, which is emerging as a potential cancer risk factor. Doing something you enjoy improves the chances that you’ll continue to be active on a consistent basis and perhaps even slowly increase the amount and intensity of activity. “The problem is that 85 per cent of women are not active enough,” Sabiston says.
However, there is one research tested tool that has been shown to help increase activity after a breast cancer diagnosis. “We looked at the effect of specific physical activity print materials on activity behaviour in a large group of breast cancer survivors,” Vallance says. The nearly 400 women were randomized to various groups: some received the print materials alone, others were given a pedometer, a third group got both, and the rest received neither. Even just the print materials increased self-reported physical activity (though not steps walked weekly) by 30 minutes, compared with the no-intervention group. Better yet, Vallance says, “when we combined the print materials with the pedometer, we were looking at about 80 to 90 more minutes per week of physical activity.”
To make these materials widely available to the public, Vallance and a co-author, Kerry Courneya, turned them into a 90-page interactive workbook called Fight Breast Cancer With Exercise (Lone Pine Publishing, 2014; an electronic version is available through iTunes).
Sabiston and her colleagues, too, have launched a resource they’re hoping will help female cancer survivors become more active. “Something women in particular tell us is that they need social support— the general idea is that if someone would just show up and drag me out of the house, I would exercise,” she says. In response, “we developed a system that helps women who have had cancer find an exercise partner,” she says.
To use the free online tool, called ActiveMatch, a woman goes to the activematch.ca website and creates a profile, answering questions about physical activity and what she’s looking for in an exercise partner. “The system finds matches based on algorithms that we’ve developed, but women can also override that and find their own exercise partners,” Sabiston says. “We’re testing that now to see if lack of social support is in fact one of these limiting factors around exercise,” she adds, “and whether helping people find partners is a good solution to the problem of lack of adequate exercise.”


Unfortunately it seems that the Conrona / Covid-19 Virus is fast becoming a reality in Ireland. At Onlinetradesmen we want to do our best to keep the tradesmen community and their families safe.
Despite some of the hysteria, for most healthy people the effects of the virus will be minimal. However, the virus still needs to be taken very seriously.
As a tradesmen, you can keep yourself heathly by being aware of how the virus spreads and following the advice below, especially when working onsite, travelling between jobs and taking cash payments.
The general advice from the HSE.ie to protect yourself and others from coronavirus is:
- Wash your hands properly and often
- Cover your mouth and nose with a tissue or your sleeve when you cough and sneeze.
- Put used tissues into a bin and wash your hands.
- Clean and disinfect frequently touched objects and surfaces.
- Try to avoid close contact with people who are unwell.
- Follow the travel advice from the Department of Foreign Affairs
Remember, if you are showing signs of illness such as respiratory symptoms, fever, cough, shortness of breath and breathing difficulties then you should:
- isolate yourself from other people - this means going into a different, well-ventilated room alone, with a phone
- phone your GP, or emergency department - if this is not possible, phone 112 or 999
- in a medical emergency (if you have severe symptoms) phone 112 or 999


Everything to make taking drugs easier, more personal, and more effective, all in one place: that is MedApp. The free app offers direct access to all information about the medicines you take: search for their names, or scan their box, and immediately find the proper patient information leaflets, current pricing, side effects, and much more. Need to visit your pharmacy? Use MedApp to check the opening hours. On top of this, MedApp provides a personal dossier to keep track of all matters related to your medicine use, such as doctors’ appointments, how you are experiencing your symptoms, and much more. Additionally, it is possible to set up smart alarms to remind you to take your medication, allowing MedApp to ensure you never forget to take your next dose.


Brief description of the drug
- Period of activity: 6-8 hours
- Drug class: Beta-2-sympathomimetic/thermogenic/anticatabolic (oral)
- Dosage: 120-160 mcg/day for men and 60-120 mcg/day for women
- Acne is absent
- There is no water retention in the body
- An increase in blood pressure sometimes
- No hepatotoxicity was detected
- There is no flavoring
- DHT conversion is absent
- Suppression of the HPTA function is absent
Clenbuterol is a beta-2-sympathomimetic, the main action of which is fat burning. A high fat-burning effect, as when using a low-calorie diet, is accompanied by an increase in the stiffness of muscle mass, veins are more clearly drawn, and a surge of strength is observed. The half-life of the drug is 35 hours.
Being a stimulant of the central nervous system, clenbuterol has a powerful catabolic effect, in many countries it is used to treat lung diseases (in particular, bronchial asthma). It is mainly used at the end of the course of steroids.
Due to the pronounced fat-burning effect, the drug is often taken for weight loss. At the same time, fat burning occurs without grueling diets, however, with some increase in body temperature.Fats are consumed for this rise in temperature.
Instructions for use
20 tablets of 40 mcg are available in a blister pack. The dosage of the drug depends on body weight and the body's reaction to side effects. For men, the average dosage is 100-140 mcg, for women 80-100 mcg per day.
Reception should begin with 1 tablet per day and, taking 1 tablet more each day, reach the required dosage. The duration of taking clenbuterol is on average 8-10 weeks. Schemes of taking the drug vary depending on the desired goal: fat burning or the optimal ratio of muscle mass and strength gain. Since clenbuterol loses its anabolic properties after 18 days from the beginning of administration, it is better to alternate the administration of the drug: 2 weeks of administration, 2 weeks of rest.
For burning fat, it is ideal for women, as it does not have such side effects as hormonal steroids.
- The most frequent side effects when taking clenbuterol are: nausea, vomiting, rapid heartbeat, feeling of anxiety and fear, headaches, sweating, light tremors of the fingers, muscle spasms, drowsiness, increased blood pressure.
- By drinking a large amount of water (5-7 liters per day), using bananas, oranges or potassium-containing preparations, you can avoid muscle cramps.
- Analgesics will help get rid of headaches.
- In general, side effects can stop by themselves after 8-10 days from the start of taking the drug.
Store at a temperature of 15-25C, in a dry place protected from light and inaccessible to children.
5 years Do not use after the expiration date indicated on the package.


Today marks the start of Migraine Awareness Week (MAW). Every year The Migraine Trust promotes Migraine Awareness Week (1-7 September 2013) to raise general awareness of migraine as a serious public health issue.
As you may know, I have suffered from migraine attacks for around 15 or so years with the latter two years as a chronic migraine sufferer. I occasionally blog about my migraine experiences in the hope it will help others. The Migraine Trust are campaigning to encourage understanding that migraine is ‘more than just a headache’.
I have found that my online migraine friends have offered a great deal of support, advice and understanding. In particular, Victoria of the Migraine Monologues is an advocate for migraine sufferers and I always learn something new from her posts.
So, whether you are a migraine sufferer or not, I urge you to take a look at the Migraine Monologues blog during MAW 2013 to learn something about the condition. Victoria will be posting each day throughout the week.
So far in 2013, I have lost 70 days to migraine. Knowing that others understand what I am going through is a great comfort.
You can find links to blogs and articles by using the hashtag #MigraineAW2013.


Sunday, 17 May 2020
From 7:00 am
Raised so far
IMPORTANT EVENT UPDATE
In light of the evolving situation surrounding the coronavirus COVID-19 outbreak, we have decided the wellbeing of our participants and colleagues is our number one priority and therefore have made the difficult, but responsible, decision to adapt our Geelong event.
We have an exciting way you can still virtually take part from Sunday 17 May. Thank you again for your support and understanding.
About Geelong Memory Walk & Jog
We have an exciting way people can still virtually still support Memory Walk & Jog.
We are asking all our participants to get active in your local area from Sunday 29 March. This could be in your backyard, a walk around your block or at home – anywhere that is safe and within the government’s guidelines.
How to get involved
Now is the time when people living with dementia need our support the most.
We’ll still walk, jog or run to make the world of difference for people living with dementia.
Register for Geelong Memory Walk & Jog today
Get active and beat dementia your way! Select either 2km, 6km or 8km as your preferred distance. Choose whether you want to walk, jog or run. Whichever way you decide to move, you’ll be helping us beat dementia to the finish line!
The first 500 people to register will receive a free t-shirt.
Fundraise for people living with dementia
Every kilometre and every dollar counts. The fundraising you do will make the world of difference to the estimated 114,779 people with dementia in VIC. And it means Dementia Australia can do more to make life better for them and their loved ones. It may even help us put a stop to dementia for good.
Geelong! It’s time to get active, get healthy and get ahead of dementia!
|Child (6-17 years)||$29.00|
|Junior (0-5 years)||FREE|
|Senior (60+ years)||$29.00|
|7:00 am||On-the-day registration|
|8:10 am||Race welcome|
|8:20 am||Group warm-up|
|8:45 am||8km runners start|
|8:50 am||6km walkers start|
|8:55 am||2km walkers start|
|10:30 am||Prize presentation|
|11:00 am||Race day finish|
*Timings and distances are subject to change
- Hannah just donated $15.98
- Jayden just registered for Geelong
- Ashleigh just registered for Geelong
- Callum just registered for Geelong
- Taylor just registered for Geelong
- Cassandra just registered for Geelong
- Lisa just donated $21.30
- Rain just donated $21.30
- Rob and Maxene just donated $100.00
- Bec just donated $106.50
- Mon & Beni just donated $58.58
- Jessica just donated $50.00
- Alison just donated $55.00
- Brydie just donated $50.00
- Jemma just donated $31.95
- Kate just donated $106.50
- Ted just donated $50.00
- Emma and Timmy just donated $200.00
- Jane just donated $106.50
- Lara just donated $58.58


We need prayers for Ronin.
Ronin had been doing really well for the last few weeks; growing to 7 pounds, completely off pain meds, and needing very little oxygen support. The cardiologists were really happy with his growth trajectory and there had been plans to have him come home sometime in September. Although we didn’t want to get our hopes up, over this last weekend Ray and I even set up a crib and rocking chair in anticipation of our baby boy’s homecoming.
But on Sunday evening, I had a call from the hospital letting me know that Ronin’s oxygen levels had started to decline and he’d been switched from a low-flow nasal cannula back to up high-flow. Then over the next few days he went from requiring 1 liter/minute to 2… 3… 4… and by Wednesday, 5.
On Monday they had done another echocardiogram to check on his heart, but the cardiologist was really pleased with Ronin’s stent placement and didn’t notice any troublesome changes. Since Ronin has a congenital heart defect known as double-outlet right ventricle (DORV), any issues with his heart are something they’d want to closely monitor to rule out first. (For more information about Ronin’s heart diagnosis, you can refer to my earlier post, “Life in the hospital: Part 2.”)
On Tuesday, I spoke with a neonatologist who seemed completely baffled with what might have caused the change. She decided to start giving Ronin micro-doses of morphine every 3 hours, thinking that he might be having low blood oxygen sat’s due to restlessness/agitation. So far nothing has necessarily improved in terms of his oxygen support, but other than being a lot sleepier now, he still looks peaceful.
Now Friday, he’s pretty much in the same condition. Still on higher oxygen support, but not necessarily in a critical state. With my limited understanding of what’s been going on in his body, it seems like this must be related to DORV causing oxygen-poor blood to circulate.
The cardiologist’s working plan is to dilate the stent in his pulmonary artery on Wednesday, September 6. When the stent was first placed – when the doctors saved his life back in early July – Ronin weighed a little over 3 pounds. Now that he’s twice as big, his heart needs to circulate more blood throughout his body. If the pulmonary artery were a garden hose, having the stent dilated would widen the hose and improve the rate of flow. Hopefully the procedure will be the only necessary intervention before his major heart repair surgery. Hopefully there isn’t something else going wrong that the doctors aren’t seeing.
I’m praying for Ronin’s body to stay strong, and for the doctors to have the knowledge and wisdom necessary to keep him safe. I’m praying for my family’s peace as we’re going through this marathon of challenges. I’m also praying that the Holy Spirit guides my days ahead. This has been a test of my endurance and perseverance, and I know it’s only by His strength that I’ve been able to keep from giving up. The lessons I’ve learned are invaluable, and this experience has made myself and my family so much stronger in our faith. I just want to stay in the center of God’s will – in His refuge. That’s the only place I’ll be able to continue experiencing His power, His mercy, His protection. And His peace.


Dear Nursing Executive, I want to give you warm and heart-felt thanks for all you do every day. Doing the work of Angels is not easy but without you, patients and families could not experience the care necessary to heal. The work you do goes so far beyond what is obvious to the eye. As a former Nurse Executive, I understand how much of you is required to accomplish even small bits of progress in the midst of the major challenges you face.
Nursing is at the heart of hospital care and has a tremendous impact on patients, families and the entire healthcare team. If nursing is not performing optimally, every stakeholder feels it. In a society where many feel nursing is an under-appreciated profession, I want you to know you are valued and respected by so many both in and out of your organization.
Patients and Families
It goes without saying that patients and families are the reason we do what we do. They come to your hospital needing your services when they are in their most vulnerable state. They may be afraid, frustrated, or angry. While you may not be privy to the past experiences that shape their perspectives, you understand that their feelings, symptoms, and perceptions result from something bigger. You stay focused on providing the unbiased and compassionate care they want and deserve. Please know for every ‘thank you’ received, there are probably hundreds more that patients and families did not express.
Your willingness and commitment to rise to challenges and high expectations is the difference between having a harmonious and high accountability team and a dysfunctional, ineffective team. You are the driver of alignment—and the glue that bonds and helps sustain alignment among many departments. You acknowledge the work to be done while advocating for your team so that they give and receive the respect and caring everyone deserves for their noble work and commitment to patients and each other. I cannot recall many meetings where the topic of “what nursing should be doing” did not arise. It can be exhausting and disheartening, making you wonder, “Do they understand how hard we are working.” Please know, even if it is not felt at that moment, the work by you and your team does not go unrecognized.
All I can say to you is WOW! Your incredible leadership has the ability to touch lives and transform careers. You congratulate publically and coach privately. Your skillful navigation of the generational divide contributes to a cohesive team focused on the goal of providing each and every patient with an exceptional patient experience. But it does not stop there. You understand that team relationships, both interdepartmental and intradepartmental, have a powerful impact on outcomes. You hold the team accountable for high expectations while fostering an environment that is blame-free and education-centric. Whether you offer a hug to the nurse who just experienced a personal loss or a high five and, of course, pizza when the team pulls through a challenging clinical situation, you do all you can do to be there for your team.
In my early days as Nurse Executive, I remember feeling overwhelmed as each department shared what they needed from Nursing. It was so difficult to prioritize all of these needs. But you do! And, more importantly, you do it in a way that makes other department leaders feel valued and respected. Others leave conversations with you feeling pride in knowing you are the ultimate collaborator and, although your plate is full, you are always open to talk. You approach each situation with the big picture in mind. You know that every department is important to the exceptional patient experience. You embrace your role and lead the charge!
I could go on, but suffice it to say, your leadership helps transform organizations so that they replace tragic outcomes with consistently magic outcomes. Please know how incredibly valued you are, and thank you for doing the amazing work you do every day!


WHAT IF YOU KNEW EXACTLY
What to Eat
FOR YOUR CANCER
Cancer treatment protocols require a complex combination of surgery, chemotherapy and radiotherapy, often accompanied by a number of other medications administered over several months, if not years. These treatments can take a real toll on the body, physically and emotionally. Getting through cancer is never going to be easy, but it can be easier. Using a whole body, systems approach, my care programmes are designed to look at how your cancer and your treatments are impacting your body, from time of diagnosis, through treatment, and into remission - we will work together to make your journey as easy as it possibly can be.
Amongst the main side effects of chemotherapy, nausea, fatigue and loss of taste mean that most of the time you won't feel like eating, let alone shopping or preparing meals. On top of all that, surgical resection of the colon may impact how you body digests and absorbs nutrients from food, even after cancer treatment ends. The care programmes described below take these factors into account and will change and adapt through your treatment protocol, personalised to your individual cancer and treatment protocol. Programme prices will vary accordingly and can be discussed during your FREE consultation.
Feed Your Warrior
Expert nutritional advice and mindset coaching, personalised to your individual needs. Cancer therapies can cause deficiencies of several vital nutrients, contributing to side effects. Food is a safe way of delivering essential nutrients to your body without concern for cancer drug interactions. This program works to replenish nutrients lost, manage side effects and boost immune system through the course of your cancer treatment protocol.
Belt and Braces
Everything in Feed your Warrior with the additional focus on deeper investigation through laboratory testing to determine more precisely where your body needs support. Testing is very individual according to need and may include urine, blood, DNA and stool analysis amongst others.
Whatever it Takes
Everything in Belt and Braces with the addition of regular and ongoing testing throughout your treatment protocol so that we can adjust your protocol as and when your body needs it. By far the best way to stay on top of side effects and achieve the best possible response to your cancer drug protocol.
After the Bell
Been given the "all clear" but feeling broken and unsure of what to do next? Cancer treatments can leave your body damaged and side effects can linger on long after the treatments end. Mental and physical healing from cancer start when your cancer treatments end - when the doctors appointments end, and friends and family have celebrated. This is your "ground zero" . After the Bell will help put your body back together again, to help you feel whole again, so you can find your new "post-cancer" self. Life after cancer can be the start of a whole new adventure, a whole new amazing YOU, and I'm passionate about showing you how!
As an add-on to any of the above packages, DNA testing provides invaluable insight into your DNA blueprint allowing deeper investigation to determine more precisely where your body needs support. The basic DNA test pack includes 3 reports (Nutrient Core, Methylation and Detoxification) plus a 1-hour consultation to interpret the results. Depending on individual needs or cancer type, additional reports can be added on, for example the Hormones report would be particularly relevant in the case of hormone driven conditions or cancers, or the Thyroid report for thyroid-related conditions of cancers.
Please note that working with me is not a substitute for standard cancer treatment
Nutritional therapy is not designed to diagnose, treat or cure any disease, including cancer
Nutritional therapy is about supporting the body’s resilience and whole person wellbeing, and I always aim to work collaboratively with oncology services.
If you'd like to know more about any of the above programs or about how I work, then please go ahead and book a FREE consultation. The button below will redirect you to the Practice Better online portal where you can use the calendar to select and book a date and time that suits you. On the day I will call you on the number provided and we can talk about your circumstances and how I might be able to help you.


I’m sure you have seen it before a friend or family member in relatively good shape and healthy has a fall and ends up in the hospital. When we were younger you popped right up. I used to marvel at my children’s ability to “bounce” after a fall but as we age a fall can have serious health side effects. So the best thing to do is to avoid falling and no I am not suggesting you sit on your couch and become a couch potato! It’s time to start moving to avoid falls.
A year ago we launched a new program called STEPS based on the latest research on fall prevention. This program includes a series of exercises designed to strengthen your muscles and especially your core muscles with a reasonable amount of walking. By strengthening your muscles you are decreasing your risk of not only falling but injury during a fall. So far from being a couch potato I am encouraging all of you to take the step towards better health. Developed by Dan Walters, PT at HomeCare of Mid Missouri, this program is personalized for each patient. Specific goals are determined by you and your physical therapist. Life is not a race but a journey by making lifestyle changes our goal is to keep you safe in your home. Just adding in walking and strength training to your daily routine studies have shown an increase in mobility and a decrease in falls ensuring you are able to stay in your current home longer.
Before starting an exercise regimen you should always check with your doctor. Then consider a falls evaluation from HomeCare of Mid Missouri. Our physical therapists can assess your risk of falls and if you would be a good match for the STEPs program.
This evaluation could get you on the path to a happier and healthier life. We would love to help you on this journey.


St. John's wort is an easy-to-grow shrub known for its beautiful yellow flowers and healing properties. In the world of medicinal herb gardening, the cultivation of healing plants becomes a therapeutic journey in itself. We’ll guide you through how to grow St. John’s wort from seed in your own garden so you can enjoy its many benefits.
St. John’s wort (Hypericum perforatum) is an herbaceous perennial with bright yellow flowers. This herb is named after the biblical St. John the Baptist due to its flowers coming into full bloom on or around his birthday on June 24. St. John’s wort has been used in Traditional European Medicine since Ancient Greece and continues to be one of the most purchased herbal products in the United States.
How to Plant St. John’s Wort Seeds
To start St. John’s wort from seed, sow seeds outdoors in the fall or start indoors 6 to 8 weeks before the last spring frost.
St. John’s Wort Seed Germination Tips
St. John’s wort seeds that are sown outdoors in the fall will overwinter and sprout in the spring.
When seeds are started indoors, they will need cold stratification for 4-6 weeks to improve germination.
St. John’s wort seeds require light for germination, so gently press seeds into the top of the growing medium.
Seeds will germinate in 14 to 21 days when soil temperature is above 70ºF.
Transplanting St. John’s Wort Plants
Once the St. John’s wort seedlings are several inches tall with two sets of true leaves and all danger of frost is passed, they can be transplanted outdoors. Harden off the seedlings and transplant them into a spot with well-draining soil in full sun to partial shade, spacing plants 18”-24” apart.
Growing St. John’s Wort Plants
St John's wort is not fussy and will grow in all kinds of soil. For good growth and plenty of blooms, plant in nutrient-rich soil. Ensure it is well-draining to avoid root rot.
This adaptable herb can grow in full sun or part shade. However, as with most plants, growing St. John's wort in full sun will result in more flowers.
Give St. John’s wort plants some space to spread. Place plants 18 to 24 inches apart. The Hypericum perforatum variety can spread two to three feet and grow 6 feet tall.
The application of additional fertilizer is unnecessary for growing St. John’s wort. If you have very poor soil, adding a layer of well-rotted compost in early spring can be beneficial. Too much nitrogen will have a detrimental effect on blossoms and medicinal strength.
Harvesting St. John’s Wort
The best time to harvest the flowers of St. John’s wort is right when they come into bloom at the end of June. A clear indicator that they’re ready to be harvested is when you see a red pigment on your skin after crushing a flower between your fingers. The flowers and leaves are best used fresh.
Medicinal Uses for St. John’s Wort
St. John’s wort is a popular choice for treating depression, anxiety, ADHD, insomnia, and restlessness. Commonly paired with lemon balm, St. John’s wort has proven to be very effective for SAD (Seasonal Affective Disorder) and OCD.
Because St. John’s wort helps balance the hormones, it can reduce and relieve depression, fatigue, cramping, bloating, and mood symptoms of PMS and menopause.
By calming the digestive organs and attacking harmful bacteria and viruses, St. John’s Wort is effective against ulcers, gastric problems, and infective digestive problems, such as gastroenteritis, dysentery, and diarrhea.
When used as a tincture:
St. John’s Wort can alleviate the physical symptoms of mild opiate withdrawal and relieve anxiety and depression for those quitting smoking by calming the nervous system.
The diuretic properties of St. John’s wort can flush out toxins through urination. The diuretic properties can also help bedwetting children by flushing the excess fluids out of the system before bedtime, preventing the buildup of fluids in the bladder!
When used as a topical oil or salve:
The tannins in St. John’s wort promote the healing of burns, bruises, sunburns, injuries, wounds, and infections due to its excellent antiseptic, antiviral, and antimicrobial properties.
When massaged into muscles, it can help relieve back pain, muscle pain, or general body aches. The oil of St. John’s wort is a fantastic choice for hemorrhoids, as it reduces inflammation, relieves pain, and expedites healing.
People with nerve pain, sharp or convulsive trigeminal neuralgia, sciatica, and Bell’s Palsy have benefited greatly from using St. John’s wort internally as a tincture or tea and as a topical oil/salve on affected areas. When used daily, it can relieve inflammation and pain symptoms of joint diseases, such as arthritis and gout, with increased benefits over time.
Lastly, St. John’s wort is an expectorant, making it effective against chest colds, congestion, respiratory disease, and influenza. It helps clear chest congestion and phlegm, healing infections and common coughs and colds.
St. John’s Wort Tincture Recipe
St. John’s wort flowers and leaves
80-proof grain alcohol or vodka
Loosely pack the flowers and leaves into a clean jar with a tight-fitting lid, filling it to the top. Add the alcohol, fully covering the flowers and leaves. Tighten the lid and label. Gently shake the jar daily for 4 to 6 weeks, adding more alcohol as needed. Strain out herbs and store in a cool, dark cupboard.
St. John’s Wort Infused Oil Recipe
4 oz (112g) fresh St. John’s wort flowers
2 cups organic olive oil
Combine flowers and olive oil in a double boiler and place over very low heat. Steep for 2 to 3 hours, keeping at a low simmer. Strain herbs from oil and store oil in a cool, dark cupboard.
** To make it into a salve, heat 1 part beeswax to 3-5 parts infused oil in a double boiler. More beeswax will make for a firmer salve. Store in a dark, cool cupboard or in the refrigerator to extend its shelf life.
St. John’s Wort should not be taken by those diagnosed with bipolar disorder, as it can increase the risk of mania. St. John’s Wort interacts with a lot of modern medicines, such as Warfarin, Digitoxin, HIV medications, and SSRIs. It can cause sun sensitivity to very fair-skinned people. Do not take for 2 weeks before surgery. Check with a physician prior to using.
Does St John’s wort come back every year?
St John's wort is a hardy perennial and will come back each spring.
Does St John’s wort spread?
St. John’s wort spreads through rhizomes. This makes it a good plant for preventing erosion but can be a problem in areas where it might overtake other desired plants.
Add St John's wort plant to your healing garden and enjoy its beautiful flowers and many medicinal uses.
Written by Ashley Clark
Found this information helpful? Share it with a gardening friend!


Tuesday, December 8, 2015
So Thanksgiving brought with it some really wonderful news this year in that I do not have to have surgery on my broken foot! I found out just a few days before I left for the holidays and I was elated to say the least. Everything was going to work out!
I was somewhat surprised as I had been told by no less than three different medical folks that "this bone does not usually heal well and likely will need surgery". Despite that dire prediction, I beat the odds!
I still am shaking my head in disbelief and wonder that I escaped this. How did this happen? Not sure but I have some thoughts. First of all I did not take the word of all of those folks to be gospel. I decided to call the surgeon who did my foot reconstructions and get his opinion. It took a few phone calls and signing releases, forwarding X-rays, etc. but it was so worth it! When I heard back he said in his opinion I would NOT need surgery and that the boot cast and forearm crutch approach would be just fine. Well that was sure welcome news! But I still was leery of what the 4 week X-rays might show. My foot looked pretty bad for sometime.
That said, I was told at the appointment where they did the 4 week X-ray that the extensive bruising, swelling and pain were largely from the tendon/cartilage injury that really was the root cause of the foot breaking. That made me feel a whole lot better. I was very careful to follow their suggestions for how to bear weight, etc. and it really paid off. At 5 weeks my foot is looking almost normal save for some minor bruising still around the lower ankle and at the toes. I'll take it!I have been careful not to overdo which is always a challenge for me but one I have taken to heart since I did not want the holidays to be hampered with crutches and pain. That certainly kept me on the straight and narrow. The frequent reminders from family and friends kept me in line too.
I was so thrilled to be able to return to Tai Chi and swimming just 4 weeks into the injury. I actually believe that being able to engage in both of those activities helped the healing process considerably. I have to mention that doing Tai Chi was in many ways why the injury I sustained was not a lot more serious. When my foot slipped I was able to regain stability largely because of the Tai Chi principles and practices of weight bearing. The foot roll and subsequent injury and broken bone were the result of the uneven surface that I encountered when I put my left foot back down. Not because of lack of balance. I could have ended up head first over a balcony if not for the Tai Chi!
So I count myself lucky indeed and very thankful that all is well!


Our dogs do not only provide us relief by their cuteness and friendliness, they too could detect some of the deadliest illnesses that can hit a human being.
Dogs use their nose as their primary defense mechanism and to sniff things, but did you know that dogs’ noses can also detect malaria, a deadly disease caused by mosquito bites.
Just in October last year, experts proved in a study that pooch show high accuracy in detecting human diseases like prostate and thyroid cancer, as well as diabetes. The same study showed that dogs can also detect malaria by sniffing people’s socks.
Steven Lindsay, one of the researchers and a public health entomologist at Durham University, notes that a dog’s smell is very keen to detect early stage of malaria.
The researchers asked Gambia students to wear nylon socks overnight. These socks, afterward, were frozen and brought to the United Kingdom where two trained Labrador dogs to sniff the socks.
These Labrador dogs can tell if the socks were worn by a person infected by Malaria since they were trained to do so for several months before the test was conducted.
The team of researchers observed whether the two Labradors would pause at any of the socks, a sign from their previous training that the person who wore the sock is indeed infected with malaria.
They then deduced that each of the two dogs was able to correctly identify children infected with malaria during that time. The results say that the two dogs 70 percent of the time or seven out of ten is correct in identifying which sock is positive with malaria.
While the dogs had some mistakes, Lindsay underscored that this is proof that a dog’s smell is a powerful detector of early signs of malaria.
Lindsay, meanwhile, promised that the team would continue with the research and provide more information about this facet of a dog’s behavior and how it can help in the medical field.
Credits to Sky News.


Session 3: Pelvic Floor Coordination
Coordinating the pelvic floor is more than squeezing your perineum. This class gives you the opportunity to explore the jelly fish like action that are the pelvic and respiratory diaphragm. It facilitates an awareness of how rhythmical breath establishes a natural coordination of these structures. This awareness assists in the development of a healthy activation of the pelvic floor, one that doesn't lead to over activation. Over activation of the pelvic floor is a common and often forgotten contributor to back pain.


Athletes Choice is a cutting edge sports performance facility where function comes first. We pride ourselves on our ability to eliminate as many risk factors for injury as possible in order to keep our athletes healthy and performing at the apex of their abilities. This is accomplished through the use of the Functional Movement Screen (FMS). By ensuring our athletes are able to perform proper functional movement patterns we can not only decrease their likelihood of injury, but also increase their ability to perform as well.
Athletes Choice has recently partnered with AMP Sports Med which is our in house chiropractic and recovery center. The AMP team provides soft tissue work using percussion therapy and various other modalities as well as recovery techniques using lasers, compression, etc.


Danish Network for Psychedelic Research would like to contribute to a non-prejudiced and scientifically based dialogue on medical and therapeutic use of psychedelic drugs in Denmark.
From the statutes
- To strengthen Danish psychedelic research, by bringing together Danish (health) professionals with an interest in and professional experience with psychedelics.
- To inform Danish educational institutions, politicians and the wider community about psychedelics in order to promote public health.
- To present psychedelic research and to promote factual discussion thereof.
In addition, we aim to create an inspiring platform for researchers and professionals, e.g. by
- Maintaining a website that provides an overview of the most important articles and resources in psychedelic research and provides access to international network of resources (databases, researchers etc).
- Organizing local meetings eg. in Journal club format.
- Attending conferences, bringing home new ideas and relationships.
- Creating a sustainable organization, socially and financially.
We are a group of people with a professional interest in the medical and therapeutic potential of psychedelic drugs.
We are a non-profit association, run by volunteer labor. Read our statutes (in danish only, at the moment. Sorry).
You can apply to be a member if you have finished a bachelors degree.


Down Syndrome Developmental Council, DDC
Includes such topics as cerebral palsy, Down Syndrome, Hearing Impairment, Rett Syndrome, Tourette Syndrome, Vision Impairment
Offers information on Tourette's and many other neurobehavioral conditions in a user-friendly environment.
Offers extensive information for individuals, families and professionals.
Works empower families, by providing families of individuals living with Rett syndrome connections to critical and useful information, programs, services, and support from diagnosis to day-to-day life. Rettsyndrome.org also coordinates, cultivates, accelerates, and funds research that will produce a cure for Rett syndrome and reveal and develop treatments. Also in Spanish
Celebrates and supports fathers and families of children with special health care needs by providing news, resources and event information.
A global community that integrates information, resources, and communication opportunities on the Internet for persons with cognitive and other disabilities, for their families, and for those that provide them services and support.
EP Magazine provides information, resources and business services for the special needs community, as well as an online health and wellness support community.
One of two Illinois Parent Training and Information (PTI) Centers providing training about IDEA, the Individuals with Disabilities Education Act to parents. FRDC serves the counties of Cook, DuPage, Grundy, Kane, Kendall, Lake, McHenry, and Will counties in northern Illinois. They provide information, trainings and resources in English and Spanish.


A Comfortable Atmosphere
When you pay a visit to Dr. Jones’ office in South Surrey, you can expect a clean reception area, examination rooms and surgical suites. We use steam-sterilized instruments for each patient’s safety. Our office can be found in a modern, newly-constructed facility, which provides a comfortable atmosphere for our patients. Because we enjoy a very low staff turnover, we pride ourselves upon our ability to form long-lasting relationships with patients of all ages.
About Dr. Jones’ Education
Dr. Jones received his Bachelor of Science in Physiology from the University of California in Davis, California, in June 1985. He then went on to pursue a Doctor of Podiatric Medicine (DPM) degree from the California College of Podiatric Medicine in San Francisco, California, in May 1989. He completed his first year of podiatric medical residency at the California College of Podiatric Medicine in San Francisco in June 1990 before going on to complete a podiatric surgical residency at the Vancouver General Hospital in June 1991.
Schedule a Podiatric Appointment
From custom orthotics to treatments for bunions, hammertoes, ingrown toenails and sports injuries, we provide comprehensive podiatric care in South Surrey. Should you wish to schedule an appointment at our office, please contact Dr. Jones today at 604‑560‑2922. You may also view our most frequently asked questions for more information about our cancellation policy, fees, office hours and more.
We provide podiatry services for patients of all ages


Pro Derma Aesthetic Centre
Pro Derma Aesthetic Centre - a Clinic with an international staff of highly qualified Specialist Doctors and Laser Technicians . Offering patients a wide range of services that allow them to retain their youth and delicately removing the short comings of ageing.
Pro Derma Aesthetic Centre is offering Anti-ageing Recontouring Treatments (HA Fillers, Botulinum Toxin injections etc.), Laser Hair Removal, Ultherapy, Skin Lightening Programs, Scars Treatments, Non-surgical liposuction, Anti- Cellulite Programs, Medical Facials and uses exclusively formulated Skin Care products from France, Spain and USA. Ensuring top quality treatments internationally renowned.
Pro Derma Aesthetic Centre promises to deliver Realistic results within the highest Standards of Health and Safety, all to Best Serve our Clients in Dubai.
Becoming our client you retain your youth for a long time!


Beck Scale for Suicide IdeationBSS
- Assess an individual's thoughts, attitudes and intentions regarding suicide
- Publication date:
- Completion time:
- 5 to 10 minutes
- Individual; Q-global® administration, scoring, and/or reporting, or manual scoring
- Age range:
- 17 years and older
- Qualification level:
The Beck Scale for Suicide Ideation (BSS) is a valuable tool for clinicians to examine suicidal intent in patients. Developed for use with patients of 17 years and over, the BSS provides a good starting point for a clinician's more detailed examination of a patient's suicidal intent.
The BSS is also useful for monitoring suicide ideation of patients who are known to be at risk for suicide
The Manual provides data on both in-patients and outpatients. The BSS items correlate highly with items that relate to suicide on the other Beck Scales:
Internal Screening Component saves time. The Scale is made up of 21 items and can be completed in 5 to 10 minutes. Two of the questions on the Scale are designed to function as an internal screening component. This component saves time and reduces the intrusiveness of the questionnaire for patients who are non-suicidal.
Average reliability coefficient: .90 (Inpatient), .87 (Outpatient)
This product is also available to level M users.
Q-global® Administration Options
This product is available on Q-global with the following administration options:
On-Screen Administration (OSA)
Your clients can complete these assessment online through Q-global. Alternatively, your client can complete the assessment in paper-pencil format, and their responses can then be data-entered into Q-global for scoring and report generation. On Screen Administrations are proctored (supervised) unless specifically indicated.
Remote On-Screen Administration (ROSA)


It is difficult to watch someone you care for go through bouts of pain. It also can be difficult to forsake precious time you could have together because your loved one is sleepy or “out of it” as the result of taking pain medication. But keeping patients comfortable and free from pain sometimes involves accepting trade-offs. It is the patient who ultimately must decide about his or her priorities in the last few weeks or months of life. At a time when so little is in a patient’s control, honoring his or her decision about how to spend what time is left and how much pain to endure is crucial to kind and meaningful caring.
- Myths and facts about pain medicine
- Non-pharmacological approaches
- Accurately describing pain
- Tips for working with medications
Using medicines is the most common strategy for relieving pain. Over-the-counter choices include aspirin, ibuprofen, or acetaminophen; doctors also prescribe pain killers such as morphine. These stronger types of medication, known as opioids, are available in several forms: pills, liquids, patches, suppositories, pumps that inject a small quantity under the skin, and fluids that are delivered through an IV.
Although prescription medicines are very effective, they often cause side effects. Consulting with the patient’s doctor will help identify the type of medication and dosage that will work best, but pinpointing the best solution may take some trial and error. Following is a list of the most prevalent side effects caused by opioids and things you can do to help the patient relieve them.
Constipation is quite common, as is nausea. However, some medications and home remedies help relieve these problems. (See our article about Caregiving Tips.)
Another side effect is involuntary twitching of muscles. This condition seems to be more distressing to family caregivers than it is to the patient. However, some medications can offset this response, or a different version of the morphine could be investigated.
Many patients feel very sleepy, especially during the first few days after an increase in dosage. Once the body adjusts to the new level, the patient usually becomes more alert and able to interact. If this does not happen, you may wish to talk to the doctor about trying a different medication or perhaps prescribing a mild stimulant to counteract the patient’s drowsiness.
Similarly, some patients respond to pain medication with symptoms of mental fuzziness, confusion, or delirium. If these responses do not resolve in a few days, the patient may want to try a different medicine.Return to top
Myths and facts about pain medicine
Many patients and families have inaccurate notions about prescription drugs that relieve pain. “Palliative care”—the medical discipline of making comfort a priority, especially at the end of life—is a relatively new field. As a consequence, people often make medication decisions on the basis of an incomplete understanding of the issues. Following are some of the most common myths about the use of opioids for pain relief:
Fear of addiction or dependency. Addiction is a physical and psychological dependency on a substance. When people worry about addictions, they often conjure images of desperate, hedonistic individuals who behave in irrational and illegal ways in order to get a “fix.” People who take morphine for pain rarely become addicted; they don’t fit this picture. For instance, patients in hospitals who are given unlimited access to a morphine pump following surgery typically undermedicate themselves. It is extremely unlikely that a patient in the advanced stages of a terminal illness will develop that type of desperate physical/psychological dependence. Unfortunately, a fear of addiction often results in family caregivers not giving the patient enough medication, which leads to the patient experiencing unnecessarily high levels of pain.
Fear of developing a tolerance. Some people are concerned that if the patient takes pain medication too early, the body will adjust (i.e., develop a tolerance) and need increasing dosages to get the same effect. Although it is true that dosages must be increased, this fear is based on an assumption that there is a ceiling on the amount of medication a person can take. Fortunately, there is no ceiling, so there is no need to endure pain in the present in order to save the medicine for some future need. If the symptoms increase, whether from tolerance or increased intensity of the disease, the dosage of the medicine can be increased indefinitely. Typically, if current dosages are no longer effective, then the amount must be increased by 25 to 50 percent. To say there is no ceiling does not mean there are no side effects, however. Increased dosages may well increase the number or severity of side effects. But if a terminally ill patient wants to be pain free, there is no need to put off relief early in the disease as an investment against potential pain in the future.
Concern that increased pain means the disease is getting worse. A person might experience increased or decreased pain for a variety of reasons. In the case of a tumor, it may simply have shifted and is now pressing on a different set of nerves. Or, psychological circumstances may have changed and altered the person’s perception of pain. For instance, relatives who were visiting have had to return home. Without the pleasant distraction of their company, the patient is more aware of physical pain and discomfort. No matter the reason for increased pain, if the patient does not communicate this change to the physician or family caregivers, he or she is not likely to experience relief from the symptom.Return to top
Heat or cold. If a particular area of the patient’s body is painful, hot or cold compresses may help relieve the discomfort. Ask your doctor which is most likely to be beneficial. A hot bath can help, but heat can also be applied through electric heating pads, hot water bottles, microwavable pillows, or gel packs. Be sure that the heat source is wrapped in a way that will protect the patient from leakage and burns. Heat therapy is best if it is applied for 20 minutes at a time. If the person you are caring for is undergoing radiation therapy, do not apply heat to that part of the body.
For some types of pain, 15 minutes of cold is a better source of comfort. Ice packs, gel packs, towels soaked in ice water, or a bag of frozen peas all make excellent cold compresses. As with heat therapy, be sure the source of the cold is wrapped to protect the patient against leakage or skin irritation.
Massage. The healing power of touch has been recognized for millennia. Massage stimulates blood flow, encourages relaxation, and increases the recipient’s feeling of well being. Great benefits can be obtained by light stroking, kneading, and rubbing. Seriously ill individuals may need the massage to be gentle and restricted to areas that are not red or inflamed. You may want to use lotion to reduce friction on the skin.
Relaxation techniques. With techniques such as deep breathing or progressive relaxation, the patient can interrupt the cycle of pain-fear-tension-more pain. Deep breathing is simply slow, deliberate inhalation and exhalation of air, with an emphasis on the release of tension with each exhale. In progressive relaxation, the patient tenses and then releases various muscle groups along the body. By contracting muscles and then relaxing them, the patient experiences the contrast and learns to identify and deliberately release tension in the body.
Prayer or spiritual support. In times of pain many people turn to prayer or spiritual pursuits and find it a source of great solace. Because physical, emotional, and spiritual well-being are interrelated, if the person you care for is spiritually inclined, the use of prayer, the reading of spiritual works, or talking with members of the clergy may indeed result in feelings of reduced pain or anxiety.
Mental techniques for pain relief. Like massage, meditation has long been recognized around the world as a method of releasing tension and easing pain. There are several types of meditation. Some forms focus on expanding the mind’s awareness beyond the level of the individual. Others concentrate the mind’s awareness on the internal functioning of the body, which, surprising as it may seem, reduces pain by placing the focus directly upon it. Either method seems to be helpful.
For those who are not inclined to meditation, guided imagery is an effective way to draw upon the mind’s ability to transform the perception of pain. Guided imagery usually entails someone giving the patient instructions in a calm, low voice, describing images and sensations such as a sunny day on the beach, with the gentle suggestion that each wave is washing the tension and pain out to sea. A slow, detailed narration of this type can help the patient by focusing attention away from the pain and onto pleasant and relaxing images.
Adjusting our attitudes. The experience of pain involves the mind’s perception of a physical sensation. Our mind, including our attitudes and the focus of our “inner voice,” can deeply influence our perception of that sensation and the degree of hopelessness we may feel about it. By using the technique of “reframing,” a patient can maximize the ability to cope with pain by altering any limiting or destructive messages to the self. For instance, “Nothing has worked. This pain is never going way,” can be reframed to “I wish I were not in pain. I guess I need to keep experimenting so I can find the right combination of approaches.” Reframing includes the practice of intentionally shifting the awareness from what isn’t working to focusing on whatever positives do exist in the situation. It challenges all-or-nothing thinking. Thus, another way to respond to hopelessness about pain would be to transform “This is useless, nothing has worked” to “This isn’t working as well as I had hoped, but ‘X’ has helped a little, and that’s a start.” Difficult as it may be, if the patient concentrates on what truly is working and gives him or herself encouragement to move forward, it will ultimately be more productive than focusing on disappointments. Focusing on defeats causes a person to be more aware of pain than if the focus is directed to victories or what might be possible.
Counseling. Although pain itself is very real, our perception of it and our confidence in our ability to cope with it have a significant impact on how much we suffer. People in chronic pain are not able to be themselves. They are constantly distracted, often irritable, and frequently discouraged. Relationships can become strained, and the person’s self esteem can plummet. Physical pain often brings with it emotional, spiritual, and social pain. Some patients find it helpful to work with a counselor trained in pain management techniques. These professionals can help not only with coping strategies to offset the physical pain of illness, but also with suggestions for handling the complicated feelings and dynamics that often arise when a person in pain is dependent on others for help and support.
Distraction. In the context of childbirth, Dr. Ferdinand Lamaze discovered that the nerve pathway that sends messages of pain to the brain can be filled with other nerve messages, effectively distracting or blocking the brain from fully registering the negative sensation. The Lamaze method uses unusual breathing patterns coupled with intense concentration to distract a laboring woman from the pain of contractions. Although “labor breathing” may be helpful for short term, stabbing, or shooting pains, it is not generally a long-term solution for chronic pain. Nevertheless, the distraction principle is a useful one. Certainly a patient with nothing else to focus on is more likely to be fully aware of his or her pain than is a patient whose attention is drawn to a specific activity. Depending on the patient’s energy level and mental capacity, useful distractions can include singing, playing cards, listening to music, watching television, talking with friends, reading, or having a story or magazine article read to them. Be aware that when distraction helps, it does not mean the pain was not real to begin with. Distraction simply blocks the pathway of the nerves leading to the brain and, thankfully, keeps the brain from registering discomfort.
Acupuncture. The Chinese have a long history of using acupuncture very successfully as a method to block pain. This ancient method of healing is based on a concept of “meridians” or pathways that circulate vital energy, called chi, throughout the body. In the Chinese approach, pain and illness are caused by blockages in these meridians. To relieve pain or illness, an acupuncturist inserts very thin, sterile needles into specific junctures on the pathways and twirls the needles to release the blockages and restore the balanced flow of chi.Return to top
Accurately describing pain
The simplest way to communicate about pain is to give it a score from 0 to 10, with zero representing no pain and 10 referring to excruciating or unbearable pain. Somehow assigning a number helps both the patient and the physician put the pain into an easy-to-understand perspective.
Many caregivers are surprised to discover that the person they care for downplays pain in front of the doctor. Even when they are asked a direct question about it, many patients deny having much pain, when in fact they have been experiencing significant discomfort or distress. A variety of reasons could explain their response: They value being stoic; they don’t want to be a “difficult patient”; they fear that more pain means the disease is getting worse; or they don’t know how to describe what they are feeling.
Other information that will help the doctor includes the answers to these questions:
- When did you start feeling this pain?
- How often do you experience it during the day?
- Where do you feel it (what part of your body)?
- Is it a burning pain? Aching? Shooting? Throbbing? Stabbing? A steady sensation of pressure?
- Does it seem to have a pattern (i.e., it comes on at a certain time or after a certain activity)?
- How long does it last?
- What has helped relieve this pain? Does anything make it worse?
- How has this pain been affecting your daily life? Your activities? Your relationships? Your mood?
Tips for working with medications
Stick to a regular schedule. In an effort to minimize the amount of medicine they take, some people try to extend the interval between dosages. Unfortunately, it is much harder to bring pain back under control than it is to prevent it from flaring up in the first place. Deviating from the schedule suggested by the doctor can result in a need for more medicine to keep the pain in check than if each dose had been taken when prescribed. If you are having trouble remembering to give a dosage, use an alarm clock or the oven timer to help remind you.
Do not skip middle-of-the-night doses. Because the body needs a constant level of medication in the system, skipping a middle-of-the-night dose is likely to result in unnecessary pain. If getting up is too difficult for the patient, shift the schedule so the late-night and early-morning doses are closer to times when he or she is more likely to be awake.
Get instructions about breakthrough pain. Sometimes a patient will begin to feel pain before the next dosage is due. Generally it is better to administer a smaller dosage in the middle than wait until the next scheduled time. Again, it is easier to stop a buildup of pain than it is to correct it after the fact.
Ask your doctor what to do if the patient vomits up the medicine. Some medications can be re-administered if they were given only a few minutes beforehand. Others require that you wait a specific interval of time before it is safe to give them again.
Consider alternate forms of the medicine. If the patient is having trouble with middle-of-the-night doses, a patch might be a better way for the medication to be administered. If the patient is having trouble swallowing or is throwing up the medicine, a patch or rectal suppository might be a preferable delivery method. Check with your doctor before you crush a pill and put it in applesauce. Some medications do not work as intended if they have been crushed or altered.
Use a pill tray. Many people with a serious illness take an overwhelming number of medicines. To help keep track of the patient’s treatment schedule, purchase a pill tray that has compartments for morning, noon, evening, and night. Because many boxes hold up to seven days’ worth of medication, choose a time when you can fill the tray without distraction. Once the tray is full, simply give the medicines one compartment at a time. You will find that using a pill tray also helps verify when the patient last took his or her medication.
Call several days in advance for refills. It often takes a doctor a few days to get a refill prescription to the pharmacy. When the patient gets down to five days’ worth of medication, call the doctor for a refill. It’s better to be safe than sorry!
Use the same pharmacy for all the patient’s prescriptions. Many patients have several doctors. It is difficult for these physicians to know what their colleagues have prescribed. Let the pharmacist help you avoid negative drug interactions. If all the patient’s prescriptions are filled at the same pharmacy, the druggist can alert you about combinations that are known to present problems.
Help monitor the pain. Keep a chart of the types of pain the patient is experiencing and when during the day the pain occurs. Help the patient rate the pain using a 0-to-10 rating system and record these numbers. The more information you can give the doctor about your loved one’s condition, the more likely it is that your health provider will be able to combat the pain.
Take periodic time away for yourself. It’s not selfish, it’s essential! Caring for a person in chronic pain can be very draining. If you do not take breaks now and then, you are likely to burn out and will not be able to give the best care possible. Check with community agencies, friends, family, or your congregation for help with respite. A simple walk around the block or lunch with a friend can do wonders for your mood and your ability to keep giving optimum care. You need to keep your strength up, if not for yourself, then for the sake of the patient.Return to top


As a qualified and registered physiotherapist, with over 20 years of experience, I can help you enhance your pre-habilitation or rehabilitation through an individual program in your home or the pool
Phone to discuss your needs and together we can work out a plan for you. We can make contact with other health professionals so that your care is aligned and tailored to your specific situation.
The charge is $85/hour plus mileage if over 10km from my base. This will give you personal 1;1 physiotherapy advice, care, and a program to continue within your own time.
I have been working with people with arthritic conditions, pre and post hip/knee replacement surgery + back surgery for the past 6 years, and currently, work part-time as a rehabilitation physiotherapist at Grace hospital.
Please phone to discuss any ideas you have in regards to enhancing your rehabilitation to your wellness state.
Kate 027 241 9084


As medical professionals know, full well, plastic surgery is not always just for aesthetics. Physical health benefits can, and often do, accompany many procedures. Periodontal plastic surgery is a popular and beneficial option for patients looking to improve their smile, yet it is also an important means of treating such anomalies as gingival recession and root exposure, “gummy” smile, and atrophy in the gums and jawbone after tooth loss. To maximize esthetic restorative potential, the gingival tissue and bone surrounding a dental restoration must be sufficient.
Over 30 years ago, the concept of a plastic surgery study club first came about at the American Academy of Periodontology’s Annual Meeting. In 1987 P.D. Miller’s classification of marginal concept of periodontal plastic surgery was new, and a group of talented and inquisitive clinicians decided to form a club to delve further into the realm of oral plastic surgery. Initially, the study club was limited to 20 clinicians who would give presentations on various aspects of mucogingival surgery. In addition to Drs. Nordland and Miller, some of the early participants were such renowned leaders in periodontics as Drs. Jay Siebert, Gary Maynard, Pat Allen, Herman Corn, Jim Mellonig, Ron Nevins, Burt Langer, Bob Shallhorn, and Randy Harris.
The interest and focus of the group expanded as international dentists and educators expressed interest in joining. Dr. Yoshihiro Ono from Japan joined the group, bringing with him a contingent of Japanese dentists to the organization’s annual meeting. Dr. Peter Raetzke from Germany, who published on the subepithelial connective tissue graft, became an active participant. Before long, what had been known as the periodontal plastic surgery study club became the International Society of Periodontal Plastic Surgeons (ISPPS), and membership was opened to surgeons interested in periodontal plastic surgery.
Under the present authors’ leadership, ISPPS is currently comprised of dental specialists throughout the world, most of whom are full-time clinicians and educators. The society meets annually the day before the AAP annual meeting to present new, innovative and, often unpublished material and techniques or modifications/refinements to existing techniques in the field of periodontal plastic and reconstructive surgery, aimed at improving overall esthetics to the benefit of patients long-term. Lively and stimulating, these presentations are limited to 15 minutes, with 5 to 10 minutes for discussion, a format that has proven to be very popular. This format allows many ideas to be presented in a brief period. The group’s passion is to disseminate this information while mentoring younger members of the organization.
ISPPS welcomes new members who have an interest in periodontal plastic surgery. In addition, students in periodontal residency programs are encouraged to attend the annual meeting. Fellowship in the ISPPS is attained after presenting to the group at five meetings.
With new technology come new surgical treatments that are achievable and predictable. Working with the restorative dentist, the periodontal plastic surgeon can enhance treatment, with the patient being the ultimate beneficiary.
The 2018 ISPPS will take place Friday, October 26 in Vancouver, British Columbia, Canada. Please click here to attend the 2018 meeting.
Dr. Peter Nordland, President
Dr. P.D. Miller as Past President
Dr. Robert Levine, Vice-President
Dr. Pat Allen, Secretary
Dr. Yoshihiro Ono as Head of International Affairs
E. Pat Allen
Jose Carlos Martins de Rosa
Robert “Bobby” Horowitz
Brendan R. Lopez
Laura M. Souza
2019 Dennis Shanelec
2017 Dr. PD Miller
2016. Dr. Peter Nordland
2015 Dr. Yoshihiro Ono
2014 Dr. Andrew Allen
2013 Dr. Peter B Raetzke
2012 Dr. Randall J. Harris
2011 Dr. Robert Schallhorn


Respiratory specialist physiotherapist, Karen Humphreys (MCSP), provides assessment, treatment and management of a range of respiratory diseases. These include COPD (chronic obstructive pulmonary disease - an umbrella term for emphysema, chronic bronchitis or both), bronchiectasis, asthma, cystic fibrosis, pulmonary fibrosis, hyperventilation syndrome, chest infections and pneumonia. Karen has clinics based at The Witney Physiotherapy Centre . She also recognises that your condition may affect you getting out and about and so she offers home visits, residential home visits and nursing home visits.
Karen's aim is to:
- carry out a thorough assessment in order to provide you with individualised treatment
- educate you on your condition
- teach you techniques to clear phlegm/sputum from your chest
- help you to manage your breathlessness
- teach and correct your inhaler technique
- advise you on exercising with a respiratory disease
- teach you breathing retraining techniques to reduce symptoms of hyperventilation
- provide you with information on how to recognise an exacerbation of your condition and when to seek further medical treatment
- provide assessments and treatments in the most appropriate setting, whether that is in a clinic, in the comfort of your own home or within a care home.


Addiction is another word for dependency. We can be dependent on many things, but this does not always have to be negative. Most people are dependent on social relationships; during childhood and adolescence we are dependent on our parents. However, when we speak of an addiction, the situation is different. In such cases, a person is so heavily dependent on a certain substance - like alcohol or drugs - or on a certain behavior – such as computer games - that they cannot imagine a life without it. People often lose control of themselves and are unable to overcome their addiction without help. With physical addition, addicts get so used to the substance over time and thus need more and more of it over time to achieve the desired effect. People with an alcohol addiction for example can drink much more than other people before they feel drunk. In Germany, addiction is considered as an illness, and therefore affected people are entitled to medical or physiological treatment.
The reason why people become addicted to certain substances or behaviors is hard to tell. However, one thing is certain: Whether substances like alcohol or drugs, or certain behaviors like playing World of Warcraft, the addiction helps to forget negative thoughts or feelings for a certain period. Therefore, it is assumed that people who have experienced difficult times in their lives are more likely to develop an addiction than others.
The consequences of an addiction heavily depend on the type of addictive substance. Those who are dependent on cigarettes are at high risk of developing lung cancer, but are not psychologically restricted and live a normal life as other people do. Conversely, people addicted to computer games don’t necessarily have to fear physical consequences, but might not be able to maintain friendships or concentrate on school or work. Some addictions can destroy people both mentally and physically. This includes, for example, addiction to various drugs like alcohol, heroin, and in some cases even cannabis.
If you have the feeling, that you cannot cope without a certain substance or behavior, even though you feel that it is not good for you, you may have developed an addiction. Even iff you are unsure, you should get always look for support, for example, with the online advice from the FeM-Mädchenhaus


Welcome to my Website!
Matt Levy Psy.D. is a licensed clinical psychologist who specializes in treating children, adolescents, young adults, and their families. Dr. Levy offers psychoeducational evaluations and psychotherapy, as well as parenting support, to those who struggle to thrive in academic, home, or social settings. Matt, a native Atlantan, understands the stresses and rigors associated with balancing school, extracurricular activities, and play. He is a firm believer that success begins with a strong therapeutic bond and works hard to meet each client at their current level of functioning.
6000 Lake Forrest Drive, Suite 575
Atlanta, GA 30328
Office Phone: 404-308-0497
Office Fax: 404-255-3234


Salem Gastro delivers state-of-the-art medical services in a professional, caring and friendly environment. Established in 1979, this group of nine gastroenterologists and over sixty staff provides specialty care, including cancer screening as well as medical and endoscopic therapies for the full spectrum of gastrointestinal and liver diseases. Their compassionate, professional staff will care for you throughout the diagnosis and treatment of disorders of the gastrointestinal tract. By remaining independently owned and operated, Salem Gastro provides these services in a timely, efficient and cost effective manner.
875 Oak St. S.E. Suite 3010
Salem, Oregon 97301


CYJ Therapy Centre is dedicated to helping you achieve optimal health and wellness through a wide range of natural and holistic treatments. And now, we're proud to announce a new addition to our services that will take your healing experience to the next level. Get ready for the amazing world of acupuncture!"
1. Harmonising Body and Mind: The Essence of Acupuncture
At its core, acupuncture is a holistic healing technique that originated in ancient China. It revolves around the concept of Qi (pronounced "chee"), the vital life force that flows through our bodies along specific pathways known as meridians. Traditional Chinese Medicine (TCM) believes that when the Qi is balanced and unobstructed, optimal health and well-being are achieved. Acupuncture aims to restore this balance by stimulating specific acupoints along the meridians, thereby harmonising the body and mind.
2. Effective Pain Relief: A Natural Alternative
One of the most well-known benefits of acupuncture is its ability to provide effective pain relief. Whether you're dealing with chronic back pain, migraines, arthritis, or sports injuries, acupuncture offers a natural alternative to conventional pain management. By targeting the root cause of the pain, rather than simply masking the symptoms, acupuncture stimulates the release of endorphins and activates the body's innate healing mechanisms. This results in reduced pain and increased mobility, allowing you to reclaim an active and fulfilling life.
3. Stress Reduction: Restoring Inner Balance
In today's high-stress society, finding effective ways to manage stress is essential for our overall well-being. Acupuncture offers a powerful antidote to the daily pressures we face. By targeting specific acupoints, acupuncture helps regulate the body's stress response system, promoting a sense of calm and relaxation. Moreover, this ancient practice can improve sleep quality, enhance mood, and increase energy levels, enabling you to navigate life's challenges with grace and resilience.
4. Boosting the Immune System: Fortify Your Defences
Bolstering our immune system has become a top priority, especially in recent times. Acupuncture has been recognized for its immune-boosting properties, making it an invaluable ally in maintaining our health and vitality. By stimulating specific acupoints, acupuncture activates the body's immune response, enhancing the production of white blood cells and strengthening the overall immune system. This can result in a reduced susceptibility to illness, faster recovery times, and increased resistance to infections.
5. Holistic Approach to Mental Health: Nurturing Emotional Well-being
Achieving optimal health goes beyond physical well-being; it encompasses mental and emotional balance as well. Acupuncture embraces a holistic approach to mental health, addressing conditions such as anxiety, depression, and insomnia. By harmonizing the body's energy flow, acupuncture helps regulate neurotransmitters and hormones, promoting emotional stability and restoring a sense of inner peace. This integrative therapy can be a valuable complement to conventional treatments, offering a comprehensive approach to mental wellness.
6. Enhanced Fertility: Opening the Path to Parenthood
For couples struggling with fertility issues, acupuncture has emerged as a promising solution. By optimizing hormonal balance, improving blood circulation, and reducing stress, acupuncture can enhance fertility and increase the chances of a successful pregnancy. This gentle and non-invasive treatment can be used alongside assisted reproductive techniques, supporting the body's natural processes and increasing the likelihood of conception.
7. Accelerated Injury Recovery: Restoring Optimal Function
Whether you're an athlete recovering from a sports injury or an individual healing from a surgery, acupuncture can significantly speed up the recovery process. By increasing blood circulation to the injured area and promoting the body's natural healing mechanisms, acupuncture can help reduce pain, inflammation, and scar tissue formation. This results in a faster and more complete recovery, allowing you to regain optimal function and get back to doing what you love.


A Residence to Preserve Your Independence
Whether you’re considering assisted living for yourself or a loved one, let us show you the benefits of Southern Estates Assisted Living. Located in Scottsboro, AL, Southern Estates Assisted Living offers a comfortable, safe environment and award-winning care to help senior residents feel at home and confident. With around-the-clock assistance, medical attention, home-cooked meals, weekly events, and all-inclusive suites, our facility offers it all. To learn more about life at Southern Estates Assisted Living, please call us at 256-574-4202.