6 Tips for Managing Holiday Stress

The holiday season can be very overwhelming for most. LBD PCN Registered Psychologist, Sheila Gothjelpsen offers these tips on managing holiday stress:

1. Evaluate expectations - whether they’re yours or someone else’s, unrealistic expectations can lead to stress. Remind yourself that you don’t have to do it all.

2. Ask for help - enlist the help of family and friends to share the load of entertaining. Reach out to others for support, advice and assistance when needed.

3. Review what you value about the holiday - ask yourself: “Am I focusing on what I truly value this holiday season?”

4. Look after yourself - self-care is important during the holiday season as increased stress can increase your risk for colds, flus and mental health issues.  Try to eat healthy and exercise as much as possible to help manage stress (we know this one is a challenge).

5. Relax - use deep breathing, meditation or any other relaxation technique to help lower overall levels of tension.

6. Make a List - not a Christmas or holiday present wish list, but rather a gratitude list.  Note all the things you’re thankful for this holiday season and review it every day.

Staying active over the holiday season

With the holidays coming up quickly, let’s remember the benefits of activity and try and reduce the amount of sitting time as much as possible.  

We all have plans and certain times set aside with family members but why not try to be creative and make the time together a little more active?  

Going for a walk in the milder weather is always a great idea and something most can take part in. Of course safety measures should be applied for walking on icy sidewalks, like using walking sticks and having good footwear or grips that give traction on the ice.  

Take the family to the local outdoor ice rink and go for a skate or maybe tobogganing on a local hill.  Play more active board games where more standing is involved or even hooking up to the Wii and play video games that involve movement. 

If you have some time off during the day, check out a local recreation centre and see what programs and classes they have to offer, maybe even try a few. 

These are just some ideas to get more activity into the holiday season as it can be so easy to relax and enjoy all the festivities and forget about keeping activity in the schedule.  Remember to aim for at least 30 minutes of moderate activity 5 days of the week and plan ahead and schedule the time in.  

Happy Holidays!

Corinne Cutler is an Exercise Specialist at the Leduc Beaumont Devon Primary Care Network.

How to keep lifestyle goals throughout this holiday season

Everywhere you look there are signs of holidays; snow, lights, decorations, Christmas trees all in preparation for the season.  Unfortunately holidays do pose challenges when it comes to watching our portions and choosing healthy options, given all the extra temptations and yummy goodies everywhere you turn. Just because it’s the holidays does not mean we can’t try to incorporate some healthy habits to keep us on track with our lifestyle and health goals.

Check out these two handouts called Healthy Holiday Eating and Eating Out the Healthy Way for some great tips!

These tips don’t just refer to the holiday season, any special occasion or time we are eating away from home still pose challenges to lifestyle goals and that these tips can also be used in those situations.

Andrea Shackel is a Registered Dietitian and Certified Diabetes Educator at the Leduc Beaumont Devon Primary Care Network.

Pelvic floor muscles and keeping them intact

Keeping your pelvic floor muscles strong and intact is an important factor in health for both men and women. 

Keeping these muscles intact and contracting properly allows for:

- providing better recovery from childbirth,

- improving control over bladder and bowel function, lessening the chances of urinary or stress incontinence,

- reducing the risk of prolapse,

- providing benefit to men for better recovery after prostate surgery.

The attached article provides some basic information and education for exercise professionals on how to assist with promoting good pelvic health.  This article also has some great information that can help promote how to increase public awareness s on the subject.  

Tips for Practitioners on Promoting Pelvic Health & Pelvic Floor Muscle Training

A great form of exercise for maintaining and increasing pelvic floor muscle strength is Pilates, which the Exercise Specialist at the PCN is certified in.  Please see your family doctor for a referral to the Leduc Beaumont Devon Primary Care Network in order to access the Exercise Specialist or any of the SMILE team members.  

Corinne Cutler is an Exercise Specialist at the LBD PCN.

Be a Diabetes Detective

Be a Detective to Manage your Diabetes

Managing your diabetes can often feel like trying to solve a mystery.  Questions that always arise up are:

How does my food effect my blood sugars?

Are my medications working? 

What does physical activity do to my blood sugars?

How come I don’t feel any different even though I am making changes?  

Diabetes is very individualized, so when it comes to figuring out how best to manage it you need to become your own detective.  The best way to do this is through Self-Monitoring your Blood Glucose (SMBG) or checking your own blood sugars!

Collect the Evidence

Checking your own blood sugars or SMBG helps you:

• -         Determine your blood sugars in that exact moment (after a meal, after activity, first thing in the morning).
• -         Determine if your blood sugars are high, low or within target.
• -         Show you in that exact moment what your food, activity and medications are doing for you.
• -         Work with your health care team to help put the puzzle pieces together with any adjustments needed for either lifestyle or medication.

I don’t like to poke my fingers so how often would I need to check?

-          As mentioned before, diabetes is very individualized, so SMBG is also individualized.  How frequent you test is dependent on your medications, your lab results, you current health status: sick, hospitalized, pregnant or even starting a new medication

What do I use to check my blood sugars?

-          You check your blood sugars through use of a portable blood glucose machine.  These devices are available through your community pharmacies or health teams.  Talk to your pharmacist or team members about what meter is right for you and coverage that is available for you

Interpreting the Evidence

Recommended blood glucose (sugar) targets for most people with diabetes*

(Your target may not be the same as the examples in this blood sugar levels chart. Yours should be specific to you.)

	A1C**	Fasting blood glucose/ blood glucose before meals (mmol/L)	Blood glucose two hours after eating (mmol/L)
Target for most people with diabetes	7.0% or less	4.0 to 7.0	5.0 to 10.0 (5.0 – 8.0 if A1C** targets not being met)

* This information is based on the Canadian Diabetes Association 2013 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada and is a guide.
** A1C is a measurement of your average blood glucose (sugar) control for the last two to three months and approximately 50 per cent of the value comes from the last 30 days.

- See more at: http://www.diabetes.ca/diabetes-and-you/healthy-living-resources/blood-glucose-insulin/managing-your-blood-glucose#sthash.JOnq46Ax.dpuf

Putting the Puzzle pieces together

Now that I have tested what do I do with the information?

-     Record your blood sugar readings in a log book or journal. This is a great way to start seeing trends and patterns.  Depending on how in-depth you want to go you can record your food, activity, medications and your blood sugar readings to get the whole picture.

-     

      Take this log book with you to your medical appointments to be able to discuss the best management options for you when it comes to managing your diabetes.

-     Look at the information you have collected. You can interpret the readings to determine whether or not it’s the food, activity or medications that needs to be reviewed.

Click on the links to see the samples of how to log your blood glucose readings:

Self-Monitoring Blood Glucose Tool

Weely Blood Glucose Log sheet (printable)

Solve the Mystery!

The more you know about diabetes and how it affects your body the better able you are to start managing it! 

If you are newly diagnosed or have question about help to manage your diabetes please ask your PCN doctor for a referral to the SMILE team, where a team of detectives can also help you out!

Please visit the CDA website for more information.

Andrea Shackel is a Registered Dietitian and Certified Diabetes Educator at the Leduc Beaumont Devon Primary Care Network.  

World Diabetes Day

World Diabetes Day is celebrated every year on November 14. It is a global event that unites millions of people around the world to raise awareness of diabetes. Blue is the colour of the diabetes circle and the global symbol of diabetes.

To recognize this important day in Edmonton, the High Level Bridge will be lit up in blue on Friday, November 14. The Canadian Diabetes Association invites everyone to join them to see the spectacular bridge lit up!

If you wish to participate, meet at the front of the Alberta Legislature Building at 6:30 PM on Friday, November 14. We will then walk the bridge together as we connect with others and reflect on the importance of recognizing World Diabetes Day.

Light refreshments will be served; please dress for the weather as the temperature is predicted to be around -16C during that time.

Diabetes and foot care

Foot Care is an essential component to your diabetes management.  Diabetes affects the circulation of your body and its immune system, which impairs the body’s ability to heal wounds. As well, over time the excess blood sugar can cause damage to the nerves in the feet, which is known as “neuropathy”. As a result of neuropathy, people are less likely to feel an injury, such as a cut or blister. If this goes unnoticed, it could become infected and lead to serious complications such as gangrene, loss of a limb, or Charcot foot, plus others. 

What can you do to reduce complications from neuropathy?  Start by visually inspecting your feet daily, including the bottom and in between your toes. Use a mirror if you have to.  Check to make sure there is no cuts, cracks, ingrown toenails, blisters, etc. Wash your feet in warm (not hot) water, using a mild soap.  Don’t soak your feet as that could cause dryness. Dry your feet carefully, especially between your toes.   If there are cuts, cracks, etc., cover them with a dry dressing suitable for sensitive skin.  Trim your toenails straight across and file and sharp edges. Don’t cut them too short.  Put unperfumed lotion on your heels and soles, and thoroughly rub it in. Do not put lotion in between your toes as this excess moisture will may promote infection. While putting on lotion, notice the temperature of your feet, it should be warm, not cold or hot. Exercise regularly to improve circulation. Wear proper footwear that is supportive and do not rub or pinch. 

If you do have neuropathy, follow the above instructions but also wear white socks instead of black or dark brown. White socks allow you to see if there is any discharge from a crack or cut. Do not put a heater or hot water bottle on your feet as you may not feel any pain it may be causing. 

It’s best for everyone to have their feet checked by a healthcare professional yearly, if not more often.  However, if you have any swelling, warmth, redness, numbness, tingling or pain in your legs or feet, contact your healthcare professional right away.  

Cherie deBoer is a Registered Nurse at the Leduc Beaumont Devon Primary Care Network.

For more information on when to see your Doctor, click this link: http://www.diabetes.ca/diabetes-and-you/healthy-living-resources/foot-care/signs-of-foot-problems

References:

Foot Care: a step toward good health. (2009). Canadian Diabetes Association. 

Family Doctor Week

November 10 - 15 marks the College of Family Physicians of Canada’s 10th Annual Family Doctor Week.

The College of Family Physicians of Canada proudly acknowledges the outstanding contributions of Canadian family doctors for their dedication to their patients and the delivery of high-quality health care.

Family Doctor Week in Canada will be celebrated during the week of the annual Family Medicine Forum from November 13 to 15 in Quebec City, QC.  

Watch the the Family Doctor Week video, here.

November is Diabetes Awareness Month - Exercise

Diabetes and the Effectiveness of Regular Physical Activity 

The short-term benefits of increasing physical activity for a person with diabetes:

• Lowers your blood glucose within one hour.
• Increases your energy and strength during the day
• Decreases stress, anxiety and fatigue
• Improves relaxation and sleep
• Improves overall well being  

The long-term benefits if activity is sustained:

• Improved blood glucose (sugar) control.
• Helps to maintain or lose weight.
• Lowered blood pressure.
• Stronger bones and muscles.
• Lower risk of diabetes complications such as eye, heart, and kidney disease.
• Improved quality of life.

One of the most effective aerobic activities with the lowest dropout rate is walking.  It can be as simple as going for a brisk walk in your neighborhood.  Click here for an example of a walking plan if you are just starting out. Feel free to print it for your own use or share it with others.  

Both aerobic and resistance exercises are important when it comes to decreasing the risk of developing or advancing Type 2 Diabetes as both help to improve the bodies insulin sensitivity.      

The following facts were taken from the Canadian Diabetes Association website:

• Low physical fitness is as strong a risk factor for mortality as smoking.
• Fitness level is one of the strongest predictors of all-cause mortality in people with diabetes.
• Physical activity can be as powerful as glucose-lowering medication… with fewer side effects.
• Regular physical activity, in conjunction with healthy eating and weight control, can reduce type 2 diabetes incidence by 60 per cent.

If you require help with getting started on an exercise or activity plan, ask your PCN family doctor for a referral to the Exercise Specialist on the SMILE team.      

Corinne Cutler is an Exercise Specialist at the Leduc Beaumont Devon Primary Care Network.                                                                                                                                                                                                                                                                                                                                                                

Diabetes Educator Day

Happy Diabetes Educator Day!

On November 5^th,2014 the Canadian Diabetes Association will recognize this date as the first annual Diabetes Educator Day.

A Certified Diabetes Educator is a health professional committed to excellence in diabetes education who has expertise knowledge in providing guidance and assistance for day to day management for people living with diabetes.  A Diabetes Educator has a sound knowledge base in diabetes care/management and education processes, as well as good communication skills and who has passed the Canadian Diabetes Educator's Certification Board (CDECB) exam.

Many health care professionals take on the role of being a CDE including pharmacists, dietitians and nurses making them an essential part of the health care team. Whether they are working directly with patients or advising health-care providers, diabetes educators play an integral role in the education, care and support of those with diabetes. Their specialized training makes them an invaluable resource.

The SMILE Healthcare Team at the Leduc Beaumont Devon Primary Care Network (LBD PCN) is proud to have three Certified Diabetes Educators on staff:

Nandini Desai, Pharmacist and Certified Diabetes Educator, has worked at the LBD PCN for nearly 6 years. Her specialties include diabetes management including insulin start, optimizing insulin management and smoking cessation. She attends the Canadian Diabetes Association annual conference on a regular basis as well as takes part in many learning opportunities with diabetes specialists. 

Andrea Shackel is a Registered Dietitian and Certified Diabetes Educator with the LBD PCN.  She has been working in the field of Chronic Disease Management with the SMILE team at the PCN for 6 years. 

Andrea received her Bachelor of Sciences in Human Nutritional Sciences from the University of Manitoba.  Her specialties of interest are obesity, diabetes and heart disease and emotional eating. Andrea is dedicated to educating patients about the health benefits of proper nutrition as well as identifying the many reasons “why” we eat which will help people become more mindful eaters.  She helps patients implement evidence-based nutrition recommendations to help manage their blood sugars, cholesterol, blood pressure and weight.

Sally Ho is a Registered Dietitian and Certified Diabetes Educator with the LBD PCN.  She joined our S.M.I.L.E. Healthcare Program (Self Manage to Improve Life Everyday) team last year, coming to us from the South Calgary Primary Care Network, where she worked in a similar setting.  Sally also works with our PCN patients in the Leduc Cardiac Rehabilitation Program, providing nutrition support to patients managing chronic disease such as hypertension, dyslipidemia, diabetes, obesity and nutrition concerns. She facilitates several education classes at the PCN, including the Weight Wise workshops Craving Changes workshops, and the Cardiac Rehabilitation’s nutrition classes.

If you are newly diagnosed, have had diabetes for a long time or having any difficulties with your diabetes management, please ask your LBD PCN family physician for a referral to the SMILE team.

Senior's Falls Prevention Month - Virtual Trek Across Alberta

This November’s Seniors’ Falls Prevention month focuses on the ‘Keep Active’ message. In partnership with UWALK, Finding Balance is hosting a virtual TREK across Alberta. Seniors across the province can join the TREK challenge by counting and recording the number of steps they take from November 1 to 30. The virtual TREK challenge begins in Coutts, Alberta and finishes in Fitzgerald, Alberta. The goal is 3,263,500 steps.

Let's take steps together to prevent falls.

You can pick up your free Finding Balance pedometer and passport (while supplies last) at the Leduc Beaumont Devon Primary Care Network office.The passport provides information on how to join, count steps, convert minutes of other activities like biking or shoveling into steps and where to log all steps. Group leaders can log steps for their group or individuals can log their own steps.

#301, 4710 - 50 Street, Leduc AB.

www.lbdpcn.com

For more information on Finding Balance and preventing falls, please visit:

http://www.findingbalancealberta.ca

National Senior Safety Week

National Senior Safety Week

November 6-12, 2014

As the Canadian population ages, injury and death from falls are on the rise. This National Senior Safety Week, November 6 to 12, the Canada Safety Council challenges all Canadians to commit to “take five to prevent falls.” With these easy steps, we can all reduce the likelihood and severity of a fall:

1. Using this infographic, check your home for tripping and slipping hazards. Click the picture to view it larger.

2. Include calcium and vitamin D in your diet with milk and nuts. Check out the Osteoporosis of Canada Calcium Calculator to find out if you’re getting enough. Osteoporosis and weakening bones increase your chances falls and fractures.

3. Check your medications. If you are on more than three medications a day, or take pills that could impair your balance such as sleeping pills, anti-depressants or blood pressure medications, have a discussion with your doctor about how to best reduce your chance of falling. 

4. Get your eyes checked. Even if you’re not experiencing symptoms, the Doctors of Optometry of Canada recommend that you have your vision checked at least once a year if you are over the age of 65, or every two years if you’re younger. Vision impairments are a leading cause of falls.

5. Exercise to keep strong.  Try a gentle strength-building exercise like yoga or Tai Chi to work your core balance and reduce the risk of falling.

We can all take steps to protect ourselves and our loved ones from preventable falls. Check the Canadian Safety Council website for more activities and resources on falls prevention during National Senior Safety Week, November 6 to 12. 

Also visit the Finding Balance website for tips on falls prevention, use their falls risk calculator and join the Virtual Trek Across Canada. You can pick up a Virtual Trek passport and pedometer for free at the Leduc Beaumont Devon Primary Care Network office. 

Goodbye Mealtime Struggles

Alberta Health Services offers a FREE workshop on mealtime struggles for parents of children 6 months to 5 years old. 

Join an introductory discussion with other parents, a pediatric Occupational Therapist (OT) and a Registered Dietitian (RD).

• Learn more about how children grow and develop eating skills.
• Explore the many reasons behind meal time struggles, and decide which first step strategies best fit your child and family.
• Learn about setting a consistent routine, connecting with your child, introducing healthy new foods and appropriate portion sizes.

Options for follow-up by an OT or RD are reviewed at the workshop.

This workshop is suitable for parents of children who do not have complex medical/feeding concerns or have had extensive feeding intervention.

Registration is required. Childcare is available.

It's flu season >:-( How to identify it and protect yourself

It’s that time of year again; time to get your flu shot.   Anyone can get the flu, but what’s even better is that anyone (six months and older) who lives, works or studies in Alberta can get the flu vaccine, free of charge.   

The flu season typically lasts from October – May, with the peak season starting in December.  Why should you get the flu vaccine?  Because it’s the best way to protect yourself and others from getting the flu and developing symptoms.   Symptoms generally appear 1-4 days after exposure to the virus and can last anywhere from 5 to 10 days, but it can take weeks to fully recover.  You can be contagious before symptoms appear and up to seven days after.   By protecting yourself, you help protect people around you who are at risk of complications from influenza. If more people are protected, less people will get sick from influenza.

What are the symptoms? 

• fever
• chills
• cough
• sore throat
• headache
• muscle aches
• stuffy nose 
• runny eyes
• extreme fatigue and weakness
• 
  

Those symptoms sound horrible! What can I do to avoid getting the flu?

https://www.ontario.ca/health-and-wellness/flu-facts

Despite my best efforts, I got the flu.  Now what can I do?

• Stay home and get plenty of rest;
• Drink lots of fluids;
• Avoid drinks with caffeine;
• Take basic pain or fever relievers but do not give acetylsalicylic acid (ASA or Aspirin®) to children and teens under the age of 18;
• Take a warm bath;
• Gargle with warm salt water or suck on lozenges;
• Use spray or saline drops for a stuffy nose;
• Avoid alcohol and tobacco.

Call you doctor or health care provider if:

• You don’t start to feel better after a few days;
• Your symptoms get worse.

Not sure if it’s the flu, cold, or the stomach “flu”?  Use this chart to help:

Click chart for a larger view

References:

Common Questions about Influenza Immunization

Flu Facts Ontario

             

To find a flu clinic near you, check out our blog post from earlier this week:

Influenza Immunization Clinics (Leduc, Beaumont, Devon, Calmar, Thorsby, Warburg, New Sarepta.

For influenza immunization clinics across Alberta, click here.

Cherie deBoer is the Chronic Disease Management Registered Nurse at the Leduc Beaumont Devon Primary Care Network.  

Influenza Immunization Clinics!

October is Immunization Awareness Month

When you make influenza immunization (also referred to as a flu shot or FluMist) an annual event, you protect yourself, your family, and our communities from infection & illness.

Influenza immunization will be available as of October 20, 2014, free of charge, to all Albertans six months of age and older, through dedicated Influenza Immunization Clinics across the province.

The brochure contains a list of local immunization clinics. For more information on immunization clinics, please see the Alberta Health Services website at www.albertahealthservices.ca

The following communities will hold drop-in immunization clinics on the following dates and time:

Leduc

Leduc Best Western – Marquis Room

5207 50 Avenue, Leduc

October 24, 2014                   9:00 am – 4:30 pm

October 25, 2014                   9:00 am – 4:30 pm

October 28, 2014                   9:00 am – 8:00 pm

November 5, 2014                 9:00 am – 8:00 pm

Leduc Public Health Centre

4219 50 Street, Leduc

November 12, 2014               9:00 am – 4:30 pm

November 18, 2014               9:00 am – 4:30 pm

Beaumont

Beaumont Health Centre

4918 50 Avenue

November 13, 2013               9:00 am – 4:30 pm

St. Vital de Beaumont Seniors Club

5204 50 Avenue, Beaumont

October 22, 2014                   9:00 am – 6:00 pm

October 27, 2014                   9:00 am – 5:00 pm

November 7, 2014                 9:00 am – 4:00 pm

November 8, 2014                 9:00 am – 4:00 pm

Devon

Devon Community Centre

20 Haven Avenue, Devon

October 23, 2014                   9:30 am – 7:30 pm

October 28, 2014                   9:30 am – 7:30 pm

Devon General Hospital

November 10, 2014               9:00 am – 4:30 pm

November 17, 2014               9:00 am – 4:30 pm

Calmar

Calmar and District Senior Citizen Club

4916 50 Avenue, Calmar

November 3, 2014                  9:00 am – 7:30 pm

Thorsby

Thorsby Health Centre

4825 Hankin Street, Thorsby

November 19, 2014                9:00 pm – 4:30 pm

Warburg

Warburg Cloverleaf Manor Lodge

5204 53 Avenue, Warburg

October 30, 2014                    1:00 pm – 4:00 pm

New Sarepta

New Sarepta Agriplex

5088 1 Street South

October 27, 2014                    9:00 am – 12:00 pm

Additional clinics may be added. Please see the Alberta Health Services website for additional clinic dates: www.albertahealthservices.ca