Ten Tips for Effective Communication With Your Doctor
By Dr. Karen Trollope-Kumar

Sometimes my work as a family doctor the days don’t always go as expected. On a busy day, I feel like I’ll never catch up, and it’s frustrating that I can’t give adequate time to each individual patient. One afternoon not long ago, I was feeling unusually tired. I looked down at my schedule and saw that my last patient was Beth, a young mother with a seven-year-old son. I thought to myself – Let’s hope this one is just a simple sore throat!

“So what brings you in today?” I asked, after a brief greeting.

“Well, I’m worried about Jimmy”, said Beth anxiously. “He’s getting into trouble at school a lot, and his teachers say he’s not paying attention. Sometimes he has stomachaches. I’m not sure what to do… Also, I’m wondering if you could just check his foot, I think he’s developed a plantar wart.”

I couldn’t help letting out a sigh. “Well, let’s just focus on the main problem,” I say. “What more information can you give me? Have you got his latest report card? Any specific comments from the teacher?”

Beth shook her head. She tried to explain more about her concerns about Jimmy, but she sensed that I was not listening closely, and she tripped over her words. Finally, I said in a voice edged with irritation, “There’s not much I can do in this short appointment. This is a complicated issue. Can you re-book for another time?”

After Beth and Jimmy left the office, I felt very guilty for brushing her off that way. I knew that she was not happy with the appointment, and neither was I. We had a communication problem, aggravated by time constraints. Unfortunately, such problems are all too common between family doctors and their patients and with a little teamwork can get the critical doctor-patient relationship back on track.

Like any healthy relationship, good communication is fundamental and that applies to the doctor-patient relationship as well. When that vital link of understanding is broken between doctor and patient, a cascade of negative consequences can result. If the patient hasn’t been able to fully explain his or her symptoms, an incorrect diagnosis might be made. If the doctor hasn’t clearly communicated his or her assessment of the problem, the treatment plan might fail. Poor communication inevitably leads to dissatisfaction for both doctor and patient.

There are ten quick tips to communicate better with your family doctor, and to make your office visit more effective:

1.     If you are seeing the doctor for a complicated issue (like Jimmy’s problem) ask the receptionist to book you a longer appointment.
2.     Prepare what you’re going to say ahead of time, and keep it concise and focused.
3.     If you’ve done some research on the Internet about your problem and want to share it with your doctor, make sure you use reputable sites to get that information.  Doctors get frustrated when patients bring in reams of information of dubious value.
4.     Avoid coming into the doctor’s office with a list of unrelated problems – focus on your main concern for that visit.
5.     If you are going in to get results of an important test, bring a friend or relative with you. Sometimes it can be hard to remember what the doctor has said, especially when the topic is emotionally laden.
6.     If you have a particular worry about a symptom (for example, Could this be cancer?), express that concern to the doctor.
7.     If the doctor advises a treatment you don’t feel comfortable with, explain your reasons, and see if an alternative approach would be possible.
8.     Keep your follow up appointment, and at that time let the doctor know how well (or not) the treatment has worked.
9.     If you’re not happy with the service you’re getting, communicate this clearly but politely, using “I” statements.  (for example, “I feel concerned about how long it took to receive these test results.”)
10.  If you’re happy with the service you’re getting from your doctor, a word of thanks or a card is always appreciated. Doctors are human too!

Improving communication requires work on the part of both the doctor and the patient. Thinking back on this appointment with Beth and Jimmy, I realized my faults: I was tired and also frustrated because the issue was complex and difficult to address during a short appointment. Yet still, I could have done a better job at communicating with compassion. On Beth’s part, she could have prepared for this appointment by thinking ahead about what information might be useful for the doctor. Working together, patients and family doctors can form great partnerships if they keep communication at the forefront of their relationship.

Dr. Karen Trollope-Kumar is a family physician in Canada and author of Cloud Messenger: Love and Loss in the Indian Himalayas. For more information, please visit www.karentrollopekumar.com.

7 SMART METABOLISM BOOSTERS- NO PRESCRIPTION NEEDED

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You may post this information as soon as you wish provided you quote our client Dr. Calapai. In return we will share on all of our social media platforms inluding twitter@kmrpr

It’s a frustrating scenario. You eat right and exercise yet you have gained weight or cannot shed weight. You may have inherited your mom's slow-motion metabolism, but the good news is; you’re not stuck with it. Research shows you can trick your body into burning calories more efficiently, especially if you hit the gym. “By strength-training just a couple of times a week, for example, you’ll reverse 50% of the seemingly inevitable metabolism slow-down that comes with age, says Dr. Christopher Calapai a New York City Osteopathic Physician board certified in family and anti-aging medicine. Here Dr. Calapai shares 7 Metabolism boosters that don’t require a visit to an endocrinologist or a prescription.

1. Value food as fuel and eat.

If you want to weigh less, you’ve got to eat less, right? Wrong! If you take in too few calories, it can cause your body to lose muscle mass and decrease your metabolic rate. Plus, when you skimp on calories, your body slows the calorie burn rate to conserve the fuel it's got. “Under-fueling is just as risky as over-fueling,” says Dr. Calapai. “In an attempt for quick, noticeable weight loss, many people wrongfully believe that eating as few calories as possible is the best solution. Not only can this lead to numerous nutritional deficiencies as the body is getting less food overall, it can actually have the opposite effect on weight loss.”

2. Mix up your workouts.

When it comes to the best workouts for weight loss, neither weights nor cardio can completely move the needle on their own. Interval training is the best way to shed pounds, increase your metabolism, improve your cholesterol profile, and improve insulin sensitivity. Turn your favorite aerobic exercise, (running, biking, even walking) into an interval workout by adding periods of intense speed (start with 30 to 60 seconds) followed by periods of rest (normal speed) for the same amount of time. Do this six to 10 times to complete a fat-slashing workout. As you get better, slowly increase the amount of time of increased intensity.

3. Become best friends with breakfast.

Commit to starting the day with a good breakfast. What should you be having? Morning munchies that are slow to digest and leave you feeling fuller longer. Try a mix of lean protein with complex carbohydrates and healthy fats. Fresh fruit, egg whites, steel cut oatmeal, Greek yogurt, fiber rich cereals are things to grab for. “You’re not kick starting your metabolism if you have coffee for breakfast. Skipping breakfast puts the body in starvation mode slowing your metabolism to a crawl to conserve energy,” says Dr. Calapai.

4. Spice up your diet.

It turns out capsaicin, the compound that gives chili peppers their mouth-searing quality, can also fire up your metabolism. Eating about one tablespoon of chopped red or green chilies boosts your body's production of heat and the activity of your sympathetic nervous system (responsible for our fight-or-flight response), according to a study published in the Journal of Nutritional Science and Vitaminology. The result is a temporary metabolism spike of about 23 percent. Stock up on chilies to add to salsas, and keep a jar of red pepper flakes on hand for topping pizzas, pastas, and stir-fries.

5. Drink green tea.

If you always opt for coffee over tea, you could be missing out on a major metabolism boost. In a recent 12-week study, participants who drank 4-5 cups of green tea daily, then did a 25-minute workout, lost an average of two more pounds and more belly fat than the non-tea-drinking exercisers. What’s is its magic? The brew contains catechins, a type of antioxidant that triggers the release of fat from fat cells and helps speed the liver’s capacity for turning fat into energy.

6. Snack smart all day.

It sounds counterintuitive. Why would you eat continually if you wanted to lose weight? Eating five to six mini meals, portioned to fit on the size of a salad plate, rather than three larger meals every day, keeps your metabolism going. "Snacking every 2 hours will also prevent you from going without food so long that you become so hungry that you overeat," says Dr. Calapai. “Try not to let more than 4 hours elapse between meals and make sure each meal includes protein, for an extra metabolic boost,” he adds. If you eat a high-fiber breakfast of cereal and fruit first thing, for example, have a midmorning snack, such as yogurt and fruit; for lunch (try four ounces of chicken or fish on top of a leafy green salad); then another snack late afternoon, like a banana and a piece of low-fat cheese. Dinner is then a lighter meal for example four to six ounces of turkey, salmon, or another lean source of protein with steamed veggies.

7. Get a good night’s sleep.

Lack of sleep is linked to a major increase in the risk of obesity. This may partly be caused by the negative effects of sleep deprivation on metabolism. Lack of sleep has also been linked with increased blood sugar levels and insulin resistance, which are both linked to a higher risk of developing type 2 diabetes It’s also been shown to boost the hunger hormone ghrelin, and decrease the fullness hormone leptin This could explain why many people who are sleep deprived feel hungry and struggle to lose weight.

About the Doctor:

Dr. Christopher Calapai, D.O. is an Osteopathic Physician board certified in family medicine, and anti-aging medicine. Proclaimed the "The Stem Cell Guru" by the New York Daily News, Dr. Calapai is a leader in the field of stem cell therapy in the U.S. His stem cell treatments have achieved remarkable results in clinical trials on patients with conditions as varied as Alzheimer's, arthritis, erectile dysfunction, frailty syndrome, heart, kidney and liver failure, lupus, MS and Parkinson's. He has worked with Mike Tyson, Mickey Rourke, Steven Seagal, and Gotham's, Donal Logue; and as a medical consultant for the New York Rangers. Connect with him via twitter @drcalapai or at www.drcal.net

The Science behind a Perfect Night’s Sleep [Infographic]

It’s common knowledge today that your lifestyle, what you eat and what you drink play a big part in your sleep pattern and quality of sleep, and while people know this and understand the concept of holistic well-being to some degree, most people don’t know exactly what factors influence their sleep and to what extent.

Normally it’s only when we aren’t sleeping well that we realise just how important a good night’s sleep is. Training regularly and eating well are extremely important to well-being but even a few nights of poor sleep can lead to daytime tiredness, lack of focus and concentration.

But getting a consistent amount of sleep every night is a challenge at the best of times, thankfully scientists have been concerned with sleep research for many years and the tips offered in the below infographic are based on years of research aimed at improving sleep quality.

But before we  consider how to get a good night’s sleep, it’s important to understand what a good night's sleep is. As described by Dr. Mehmet Oz, MD these are the most important factors when deciding if we are sleeping well or not:

1. Sleep latency – the time it takes to fall asleep
2. Sleep stages 1 & 2 – getting enough stage 2 sleep, sleep that rests the parts of your brain that you use during the day
3. Sleep stages 3 & 4 – these decline with age but are the restorative stages.

While it can be difficult to monitor these different stages effectively, overall if you’re waking up feeling tired and are tired throughout most of the day then you probably aren’t sleeping through all of the above stages, and it’s likely that your sleep quality can be improved.

For more information about the science behind a perfect night’s sleep check out the following infographic created by De Vere:

Remington Pushes Green Earth Agenda for Earth Day

Downtown Markham NA’s largest LEED® Development

Downtown Markham, April 17, 2017 – The Remington Group remains fully committed to its green agenda for Downtown Markham.  This Earth Day it is planning a full program to help the community learn more about being environmentally friendly.  And it is focused particularly on its youngest residents.  Remington Group is offering a host of activities and festivities to educate the community on how to be more sustainable, learn about and visit with Canada's native animals, and test drive an EVO car.

To provide a distraction for the youngest visitors and reinforce their appreciation for time spent outdoors, they will be offer free rides on the Pride of Canada Carousel, made entirely from recycled materials.  Hidden in the colourful characters of the carousel they will find repurposed scrap metal, from all parts of the country.

"Downtown Markham is a unique development in Canada, built from the ground-up to integrate with, rather than build over, the natural environment," says Rudy Bratty, Chairman and CEO, The Remington Group. "We are determined to create a centre where the residents of Downtown Markham can live, work and play in an economically vibrant community that emphasizes sustainable development, public space, alternative energy and a higher quality of life."

Downtown Markham is the largest LEED® development in North America. Projects pursuing LEED® certification earn points across several areas that address sustainability issues. Based on the number of points achieved, a project then receives one of four LEED® rating levels: Certified, Silver, Gold and Platinum. The Remington Group only designs buildings with targets for LEED® Silver or higher.  Construction under LEED® criteria allows Remington to measure its ongoing performance, ensuring water, energy and other critical resources are managed in the most effective manner possible. 

Green initiatives used by the Remington Group:

• High density development which minimizes the environmental footprint
• Past, current and future buildings will be located close to public transit and bike paths, reducing the dependency on cars
• All high-rise communities have charging stations for electric cars
• Past, current and future buildings will have bicycle storage
• Past, current and future projects will be respectful of natural ecosystems
• Use of “green seal” certified paints are made of mostly natural, biodegradable compounds
• Use of high performance double-glazing windows ensure maximum energy efficiency
• Use of ventilators recover heated or cooled air and guarantee substantial energy savings
• Use of thermal-insulated walls minimize drafts
• Remington is working to preserve the existing Rouge River ecology while taking steps to regenerate hundreds of species of wildlife after years of farming and is committed to creating green spaces around its development projects
• Remington uses natural materials found locally to decrease the carbon footprint
• Remington’s Downtown Markham complex uses high-efficiency water recycling and heating that reduces emissions by 50%

Event Information:

Celebrate Earth Day in Downtown Markham

Date: April 22, 2017

Time: 10am to 4pm

Address: 169 Enterprise Blvd, Downtown Markham

Summer Smart Sunshine Tips to Boost Vitamin D Levels

TORONTO, Ont. (April 6, 2017) – The daylight hours are getting longer, the sun is getting stronger and summer is just around the corner. Make this the year that you optimize your vitamin D levels through effective sun exposure. Enjoy the health benefits and disease prevention from optimal vitamin D levels and learn to control your risks from sun exposure.

Vitamin D is made naturally in your body when UVB rays from the sun convert cholesterol in your skin to pre-vitamin D3. We make about 90% of our vitamin D from UVB sun exposure. UVB rays are short and only reach the earth when the sun is directly above us. We can’t make vitamin D in the winter in Canada because the sun is at too low of an angle and the UVB rays are absorbed in the atmosphere.

You make vitamin D in Canada between the months of May and October. The best time for exposure is around midday, between 10am and 2pm, when the UV index is above 3 and your shadow is shorter than your height. The further you get from noon, the lower the amount of vitamin D you’ll make. The sun’s visible light may penetrate through glass, but UVB light will not therefore you will not make vitamin D.

Full body sun exposure at non-burning levels can create between 10,000-25,000 IU of vitamin D in your skin. You can never get too much vitamin D from the sun as your skin self regulates itself, whereas ingesting vitamin D does not have the same control. In addition, vitamin D that you make from the sun lasts twice as long in your body as vitamin D taken through supplements or food.

Statistics Canada reports that Canadian vitamin D levels have dropped by 10% over the past six years. The root cause of this decrease is lower sunshine exposure. People are just not getting outside around midday in the summer and making vitamin D and when they are outside they are using sunscreen which if applied correctly prevents 95%+ of vitamin D production.

In Canada, 12 million Canadians (35%) have vitamin D blood levels below the recommendations from Health Canada. This puts these people at a higher risk for several diseases, including cardiovascular disease, cancer, osteoporosis, diabetes, multiple sclerosis, Alzheimer’s disease and many more. In fact, a study completed in 2016 reported that if Canadians increased their vitamin D levels to the recommended level of 100 nmol/L, we would save $12.5B in healthcare costs and 23,000 premature deaths annually.

A recent study reported that women who avoided the sun have twice the risk of all cause death. The authors said that “avoidance of sun exposure is a risk factor for death of a similar magnitude as smoking.”

Skin cancer is a concern and risk of sun exposure must be managed and balanced with the benefits from vitamin D and other photoproducts. Research has shown that people with higher sun exposure such as outdoor workers, who have 3-10 times the sun exposure as indoor workers, have a lower incidence of melanoma. The National Cancer Institute reports that melanoma risk is increased as a result of intermittent acute sun exposure leading to sunburn. People who are a skin type 1, with white or very pale skin colour, red or blonde hair colour and who always burn and never tan, should severely limit their sun exposure.

The Vitamin D Society offers the following tips:

• Know your own skin and skin type. Don’t burn. Never overexpose yourself.
• Acclimatize or condition your skin for sun exposure by gradually building or lengthening exposure times as your skin begins to tan to reduce your risk of burning
• Prevent burning and overexposure when required through the use of hats, clothing, shade and sunscreens
• For vitamin D get sun exposure at midday, between 10am and 2pm, when the UV index is above 3 and your shadow is shorter than your height
• Expose more skin for a shorter period of time to generate more vitamin D while reducing your risk of overexposure.

It’s important to manage the risk and enjoy the rewards of moderate sun exposure for good health. Cancer Research UK, through the Consensus Vitamin D Position Statement, offers the following recommendation: “Enjoy the sun safely while taking care not to burn, can help provide the benefits of vitamin D without unduly raising the risk of skin cancer.”

“This advice may go against what current health organizations recommend,” says Perry Holman, Executive Director of the Vitamin D Society. “They typically recommend you stay out of the sun at midday and use sunscreen when outdoors. But this would reduce your potential vitamin D production and does not consider the benefits as well as the risks of sun exposure on overall health. You need to have balance.”

About the Vitamin D Society:

The Vitamin D Society is a Canadian non-profit group organized to increase awareness of the many health conditions strongly linked to vitamin D deficiency; encourage people to be proactive in protecting their health and have their vitamin D levels tested annually; and help fund valuable vitamin D research. The Vitamin D Society recommends people achieve and maintain optimal 25(OH)D blood levels between 100 – 150 nmol/L (Can) or 40-60 ng/ml (USA).

To learn more about vitamin D, please visit www.vitamindsociety.org

mobileDOCTOR by guard.me - Introducing Canada's First Telemedicine Program for International Students

SOURCE guard.me International Insurance

Canada's Minister of Health gets a healthy dose of hope and happiness

SOURCE Saint Elizabeth Health Care

Seasonal Allergies: Stop the Itching & Sneezing With These new Apps

Toronto’s Beer-iest 5K Run Returns to Ontario Place

Toronto (April 10, 2017) --- More than 3,000 runners, walkers and beer lovers are expected to lace up for the second annual Famous Canadian Beer Run on Sunday, September 17, 2017. The event features a scenic 5-kilometre run through Ontario Place, followed by a Craft Beer and Food Festival for participants at the finish line. Costumed runners, cold beer and fantastic live entertainment make for a memorable run for beginners, beer lovers and seasoned racers alike!

Recently named by Toronto.com as one of Toronto’s Best Fun Runs, this beer-themed event offers participants stunning views of Lake Ontario and the city skyline as they make their way to the finish line where beer awaits. Crossing the finish line into the heart of the Craft Beer and Food Festival participants are handed a custom beer stein and are invited to sample brews from Ontario’s top craft breweries, including Beau’s All Natural, Lost Craft Beer, High Park Brewery, Great Lakes Brewery and Shawn and Ed Brewing Co. Other alcoholic beverages such as soCIALITE Vodka and Shiny Apple Cider are also on hand for non-beer drinkers.

Enjoying an afternoon relaxing and recovering from the race, the Festival features a live band and food from some of the city’s top food vendors, including Heirloom Toronto. Traditional post-run food like bagels and bananas are also on offer. Vendors such as event sponsor New Balance Toronto and the Society of Beer Drinking Ladies are on-site with running and beer-themed products available for purchase. The Famous Canadian Beer Run is an official Toronto Beer Week event.

Included in run registration is a race t-shirt, custom beer stein, beer chips good for two 8 oz. beers (or 4 samples) at the Festival and a race kit. The run is not a timed event and is open to runners and walkers of all abilities. Those who do not wish to participate in the 5K can attend the Craft Beer and Food Festival by purchasing a Festival Only pass ($25), which also includes the stein and beer chips good for two 8 oz. beers (or 4 samples). Additional beer tokens can be purchased in advance or on-site. Twenty-five “Brew Crew” runners from Toronto’s RUN-TO-BEER club dress up in costume to run alongside and cheer other runners along.

Early-bird pricing for the event is in effect until April 30^th and the first 450 registrants receive a free Run Hoppy toque. Registration is open online at www.runforbeer.ca.

Government of Canada and JDRF join forces to defeat diabetes

Building a strong partnership to accelerate clinical research on type 1 diabetes

OTTAWA, April 10, 2017 /CNW/ - David McGuinty, MP for Ottawa South, on behalf of the Honourable Jane Philpott, Minister of Health, announced today that the Government of Canada is investing in a new partnership that will help improve health outcomes and quality of care for the more than 300,000 Canadians living with type 1 diabetes, and their families.

The announcement was made at the Children's Hospital of Eastern Ontario (CHEO). Members of the All-Party Juvenile Diabetes Caucus – Pamela Goldsmith-Jones, MP for West Vancouver—Sunshine Coast—Sea to Sky Country, Sonia Sidhu, MP for Brampton South, and Filomena Tassi, MP for Hamilton West—Ancaster—Dundas – were on hand for the announcement.

The Government of Canada, through the Canadian Institutes of Health Research (CIHR), is partnering with JDRF to support clinical trials research for type 1 diabetes. Both CIHR and JDRF have committed $15M to the Partnership to Defeat Diabetes, for a total investment of $30M.

JDRF and CIHR share a vision of improved care, outcomes and treatment for Canadians living with Type 1 diabetes. The investment announced today will advance the search for a cure and ensure that research results are applied for patient care for those living with diabetes and other autoimmune diseases. This world-class collaboration also provides an opportunity to maintain Canada's leadership in diabetes research and clinical trials.

CIHR welcomes investments from important charities like JDRF. These partnerships play a key role in advancing world-class research that strengthens the health care system and improves the health of Canadians.

Quotes

"The Government of Canada recognizes the impact that type 1 diabetes has on Canadians and their families. This research will help improve the quality of life for Canadians living with type 1 diabetes and drive efforts to find a cure for this condition."
Jane Philpott
Minister of Health

"CIHR is proud to be working with JDRF to support research on type 1 diabetes. This new partnership will focus the efforts of the diabetes research community in Canada and speed the development of new and better treatments for all Canadians with diabetes. "
Dr. Philip Sherman
Scientific Director, CIHR Institute of Nutrition, Metabolism and Diabetes

"We are honoured to partner with CIHR to continue funding the best and brightest scientists in the field. This partnership will enable JDRF Canada to make significant advancements in the fight against diabetes and to positively impact the lives of the hundreds of thousands of Canadians currently living with type 1 diabetes. I am also grateful for the hard work of the All-Party Juvenile Diabetes Caucus, chaired by MP Pam Goldsmith-Jones. Pam is a strong advocate for the partnership between the Canadian Institutes of Health Research and JDRF, and for Canada's leadership in tackling diabetes."
Dave Prowten
President and CEO, JDRF Canada  

"Canada is known for its state-of-the-art type 1 diabetes research, and has played a pivotal role in ground-breaking discoveries. We are pleased to be entering into this exciting partnership with CIHR to advance global science excellence."
Derek Rapp
CEO, JDRF International 

"As a parent of a daughter who lives with type 1 diabetes, I know how challenging life is for these children and their families. Canadians are very grateful to Minister Philpott and for the constant efforts of JDRF, which have resulted in this historic investment in diabetes research."
Pamela Goldsmith-Jones, MP for West Vancouver—Sunshine Coast—Sea to Sky Country,
Chair of the All-Party Juvenile Diabetes Caucus 

Quick Facts

• Type 1 diabetes is a disease in which the pancreas does not produce insulin. When this happens, blood glucose levels rise and, over time, the high level of glucose can damage nerves, blood vessels and organs.
• An estimated 300,000 Canadians are living with type 1 diabetes. The number of people living with type 1 diabetes is increasing by 5% annually – and the greatest rise is in children under five years of age.
• CIHR and JDRF have established a $30 million partnership to fund clinical research to improve the treatment of type 1 diabetes and accelerate the search for a cure.

At the Canadian Institutes of Health Research (CIHR), we know that research has the power to change lives. As Canada's health research investment agency, we collaborate with partners and researchers to support the discoveries and innovations that improve our health and strengthen our health care system. www.cihr-irsc.gc.ca

JDRF is the leading global organization funding type 1 diabetes research. JDRF's goal is to progressively remove the impact of type 1 diabetes from people's lives until we achieve a world without type 1 diabetes. JDRF collaborates with a wide spectrum of partners and is the only organization with the scientific resources, regulatory influence, and a working plan to better treat, prevent, and eventually cure type 1 diabetes. As the largest charitable supporter of type 1 diabetes research, JDRF is currently sponsoring $530 million in scientific research in 18 countries. 
www.jdrf.ca

SOURCE Canadian Institutes of Health Research