Should You Detoxify Your Body?
Are your kidneys and liver really lint traps for toxins? Is it true that your body is so loaded with toxins that if they don’t kill you they will most certainly sap your energy and age you prematurely? Yes. And No.
You have seen the ads and heard the claims that if you soak your feet in the ‘remarkable’ detoxifying water that all kinds of horrific toxins will flee your body. There is NO science behind these claims. Nor is there any science to say that fasting is an effective means to detoxify because if you stop eating, you stop feeding your intestines the fiber they require to help expel their contents.
In an effort to detoxify you could undergo colonic cleanses and coffee enemas and drink nothing but celery juice for two weeks. But in the end (no pun intended) you will not experience any significant benefits unless you choose to adopt a detoxifying lifestyle.
So No. An exhaustive review of scientific and medical papers does not uncover any particular detoxification process that is going to lift your spirit and your health to any new heights.
But Yes. You need to detoxify. Detoxification however, is not a singular procedure. It is simple, but it may not be easy to make the changes that you need to make in order to detoxify your body. Because detoxifying your body is detoxifying your life.
5 Steps to Detoxify, and Change Your Life in the Process
Here are the 5 most effective steps to detoxify and to achieve renewed energy, better sleep and a degree of happiness that you may not have ever known.
1) Eat Quality Calories – Minimize the amount of toxins that you ingest by choosing organic foods or those grown without pesticides and herbicides. And choose high quality, nutrient-dense calories whenever possible. A good grass fed steak may be the same amount of calories as a couple of chocolate bars but the nutritional value is so superior in the steak, that your body would thank you to eat the steak.
And don’t worry about red meat in moderation harming you – that’s a bunch of baloney. Now baloney WILL actually harm you because it is processed meat. Stay far away from processed meat and all of the additives that they contain.
Detoxify by: reduce sugar consumption, choose untreated foods, know what you’re buying, undertake an occasional elimination diet to determine if you feel better if you go a week without dairy products or wheat products (lactose and gluten are two common allergens)
2) Breathe – the greatest mechanism your body has to eliminate toxins are your lungs. Everyone breathes, but few of us do it consciously enough to expel air from deep in our lungs or to fill them up completely with a few deep, purifying breaths.
Detoxify by: taking a few minutes several times a day to sit up straight in your chair, drop your shoulders and take ten deep breaths. Let all toxic thoughts escape with each exhale.
3) Move Your Body – I talked to Corinna Anne from Limitless Motion about the detoxifying power of stretching and movement. Corinna works at Kingsland Farmers’ Market and has an impressive list of clients and credentials. She too promotes deep breathing and “detoxification” from the tension in muscles through stretching. A simple process she suggests is to roll up a towel tightly, place it horizontally beneath your shoulder blades and allow your head and back to drop to the floor. Let go of any negative thoughts. Breathe. Allow your body to relax completely.
Detoxify by: This gentle extension exercise can be very soothing to the body, but truthfully any rhythmic movement or stretch helps your system to detoxify.
4) Chill Out – do you know that when you yell at the driver who didn’t use his signal light or the waiter who messed up your order that you are putting a heavy burden on your immune system? Your heart, nervous system and digestive system all react to strong emotions such as hatred or anger or even frustration. We haven’t evolved enough to outgrow the fight/flight response that negative emotions trigger. There is no question that negative emotions are toxic to your system.
Detoxify by: training your mind to respond more calmly to different situations, change your perspective at least for a few moments and consider the burden you place on your immune system when you allow negativity to rule your reactions
5) Like Yourself – I don’t want to dramatize, but berating yourself, disliking yourself, hating your body and treating yourself poorly in terms of what you eat and think, can kill you. Many people are toxic to themselves. It’s a scientific and statistical fact that happy people live longer.
Detoxify By: cutting yourself some slack, not allowing negative thoughts about yourself to dwell in your mind, call someone who “gets” you, write a love letter to your niece… just doing something nice helps you feel good about yourself
This is a simplistic list and truthfully every one of these 5 items warrants an article on its own. That being said, just being more aware of these steps and implementing them as often as you can, will have a positive, detoxifying effect on your life.
Lori Wheeler
Kingsland Farmers’ Market
7711 Macleod Trail S, Calgary
Dr John’s Community Health Report – December 2011
“Bladder Control”
Canada is a lot like Australia. We share the same type of geography in that both countries are known to have long distances between rest rooms. If we all had global positioning devices we could program them for regular rest room stops when we plan a long trip by car.
I remember the long trips in our old station wagon with its port-a-potty or handy road side clumps of bushes when the small fry or, older folks, really had to go.Speaking of rest stops let us see what our medical people can do for “bladder control”.
For many, urinary incontinence may be due to an over active bladder that causes a sudden and unexpected urge to urinate. Others deal with stress incontinence which means that unless you are really prepared, jumping, coughing or sneezing are guaranteed triggers for an unintentional loss of urine. Stress incontinence is more likely to occur in women where weakened pelvic floor support exists due to past or present pregnancies or childbirth experiences. Such can create temporary increases in pressure on top of the bladder which can, in turn, allow urine to slip past the sphincter and result in the leakage of urine. This can increasingly happen with some with laughing, lifting something heavy, coughing, sneezing or exercising vigorously.
Loss of estrogen with the menopause reduces tissue tone and, in some, this makes urinary leakage more likely. In men, operations on the prostate gland may also lead to some degree of urinary leakage.
In an overactive bladder (urge incontinence), there is an involuntary urinary contraction of the bladder associated with an urgent need to urinate, that often can’t be stopped or delayed.
Assessments by your physician or an urologist can help sort out the problems of stress incontinence or an overactive bladder. Some surgical procedures are available for dealing with these types of problems.
Dr. John Morgan (403) 251-5704
e-mail: jcmorgan@shaw.ca
Dr John’s Community Health Report – November 2011
“Maintaining a Support Network”
Social connections play a vital role in your health and well-being. Maintaining a strong network of family and friends involve strategies on your part that include the following:
Make relationships a priority—Don’t take your partner or other loved ones and friends for granted. Work on these relationships and keep in touch. E-Mail is a great way of keeping in touch. They can get back to you, when it is convenient.
The importance of give and take—If someone gives you support and is interested in your problems be sure to express your love and appreciation. A note or a small gift is a great idea.
Respecting boundaries –Try to be there for your friends and family, but don’t overwhelm them.
Avoid endless complaining and negativity –It is tiresome and draining to listen to the same old gripes and negative viewpoints of one, over and over again -particularly in family matters.
Adopt a positive outlook –If you have trouble doing this naturally, follow the lead of others you admire in this respect and try to see the humor in some of life’s experiences.
Listening — Minimize distractions while talking to others. Try to remember what is going on in other people’s lives and speak of interests that you know others have or perhaps those which you share.
Dr. John Morgan (403) 251-5704
E-mail: jcmorgan@shaw.ca
Dr John’s Community Health Report – Sept 2011
“What is your proper weight and how do you maintain it?”
In my younger days in high school and at university I was 5 feet, 10 inches tall and weighed 155 pounds. These were, in my view, good height and weight numbers for playing hockey, basketball and football. I maintained these throughout my medical school training, my post graduate training, and for several decades of specialty practice as a cardiologist. Curling was the only regular sporting activity that I took part in during my forties and fifties but I remained active by mowing grass and gardening in the summer and shoveling snow in the winter and this allowed me to keep my weight at 155 pounds over the years.
In my seventies I developed some health problems. From time to time I had heart palpitations and some episodes of racing of the heart. These were diagnosed and have been successfully controlled with medications. I kept up my busy medical practice but I also began to walk regularly in Fish Creek Park and ride a bicycle. I changed my diet by adding more fish and less meat and also took smaller portions of all foods. I began adding fruit to my salads and morning cereals. My weight gradually came down in these years, dropping from 155 to 140 pounds.
My spouse gave me an ultimatum as I neared age 75. This was: “You have never had chest pain suggestive of coronary artery disease but you should undertake no more snow shoveling or any vigorous activity in the cold” she said. Her (reasonable) belief was that my obituary in the paper should not lead people to discover that I, a physician, possibly died while attacking a dump of Calgary snow in our driveway.
Earlier this year, I required an urgent coronary angioplasty with insertion of three stents to prevent a heart attack. This is a procedure whereby a catheter is threaded up the aorta and into coronary arteries that have constrictions of plaque in them. The balloon on the end of the catheter is inflated and leaves behind a metal wire stent to keep the artery patent, after the catheter is withdrawn. My cardiologist was content with my weight of 140 pounds but prescribed a walking program for me of one mile on warm days three times a week. I try to walk at slow and faster rates of speed, and slow down, of course, when I get out of puff. My spouse is teaching me a bit more about food and nutrition so I can control my diet and my weight which is sticking at 140 pounds. I am out of the snow shoveling business, of course, and this summer have given up mowing the grass.
Finally, the best advice I have for anyone is to fall in love when you are young and never give it up and, of course, listen to her advice.
Dr. John Morgan (403) 251-5704
E-mail: jcmorgan@shaw.ca
Dr John’s Community Health Report – June 2011
“Outwitting Our Taste Buds”
Eating great foods with friends and loved ones, is a powerful force. It is also one of the great pleasures in life to look forward to. It is likely also a great force behind the cook book publication industry. Taken at its worst, however, too much food or ingestion of the wrong types of foods can be a powerful force in the creation of obesity and other resultant illness. Bad eating habit formation in your own home and kitchen is to be avoided.
As we all know, there are many foods of a seasonal nature, such as fruits and vegetables which give us positive things to look for, on grocery store shelves. These are healthy and portable food choices which have significantly lower calorie counts than foods made of complex sugars and starches and fat content.
Here are a few ways to outwit your taste buds:
a) Look forward to the in-season ripening strawberries, grapes and dark cherries. Add these fruits to salads or serve them mixed in different yogurts. Do the same thing with vegetables by cutting them up and assigning some of them to soups, casseroles, or put them on the surface of pizzas. These tips extend the use of fruits and vegetables in the kitchen.
b) Keep unhealthy foods that you can’t resist (potato chips etc.) out of the house or only in small amounts in the home larder. Try to think of them as rewards for not messing up with your weight control when you finally find them in the neverland part of your freezer.
c) Think of some ‘special’ foods as special treats that you only eat when you can share at least half of it with a special friend. In our house, a few hidden away O’Henry bars are kept as a special treat, to be eaten with a special friend. Now if I can only remember, where I hid them.
Dr. John Morgan M.D. (403) 251-5704 E-mail: jcmorgan@shaw.ca
Dr. John’s Community Health Report – May 2011
“ A Healthy Mouth”
Having a healthy mouth starts by looking after the enamel surface of your teeth. This enamel looks and feels pretty hard but it is actually pretty thin and needs protecting. The visible white enamel covers the crown of each tooth. Knowing what to look out for and what you can do to promote an enamel-friendly setting in your mouth, can make a big difference in oral health.
An adequate flow of saliva washing over your teeth and an adequate fluoride intake (having fluoride in your water supply and all recommended fluoride applications by your dentist) is the right combination for the enamel surfaces of your teeth. This saliva and fluoride supplies high levels of calcium and phosphate ions which builds up on the surface of the enamel of your teeth and helps prevent the cracking of the enamel on the surface that can lead to infections and cavities. The washing of the teeth by saliva neutralizes damaging acids and limits bacterial growth that can dissolve tooth enamel.
A lot of people use bottled water or have in home water filters. Both of these are quite low in fluorides, so the use of fluoride tooth paste twice a day or oral fluoride rinses are helpful in getting a good fluoride supply.
I and my spouse visit our dentists every three or four months and receive fluoride applications along with dental cleaning of the enamel surfaces of our teeth.
Some ways to increase the saliva flow action (which assists in keeping the enamel surfaces of the teeth clean) are: chew sugar-free gum or suck on sugar-free candy.
Avoid lemon flavoured hard candy as it contains acid and increases the risk of tooth decay. If you are subject to dry mouth when you sleep, you can add moisture to the air with a bed-side humidifier.
The combination of good oral health, adequate saliva, fluoride treatments and regular dental visits should work to keep your mouth healthy.
Dr. John Morgan M.D. (403) 251-5704 E-mail: jcmorgan@shaw.ca
Dr John’s Community Health Report
“Multiple Sclerosis – Treatment or Hope ?”
In my February 2011 and March 2011 Health Reports, I discussed treatment of heart disease and the twenty year history of research that was required to bring coronary angioplasty procedures up to their current level of expertise in preventing heart attacks.
Currently some sufferers of multiple sclerosis are agitating for the spending of large amounts of federal money in new research, based on the results of only one uncontrolled study done by a physician named Dr. Zamboni and his colleagues. These physicians postulate that multiple sclerosis is caused by chronic cerebro-spinal venous insufficiency and can be treated by percutaneous angioplasty of venous structures. This research is both novel and unexpected according to an editorial in the Canadian Medical Association Journal in its August 2010 issue.
Even though the Zamboni article was just published in 2009, some members of our parliament in Ottawa are lobbying the federal government for new funding for multiple sclerosis research, based on the Zamboni et al work. Also, it seems that desperation with their condition has led some multiple sclerosis patients to file a lawsuit against the government in British Columbia, claiming that the denial of funds for this type of research, is discriminatory.
Proper research takes time and adequate funding and there are no easy pathways to success. It can’t be done on the basis of hope alone for a cure or effective treatment. Physicians know that multiple sclerosis is a disease that is difficult to study because the disease, by its natural progression, tends to wax and wane. It is also difficult to study because many patients are needed to do it properly, and they should be studied along with a matching control group of patients who did not get the treatment, in order to properly compare the effects of the treatment group, to the no treatment group.
In my view, good health policy decisions for the funding of research should not be based on the hope and desperation of some sufferers of a disease process. Rather, such decisions should be based upon study designs that are scientifically sound, are ethical, and produce findings that are replicable elsewhere.
For example, advances in the treatment of heart disease such as performance of angioplasties for coronary artery disease took two to three decades of specialized research by cardiologists to fully evaluate the procedure for its merit and to develop clinical expertise in its performance. To add funding or, to divert funding for research from one disease process to another, cannot wisely be done on the basis of one uncontrolled study, which is the case with the Zamboni procedure.
Please keep politicians out of clinical research. Seek the advice of cool decision makers who listen with knowledgeable ears to research specialists who must come for money with scientifically sound research proposals. It can’t be done in a rush.
John Morgan M.D. (403) 251-5704 E-mail: jcmorgan@shaw.ca
Dr. John’s Community Health Report
“Advances in Treating Heart Disease” – Part 2
In discussing advances in treating heart disease last month, I described my own experience of developing episodes of unstable heart disease; how that developed; and how such led to requiring coronary angiography, followed by urgent coronary angioplasties and coronary stent insertions. I had wakened at night with severe chest and left arm pains. I fortunately had nitroglycerine at home and got quick relief with a spray of this under my tongue. My cardiologist did a treadmill test and this was positive. He arranged and did coronary angiograms which visualized occlusions in two of my three coronary arteries. These were thankfully found before they caused any significant heart muscle layer damage that one suffers if the vessels become fully occluded. Later the same day, I had a coronary angioplasty with insertion of a coronary artery stent into one of my blocked arteries which feeds the back of my heart and, the next day, the same type of procedure was undertaken to restore patency to the artery which feeds blood and oxygen in the blood, to the left side of my heart. Again there was no evidence of damage to the heart muscle.
Before going home after the procedure, I was put on a daily dose of a statin drug to reduce my LDL’s (harmful blood fats) and I also was prescribed a daily doses of Plavix (clopodogrel) and aspirin, to protect my stents from clotting, over the next year.
I would like to outline what I did on the advice of my cardiologist. First of all I continued having my influenza vaccine in the fall to protect me from heart attacks and strokes. I continued my low fat diet and took my daily statin. From a diet point of view I followed a low fat diet, and over the next three months dropped and maintained my weight from 155 to 140 pounds. I am able to keep up a fairly brisk walk of just under one mile, three days a week. I have not had any recurrences of angina.
I plan to stay on the same program until told, otherwise, and this week, one year after my angioplasties and stent insertions, I will see my cardiologist and likely have a repeat treadmill study done. If he thinks it is appropriate, he will prescribe a drug program to reduce the likelihood of clotting at the site of my stents, in future.
This hopefully has given you some idea about what treatment is available for coronary artery occlusions that are discrete in nature. If one develops diffuse occlusions sometimes the better or only recommended treatment is surgical coronary artery bypass grafting.
John Morgan M.D. (403) 251-5704
E-mail: jcmorgan@shaw.ca
Dr. John’s Community Health Report February 2011
“Advances in Treating Heart Disease” — Part 1
Having been recently through urgent coronary angioplasty procedures and stent insertions, I am aware of the importance of a careful program to protect the status of these repairs – and particularly to prevent clotting at the sites of the metallic stents that are permanently left in place to keep the coronary arteries patent.
In our treatment of coronary heart disease, particularly in patients with unstable angina, coronary angiograms are done urgently. This involves injecting the arteries that nourish the heart with special dye mixtures. If one’s study shows a descrete narrowing of areas in the arteries of 70% or more, these areas are dealt with by balloon procedures that open up the narrowing, and then a stent or mechanical ring is placed inside the artery to keep it from narrowing again. This device contains material that helps prevent blood clotting at the site of the stent and in addition, the patient takes long term aspirin and clopidogrel (plavix) medications to prevent blood clots.
For these procedures, patient’s are only in hospital overnight and they require long term drug management, so I am going to review the long term management in my February and March Community Health Reports. In addition to protecting the stents from clotting, these patients also have problems such as smoking, obesity, hypertension, and may require cardiac rehabilitation exercise programs that should be carried out.
These patients should continue having yearly flu shots which also, scientific studies say, helps prevent strokes and heart attacks. All patients with a tolerance for same, are placed on a statin medication to reduce lower density lipo-proteins (LDL) which are harmful blood fats. The prevent program after the procedure then relies on clot prevention medications (aspirin and plavix, a statin) and whatever other treatment the cardiologist recommends.
The goal of the prevent program is to prevent harm to the implanted stent such as clotting and prevent or reduce any further narrowing of coronary arteries by disease with a cardiac rehabilitation program and other measures to control lipid levels and blood pressure.
Normally, the angioplasty/stent procedure patient will have a cardiology consultation a year after their procedure(s), to decide on long term therapy. A follow up stress testing procedure is a good idea at that time, to be sure that the stents are still giving good protection to the patency of the patients’ coronary arteries. In my March 2011 Community Health Report, I will follow up with a description of my own experience as a patient who has gone through these procedures and how it was followed up, one year afterwards.
John Morgan M.D. (403)251-5704 E-mail: jcmorgan@shaw.ca
Dr. John’s Community Health Report January 2011
“The Minister of Health and Wellness”
Gene Zwozdesky broke bread with the Calgary Medical Profession on June 9th, 2010.
The Honourable Gene Zwozdesky was appointed Minister of Health and Wellness on January 15th, 2010 and the physicians of Calgary had the opportunity to meet with him at their annual meeting of their CAPA Society on June 9th, 2010, at the Glencoe Club in the city.
The Minister has held previous cabinet appointments in the province in Aboriginal Affairs, Education and Community Development and he has also been Associate Minister of Health (1999) and of Capital Planning (2007).
Since his appointment to the Health and Wellness portfolio the minister has been very active touring Alberta hospitals and having frank discussions with physicians and hospital staff workers, where he has asked them what they felt the problems were in his ministry, and how they should be handled? At our dinner meeting with the minister and the Calgary physicians, he made a friendly opening presentation and then threw the meeting open to all of the questions and concerns of the physicians in the audience.
The minister in his remarks emphasized the importance of having a “Performance Measurement of the Health and Wellness System in the Province”. He admitted that there were persistent problems in health care delivery, including the following:
1) Public access into the system.
2) Access of the public to medical and surgical specialists.
3) 15 to 20% of people were ending up in emergency for primary care as they do not have family physicians.
4) Getting to see surgeons, and being operated on, in a timely fashion.
In his discussion the minister announced that 10 new beds would be added to expand the emergency department at the Rocky View Hospital in Calgary and 16 beds would be added at the Royal Alexandria Hospital in Edmonton. These are focal points of stress in both cities and expanded areas for observation and care were developed. It takes patients out of waiting rooms and puts them in special medical assessment areas.
In addition, the minister said that the public is going to be consulted on changes in the delivery of health care. He stated that the current budget in his portfolio of 7.5 billion will be expanded to 8.5 billion in the current budget and then expanded by 6% each year, with a five year funding adjustment. In addition, a separate adjustment of 1.5% for new innovations in the health care system, will be utilized.
The meeting was frank and open with both the physicians and the minister presenting their concerns about the pressure points in the system and how they can be properly addressed.
Having met several health ministers in the past, I feel that our new minister is listening to physicians and that he has an excellent background in planning and funding. Hopefully his approach to identified problems will remain practical and the public will, accordingly, be well represented.
John Morgan M.D. (403) 251-5704 E-mail: jcmorgan@shaw.ca
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Dr. John’s Community Health Report December 2010
“Primary Care“
Having had a very long perspective in the art and science of being a physician I have seen and practiced a degree of mobility where I have concentrated on looking after patients and working with their primary care doctors. I have been both a consultant in cardiology and have looked after a growing number of patients with cardiac problems, with the latter process being shared with family practitioners and specialists in internal medicine.
With the Canadian Health system I have had the best of both worlds. I can look after the acutely ill in our sometimes creaky hospitals and also offer the patients both excellent and free cardiac care. In office practice I can offer excellent cardiac testing done in a non hospital private clinical setting. This testing is prompt and complete and I have access to sub specialists in various heart specialties without lengthy waiting times. The care is prompt and remains free.
This all sounds pretty good from the patient’s point of view but there is still some access problems for patients. Their relationships with family practitioners and the consultants in internal medicine remains pretty good outside of the hospital but there is no longer a good patient physician relationship at the hospital level where in the emergency room they see a different emergency room physician often after a fairly long wait, as this new physician has a long list of patients to see. This new physician has to start from scratch as he has never seen the patient before. He has to make a diagnosis and initiate treatment without the help of the patient’s previous physicians. Seems to me, that this is at best a lot of duplication.
On paper, the emergency room system sounds simple and it should work well, but the problem is that it it is not a single physician looking after a single patient, but a single physician seeing many, many patients, none of whom he has seen before. It does slow down a guy or gal down when they are in charge of an emergency room. Of course, none of the hard working nurses in the emergency have ever seen the patients before either.
All of this is not a patient problem. It is a knowledge and a communication problem. The experience of the physicians that knows the patient is totally discounted in the current system, and it ends up with the patient being dispatched in emergency for a number of expensive screening procedures in labs and X-Ray to fill in for the lack of experience of the new treating physician. This system is what I call strangers looking after strangers and the process often requires several hours of getting to the bedside of a new patient.
There must be a better way of doing primary care.
Dr. John Morgan
80 Woodacres Dr. SW T2W4S6
403-251-5704
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Dr. John’s Community Health Report November 2010
“Sometimes things are used because they are available“
In the early 1960’s patients’ lives started to be saved by sending shocks through the wall of the chest of patients and stopping attacks of electrical shimmering of the heart (fibrillation of the heart).
This electrical fibrillation became a part of code procedures which was treated by external massage of the heart through compressing the chest and the use of electrical shocks of the heart through the chest wall over the heart and resetting the beat of the heart.
Over the ensuing couple of decades implanted systems in the chest to automatically defibrillate the heart were developed. In the event of heart stoppages the implanted devices would function just like an external shocker through the chest wall.
Over time more and more of these electrical defibrillators were implanted in patients by very enthusiastic electrical heart specialists with little regard to the presence or absence of underlying mechanical failure of the heart due to damage to the heart. The defibrillators were often implanted in patients with severe left ventricular dysfunction.
If elderly patients have had at least one previous admission to hospital with heart failure, the subsequent use of an implanted defibrillator is not likely to provide meaningful survival to these patients.
The concept that a “one size fits all” approach to the use of Implantable Defibrillators may represent neither the most effective use of resources nor the best balance between risk and benefit in many of these patients.
Dr. John Morgan
80 Woodacres Dr. SW T2W4S6
403-251-5704
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Dr. John’s Community Health Report September 2010
“ Personal Directives—–A New Approach”
Advance Directives or Living Wills have been available to Albertans for several years. Usually these documents have been drafted where an individual names a spouse, a family member or a close friend as their agent in case they become incapacitated by an accident or an illness. This document consists of a list of instructions that can be used by the agent to show health care workers what the writer of the living will or personal directive wants or does not want in terms of acceptable medical care.
The problem in the past has been that the health care workers often do not know that this particular document exists let alone what the directive wishes to take place, in terms of care.
Now, in Alberta legislation has been passed in which any Albertan can register the fact that a personal directive exists and the name of the agent who knows the wishes of the individual and the location of the agent where care givers can contact to find out the wishes in the personal directives. This registration can be done on the internet. This enables health care workers to contact the agent.
This process of registration is administered by the Office of the Public Guardian. It does not contain the details of the personal directives. It merely indicates that an individual has a personal directive, the date it was signed and provides contact information for the individual and the name and location of the agent who knows the details of the directives. The information simply brings the health care workers in touch with the person who knows the wishes of the person who wrote the personal directives. This would include details concerning treatments that were acceptable or not by the writer of the personal directives.
The whole process is done to respect the wishes of Albertans.
In our province a directive of this type can cover details such as short term and long term incapacitation. People can register their directives through a lawyer, or through the Public Guardian by phone or on line at www.seniors.gov.ab.ca/opg/registry/ I have tried the website and it is easy to use. The process assures good communication so that the wishes of people are going to be followed. It helps families such as mine where I am asking my daughter who is a nurse to act as my agent in health care matters and I will register her name so that she follows my personal directives that I will list for her.
Dr. John Morgan
80 Woodacres Dr. SW T2W4S6
403-251-5704
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Dr. John’s Community Health Report June 2010
“ The Colon and Health “
There is a long list of procedures and treatments that are purported to prevent toxic processes in the colon by health purveyors, such as naturopaths or other practitioners who promote their own medical treatments of the colon. They usually use vague terms such as relieving nerve pressures and clearing out toxins or the build up of other abnormal materials. This type of advice and treatment is offered as a matter of faith. Fortunately, the majority of patients that seek these types of treatments are not ill and seem to feel that these treatments are helpful.
One of the treatments that seems to have a patient following is cleansing treatments of the colon of what is thought to be removal of toxic material from the bowel.
The only time a regular physician studies the colon is when a gastroenterologist studies the colon and wishes to cleanse it first in order to see if there is any evidence of bowel infection or malignancy. There is no other scientific reason to cleanse the colon.
From a function point of view there is no practical reason to cleanse the colon. The colon is a long muscular tube with a thin lining and if extends from the lower part of the abdomen on the right extending upward near to the liver and then over to the left much like a picture frame extending then down on the left side of the abdomen to the rectum. The colon in function is a master eliminator. The muscular colon gradually moves the contents of the colon in one direction only which is toward the rectum. It is a one way street with only one function in mind along with the additional function of absorbing some fluid in the transit. Nature does the job. It does not need enemas or other sluicing procedures to get rid of the waste or the bowel bacteria.
Interference with the colon’s normal function with cleansing long term interferes with the normal functioning of the colon and it can even raise the possibility of creating a tear in the wall of the colon with a perforation that could be a surgical emergency.
Dr. John Morgan
80 Woodacres Dr. SW T2W4S6
403-251-5704
jcmorgan@shaw.ca
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“ Going To See Your Doctor “
Dr. John’s Community Health Report - May 2010
Looking back to my early years of practice I remember my first office nurse. Her name was Marion and she was a graduate of one of the old schools of nursing called the Edmonton General Hospital. Marion truly represented the old school as she came to work immaculately dressed in her full nursing outfit, including white stockings and her starched nursing cap. Starch was not spared. In appearance, Marion was definitely of the old school, where one of the rules of behaviour was a degree of formality. I was the doctor and Marion was the nurse. She was not above getting a patient ready for a physical examination and remarking to the patient with a zinger or two, such as “Patients coming for an examination should bathe”. She was delightful in all other respects, but she certainly set a high standard for people coming in to see her physician.
Now for some advice for people that are coming in to see a doctor. I have found that informality now is the rule of the day. The doctor has someone at the desk in the waiting room as well as one or two assistants who call out your name and take you into an examination room. It is always a good idea to go up to the desk when you arrive so that they know that you have kept your appointment. The doctor’s assistant usually comes out and calls your name. She is dressed informally. They always ask why have you come in, and then they get you ready for an examination, as they get some data from you and insert your history into the keys of a computer. It is always best to prepare yourself in advance if a physical examination is going to be carried out. Bathing is not forbidden. Loose fitting clothes and avoiding tight undergarments such as pantyhose in women
It is best not to eat before coming to the doctor’s office—this particularly applies to avoiding large meals, drinking tea, coffee and caffeinated beverages for at least two hours before coming to the doctor’s office. Food drink and smoking can temporarily raise the heart rate and the blood pressure. The same stress can occur with a full bladder and it is best to tend to that problem before coming to the office.
If special male of female examinations are planned it is best to know this when booking the appointment in case any special preparation is necessary.
Generally it is best to try not rushing to get to the appointment. Be quiet and relaxed while waiting to come into the doctor’s examination room.
Be prepared to answer the questions from the doctor’s assistant. She may ask you about allergies and the medications that you have been taking. It is a good idea to bring your medications in case the assistant or the physician wants to review them. If you have any information from another physician or an emergency room visit you can tell your doctor about it.
Physicians like to concentrate on what single problem made you seek advice. Springing something new such as wanting a general examination or perhaps a specialist consultation is not too appropriate at the time of the visit.
Most of all thank everybody when you leave. They love patient patients.
Dr. John Morgan
80 Woodacres Dr. SW T2W4S6
403-251-5704
jcmorgan@shaw.ca
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“Vitamin D—–How Much is Enough?”
Dr. John’s Community Health Report - March 2010
Vitamin D is the only nutrient that the body can make for itself. Sun exposure with its ultraviolet B waves interact with a chemical in the skin changing it to an inactive form of vitamin D. An exposure to the sun for 10-15 minutes three times a week is considered adequate for an intake of Vitamin D. Because of the risk of skin cancer it is probably safer to get Vitamin D from food or drug supplements of Vitamin D than from sun exposure.
Food sources rich in Vitamin D are limited. Fatty fish, fish liver oils and egg yolks top the list along with vitamin D fortified foods such as milk.
How much vitamin D is enough to prevent deficiency problems?
Some of the following studies suggest the use of a vitamin D supplement particularly in the older age groups. Fracture prevention. Higher doses of vitamin D 400 Int. Units or more a day lowered the incidence of bone fractures in general by 20% in the spines of people over the age of 65 years. In cognitive studies, patients who had higher levels of vitamin D in the blood scored higher in executive functions. They were better able to plan, organize, tend to details and think abstractly. Another study of more than 1700 older adults found that those with the lowest vitamin D levels were more than twice as likely to have impaired thinking skills as were who had the highest vitamin D levels.
How much vitamin D supplement is enough? The current recommendation for patients of fifty years or older is 400 Int. Units a day. For patients with known osteoporosis the upper limits daily is no more than 2000 Int. Units.
Experts agree that an optimal vitamin D blood level is 30 nanograms per milliliter (Ng/ml)
In older ages vitamin supplements of 400 Int. Units a day are recommended, but you should follow the advice of your family physician in making this decision.
Dr. John Morgan
80 Woodacres Dr. SW T2W-4S6
403-251-5704
jcmorgan@shaw.ca
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“ How Much Medical Care is Enough ? “
Dr. John’s Community Health Report – February 2010
This past few months I have been involved with a group of young medical students at the University of Calgary discussing medical ethics in clinical care including end of life decision making by patients and their families.
Modern society is a “Death Denying” people who have great faith in the medical profession in their ability to sustain and to prolong life when they offer great technical achievements to try and reverse the inevitable.
Death is always in the news. Large scale disasters such as the Katrina flooding in New Orleans and the possibility of H1N1 or other viral epidemic with fatal consequences, is great fare in our newspapers and television outlets.
The expectation of the public is to do everything possible to prevent death. While this is a natural wish, we know that there is a gradual deterioration of ill patients in hospitals and in long term care facilities where decisions as to appropriate or inappropriate care has to be made, and even decisions not to resuscitate a very ill patient should be made. Living wills or advance directives, where we recognize the autonomy of people when they are lucid or by the knowledge of close family members who clearly want the wishes of a loved one to be followed, help the care givers while demands for care that serves no useful purpose are voiced by some distraught relatives.
Physicians are helped when there is a clear transfer of autonomy, either by the advanced directive or the patient or agents in the family that know the long standing wishes of the patient.
Having families that demand ineffective or inappropriate care in emergency rooms or acute care facilities of a hospital, can usually be settled by a family conference with the caregivers.
In my medical career I found the social service department in the hospital to be a great help. They were dressed like the family, and often met with the family and shared their thoughts with the family. This type of shared companionship with family members allowed for better communication with the physicians and the nurses.
In health care we must understand that “wanting does not always mean getting” when it comes to making decisions in critical situations.
Dr. John Morgan
80 Woodacres Dr. SW T2W-4S6
403-251-5704
jcmorgan@shaw.ca
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Dr. John’s Community Health Report – December 2009
“Obesity and the Snake Oil Treatment”
An editorial in the Canadian Medical Association Journal back last February made the following observations about weight-loss programs and what we should do about the sellers of snake oil treatments for this major problem.
“The $50 billion North American weight-loss industry comprises a morass of fantastical claims of products and programs promising quick, easy, and long-lasting results. Given this wealth of magical weight-loss aids, why is obesity still a problem? Perhaps because magic exists solely within consumer hopes and dreams, which many commercial weight-loss providers happily exploit.”
“Recognizing the substantial morbidity and mortality associated with obesity, physicians, public health campaigns and nongovernmental organizations fuel the fire of the public’s weight-loss desires by promoting awareness of obesity’s risks. However, by not explicitly recommending evidence-based treatments, these well-intentioned messages drive consumers to blindly navigate in an unregulated wilderness. This has, at times, had fatal consequences, as with the administration of ephedra and with medically unsupervised very-low-calorie diets.”
“Physicians, governments and public health departments all share medical and moral obligations to protect consumers from shady weight-loss practices. Since weight loss addresses a medical concern for which treatment guidelines exist weight-loss products and services must be regulated to protect consumer health. Currently, hospitals and other health care facilities, both private and public, are subject to mandatory accreditation.”
“Before we can truly address the devastating obesity epidemic, we must first stem the centuries-old flow of snake oil. We call on governments to require formal accreditation of weight-loss providers to ensure quality and to protect consumers with an easily recognizable means of identifying evidence-based services. Simultaneously governments must pass legislation to subject weight-loss products to regulatory approval before they can be marketed.”
“Neither public health agencies nor the medical community are doing enough to solve the problems of obesity. Those suffering with obesity are often desperate for solutions and hence prone to exploitation. It’s time to put an end to this nonsense.”
Dr. John Morgan
80 Woodacres Dr. SW T2W-4S6
403-251-5704
jcmorgan@shaw.ca
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Dr. Morgan’s Community Health Report – November 2009
“Practicing Medicine in Pioneer Alberta”
As a change of pace for my readers, I am going to quote some passages written by my great uncle who practiced medicine in High River Alberta back in 1901. His name was Dr. G.D. Stanley and he recounted some of these stories in his book “Fun in the Foothills” that I am going to quote from.
“I assume that my readers are anxious to know what initial surgical operations or medical cures were, that established my professional reputation on a sufficiently sure and sound basis, that I have been able to carry on with a fair degree of success ever since. I should say that my first two cases did the trick.”
“The first case was one of quinsy (ed. note–a throat infection). My young patient was unable to swallow at all, and was having considerable difficulty breathing. I attempted to palpate the abscess in his throat but in my clumsy nervousness I poked it with the end of my finger—and presto the abscess discharged, and the cure was effected. The magic outcome was a winner for the new doctor, and the entire community soon heard all about it.”
“The second case was that of a well known character, a stock detective Jackson, who presented himself to have a couple of molar teeth extracted. I want them both out he said pointing to the two lower molars on one side of his mouth. I had only one pair of upper molar forceps but used it to tackle the job. I fastened the forceps to one of the back molars and began to extract it. The tips of the forceps slipped its hold, lodged between the two teeth and out came the two molars as clean as a whistle. The new doctor was not only expert to pull a single tooth but he knew how to get them out two at a time.”
“Another outstanding success became widely known. This was a medical case from the United States brought up by her brother because of a long and continuous illness. Three minutes convinced me that she was a psychoneurotic to a high degree, but I took three days, off and on, to complete a most detailed physical checkup and discussed the findings with her. My prescription for her consisted of only Aqua distilata, Aqua purifacta and Aqua colorata. The dose was exactly ten drops of this mixture in a glass of water before meals along with the warning that if she had any doubt to the accuracy of the count to throw the dose away and recount the drops in a new dose. The treatment worked like a charm, and for many years the High River druggist repeated the prescription for many addresses in the United States over many years. (ed. note–prescription of distilled, pure and coloured waters).”
Ed. Note–Dr. Stanley came to Alberta just before it became a province. He practiced in High River and later in Calgary where he was one of the founders of the Calgary Associate Clinic. He became one of my mentors, and encouraged me to come to Calgary to practice medicine, which I did in the mid 1950’s.
Dr. John Morgan
80 Woodacres Dr. SW T2W-4S6
403-251-5704
jcmorgan@shaw.ca
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Dr. John’s Community Health Report – October 2009
“Acute Infections, Vaccinations, and the Prevention of Heart Disease”
In my September Community Health Report I commented on immunization guidelines for adults. One of the areas that I explored was the use of pneumococcal vaccines to prevent pneumonia in smokers, asthmatics and in all older people. Thinking about this, I want to explore how important it is to prevent heart disease in older people by the use of vaccines against pulmonary infections.
I would like the reader to understand where I am coming from in this matter. Now that I have retired from active medical practice, I have tried to follow my own advice. Ten years ago, I began having flu shots every fall and as I was then getting into my mid 60′s, I also had a single vaccine shot against pneumonia. Ten years have gone by, and my good record against pulmonary infections has been broken by episodes of pulmonary infections in the last three winters. With this change, I am now thinking about having a repeat vaccine injection against pneumonias. I checked the medical literature, and found that this was a recommendation made by researchers in this field. A physician should not try to treat himself so I am going to ask my own doctor about it.
I possibly have what medical research people call a “Healthy User” bias, as a receipt of a pneumococcal vaccine may be an indication of better access to health care, a healthier attitude towards a good life style, and with my better control of risk factors. I plead guilty to all of these counts, as I have decided that I am going to look after myself, as it is my problem, and not the problem of the Calgary Health Region.
In reviewing the medical literature on pulmonary infections triggering episodes of heat disease I found one researcher who reviewed 170 patients that came into hospital over five years with pneumonia, and he found in this group that 7% of them had heart attacks while they were in the hospital. In another study a researcher found that in the two weeks before coming into hospital with a heart attack that 28% of the patients had pulmonary tract infections. These were not well controlled studies, but they were suggestive enough to consider the use of pneumococcal vaccine in all older patients with a possible booster dose of the vaccine about ten years later.
Join me then in being a “Healthy User” of our health system. Prevent the problems don’t enjoy them.
Dr. John Morgan
80 Woodacres Dr. SW T2W-4S6
403-251-5704
jcmorgan@shaw.ca
