Strategies to help you get a good night’s sleep

There are a hundred different ways we try to fall asleep – including counting to 100 – but those restless nights are serious and if ignored can have take a major physical and emotional toll on a person’s well-being.

“We live in a society that emphasizes efficiency, and in order to be efficient, we have to sacrifice something, which often ends up being sleep,” says Dr. Jacqueline Sze, Psychiatrist at The Scarborough Hospital. “However, we must put greater emphasis on the importance of sleep for our physical and mental health.”

She adds that generally people with existing mental health issues such as depression or anxiety are more likely to suffer from sleep disorders, but everyone experiences stressful periods, which can affect the quality of our sleep. Whether you have a problem with falling asleep, staying asleep or interrupted sleep, the lack of rest can be detrimental to our overall health.

Short-term effects include irritability, difficulty paying attention, headaches, pain and nausea, while long-term, it can increase the risk of developing a mental health issue and even lead to mortality.

Some strategies suggested by Dr. Sze to improve sleep include:

• Rule out any medical problems such as sleep apnea, Restless Leg Syndrome, bladder issues and other physical conditions that can cause sleep deprivation.

• Rule out environmental issues that could be affecting the quality of your sleep such as noise or too much light. Make sure your bedroom is quiet and comfortable, and use your bed for sleep and sex only.

• Go to bed and wake up at the same time every day, even on the weekends. It’s understandable that life will interfere at times with your sleeping patterns, but trying to maintain a schedule will help your overall quality of sleep.

• If you can’t fall asleep, get up and read a relaxing book, knit or clean – something that doesn’t activate your brain. Watching television and spending time on the computer are not helpful sleep hygiene techniques.

• Develop a bedtime ritual. Humans are creatures of habit, so taking a hot bath or drinking an herbal tea every night before bed can train your body and brain to prepare for sleep.

• Stay away from caffeine, alcohol or nicotine about four hours before bedtime. You may find these can help you fall asleep, but they actually affect the quality of sleep, so chances are you won’t feel rested the next day.

• Do not overuse medication to help you sleep. Medication can become ineffective after two to four weeks of consistent use and can stop working. It’s better to develop good sleeping habits that will train your body to sleep well naturally for the long-term. Medications can also make you feel drowsy and tired the next day.

• It may be necessary to make changes to your lifestyle as certain activities such as staying up all night and sleeping during the day (unless you are a shift-worker) can lead to erratic sleep patterns.

• Keep a sleep diary and chart when you go to bed, when you wake up in the morning, the number of times you wake up during the night, any naps and other patterns you experience. This can be valuable information if and when you enlist the support of a medical professional.

It’s important to remember there are no set hours for getting a good night’s sleep. Everyone is different, and some people may need more or less sleep than others to feel rested.

Dr. Sze adds that a consistent battle with getting a good night’s sleep may be an early sign of a mental health issue such as depression. Also, people who suffer from previous sleep disorders are more likely to experience them in the future. So it’s a good idea to develop good sleep hygiene and discuss any concerns with your doctor.

Immunization; it’s not just for kids.

When you think of immunization, it’s usually in relation to children. But immunization is just as important for adults, and it’s the most effective way to protect you and your family against a number of very serious infections.

“Adults often think about travel-related immunization for exotic illnesses and what vaccines they should get before they leave,” says Teresa McCormack, Registered Nurse in the Occupational Health and Safety Department at TSH. “While these are extremely important, it’s also important for adults to ensure they have all of their routine immunizations up to date, including boosters. There are also specific vaccines available for people over 60 such as pneumococcal and shingles.”

If you’re travelling, there are certain vaccines you should get depending on the country you are visiting. You can talk to your healthcare provider, local public health office, or you can visit http://www.travelhealth.gc.ca/ for more information about specific vaccines.

Some adults may not have received common vaccines due to changes in the immunization schedule when they were children, or if they have moved to Canada from another country.

“Measles, mumps, rubella and chicken pox are given to children,” says Teresa. “But if you didn’t receive the vaccine as a child, you should ask for it. Although these diseases are rare in Canada, you could still be susceptible to them if you travel to countries where they are more common.”

Here is a list of some other vaccines you should have up to date:

Tetanus – everyone; every 10 years

Diphtheria – everyone; every 10 years

Whooping Cough (Pertussis) – everyone; once in adulthood

Influenza (Flu shot) – everyone; every year

Pneumonia (Pneumococcal) – people age 19 to 64 with specific medical conditions and everyone over age 65; once in your lifetime

Hepatitis B – People with medical, occupational or lifestyle risks and anyone who wants protection; a series of vaccines over a period of time

Hepatitis A – People with medical, occupational or lifestyle risks and anyone who wants protection; a series of vaccines over a period of time

Meningococcal – people with specific medical conditions and people living in residential accommodation including students and military personnel; there are a number of different vaccines – talk to your healthcare provider about which one is right for you

Human Papillomavirus (HPV) – females and males nine to 26 years old; three doses within six months

Shingles (Herpes zoster) – age 60 and over; once in your lifetime

The dangers in our favourite comfort foods

Homemade chicken soup, macaroni and cheese, curry and rice, bread pudding. These are comfort foods; they give us a sense of well being when sick, distressed, far from home or lonely. Each person has their own favourite comfort food, often something from childhood that is soothing and creates a sense of well being.

Although these foods bring us comfort, they are often high in sugar, fat and carbohydrates which can cause weight gain, raise blood pressure, and affect the heart and liver.

“There is actually science behind why we feel good when we eat these foods,” says Wendy Levin, Registered Dietitian and Certified Diabetes Educator at The Scarborough Hospital. “Starchy foods raise our serotonin levels, which makes us feel good. And warm foods release endorphins which can cause us to feel less pain and fewer negative effects of stress.”

But the calorie and fat count in some of these favourites can be high. For example:

• Homemade macaroni and cheese – 466 calories, 23g fat, 45g carbs
• Homemade chocolate chip cookies –330 calories, 16g fat, 46g carbs
• Beef Patty – 300 calories, 14g fat, 34g carb
• Sticky Rice Wrapped in Lotus Leaf (100 g) – 220 calories, 7g fat, 31g carbs
• Small fries – 250 calories, 13g fat, 30g carb
• Mixed Nuts (½ cup) – 400 calories, 35g fat, 15g carb

“You don’t have to stop eating your favourite comfort food altogether,” says Wendy. “But you can adjust the recipes to make them healthier, eat smaller portions, and enjoy them less often. Moderation is the key.”

Recipes can always be adjusted by reducing the fat, adding less salt, less sugar or using sweeteners in place of sugar.

Keeping your New Year’s fitness goals

The New Year is an opportunity for fresh starts and setting new goals. Improving fitness levels continues to be one of the most popular resolutions, yet it’s also one of the most difficult for a majority of individuals to maintain.

“Research indicates that more than two-thirds of people who set fitness goals at the beginning of the year give up within two months,” says Lori Irvine, Organization and Employee Development Coordinator at The Scarborough Hospital. “However, by following some key steps, you can dramatically improve your odds of sticking to your goals.”

Lori offers the following tips when setting a New Year’s fitness plan:

• Set realistic fitness goals – Ensure you speak with your physician before beginning any fitness regimen and make an appointment with a personal trainer who can help you break your overall goals into smaller, reachable targets.
• Write down your fitness goals – Simply writing down your short-term and long-term goals and the steps involved in meeting them can increase your motivation and reduce the chance of giving up. 
• Tell your family and friends – Verbalizing your fitness plan and letting others know about it can help you feel more accountable to your goals.
• Prioritize and schedule regular exercise – You’ll be more likely to stick to your fitness routine if it’s scheduled into your calendar like any other commitment.
• Choose a gym or fitness routine that is close to your home or accessible during your commute to and from work – A convenient location means you’ll be less likely to skip your fitness routine due to factors such as bad weather, traffic, etc.
• Don’t try to be perfect! – Whether it’s missing a couple of workouts or giving in to a treat, don’t beat yourself up over the occasional slip.
• Reward yourself – Whenever you achieve or complete a part of your fitness plan, reward yourself! Buy something you’ve wanted for a while, go for a spa treatment, etc. Do whatever makes you feel good about all your hard work – you deserve it!

Eight reasons to have an annual check-up

Having an annual exam is a ritual for many, but others feel a trip to the doctor’s office is only necessary when something is wrong. But an annual check-up may help you stay healthy, longer. 

Why go to the doctor when you feel healthy?

“An annual check-up can provide your physician with valuable information should you become ill,” says Dr. Irene Polidoulis, a family medicine physician with The Scarborough Hospital. “It can also help diagnose disease early and allow your physician to provide advice on disease prevention. Everyone, regardless of age, should have an annual check-up.”

Dr. Polidoulis explains why an annual check-up is valuable:

1. Regular check-ups allow your physician to build a health history and gather baseline health information that is invaluable should you become ill.
2. Diagnostic tests, like blood tests, and routine screenings can diagnose disease before you show symptoms. Early detection of disease can result in better health outcomes.
3. Studying your family’s medical history and discussing lifestyle helps your doctor determine your risk factors and allows him to make recommendations about disease prevention.
4. An annual visit with your physician helps build a more comfortable doctor-patient relationship. When you feel comfortable with your physician, you are more likely to share pertinent health information.
5. An annual check-up isn’t just about your physical well-being; it is also about your mental health. This appointment is a good opportunity to receive counselling or advice about issues like depression, stress or anxiety.
6. Are you struggling with your weight or want to quit smoking? Advice about these kinds of issues can be provided during your check-up.
7. If you’ve been healthy all year and haven’t seen your doctor, the annual trip is a good time to ensure vaccinations are up to date.
8. Peace of mind. Any health worries you have may be alleviated with an annual check-up.

Eight reasons to be tested for prostate cancer

There’s been a lot of buzz about “Movember” a light-hearted campaign involving men growing moustaches during the month of November to bring awareness about a serious disease – prostate cancer.

As the most common cancer affecting men, prostate cancer will be diagnosed in 24,600 men in Canada this year and 4,300 men will die from the disease.

“Typically, in the early stages, prostate cancer has no signs or symptoms,” says Dr. Edward Woods, a urologist at The Scarborough Hospital. “That’s why it is important for men to be tested regularly, before symptoms occur. Prostate cancer is very treatable if detected and treated early.”

Here are eight reasons why men 40 years and older should be tested for prostate cancer:

1. Early diagnosis is imperative.
2. One in six men will be diagnosed with prostate cancer in his lifetime.
3. The disease is more commonly being diagnosed in men in their 40s.
4. When found early, 90 per cent of prostate cancer cases are curable.
5. Prostate cancer often has no signs or symptoms in the early stages; proactive testing can detect the disease early.
6. Due to an aging population, the incidence of prostate cancer is on the rise.
7. If you have a family history of prostate cancer you are at higher risk.
8. Testing for prostate cancer could save your life.

Six tips for testicular self-exams

Toronto Public Health recently launched the “Check Your Package” ad campaign aimed at creating awareness about testicular cancer and the importance of monthly self exams. Ads for the campaign, which include a photo of a man’s midsection, were denied by Facebook and deemed distasteful and threatening.

“Testicular cancer is the most common type of cancer among men 15 to 35,” says Dr. Henry Krieger, a medical oncologist with The Scarborough Hospital for 35 years. “In most cases, the cancer is curable if detected early. It is important to bring awareness to the significance of self exams.”

When conducting a self exam, check for swelling or enlargement of a testicle; a hard lump on the front or sides of your testicles; an increase in firmness; and pain, discomfort or a heavy feeling in the scrotum or lower abdomen. If you have any of these symptoms you should consult a doctor.

Here are the steps to conducting a monthly self exam:

1. Look at your testicles in the mirror and get familiar with their size, shape and feel.
2. After a bath or shower, hold the scrotal skin in the palms of your hands.
3. Check one testicle at a time.
4. Using both hands, gently roll each testicle between your fingers.
5. Gently roll your thumb over the top of the testicle. You should be able to feel the epididymis, the tube that carries sperm. This is a normal lump at the back of each testicle.
6. Repeat monthly.