So it only makes sense that farmers stop listening when they’re told they should engage in exercise, which, in their minds, is defined as physical exertion that doesn’t get anything done, not even moving a bag of seed.

Besides, who has time?

Still, in today’s high-tech, high-voltage world, farming isn’t as physically taxing as it was for our parents or grandparents. And farmers don’t always stay as young as they might like to think.

So, there’s a lot more that today’s farmers can get from incorporating physical exercise into their daily and weekly routines than they used to, even if they don’t particularly care about carving a set of six-pack abs.

Plus, not only can the mental and emotional health benefits be life changing, but exercise can make you a better farmer too by making all those day-to-day stresses a little easier to tackle.

And you don’t have to sign up for a gym membership or assign a rigid workout routine every day to achieve these things.

Plus, it turns out summer can be the best time of year to get into the habit.

Jocelyn Velestuk, who farms near Broadview, Sask., with husband Jesse, admits she isn’t committed to a regular fitness workout, but she does try to make physical movement and exercise a priority.

“I am not the kind of person who has had a routine of working out at 6 a.m. every single day for the past 10 years,” Velestuk says. “But I’ve always come back to fitness, and I think even just having that mindset means that I’m going to choose to go for that walk or do that different workout program to get a little more fit.”

Helping with the stress and strain

“Mentally, it can get tough in life for a farmer, and I’ve gotten to almost a freeze state, and it’s keeping moving that keeps me going,” Velestuk says. “The mind and body are connected and how we do things is part of that, just building movement into the everyday is so important.”

At the opposite end, Stuart Chutter began running in 2019, starting with a four-mile trot around a section of his farm near Melville, Sask., and today he is running ultra marathons, routinely covering 100 miles in a race.

But Chutter never set out to be a marathon runner, just to relieve some of the day-to-day stress of life on the farm.

“I was just a farmer running my farm. Then one day I went for a run,” Chutter says. “It wasn’t fitness-related or physical health-related, it wasn’t that I was going to go out and be a runner or that fitness was taking over my life. I felt like I had so much stress in my body that year, and I thought that maybe running down my gravel road might help take some weight off my shoulders and help balance things a bit.”

Chutter soon discovered that he loved running and has found a ton of benefits come from it besides just getting fitter.

“Running just called to me and it became both a stress relief and an escape for me, but also an expansive part of my life,” he says. “It’s so easy to identify as a farmer and the farm can consume you. Becoming a runner as well was not intentional but a way to rebalance things and expand my experiences and identity, and I think that, in itself, naturally helped deal with the stress and weight that can sometimes come with farming.”

There is so much emphasis today on farm business management, but Chutter has found that running has given him the time and headspace to have the important internal discussions that underpin good life and farm decisions.

“It was time away and time to think and process things. I found so many solutions on a gravel road, running,” he says. “Running has taught me so many lessons that are applicable to my life in terms of consistency, confidence, and what I am capable of. Exercise is just an example of the habits and consistencies that have overflowed into every other element of my life. Physical health is such a fundamental part of mental health.”

How to make time for fitness?

Velestuk is well aware that fitness also has to fit around the realities and rhythms of a busy farm and family life, plus other commitments such as her role as vice-chair of the Saskatchewan Wheat Development Commission.

“Life evolves as we go and sometimes it’s hard to find the time and prioritize fitness, so I think it’s really important to recognize that it’s okay, that we have ebbs and flows in life and that we just try something else,” Velestuk says. “A couple of summers ago, my whole family got into the routine of going for a walk every morning, and at the end of our walk, we would run along this giant row of bales. I am telling you, that’s a good workout.”

With small children interrupting any exercise she did attempt, Velestuk found creative ways to keep going while including them in the process.

“One winter I had two little ones and we went downstairs and started running as I did the laundry,” she says. “I set the timer for half an hour and gave the kids turns to lead my workouts. It was important for me to find other ways to exercise and to do that with the kids.”

What’s important is to just keep moving, Velestuk says.

“Some people think that in order to be fit we have to do something structured every day, and if we don’t, that it doesn’t count, and I think that’s really not the case at all,” Velestuk says. “It’s just about having movement as a priority. Last fall, I was driving the 1,200-bushel grain cart for two combines, and I had about 15 to 20 minutes in between dumps, so I would go park somewhere and go for a walk and take in the nature. Those little things for me, mean everything.”

Make it fun

Chutter’s tip for making daily physical activity a priority is to find something to do that you love and that is fun.

“Exercise doesn’t have to be painful or miserable or boring,” he says. “Just because you are laughing and smiling and playing it as a game, or going with neighbours, or going for group fitness, or whatever it is that makes it enjoyable, if that’s curling, baseball, a hockey league, running, biking; just because you are laughing doesn’t mean it’s not working, so find the thing where you are laughing and enjoying the process.”

And you don’t have to stick to the YouTube stereotypes. “There is a perception that fitness means going to a gym and lifting something heavy and then you are going to be sore the next day and everything is going to hurt,” Chutter says. “If you like that, go for it. And if you like going out in the morning with your dog and a cup of coffee and walking to the end of the road to watch the sunrise, do that too.”

Don’t set unrealistic goals

It may not be possible to exercise every day and there may be periods when it’s just not going to happen. You can’t always be as physically active as you might want, so it’s important not to put pressure on yourself or set unrealistic expectations about your fitness goals.

“I don’t love routine, so I have to do what works for me at the time and give myself grace within that,” Velestuk says. “Sometimes it means things like taking the stairs when I am at a conference instead of the elevator. Things like that actually do make a difference. You might think, ‘this isn’t making me the fittess person’ but it’s actually keeping you at a fitness level where you feel better, and that’s what’s important.”

Exercise, of course, is just one part of healthy living. It’s just as important to eat healthy, but Velestuk believes these are all things that anyone can change at any time in their lives if they want to.

“We’ve had periods of time where we were just so, like, stressed and burnt out, and the kids were getting boxed macaroni and cheese,” she says. “But you can learn about what is best for your body and what you eat can make a huge difference to your mental health and ability to deal with stress. Dealing with stress, eating right and keeping moving is all important, and it’s never going to be perfect or even maybe consistent, so we don’t expect that. But I’m always making an effort to add something in.”

As a first-generation farmer, Chutter admits there were times, especially in the early days of his farming career, where the last thing on his mind was regular physical activity.

“That was fine, that was the season and that was what I needed,” he says. “Everyone is on their own path and prioritizing what’s important. For me and my farm journey as things progressed and I got things more under control I could make some of those intentional decisions about how I wanted to live. ”

Getting stronger in lots of different ways

It’s tempting to think that when you make time to do more physical activity, you will quickly see tangible results. And, after all, that is possible depending on the type of activity you undertake. So it’s quite realistic to expect biceps to bulge a bit more if you are lifting heavy weights on a regular basis, or for some body fat to shrink if you are doing daily high intensity workouts.

But even when you don’t see outward, physical changes, the benefits are still accruing and they will heighten your ability to tackle day-to-day tasks with less stress and strain.

“I’ve noticed that even doing everyday things on the farm, I’m stronger than I’ve ever been,” Velestuk says. “One time we had a flat combine tire, and nothing else there to lift it into the back of the truck. So, either I helped or we had to drive 30 minutes to get someone to help. You don’t want to hurt yourself but you also want to be able to do things like that. We move a lot of corral panels, so maintaining strength in order to do stuff like that is important, but you also get stronger by doing the work too.”

Chutter has also been surprised by the improvement in his farm work.

“I can jump over a gate; if a cow is going around a corner, I can just be over it and turn her around, or throw bags of seed around, it didn’t take too long after incorporating fitness into my life that I would be out doing things and realizing this is easier,” he says. “I am stronger in so many ways.”

Besides the ability to perform physical tasks more easily, Chutter has also discovered a deeper connection to and appreciation for his land and his farm.

“I am out on my land more and I see more, understand it and can manage it better,” he says. “I am running down my roads seeing things all the time, I am just so much more aware of what is going on in my fields, with my livestock, in my community. It has given me more exposure to my farm, again not intentionally, but I know what that fence looks like, where all the fox dens are…”

Chutter runs because, to him, fitness is about living a full life on and off the farm. “I want to work hard on my farm and be able to get up and do it again tomorrow,” he says. “I want to be healthy and live a long time, I never want to have to say no to something because I can’t keep up.”

– This article was originally published in the April 2024 issue of Country Guide.

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The pink colour of the nails is due to the blood vessels in the tissue beneath the nail. Ordinarily, nails grow about one millimetre each week (about two inches a year).

Nails protect the sensitive ends of fingers and toes and enhance our ability to pick up items or perform tasks such as turning a page in a book. However, in dry, cold weather or with overuse nails can become brittle and crack, as can supporting structures like cuticles.

Nails can be moisturized in much the same ways as you moisture your skin when it is dry. The ideal products for nails are emollient ointments like ceramides, lanolin and petroleum jelly compounds. Applied after handwashing, these topicals act a barrier and they lock-in moisture, but you will need to re-apply often. If cuticles are damaged, try cuticle cream or oil.

Taking care of fingernails and toenails will help prevent cracking and drying. Also remember that both nail polish and nail polish remover are drying, so if a problem exists they should be avoided.

When working with the hands, protecting your nails is key. For example, wear gloves when washing dishes or doing housework, and protect your hands when doing outdoor chores. Also avoid perfumed products since the perfume has the ability to cause allergic reactions that increase skin sensitivity.

There are many health conditions that can affect the nails. About half of people with psoriasis have nail involvement, specifically pitting or thickening. If the nails are involved, about five to 10 per cent of these people with psoriasis will also have joint involvement.

Fungal infections of the nail or onychomycosis, especially of the toenails, result in white or brownish lesions of the nails coupled with some thickening as well. These infections can be treated with antifungal agents.

When a nail infection is caused by Pseudomonas, excessive exposure to water can turn the nails a greenish colour. Antibiotic treatment resolves this problem. Lymphedema, which is fluid retention due to an impaired lymph system, results in yellow nails. In this case, treatment of the underlying cause is essential. With rheumatoid arthritis the nails can separate from the nail bed, a condition called onycholysis, and a yellowish discolouration can appear at the ends of the nails, which may also be thickened. With iron deficiencies, koilonychia or spoon-shaped nails can be seen.

There are many oral treatments for damaged nails, although it is unclear if any are effective because any oral treatment can be destroyed by digestive acids. The ones most often promoted include biotin, the vitamin B group and collagen.

Always remember, eat a balanced diet with good fluid intake. This will help your overall health and your nails. And remember this too: cut nails straight across, then file to smooth the rough edges.

The post Guide Health: Why you should take better care of your fingernails appeared first on Country Guide.

Across Canada, 90 per cent of us are exposed to herpes infection by the time we reach adulthood, although only 20 to 40 per cent experience recurrent cold sore outbreaks.

The initial infection results from contact with saliva that contains the virus. It is usually indistinguishable from an upper respiratory tract infection. However, there can be fever, chills, muscle aches, plus an outbreak of tiny blisters in and around the mouth.

On average this initial infection lasts about three weeks, but the virus is able to remain dormant in the neural ganglion cells (that is, the nerve cells that branch from the brain or central nervous system to the facial epithelia or skin).

Thus, once infected, we may be always infected and the virus itself may persist and be reactivated to cause cold sore symptoms.

Reactivation of the herpes virus is usually the result of a stress. Infections, fever and other viral infections such as the common cold place a strain on the body’s systems which can trigger cold sore outbreaks.

In fact, it was this close relationship between the common cold and herpes that gave the latter its common name of “cold sores.” Other stressors can include sun exposure, impaired immune system such as with HIV infections, women’s monthly periods and eczema.

As well, emotional stress on its own can promote an outbreak.

Cold sores are comprised of fluid-filled blisters usually around the mouth, lips and nose. The blisters break open and ooze so that crusts eventually form over the lesions. The cold sores last for two to three weeks and clear without leaving scars. They can be painful, itchy and cause a burning sensation.

Often, because of the irritation, people scratch them, which may lead to secondary bacterial infections.

Antiviral drugs are the mainstay of therapy. However, they must be started as soon as possible because as time elapses the viral numbers can increase dramatically to the point where they overwhelm the drug.

Acyclovir cream and ointment can be applied directly to the cold sore, but the treatment needs to be applied at least five times daily and care needs to be taken to not touch the application tube to the lesion.

Oral antivirals include acyclovir, famciclovir and valacyclovir. Again, they must be started as soon as possible. Some people experience a prodrome or a “tingling” sensation just prior to a cold sore outbreak. This is the ideal time to start antiviral drugs.

Cool or warm compresses applied to the lesions, oral pain relievers like acetaminophen, and even topical anaesthetic/anti-inflammatory products may help alleviate symptoms.

Cold sores are certainly unpleasant, but they are not deadly. Be aware, though, that people with immune system problems whose cold sores are severe or recur often, or whose eyes may become infected need to consult their health care provider as soon as possible.

The post Guide Health: Cold sores — why don’t they just go away? appeared first on Country Guide.

Sleep relaxes the soft tissues in the roof of the mouth (i.e. the soft palate) and in both your throat and your tongue. Snoring is the sound that air makes passing over these relaxed tissues, much like air passing over the reeds in an oboe when it makes music.

The distinction, however, is that when the relaxed tissues block airways, sleep apnea actually stops you from breathing for anywhere from 10 to 15 seconds. This pattern can occur from five to 30 times each night, making it difficult to get deep, restful sleep.

Most everyone snores from time to time. By contrast, it is estimated only about 6 per cent of Canadians experience sleep apnea. (This number may be low because many people decide to self-treat their symptoms.)

Besides snoring, which can be very loud, sleep apnea can lead to a dry mouth, gasping for air during sleep, morning headache, daytime drowsiness, irritability, and difficulty sleeping. Often a bed partner may notice the breathing symptoms, including snoring, with the affected person complaining of poor sleep quality and daytime tiredness.

Some people are more at risk for sleep apnea, for example overweight individuals and people with narrowed airways due to tonsils or adenoids. Also at higher risk are those with a family history of sleep apnea or who have thicker necks with narrower airways.

Sleep apnea occurs generally in adults, not children, and it becomes more common with age.

Smokers are three times more likely to experience sleep apnea. Any medications that relax muscles in the mouth, throat or tongue can contribute to sleep apnea too, for example alcohol, anti-anxiety medications, muscle relaxants and narcotic pain relievers. If you have nasal congestion due to conditions like allergies, colds or even nasal polyps, then breathing through the mouth may result in snoring and sleep apnea.

Men are two or three times more likely to experience snoring and sleep apnea, although with age and with the menopausal decline in hormones, women increase their risk.

Often medical conditions contribute to sleep apnea. Congestive heart failure, high blood pressure, diabetes, Parkinson’s disease, stroke, asthma, and chronic obstructive pulmonary disease (COPD) increase the risk and can worsen existing problems. As well, sudden drops in blood oxygenation that occur with sleep apnea can have an impact on cardiovascular health.

Complications after major surgery are possible with sleep apnea since recovery may require lying flat on the back, worsening breathing.

Obviously, opening your airways and keeping them open will reduce both snoring and sleep apnea. Self-adhesive nasal strips will keep nasal passages open and may help breathing. Elevating the head of the bed by placing several books or bricks under the legs at the head of the bed or by using a wedge-shaped pillow or mattress insert will enable gravity to keep relaxed tissues from blocking the airways. Some beds have an option for elevating the head of the bed. Sleeping on piled-up pillows won’t work because during the night the pillows will slip.

A continuous positive airway pressure (i.e. CPAP) mask and machine is the recommended treatment for sleep apnea. However, these can be uncomfortable and claustrophobic. Some are automatic machines that adjust the pressure on their own while others can be set by the user.

They all deliver a steady stream of air to the sleeper preventing both snoring and sleep apnea. Humidification is needed to keep airway tissues from being damaged, and regular cleaning is essential.

The key is not to ignore either snoring or sleep apnea. Instead, look for an underlying cause and take measures to reduce the health impact.

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Between one- and two-thirds of Canadians have had a cavity or have been treated for one. The number isn’t really known because many people self-treat or don’t treat at all. Of more concern is that about 11 per cent of Canadians have periodontal or gum disease. And a third of us admit we don’t brush our teeth at all.

Dental decay (i.e. cavities) results from the combination of carbohydrates or sugars and other debris left on the teeth. These materials make an ideal breeding ground for micro-organisms, mainly streptococcus, staphylococcus and lactobacillus. The bacteria form a sticky film on the tooth surface which is commonly called plaque.

The bacteria in plaque excrete acidic substances which damage enamel leading to tooth decay. When plaque hardens, it becomes tartar which is difficult to remove from teeth. As well, periodontal disease involving inflammation and infection of the gums can happen and worsen dental health.

More ‘Guide Health’ with Marie Berry: Drugs for your brain’s health

An additional result of poor dental health is that, even with tiny damage to mouth tissues, excess sugars and bacteria in the mouth can enter the blood stream. With these extra bacteria in the cardiovascular system, the risk increases for inflammation and plaque formation in blood vessels leading to clogged arteries that in turn can contribute to heart disease, stroke and high blood pressure. The bacteria can even infect the pericardium (the tissue surrounding the heart) and cause endocarditis.

There is also a link with diabetes. Diabetes itself can lead to an increased risk for poor dental health, and, conversely, poor dental health can worsen control of diabetes.

As well, increased numbers of bacteria in the mouth mean there is an increased risk that they might be inhaled and lead to pneumonia. In pregnancy poor dental health is also linked to premature birth and low birth weight, and studies seem to show a relationship between mouth infections and Alzheimer’s disease symptoms, although it is not known why, and poor oral hygiene can also increase the risk for sleeping problems, pancreatic cancer, oral cancer and even obesity.

Sometimes, it is a medication that increases the risk for dental problems and thus the other various health issues. When a drug causes dry mouth, it may mean there will not be sufficient saliva to help wash away debris, plaque and even bacteria from teeth and gums. Some examples include antihistamines, decongestants, narcotic pain relievers, high blood pressure drugs, antidepressants, and even bladder control drugs.

To avoid this problem sucking on a sugar-free hard candy or ice chips, sipping water or even using an artificial saliva product will help. Some medications, for example phenytoin, cyclosporin and calcium channel blockers such as amlodipine and nifedipine can cause gingival hyperplasia or overgrowth of gum tissue which in turn can lead to an increase in dental disease.

Some individuals have an increased risk for poor dental health, for example smokers and people who have frequent sugary snacks and beverages as well as diabetics, people with a family history of dental problems, women experiencing hormonal changes in menopause, and individuals with acid reflux or frequent vomiting.

Individuals with such risks need to be very careful with their dental habits. By avoiding sugary snacks and tobacco products and by eating plenty of fruits and vegetables, some of these risk factors will be reduced.

Knowing all this, we should all be motivated to pay attention to our dental health. This means brushing teeth at least twice daily — morning and night, and after eating is ideal. Floss at least once a day, but before brushing, so that brushing will remove any debris that is loosened. Dental floss is sometimes difficult to use, but there are floss picks and water flossers; regardless of the option chosen, the idea is to get between the teeth to remove debris and sugars which can lead to plaque and dental decay. For overall good health, good dental care is essential.

The post Guide Health: Taking care of your teeth is always a good idea appeared first on Country Guide.

The Alzheimer’s Society’s 2020 numbers have 569,600 Canadians living with a diagnosis of Alzheimer’s disease and almost two-thirds are women, but women live longer than men and Alzheimer’s disease is a disease of older age.

Alzheimer’s disease is defined as a cognitive decline which interferes with activities of daily living.

Recent advertisements promote memory products such as Neuriva and Neuriva Plus for brain health. However, there have been no clinical trials.

For the most part, memory products are combinations of vitamins and trace substances. For example, Neuriva combines vitamin B6, coffee fruit extract and phosphatidylserine. Phosphatidylserine is a substance found in a wide variety of foods and is used in the body for the manufacture of cell walls.

Phosphatidylserine is synthesized from cabbage or soybean sources, but in higher doses can increase the risk for insomnia and indigestion. The “Plus” product contains other B vitamins such as vitamin B12 and folate. Unfortunately, as with all water soluble vitamins, excess amounts are excreted in the urine. A high price may only mean expensive urine.

The dietary supplement ginkgo biloba is heavily promoted for memory support but when it has been studied for the prevention or treatment of dementia or cognitive decline, it has shown no effectiveness.

Vitamin E supplements have also been touted to improve memory, but in a longterm prevention study of antioxidants such a vitamin E, no significant changes were found.

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Another remedy is apoaequorin, but it is considered ineffective in improving memory and is not available for sale in Canada.

With a diagnosis of Alzheimer’s disease, early treatment is possible to delay the progression of the disease. This allows people time to make plans. Cholinesterase inhibitors such as donepezil and rivastigmine leave more of the neuro chemical acetylcholine in the brain.

N-methyl-D-aspartate or NMDA inhibitors are thought to prevent overstimulation at NMDA receptors, thereby reducing symptoms. The two types of drugs can be used together, but neither group is able to “cure” the disease, only slow it.

The most recent drug for dementia is an IV infusion of aducanumab. This is a monoclonal antibody that targets and reduces amyloid beta plaques in the brain. With a reduction of these plaques, nervous system messages are more readily transmitted.

It is not available in Canada and is only indicated for early Alzheimer’s disease. Controversy surrounds aducanumab in that the original clinical trials were terminated because results showed no better outcomes than with a placebo. However, when the data was re-examined, higher doses seemed to show improvement.

Even with the more recent announcement of lecanemab studies, it appears unlikely there will be a “magic pill” for memory, especially one without side effects. However, there are numerous non-drug approaches that can help.

Just like exercising muscles to keep them fit, exercising memory is also important. This can include doing puzzles, learning a new language or learning dance steps.

As well, exercise, especially aerobic exercise, increases the release of neurophins which in turn promote the development of neurons. Exercise can also result in the release of endorphins and the increase of synaptic transmission.

A good night’s sleep also improves working memory, language processing, creative thinking, and decision-making. Meditation, yoga, music and spirituality all improve attention and memory too.

Stay healthy, eat well, and socialize with friends and relatives. And remember, if you don’t use your memory, you may lose it!

The post Guide Health: Drugs for your brain’s health appeared first on Country Guide.

All medication certainly needs to be in original containers with individual labels. That includes non-prescription drugs as well as prescription ones. It is never a good idea to mix different types of tablets in one bottle, or have them loose in a pocket or purse.

When travelling with narcotic pain relievers, make sure the labelling is clear. You may even want to carry a copy of the prescription so security and border agents will know that the drugs are legitimate.

A copy of a prescription for any type of medication, along with the pharmacy’s and prescriber’s contact information, is a good idea, especially if medication is lost or travel is delayed. The information will make replacing it easier.

Some types of medication, for example insulin for diabetes treatment, need to be kept cool. Travel containers for these types of medication are available, and of course they should never be stored where they would be too hot, for example in a car trunk or on the dash.

More Guide Health: What causes drug shortages?

For insulin use, needles are needed and these may be considered a security threat. Again, carrying a copy of the prescription or even a doctor’s note about the medication is a good strategy. 

Always carry extra medication so that if there is a trip delay or even damage to the medication, there will be sufficient to last through the complete trip. When flying, packing medication in carry-on bags is ideal, especially now when checked luggage is often misplaced. 

Also remember that while cannabis products may be legal here in Canada, they may not be in other countries. Perhaps these products are best left at home.

When travelling to remote areas or even camping, remember to pack a first aid kit. There are first aid kits that will provide all the basics, but making a personalized kit may be more suitable with, for example, foot and blister pads, insect bite remedies and sunburn treatments. If anyone in the travel group has an allergy, antihistamines and even epinephrine auto injectors should be included. And, if the area is unfamiliar, checking the location of the nearest emergency department or clinic before you leave may save time in the event of an emergency.

If time zones are crossed, it can be difficult to determine when to take medication. For time differences of two to three hours, it’s recommended that you adjust to the time in your destination.

When medications require specific instructions, such as taking with food or on an empty stomach, adapt these instructions to the new time zone.

Generally, a longer interval in a dosing schedule is preferred to a shorter one, but if the medication regime is complex, consult a pharmacist or doctor in order to sort out timing.

Considering medication logistics before travel will mean that any holiday will be more pleasant. Be prepared!

The post Guide Health: Travelling with medication appeared first on Country Guide.

At one time drug shortages were uncommon, but we should keep in mind that, historically, there were fewer drugs than we have today, as well as fewer drugs that have very specialized functions. 

A recent report in the Canadian Medical Association Journal says 45 per cent of the drugs in Canada have had at least one shortage in the past five years. The association also anticipates that drug shortages are going to become even more common.

Health Canada even puts them in categories. “Tier 1” is an anticipated shortage; “Tier 2” means supply is less than demand..

However, it is the “Tier 3” shortages that are the big concern. These have the greatest impact on the health of Canadians because Tier 3 indicates there are limited supplies of alternative drugs or access to alternate therapies.

Drug manufacturers have a mandatory reporting requirement for drug shortages and Health Canada does track these at drugshortagescanada.ca. Anyone can search the web site for specific drugs.

The reasons for drug shortages are varied. They may arise from a shipping or supply chain problem for either the drug itself or for ingredients that go into the drug. Problems with product quality can include contamination or stability issues, which means that a drug may be recalled and not supplied again until the quality control issues have be rectified.

Often, business reasons may dictate whether a drug is manufactured at all, and in what quantity. When one drug is in short supply, the demand for another drug may increase and a domino effect can occur with the availability of alternate drugs becoming affected.

However, manufacturing disruptions are the leading cause of shortages, cited in over half of the instances.

If the drug is a combination of two or more active ingredients, then there may be an option to take the ingredients individually. It means you have to swallow two or more tablets rather than one, but that is a minor drawback.

You do need to be cautious about their strengths, however, and you may find you need to take half tablets as a result. Remember to use a pill splitter to break the tablet in half accurately.

If a once-daily extended release formulation is unavailable, changing to a regular release formulation may be a solution. Yes, more tablets may be needed, but therapeutically the same daily dose will be achieved. 

If oral tablets or capsules are short, a liquid formulation may be recommended. Again, although this may be less convenient, the actual dose will be the same.

As always, when changing among tablets, liquids and various strengths, make sure the calculations are done correctly so that the same dose is achieved.

In some cases, there is no equivalent product and an alternative therapy is needed. Staying within the same therapeutic group of medications is ideal. For example, when one of the angiotensin receptor blockers was short, the recommendation was to choose another drug from the same group for blood pressure control.

Sometimes, though, the drug is unique and has no other therapeutic equivalents. In such cases, a reassessment is usually needed in order to select another therapy.

When a drug is short, it is important not to stockpile because this will only compound the overall shortage and the drug may not be used prior to its expiry date. Ideally, knowledge is the best approach, so remember that there are options for drug shortages.

Today, drugs control many conditions that led to deaths in the past. For example, with modern treatments, individuals with diabetes or hypertension often live much longer and they are much healthier. When a drug shortage occurs, an alternative is certainly required!

The post Guide Health: Drug shortages appeared first on Country Guide.

Osteoarthritis is considered a “wear and tear” condition which sees the eroding away of the connective tissues and cartilage that supports joints. With age, the accumulated usage of your joints begins to add up, which is why osteoporosis is more common after age 50 and in people who use their joints a lot, for example athletes.

Also note that if joints have abnormalities or have been injured, osteoporosis is also more likely to occur.

The joints that are most often involved in osteoarthritis are hands, knees and hips. These are the joints that are most often used. Osteoarthritis of hands is often asymptomatic. If knees or hips are affected, however, mobility declines. There is stiffness, reduced range of motion, swelling and pain.

Pain occurs most often when joints are used; stiffness is common when joints aren’t being used, for example upon waking up in the morning.

As osteoporosis progresses, instability of the joint occurs, a grating or scraping feeling happens in the joint, and sounds such as clicking or crackling are heard.

Being overweight is the most common risk factor for osteoporosis. With more weight, joints need to work harder and this leads to more damage. Weight loss of just four and a half pounds is associated with a 20 to 30 per cent reduction in risk. It follows that weight loss and lifestyle measures such as exercise and diet are the primary recommendations. 

Pain relievers are the cornerstone of osteoporosis therapy. Acetaminophen is often the initial drug chosen. To obtain the most benefit it needs to be taken regularly to prevent pain symptoms. The recommended maximum doses are 4 grams (8 extra-strength tablets) daily for adults and 3 grams (6 extra-strength tablets) daily for seniors. Because liver damage can occur, especially if consuming alcohol at the same time, people with liver conditions need to avoid the drug.

Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, diclofenac and naproxen reduce both pain and inflammation. Again, they need to be taken regularly to prevent pain. Stomach irritation and kidney damage can occur, however, so they are contraindicated in disease conditions that involve the kidneys or gastro-intestinal tract. Topical NSAID creams deliver the active ingredient directly to the joint and are especially useful in knee and hand osteoarthritis.

With more severe osteoarthritis, more potent pain relievers such as opioids may be needed. Care is required, however, to avoid adverse effects such as constipation, sedation and dependency.

Hylan polymer injections may be administered directly into the joints and replace synovial fluid, although these injections have mixed results and their effect is only temporary. As well, intra-articular steroid injections are sometimes used to alleviate inflammation symptoms.

There are many natural remedies promoted for osteoarthritis, but there is little evidence that they actually target the underlying cause. Rather, effectiveness may be related to a placebo effect; if someone thinks they can be more active with the natural remedy, they are more active and it is the increased exercise that is the successful treatment. But, remember to check any natural remedy for safety!

The post Guide Health: The ache of osteoarthritis appeared first on Country Guide.

On average, individuals have two to four million sweat glands made up of a combination of eccrine, apocrine and apoeccrine glands depending upon the body location. Children have a higher density of sweat glands because the same number of glands are distributed across a smaller skin surface. Women have a higher density too because of their smaller skin surface while, conversely, larger individuals have fewer per unit area of skin.

Sweating plays a critical role in thermo-regulation. In hotter environments or with strenuous physical activity body temperature rises enough to trigger the sweat glands to produce sweat. Evaporation of sweat from the skin surface cools the skin and keeps body temperature within normal range which is why sweating, although unpleasant, is necessary.

With a hot temperature of 30 C or above, working or exercising outdoors for at least one hour can mean, on average, production of 16 ounces of sweat just to keep the body cool. Dehydration can result and by the time that someone feels thirsty, they may have lost a large volume of fluid.

A good fluid intake is essential, and water is ideal. Beverages containing caffeine should be avoided because they can contribute to dehydration. There are numerous oral rehydration solutions and/or “sports” beverages available which also contain minerals that help replace lost levels; however, some people cannot tolerate some minerals or additives and need to avoid certain products. Reading the label is important.

Sometimes excessive sweating is associated with an underlying condition, for example hypoglycemia or low blood sugar, fever, infection, overactive thyroid, or some types of cancer. Ideally good control of the underlying condition or treating it will reduce sweating. For people with diabetes, being aware of the symptoms of hypoglycemia and always having 20 grams of carbohydrate (such as glucose tablets) at hand is essential.

Vasomotor symptoms or “hot flashes” experienced in menopause include excessive sweating. Non-drug approaches are usually the first recommendations followed by drug therapy such as hormonal therapies or drugs like paroxetine and venlafaxine.

Anhidrosis is lack of sweating and extra care needs to be taken to avoid dehydration. Skin damage from scars, trauma or even diseases like psoriasis can physically damage the sweat glands. Connective tissue diseases such as lupus can also damage sweat glands.

Any nerve system damage may interfere with the functioning of the sweat glands in that they are still present, but they do not receive nervous system messages to produce sweat. Some examples include nerve damage caused by alcoholism, nerve conditions like diabetic neuropathy, nervous system diseases such as Parkinson’s disease, and even spinal cord injuries. It may even be a genetic factor that results in anhidrosis.

Drug adverse events may reduce the production of sweat. Most occur through anticholinergic effects on the nervous system. Tricyclic antidepressants like amitriptyline, incontinence drugs like oxybutynin and tolterodine, seizure medications like topiramate, and even narcotic pain relievers can have these effects. Botulism toxin works through the nervous system to reduce the response of the sweat glands, and it is sometimes used to reduce excessive sweating or hyperhidrosis.

Sweating is a necessary body function, but ensuring a good fluid intake, wearing loose-fitting light clothing, and avoiding unnecessary exertion will help reduce unpleasant excessive symptoms and dehydration. Keep in mind too that applying an antiperspirant before bedtime will allow it to sink into the skin overnight and be more effective during the day.

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