Charlton Health is very proud of our team as they continue to offer excellent care during this difficult time.  As we are very aware of the importance of maintaining treatment for autoimmune diseases, we are making every effort to ensure your treatment continues with the highest measures of  safety.   All infusion clinics are screening every patient before they come for an infusion to be sure they have no symptoms, have not been in contact with a positive case of COVID-19, or a quarantined person and have not travelled outside of Canada in the last 14 days.  Each clinic fully cleans all surfaces before and after each patient and is positioning patients to maintain an appropriate distancing.  A person on treatment in a state of low disease activity, has less infection risk than a flared untreated person.

Our advice is:

• Maintain treatment
• Practice excellent hand washing
• Don’t touch your face
• Maintain physical distancing
• Continue with your medical treatment and appointments when appropriate, and other than that: STAY HOME!

As a follow-up to last week’s  message on Covid-19, we are sharing the Ontario Rheumatology Association (ORA) statement regarding medications provided at infusion clinics as essential medications.   All of our clinics continue to operate with the highest vigilance to protect patients and maintain their treatments.

Read the protocol here.

The Ontario Ministry of Health guidelines are being updated daily. Current guidance at our clinics is if you have travelled outside of Canada in the past 14 days and have symptoms of infection, such as fever or feeling feverish, cough, shortness of breath, or breathing difficulties; or if you have been in contact with a person with confirmed or suspected COVID-19 that you self-isolate. Cancel and reschedule your appointment with our clinics. Contact Telehealth Ontario at 1-866-797-0000 or your local Public Health department for further direction. If you’re in Hamilton, you can reach the City’s COVID-19 Public Health line at 905-546-2424 ext. 7970.

It is well known that people with autoimmune diseases or any chronic condition have an increased risk of infection, irrespective of their treatment. We have received many calls from people who are currently on disease modifying treatments, such as biologics, that are concerned about their treatment during this COVID-19 pandemic. It is important to note that a person who is in low disease activity on their medication has less infection risk than someone who is off treatment and in a flared state, and that prednisone carries a greater infection risk than our disease modifying treatments.

The decision to hold medication is one between you and your prescriber. General advice would include holding your medication during any active infection which would include fever, cough, and shortness of breath, which are also signs of COVID-19. If you have been exposed to a confirmed or presumed case of COVID-19 or a person with an acute respiratory illness, consideration should be made to hold your treatment and monitor symptoms of infection for up to 14 days as a precautionary measure.

It is important to note that these are general principles to help guide you through this time. This information does not replace individual advice from your prescriber.

For all those that receive home delivery of your medication, our drivers will have an altered protocol over the coming weeks. New procedures will include delivery of medication to the door wearing gloves, ringing the doorbell, setting down the delivery package and stepping back two metres. When the door opens, patients are to acknowledge receipt of package but will not be required to sign. The delivery person will be signing on their behalf confirming date and time and any details of the delivery. They will not leave until they know medication is safely in your possession. This is being done to reduce potential exposure and to respect your personal space during this time. As always, those that visit our clinics can be assured that we are highly vigilant in sanitizing our spaces as always.

It is highly recommended you follow Health Canada guidelines for hand washing (including using paper towels on door handles where possible), surface cleaning, and avoiding situations where large crowds are gathered in close proximity. As always, we encourage you to optimize your own health.  Stay hydrated, get enough sleep, fresh air, and exercise and eat a balanced diet following Canada’s Food Guide.  These actions will help you maintain a strong immune system.

Recently I have had people come into the clinic who started on a new medication months prior and persevered with very difficult adverse effects of nausea, fatigue, and headache that were affecting their quality of life. Although most of our medications have a very low incidence of these adverse effects, when you do find that a medication doesn’t agree with you, it is essential that you consult your healthcare professional about ways to manage the adverse effects and to verify if what you’re experiencing is likely due to the medication. In many cases, disease modifying treatments for autoimmune inflammatory conditions are prescribed and then assessed for their full effectiveness three months later. It is important to not suffer for three months if you are experiencing unpleasant side effects but rather call for guidance as a new medication could be ordered to replace the one you are taking or dosage adjustments made.

• Eat fresh non-processed foods with low sugar content
• Drink plenty of water daily (often start with full 8 oz glasses right after you get up to start your day and continue to carry a water bottle with you, drinking often)
• Keep moving; regardless of limited mobility (we’re happy to help with ideas), 150 minutes/week of exercise is so important for overall well being (hot pools, mall walking in the cold weather, chair fitness are all options)
• Spend time with people that make you feel good; human contact and socialization are vital
• Get plenty of rest; 7-8 hours of sleep is important in reducing body stress, repairing tissue, decreasing pain, improving mood, and energy to name a few

We wish you all the best in the new decade!

It is not a surprise that special occasions create both good and bad stress. For some these are happy times spent with friends and family, and for others it can be a very difficult time of year. Regardless of this, managing stress is important. Our body produces cortisol in response to stressors and excess cortisol production translates into increased inflammation in the body. For many conditions where high inflammation causes flares, this can very difficult as not only is the person stressed, but they are also flaring.

So, as we enter into this holiday season filled with busy schedules and many expectations, remember to look after yourself, take some deep breaths and try to enjoy the moments rather than getting overwhelmed.

We wish everyone all the best for the season however you choose to celebrate.

Today we continue our “Looking Back” series with one of our most popular blogs, “Beating the Winter Blues.” It seems pretty appropriately timed, too!

Here is the original post…

We know winter can be tough on a lot of people. Here are some tips on beating the winter blues…

Keep active

Research has shown that a daily one-hour walk in the middle of the day could be as helpful as light treatment for coping with the winter blues.

Get outside

Go outdoors in natural daylight as much as possible, especially at midday and on brighter days. Inside your home, choose pale colours that reflect light from outside, and sit near windows whenever you can

Keep warm

If your symptoms are so bad that you can’t live a normal life, see your family doctor for medical help. Being cold makes you more depressed. It’s also been shown that staying warm can reduce the winter blues by half.

Keep warm with hot drinks and hot food. Wear warm clothes and shoes, and aim to keep your home between 18C and 21C (or 64F and 70F degrees).

Eat a healthy diet

A healthy diet will boost your mood, give you more energy and stop you putting on weight over winter. Balance your craving for carbohydrates, such as pasta and potatoes, with plenty of fresh fruit and vegetables.

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See the light

Some people find light therapy effective for seasonal depression. One way to get light therapy at home in winter is to sit in front of a light box for up to two hours a day.

Light boxes give out very bright light at least 10 times stronger than ordinary home and office lighting. Some people find that using a dawn simulator [a bedside light, connected to an alarm clock, that mimics a sunrise and wakes you up gradually] as well as a light box can enhance the beneficial effect.

Take up a new hobby

Keeping your mind active with a new interest seems to ward off symptoms of SAD. It could be anything, such as playing bridge, singing, knitting, joining a gym, keeping a journal, or writing a blog. The important thing is that you have something to look forward to and concentrate on.

See your friends and family

It’s been shown that socializing is good for your mental health and helps ward off the winter blues. Make an effort to keep in touch with people you care about and accept any invitations you get to social events, even if you only go for a little while.

Talk it through

Talking treatments such as counselling, psychotherapy or cognitive behavioural therapy (CBT) can help you cope with symptoms.

Join a support group

Sharing your experience with others who know what it’s like to have SAD is very therapeutic and can make your symptoms more bearable.

Seek help

If your symptoms are so bad that you can’t live a normal life, see your family doctor for medical help.

Evelyn Gilkinson is the Nurse Lead for Charlton Health Inc. Before devoting herself solely to Infusing Biologics, Gilkinson worked at Toronto General Hospital, Flinders Medical Centre (Adelaide, Australia), and the London Health Science Centre in Thoracic Step Down, neonate, pediatric and adult Intensive Care, Recovery Room, and Emergency Medicine. Evelyn has done research for The Canadian Cervical Spine Study and with the AIM Health Group. She established the first out-of Hospital Infusion Centres in London and Waterloo. For the last twelve years, Evelyn was the Nurse Supervisor for South Western Ontario for many infusion sites until joining the Charlton team in the summer of 2016.