This week, we are pleased to bring you information about a Chronic Pain Public Forum. Charlton Health highly recommends this session for anyone living in chronic pain or for people who support those with chronic pain. This amazing public forum has been a well received annual event and is one not to be missed!

For more information, please call the Ontario Pain Foundation at 905-592-1516 or email at theontariopainfoundation@gmail.com.

In our last blog, we discussed the impact of excess weight and inflammation in the body.  While we all know exercise is one of the fundamental ways to increase weight loss, we also know that it is not always easy for people to add exercise to their routines. One of the best ways to incorporate exercise into your routine is walking! Increasing every week by a few minutes to reach the 150 minutes/week goal may be a great way to start.

With that, we know that walking is not a viable option for some. For many people with joint issues, movement in the water is the most beneficial. This allows for increased blood flow to the brain and other parts of the body while moving in the water, and in addition, water provides a benefit of hydrotherapy to the joints. Many communities have a hot water pool to facilitate exercise for those with arthritis and may even provide a lift chair to lower you into the water.

For those who prefer the comfort of their own home, a wonderful program called “from soup to tomatoes” is available as an online session promoting movement while seated. Learn more about this program here.

The Arthritis Society provides physiotherapists for those living with arthritis. They can help structure an exercise program that is safe for you. Please don’t hesitate to use these resources – you can learn more here.

The vast majority of disease states are improved through exercise. In fact, one of the best strategies to preserve memory is exercise. Ultimately, The most important thing is to keep moving. If you’d like more help, speak to your healthcare provider today.

Carolyn Whiskin is the Pharmacy Manager for Charlton Health.  Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.

At the recent international menopause Society meeting in Vancouver, a session on the relationship between excess weight and inflammation was presented. Fat cells called adipocytes,  produce hormones such as TNF( tumour necrosis factor), IL-6 ( interleukin 6), leptin and resistin.  These substances cause a pro-inflammatory state which leads to decreased sleep quality, increased pain and increased potential for cancer development.    It is also very negative for heart disease risk and the development of diabetes.

As the prevalence of obesity increases in menopause, we must be mindful of the impact that this weight is having.  It is known that people who have a lower caloric intake diet have an expanded life span over those with high calorie diet.  Of interest, women who have greater amounts of abdominal fat have a harder time dissipating heat during a hot flash and therefore are more affected than those who have less fat accumulation. Not only is excess weight hard on the joints and worsens osteoarthritis, the fat cells themselves are generating excess inflammation which contributes to further pain.

Setting reasonable goals is important. A weight loss of even 5% can be very meaningful.
Currently 14% of the global population is obese,  with a rate of 34.8% in the United States.

Caloric restriction and exercise are the fundamentals of weight management.  A healthy goal is 150 to 175 minutes of aerobic exercise per week which can be split over 3 to 4 sessions. In addition, 2 sessions of resistance training is suggested per week. This can be easier said than done, especially when people have mobility and joint issues.  Stay tuned to our next blog to address some strategies for exercise with these limitations.

Carolyn Whiskin is the Pharmacy Manager for Charlton Health.  Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.

Last week, we brought you the news that September is Arthritis Month. With that in mind, we wanted to share this great event that is coming up to benefit the Arthritis Society.

The 2nd Annual Diamond Chef Challenge is taking place on Friday, October 26th at the Art Gallery of Hamilton and will have Stacie Royds and Paresh Thakker battling it out for the Diamond Chef Award. These two Chopped Canada contestants will battle and make the best tapas in town.

This event is to help Arthritis Society, shine the light on the 24,000 Canadian children who suffer from arthritis.

Learn more and get your tickets here.

September is Arthritis Awareness Month, a month to draw awareness to the millions that are affected by this disease. This inflammatory condition can cause longterm damage to the joints in the body and ongoing pain, swelling, and stiffness. As such a common ailment, most people know someone with Arthritis and can see the toll it can take on a person.

According to the Arthritis Society, by 2035, nearly 40% more people will have arthritis than today – that’s 8.5 million Canadians. The good news is that there are so many support groups, resources, and meetings that you can call on for help. At Charlton, we specialize in treatment for Arthritis and are happy to discuss your options at any time.

Learn more about Arthritis Awareness Month here. 

As school starts back up again and the summer holidays come to an end, I would like to talk about the idea of going on a drug holiday.  This could be interpreted in a variety of different ways but what I am talking about is taking a break from our medications.  This term was made popular with some of the medications for osteoporosis.

When someone has been diagnosed with osteoporosis and starts to take a medication to stop the deterioration of the bone the big questions is: “For how long will I need to take it?” Well it will take at least a year to see some improvement in bone density and maybe even longer.  We are often pleased when we stop seeing loss of bone in a year’s time.  Every day our bones break down and rebuild to become stronger.  As we get older the breaking down process is happening faster than the rebuilding. The medications work by telling the bone to stop breaking down.   We then need to help our bones rebuild by supplying them with the right building materials such as calcium and vitamin D.  Exercise and muscular activity are like the foremen instructing the bones to grow.

There is a theory that if we tell the bones to stop breaking down for too long we may be building new bone on old weak bone which does not provide a good foundation.   This may happen if we continue to take a medication for too long. And thus, the idea of a Drug holiday is born.

A drug holiday only benefits certain people and certain medications.  The bisphosphonates are a class of oral medications often taken once weekly or one a month. Examples are Alendronate, Risedronate.   These drugs stay in our bones for a very long time.  If someone has been on one of these bisphosphates for 5 years, has seen improvement and now has a low risk of fracture, they may qualify for a “drug holiday” and may temporarily stop their medication.  While on “holiday” the drug will still remain in the bone protecting it for some time. This decision to go on holiday would need to be assessed by their doctor and reassessed annually to determine if and when they need to restart.  We don’t usually get to go on vacation forever do we?

What is very important to note is that there is another very common injectable drug for osteoporosis. It is called denosumab and it is given every 6 months at the doctor’s office.  Although the injection is given every 6 months, the medication does not stay in the bone much longer than this.  When a patient misses their injection, we start to see deterioration quite quickly.  This medication would not qualify for a drug holiday.

Whether you get to go on a drug holiday or not, let’s get out there and enjoy these last few days of the summer season.  We are bound to absorb a little more vitamin D and those muscles will tell our bones to start growing.

Kerry Roberts has practiced pharmacy in the Halton and Hamilton Regions for 14 years, and recently joined the Charlton Health Pharmacist Team. Kerry specializes in various areas of pharmacy, such as diabetes, medication scheduling and education, compounding, and smoking cessation. She is a Certified Menopause Practitioner with the North American Menopause Society. 

Jennifer Heipel would like to introduce Shelter Health Network to the Charlton Health family.  The recent collaboration that was made will allow services such as: Outreach workers, Case workers, Community HCV Nurse and a Hepatitis C Peer Group for all hepatitis C patients.  We look forward to working with them and offering both existing as well as new patients these amazing services that can be offered!  A peer group for Hepatitis patients will allow people to both understand and discuss the treatments that will be offered with those who have actually undergone therapy for Hepatitis C.

For more information, please view the attached flyer: Hep C Peer Support Group

Jennifer Heipel has approximately 12 years of experience working as a hepatology nurse/clinical research coordinator for several gastroenterologists, hepatologists, infectious diseases and addiction specialists. She is trained in the treatment of Hepatitis B and C therapies as well as general hepatology and pre/post liver transplant follow up. Jennifer serves as Charlton Health’s full time Hepatology Nurse and manages the Hepatology Program. She has worked and continues to work with Dr. Puglia at McMaster University and other area Gastroenterologists to develop a comprehensive, in-house Hepatology program and Hepatitis C program here at Charlton Health.