Dry eyes can be caused by many things: from too much “screen time” being on your computer or tablet, to auto-immune conditions. There is a 30% incidence in dry eye in people over age 50. There are three layers to the eye tears that protect our eyes; water, oil and mucous. In conditions where tears evaporate too quickly, this is often due to a lack of the oil layer. The water layer being deficient occurs in about 80% of people with dry eyes. There are now artificial tears which include an oil layer. Prescription eye drops can also offer great benefit especially when there is an autoimmune cause for the dry eye. The eye drop chosen depends on the reason for the dry eye and this can be properly assessed by an optometrist or ophthalmologist.

A helpful website to assess your dry eye is: www.dryeyedisease.ca. The Canadian Dry Eye Assessment Tool is included on this site.

Stay tuned for our next blog where we will discuss patients who suffer from dry nose and treatment options.

It is well known that even 1/2 a grapefruit or one glass of juice can reduce an enzyme called cytochrome P450 (CYP 450) by 50% for up to 24 hours.  This is important because some medications such as atorvastatin, amlodipine, carbamazepine and one of our newest medications for rheumatoid arthritis, tofacitinib (Xeljanz) need this enzyme to be eliminated from the body.  If grapefruit juice is combined with these medications, they could accumulate in the body increasing the potential for adverse effects. Therefore, it is recommended that grapefruit not be ingested with medications requiring this enzyme for processing.

Not all fruits contain furanocoumarin derivatives which seem to the culprit in affecting this enzyme. However, lab studies indicate that pomegranate, pomelo, black mulberry juice, wild grape juice, and black raspberry juice also interfere with CYP3A4. Pomegranate is now known to have as significant an impact as grapefruit.

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 Thursday, the first dose in Canada of a new biologic treatment for psoriasis was injected at Charlton Health.  Guselkumab is marketed under the name of Tremfya and is approved by Health Canada for moderate to severe plaque  psoriasis.  It is given by injection using a pre-filled syringe on day 1 of treatment, followed by an injection on day 28 and a maintenance of every 8 weeks.  Guselkumab works by removing an inflammatory cytokine called interleukin 23, which is produced in excess in the skin cells of patients with psoriasis.  We are very excited to be offering this new and effective treatment at Charlton Health.

In April of 2017 a new form of hormone therapy was approved by Health Canada for women with an intact uterus.  It has already been in the United States for over a year. When giving systemic doses of estrogen for the treatment of hot flashes and other symptoms of menopause, progesterone is commonly given to block estrogen stimulating the lining of the uterus.  As some women cannot tolerate progesterone, this new product offers the benefits of estrogen with a different agent to block stiumulation to the uterus.  The additional benefit is that it also blocks estrogen stimulus to the breast.  This product is referred to as a tissue selective estrogen complex (TSEC).  It is a combination of oral conjugated estrogen and a selective estrogen receptor modulator called Bazedoxifene.  It is sold under the name of Duavive.  This offers women who are appropriate candidates for hormone therapy another option.

Our pharmacist Carolyn Whiskin is not only a specialist in the field of biologic medication but is also a certified menopause practitioner with the North American Menopause Society (NAMS).  She recently returned from the annual NAMS meeting in Philadelphia. Over the next several weeks we will be sharing some of the key learnings from this meeting. Be sure to follow our weekly blog and Facebook page for this information.

Normal changes in memory occur with aging, but it is important to recognize changes that require further assessment. Alzheimer’s Disease changes may include: poor judgement and decision making, new problems with words in speaking or writing, changes in mood and personality with increased irritability, inability to manage a budget, losing track of the date or season, difficulty having a conversation, misplacing things and being unable to retrace them.  There are conditions, which if left untreated can mimic Alzheimers Disease and these need to be investigated and managed.  Certain prescription medications, drug interactions, low vitamin B12,  an under-active thyroid gland, a tumour, urinary tract infection and untreated depression are all possible causes of a change in cognitive function as well. Women seem to have an increase in vulnerability for cognitive decline with a lower estrogen levels after menopause being one of the contributors.

One of the biggest preventative strategies for memory loss is exercise. Being outside, maintaining movement and socialization are key!

Our pharmacist Carolyn Whiskin is not only a specialist in the field of biologic medication but is also a certified menopause practitioner with the North American Menopause Society (NAMS).  She recently returned from the annual NAMS meeting in Philadelphia. Over the next several weeks we will be sharing some of the key learnings from this meeting. Be sure to follow our weekly blog and Facebook page for this information.

HDL (high density lipoproteins)  have always been known as the good cholesterol as they can pull “bad cholesterol” away from the blood vessel wall. At the 2017 North American Menopause Society Meeting held last month in Philadelphia, research was presented that shed a new light on HDL.

After menopause a rise in HDL may not be so beneficial.  It appears that higher levels are due to HDL becoming dysfunctional and picking up more cholesterol which is subsequently redeposited in blood vessels.  This phenomenon also exists with inflammatory diseases where elevated HDL is associated with high inflammation and actually leads to greater cardiovascular risk.  Stay tuned as we learn more about different facets of HDL and it’s different types of particle sizes and effects.

Our pharmacist Carolyn Whiskin is not only a specialist in the field of biologic medication but is also a certified menopause practitioner with the North American Menopause Society (NAMS).  She recently returned from the annual NAMS meeting in Philadelphia. Over the next several weeks we will be sharing some of the key learnings from this meeting. Be sure to follow our weekly blog and Facebook page for this information.

Dr. Neil Binkley is part of the Osteoporosis Clinical Research Program at the University of Wisconsin. He was very passionate about preventing fractures as the consequences of breaking a weakened bone are significant and greatly affect a person’s ability to live independently.  It is now the opinion that anyone who has a fracture over the age of 50 should be investigated for future fracture risk.  Many factors contribute to fracture risk; one of the biggest being the risk of falling. Poor balance, instability in walking, neuropathy and impaired vision all increase falls.  Maintaining strong muscles is also vital to stability and preventing falls.  Not enough importance is placed on muscle strength and preventing fracture. The greatest risk of breaking a bone is having low bone density and low muscle mass.  It is a myth that excess fat acts as a cushion and prevents fracture.  In fact, obesity increases the risk of fracture especially ankle and upper leg fractures.  Beyond our current great treatments for osteoporosis which strengthen bone, new therapies are being investigated to improve muscle mass.

Our pharmacist Carolyn Whiskin is not only a specialist in the field of biologic medication but is also a certified menopause practitioner with the North American Menopause Society (NAMS).  She recently returned from the annual NAMS meeting in Philadelphia. Over the next several weeks we will be sharing some of the key learnings from this meeting. Be sure to follow our weekly blog and Facebook page for this information.

This week, we’re pleased to be bringing you information on an upcoming FREE forum that our pharmacist, Carolyn Whiskin, will be speaking at. The Ontario Pain Foundation regularly hosts these sorts of forums on a wide range of topics surrounding pain management.

Carolyn Whiskin will be speaking on “Integrating Natural and Traditional Medicine for Treating Pain.”

Please see the attached flyer for more information.

“Pain and the Opioid Crisis… Toward the conquest of pain…”

Location: Burlington Seniors’ Centre, 2285 New Street (in Central Park), Burlington

Time: 2:00 – 6:00 p.m.

Date: Sunday,  5 November, 2017

Photo from: http://diabetestimes.co.uk/special-baby-formula-does-not-affect-type-1-diabetes/

Healthy mom equals healthy baby. This was the clear message from an educational forum on the treament of autoimmune diseases during pregnancy. Many of the medications used for autoimmune conditions such as inflammatory arthritis, inflammatory bowel disease and psoriasis can be safely given during pregnancy.

The greatest risk to the baby is to have the mom have a flare of her disease during pregnancy. Family planning is important to ensure a safe treatment plan is in place and any medications deemed unsafe are stopped prior to becoming pregnant. Being in low disease activity, if not remission, increases the success of the pregnancy and increases fertility.

Biologic medications are composed of protein and cannot cross the placenta until late in the second trimester. One particular biologic medication doesn’t cross the placenta at any time during pregnancy. Therefore, some women will continue a biologic throughout their pregnancy while others may stop by the third trimester.

Each woman’s treatment regimen must be individually assessed, so start the dialogue early if family planning is in your future.

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.

The GLA:D program is an education and exercise program developed by researchers in Denmark for individuals with hip or knee osteoarthritis symptoms. Research from the GLA:D program in Denmark has shown a reduction in progression of symptoms by 27%. Other outcomes include a reduction in pain intensity, reduced use of joint related pain killers, and fewer individuals on sick leave. Program participants also reported high levels of satisfaction with the program and increased levels of physical activity 12 months after starting the program. (Information from gladcanada.ca)

There are now several centres within Ontario that offer the GLA:D program. Visit their website to find the centre closest to you.  I have spoken with physiotherapists involved with GLA:D and am very impressed with the results the program provides.

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.