The Little Things...

Watch this week's video: http://www.youtube.com/watch?v=UwT5t47I1fI


It’s one of my favorite commercials. You see a woman fussing around her perfectly decorated home, making sure her holiday table is just so. The candles are lit, the wine is poured and a gentle wave of Christmas classics breeze over the scene. Then the doorbell rings, and as our Martha Stewart protégé turns to greet her first guest, you see the back of her cocktail dress tucked into her pantyhose. I guess you can glean 3 key messages from this whole scenario: nobody’s perfect, haste makes waste or it’s the little things that can really make a difference. I tend to favor the latter.

In the world of holiday entertaining, a small oversight like this wouldn’t make the difference between life and death (unless dying from embarrassment counts…). In the world of medicine, however, the devil is truly in the details. And that’s especially true in the intensive care unit, or ICU, which houses the sickest patients in the hospital. If you’ve never been to one, consider yourself lucky. If you have, you’ll never take simple things like being able to breathe on your own for granted again.

Clinical teams in any ICU can be so busy treating the big problems they may overlook the small and relatively simple opportunities that can make a huge impact on patient outcomes. Consider this: for patients on a ventilator, raising the head of their bed can help prevent a serious lung infection called pneumonia. A simple 45 degrees can turn a situation 180. Who would have thought?

It was news to me, but not to Sunnybrook Intensive Care Specialist Dr. Damon Scales. He and his research team wanted to find a way to bring the little things back into focus. What followed was a very cool study that has never been done before. It linked the ICUs of 15 community hospitals across Ontario through videoconferencing. Through educational seminars and simple checklists (similar to those used by pilots before takeoff), 6 small but powerful interventions made it back on the radar.

Dr. Scales says this was an extremely rewarding project. The rates of complications and death are higher in the ICU than any other area of the hospital, so focusing on the details means the most vulnerable patients benefit. In the first year of this Sunnybrook-led study, more than 9,000 patients were impacted, and adherence to some of these practices more than doubled. And those benefits continue. After all, once you know better, you can do better.

Now that you know the big picture, read all about the study details here.

Predicting Disease, 10 Years Before it Happens...

Watch this week's video: http://www.youtube.com/watch?v=ujx7vk_P6pI

Early in my career as a medical reporter, I was sent to New Orleans to cover a cardiovascular conference, which presented an avalanche of new international heart research in 3 jargon heavy days. I’d find relief from the hours of lectures and hundreds of poster presentations by indulging in local culture after hours. Walks through the French Quarter, sizzling Cajun cuisine and yes, even a drink at Jimmy Buffet’s Margaritaville, a restaurant complete with a fiberglass shark suspended from the ceiling (next to the main stage, of course!). On my last day there, with an hour to kill before heading to airport, I found myself sitting in a small downtown nook having my palm read. A complete skeptic, I was eventually surprised to learn that all of what she told me would unfold in the three years to come.

For the first time, it made me question if my future is already spelled out, or up for negotiation for both matters of the heart and body. When it comes to physical health, no doubt, a mix of genetics and environment play a role, as do our good and bad choices. But knowing what your future holds can help you prepare for, and even delay, the inevitable.

Here at Sunnybrook, researchers have now found that a series of tests can accurately predict who will develop Alzheimer’s disease and other types of dementia up to 10 years in advance. The tests include things like verbal recall, and matching digits and symbols. Long before it’s obvious to a person who will be affected by these memory-robbing conditions, changes are already brewing in the brain. These tests help spot that, and the benefits to patients are huge, helping determine who may benefit from drugs or participation in a clinical trial. Also, knowing means patients can take steps to help delay the onset of the disease by eating better, exercising more and engaging in activities that keep the brain alert. While there is no stopping the train, there is slowing it down, so to speak.

Delaying the onset of disease can also save a huge amount of money. A second Sunnybrook study has found that the costs of caring for patients with Alzheimer’s disease is massive, costing caregivers up to $4,000 every month, out of pocket.

But before you run out and demand these tests, you should know they are only for patients aged 65 and older. Anyone concerned about a memory problem should start with a visit to their family doctor to help rule out any other potential causes, like dietary problems or even depression. After that, if your doctor determines that you are eligible, you’ll need to be referred to a trained neuropsychologist to have these tests done. So while your future may be laid out, at least you’ll still have some control in the palm of your hand.

For more information on another Sunnybrook study on Alzheimer’s Disease, click here.

Is this the year?

Watch this week's video: http://www.youtube.com/watch?v=akGPNGW5mSc

There was a collective glow at my gym this morning. The early 5 am hour was illuminated by streaks of shiny new running shoes racing along rows of treadmills and stomping madly on elliptical machines. The normally quiet environment had been interrupted by the resolve of many to make this the year to be fitter, leaner and healthier. In fact, losing weight is the number one promise people make to themselves as the final verses of Auld Lang Syne trickle over the televisions broadcasts at midnight. Guaranteed, by the time Valentine chocolates are in stores, many people will have replaced the dumbbells with caramel clusters. So what goes wrong?

There isn't a large body of scientifically proven evidence around New Year's resolutions, but here are a few tidbits I did dig up. About half of us will make one. And Sunnybrook experts say for the majority of people, no matter what their resolution is, they will fail five times before succeeding. Quick math makes that five years to actually make a promised change reality. Holy cow, how depressing! Bad habits are especially hard to break because of the instant reward that typically follows. If you do want to make a change, do it for the right reasons, get support, be accountable and have a daily plan to make it happen. Also take a good look at why past resolutions have failed, and how to break the cycle this time.

Maybe that means resolving not to resolve anything in 2011. Fair enough. I tend to fall into that category myself. I started filing my paperwork as soon as it came in last spring, rejoined my spinning class last September, and have made an overall effort to get more sleep. January first had nothing to do with it. Somehow, that took the pressure off and made the changes stick.

So whatever it is you want to achieve in your life, remember that following through is more important than the date of the promise. Here’s to making your proverbial new running shoe into a comfortable slipper you can wear everyday. Happy New Year!