A Helping Hand

Watch this week's video: http://www.youtube.com/watch?v=wX9qgoFrMjc

My kids were playing doctor last weekend, and eventually turned the white plastic medical kit over to me. After pleading that I check for any boo-boo’s, I grabbed the miniature stethoscope and proceeded to evaluate heartbeats and breathing. It was all fun until I realized I had forgotten about the muffins I was baking downstairs. The terrible smell of burned banana-bran eventually wafted upstairs to our play area, as I dashed to the kitchen adorned in a play nurse cap. (The kids were amused, but the muffins were inoperable.)

I know the desire to be in two places at once isn’t restricted to busy, and often distracted, mothers like myself. Think of how much you could get done if you had a clone! Twice the work, twice the fun, and never burning another muffin again! Not wanting to wade into the murky waters of DNA ethics, however, I’ll take second best: a helping hand. In my case, it’s asking my husband to be where I can’t. It’s a common sense concept that has permeated hospital structure as well in the form of an increasingly popular role, called Physician Assistants (PA’s). They work under the supervision of physicians, and serve as an extension to the services doctors provide.

Zlata Janicijevic was the first PA Sunnybrook hired a year and a half ago. Working in the emergency department, which also happens to be Canada’s largest trauma centre, she says the beauty of her job is that more patients are seen. “I’ve had a lot of people who are surprised when I call to see them saying, ‘Wow! I didn’t have to wait for long at all today!’ And that’s the whole purpose, to see patients, especially the lower acuity patients, and get them in and out of the emergency department as quickly as possible.”

What PA’s do largely depends on what department they are working in. For Zlata, a typical shift can bring anything from minor cuts to major traumas, and she’s trained to deal with it all. PA’s have a long history in the military and the U.S, where tens of thousands are working. They are a more recent addition to the clinical world here in Canada, but evidence shows they do increase access to care and cut down on wait times.

Sunnybrook now employs 4 PA’s, all in the emergency department. That’s more than any other hospital in Ontario. Dr. Joshua Tepper, Sunnybrook’s VP of Education, tells me it’s all part and parcel to a team approach that puts patients first.

This weekend, I’ll happily play doctor with my kids again and delegate my husband to kitchen duty (or vice versa). As I learned from my muffin fiasco, four hands are better than two. And for a health care system stretched in its own ways, the proverbial helping hand that PA’s provide is a welcome and necessary one.

Take 2 doses of love and call me in the morning...

Watch this week's video: http://www.youtube.com/watch?v=k9C65j16nYY

Thanks to emotionally (and sexually) charged television dramas like ER, Gray’s Anatomy and House, it’s not difficult to picture how love can strike within hospital walls. The hours are long, and the work can push you to the brink of humanity. Case in point, one particular (and anonymous!) manager here at Sunnybrook, who deals with more life and death situations than e-mails some days. As we sat in her office chatting about the nuances of office romance, she told me about a recent relationship she had had with a physician. Admittedly, after a 14-hour shift, neither one of them had energy left to hit the dating circuit. Plus, finding a fish in the same pond means everyone gets the jig.

Eighteen years ago, emergency physician Dr. Michael Schull met his future wife, radiologist Dr. Josee Sarrazin, while attending to a particularly horrific trauma patient. “I was a resident on the trauma team, and Josee was a radiology fellow,” recalls Dr. Schull. “It was a severe trauma and we needed a bedside ultrasound. She came in and I noticed her, and made a point of visiting radiology quite frequently after that!”

“The way he got me was by pronouncing my name correctly, “ Josee laughs. So he almost had her at bonjour!

I only had to ask around for a minute to find out there are many other couples within the 10,000 other employees here at Sunnybrook. And the situation is the same at hospitals across the country. Sex and relationship columnist Josey Vogels isn’t surprised. “Comments from people in the same profession or field indicate that there is a shorthand there,” she told me over the phone. “You understand each other’s world. Even some of the emotional stuff, you just don’t have to explain things.”

Drs. Schull and Sarrazin agree. “When you’re working hard, you’ve got the four walls of the hospital so you tend to find people within that domain. And they often understand what your life is like, and what your work’s like.”

That said, no matter what your profession, Vogels insists that you have to work hard to keep things real. That means taking time for conversations other than work (and kids, and bills, and other general mood killers!) Don’t overlook the big impact of small gestures. And realize the perfect Valentine’s Day gift is more about the time, and not the money, you spend.

Drs. Schull and Sarrazin made a conscious decision to live close to the hospital, knowing their busy schedules would only be further stressed by a long commute. “Practically, we drive to work together most days, our kids go to school nearby so we can drop them off,” says Dr. Schull. “And even though we don’t have lunch together very often, I’ll pop by to say hello or bring by coffee.”

In other words, they still care and make an effort. And anyone who is married or otherwise committed will tell you, that’s real romance. Happy Valentine’s Day!

Jack Frost Nipping at Your Nose...and Hands, and Face...

Watch this week's video: http://www.youtube.com/watch?v=lAtKEGer1YI

I know that opposites attract, and in my own marriage, this is glaringly evident when it comes to a very unexpected topic: moisturizing. Admittedly addicted, I’ve equipped more than half the rooms in my house with a bottle of lotion. Tucked away in the scarf closet for a quick squirt before bundling up, stored in the kitchen to glisten up after scrubbing dishes, and of course on clear display in each bathroom. Love it! It’s all topped off with my evening ritual of overnight skin creams and moisture socks (because feet count, too!) My husband, on the other hand, has grown a winter beard, arguing that provides better protection from the elements than any store bought product, and will only pump cream on his hands if they are literally cracking apart.
Here’s a typical interaction:

“Do you want some lotion babe? Your hands are like sandpaper”, I’ll say.
“Nope.”
Short silence.
“Don’t you care?”
“Nope.”
Ah, marriage.

I felt vindicated after speaking with one of Sunnybrook’s dermatologists Dr. Kucy Pon. Her skin literally radiates as she walks down the hall, so here is someone I want to take advice from! She told me that we make some common mistakes this time of year, like taking long hot showers, using drying cleansers and wearing irritating fabrics, like wool. Add to this a lack of overall humidity and indoor heating, and you end up chapped and itchy. Dr. Pon also says winter is a time she commonly sees flare-ups of pre-existing skin conditions, like eczema.

Her best advice is to turn down the heat and lengths of baths and showers, choose gentle cleaners and to moisturize while skin is still dewy with a fragrance-free product. Look for ingredients like urea, glycerin and petrolatum. Place humidifiers in your home, and layer gentler fabrics, like cotton, close to the skin.

And don’t be part of the nearly 80% of people who forget to wear sunscreen in the winter! Dr. Pon says harmful UV rays still abound, and can be particularly potent when bounced off bright snow. The Canadian Dermatology Association recommends an SPF of 30 or higher, applied in liberal amounts over the body.

So don’t hold back! Just think of it as great practice for the summer months ahead. Can’t wait to let my husband know…

Too Much of a Good Thing?

When Fiona Savage started running 37 years ago, she was told it would be bad for her joints and knees. It didn’t stop her from accumulating some serious mileage on her well-toned legs. She’s run 27 marathons (including a first place finish in the Arctic) and two 92.5 kilometre runs. She credits her late father, Oliver, who personified healthy living long before it was in vogue, and her beautiful 13-year-old daughter Morag for inspiration. Fiona’s goal is to live to 100 and run a marathon the same year to celebrate. What a woman! So far, her knees and joints are doing fine. And she says the mental benefits have also been huge.

But surprisingly, new Sunnybrook research questions the effect of strenuous exercise on cognition in later life and the risk of dementia. According to the new study, moderate over strenuous exercise appears to be best for clear thinking as we age. Sunnybrook’s lead researcher Dr. Mary Tierney and her team specifically examined the association in women because strenuous activity is known to affect sex hormone levels. And over a lifetime, reductions in estrogen levels have been found to negatively affect cognition in older age.

The big unanswered question is how much is too much, something only more study in a larger group of women can address. That said, maintaining regular physical activity is probably the best magic pill you can give yourself when it comes to good health. The Alzheimer Society advocates moderate physical activity to promote brain health, and I’ve yet to meet a doctor who doesn’t recommend the same. But kicking that up to extreme levels, may result in different outcomes.

Pardon the pun, but all this information has been on my mind a lot in the past week. Every second morning, I wake up at 4:45am, slip on my running gear and head out the door for a 40-minute run. Just me, the paper delivery person and the stray raccoon scurrying out of sight. For 39 minutes I love it. When I’ve hit 40 minutes, I’m done. I’ve always felt inadequate for not being able to push it harder. At the very least, this new research is making me feel a little less guilty.

For more information on the study, click here.