Health Canada Issues Advisory on EpiPen Shortage

Health Canada Issues Advisory on EpiPen Shortage | Dr. Ali Ghahary

Almost 3 million Canadians suffer from food allergies. An allergic response can be mild – such as itching, a rash and hives – to much more severe – including going into anaphylaxis.

While many Canadians find relief from allergies by taking over-the-counter medications, such as Benadryl or Reactine, the only way to reverse an allergic reaction for others is to take epinephrine – or use what’s commonly known as EpiPen, an auto-injector that releases a specific dose of epinephrine into the body. Using epinephrine (or an EpiPen) can be a live-saving measure. The most common allergens requiring the use of epinephrine in both children and adults include (but are not limited to) the following:

• Peanuts (and other nuts)
• Shellfish
• Eggs
• Milk

Currently, Pfizer Canada says the shortage only applies to the 0.3mg format of EpiPen, and is the result of what they’re calling a manufacturing disruption. The 0.15mg format, EpiPen Jr., which is designed for children, is unaffected by the shortage. The shortage also does not apply to the United States.

Unfortunately, because of this shortage, Pfizer Canada says there will be a period of 2 to 4 weeks without any inventory, and that the shortage likely won’t be fully resolved until the end of February or into the beginning of March. This also means that individuals looking to get or renew an EpiPen prescription may run into trouble. As such, Pfizer Canada is asking pharmacies to keep an eye on their supply, as there are currently no alternative treatment options to EpiPens on the market.

If you have an EpiPen but it is close to its expiry date, Pfizer Canada says that EpiPens don’t expire until the last day of the month, meaning they’re still safe to use. If your EpiPen is past its expiry date, Pfizer Canada says individuals can also still use their epinephrine auto-injectors in emergency situations; and, as always, you should call 911 in the event that you need to use your EpiPen so that you can be monitored by medical personnel, as there’s a possibility that your allergic reaction could return.

For more information on this advisory, visit Health Canada’s website at or contact your local pharmacy.

How to Get Your Kids to Eat More Vegetables

How to Get Your Kids to Eat More Vegetables | Dr. Ali Ghahary

Healthy eating is something we, as adults, strive to do on a regular basis. We know that healthy eating plays an integral role in our overall wellbeing, such as reducing high blood pressure and cholesterol, boosting our immune system, and maintaining a healthy weight. However, for children, getting them to eat their vegetables can be quite a feat.

What makes kids so against eating their vegetables? One of the biggest reasons is the fact that we encourage them to eat them because of their many health benefits – i.e. by telling them they can make you tall, stronger, etc. – but according to a 2014 study done by Dr. Ayelet Fishbach of the University of Chicago’s Booth School of Business, that’s not what kids want to hear and it only makes them less receptive to the idea of eating healthy. Children are much more likely to eat vegetables when they’re presented to them as being “delicious” rather than being told about their benefits. Parents also often praise their children for eating vegetables – more so compared to other food items on their dinner plate. While praise is never a bad thing, it can sometimes become excessive and cause the child to question why they’re eating vegetables in the first place, and may make them less motivated to do so.

When it comes to kids eating vegetables, preparation also has a lot to do with it. If you hand your child a plate of steamed vegetables, changes are they’ll be less likely to want to eat them. Vegetables also tend to taste much more bitter to children than to adults. There are, however, different ways you can make vegetables more appetizing.

Broccoli, for example, can be cooked in the oven by melting cheddar, mozzarella, or parmesan cheese on top. It could also be used to make broccoli and cheese soup. Sweet potato can also be turned into fries. Not only do they taste good, but they’ll leave your child feeling fuller for longer periods of time and less likely to want to snack in between meals. Sometimes the colour of vegetables alone can be enough to turn kids off them, so make sure you’re also including a variety of vegetables on their plate during mealtime. If they’re used to eating green vegetables, switch to red and orange vegetables such as carrots and tomato. Vegetables can also be easily incorporated into many kid-favourite meals, such as casseroles, pizza, and nachos.

Click here for more tips on healthy eating from Dr. Ali Ghahary.

Sinusitis Symptoms, Diagnosis and Treatment

Sinuses | Dr. Ali Ghahary

Your sinuses make up your upper respiratory tract from your nose all the way to your throat. They are located in your forehead (known as the frontal sinuses), your cheekbones (known as the maxillary sinuses), and behind the nose (known as the ethmoid and sphenoid sinuses.) The sinuses are responsible for protecting us from pollutants, dust, and other micro-organisms by producing a layer of mucus that moisturizes the inside of the nose.

Symptoms and Causes of Sinusitis

The sinuses are one of the top reasons why patients will seek medical treatment, says family physician Dr. Ali Ghahary.

For example, when you have a cold, it is not uncommon to develop a sinus infection – also known as sinusitis. Symptoms of a sinus infection/sinusitis include facial pain and/or a feeling of pressure in the face, pain in the forehead/headache, fever, nasal congestion, and a reduced sense of smell and/or taste – all of which are caused by inflammation. It’s also not uncommon to mistake sinus infections for dental problems. This is because the sinuses and teeth are close in proximity; therefore it’s not uncommon to also develop pain in the upper rear teeth.

Sinusitis is not just something that happens with the common cold, however. It can also become a chronic condition. In order to be diagnosed with chronic sinusitis, individuals will generally experience sinus inflammation that lasts for more than 3 months – and it is often the result of something other than the common cold. Things such as allergies, abnormal sinus anatomy, and blockage due to polyps (overgrowth of tissue that blocks the flow of air and mucus), and allergies can all cause chronic sinusitis.

Diagnosing Sinusitis

Diagnosing sinus infections/sinusitis is generally quite easy, as doctors can often determine whether or not a patient has sinusitis based on their symptoms alone. However, Dr. Ali Ghahary may also refer patients for medical imaging tests, such as an X-ray, to determine whether or not a sinus infection is present. For a more detailed look at the sinuses, patients may also be referred for a CT scan or an MRI. An MRI provides a much clearer look at the nasal cavities.

Treatment for Sinusitis

If a patient’s sinusitis is due to a viral infection, they will unfortunately simply have to wait and let nature take its course. However, Dr. Ali Ghahary says that patients can try a few things on their own to help relieve symptoms. First and foremost, Dr. Ali Ghahary recommends patients drink plenty of fluids. Keeping yourself hydrated can help thin the mucus and reduce the feeling of congestion. Taking a hot bath or shower can also help you feel better, as breathing in the warm and moist air can also help keep your sinuses open and reduce pressure. Using saline spray, which can be found at any pharmacy, also helps keep the nasal passages open as well as removes excess mucus and bacteria. Pharmacies also offer different nasal decongestant sprays, such as Otrivin. However, it’s important to note that these sprays should not be used longer than the recommended period of time (usually 3 to 5 days). Overuse of nasal decongestants can actually lead to what’s known as rebound congestion (or rhinitis medicamentosa), making you feel much worse. If you’re looking for relief from nasal congestion, try taking Advil Cold & Sinus or Tylenol Cold & Sinus, as you are less likely to develop rebound congestion from medications that are taken orally.

If you are experiencing a significant amount of pain and notice a thick, green discharge coming from the nose, this may be indicative of a severe sinus infection and should be treated with a course of antibiotics. Antibiotics commonly used to treat sinus infections include Amoxicillin and Clarithromycin. If you are allergic to either of these medications, Clindamycin is often used as an alternative.

Heart Disease

Heart Disease | Dr. Ali Ghahary

According to data gathered by the Public Health Agency of Canada, approximately 2.5 million Canadians over the age of 20 currently live with heart disease, while an estimated 9 in 10 Canadians have at least one precursor for heart disease.

Heart Disease Explained

Heart disease occurs when calcium, fatty material and scar tissue (also known as plaque) builds up in the coronary arteries. These arteries are responsible for supplying the heart with blood and nutrients, as well as supplying the oxygen it needs to pump that blood. However, when these arteries become narrow the heart is unable to get the amount of blood it needs. Over time this build-up can also obstruct the blood vessels, which ultimately results in restricted blood flow.

Symptoms of Heart Disease

Common symptoms of heart disease due to restricted blood flow include angina (the medical term used to describe chest pain related to heart disease), fatigue, shortness of breath, muscle weakness, confusion, and pain in the legs, arms, or any other area of the body where there is a blocked artery. Heart attacks and stroke can also occur as a result of heart disease. If you notice things like severe chest pain in conjecture with shortness of breath, pain in the shoulders, neck, back, arms or jaw, abdominal pain, nausea, vomiting, light-headedness, perspiration, weakness or numbness of the face and/or limbs, difficulty speaking or understanding speech, loss of balance, vision problems, or a sudden and severe headache, you should seek medical attention immediately by calling 911. If left unchecked, symptoms of a heart attack and/or stroke can lead to complications, and may also be fatal.

Heart Disease Risk Factors

There are many risk factors associated with the development of heart disease. It can be hereditary, meaning it runs in the family therefore substantially increasing your risk of developing it. Heart disease can also be the result of high cholesterol, high blood pressure, tobacco use, emotional stress, lack of physical activity, lack of exercise, obesity, and diabetes.

How to Prevent Heart Disease

In order to prevent heart disease, Dr. Ali Ghahary, a family physician at Brentwood Medical Clinic in Burnaby, says patients need to make sure they’re living healthy lifestyles. This means no smoking, eating a healthy diet, and getting regular physical activity.

While a bad habit such as smoking can sometimes be difficult to break, Dr. Ali Ghahary shares tips to help you do that, which can be found by clicking here.

When it comes to healthy eating, you’ll want to avoid foods that are high in fat and consume more foods that are rich in nutrients. For example, more fruits, vegetables, and whole grains. You can find a wide variety of healthy eating tips here, as well as by following Dr. Ali Ghahary on Twitter at @DrAliGhahary, on Instagram, and on Facebook.

Exercise is also not only a great way to reduce your risk of heart disease, but it can also help lower your cholesterol and blood pressure, as well as control your blood sugar levels. If you’re someone who isn’t used to getting regular exercise, Dr. Ali Ghahary suggests starting slow – such as going for 30 minute walks.

If you have any concerns relating to heart disease, it’s a good idea to address those concerns with your physician as soon as possible. If you do not have a family physician, Dr. Ali Ghahary is available to see patients at Brentwood Medical Clinic on a walk-in basis.

Types of Depression

Types of Depression | Dr. Ali Ghahary

With Bell Let’s Talk Day just two weeks away, this article is going to take a closer look at the different types of depression.

We all experience bouts of sadness from time to time, but if that sadness interferes with your every day life and happens more frequently than normal, you may have depression. Depression is a broad term to describe different variants of it, which Dr. Ali Ghahary, a family physician from Vancouver, outlines below.

Major Depression

This is the most common type of depression to be diagnosed with. Symptoms of major depression include loss of interest in activities, struggles with weight (such as weight loss or weight gain), difficulty sleeping, feeling sluggish, feeling restless, feeling agitated, fatigue, as well as thoughts of worthlessness and thoughts of suicide. If you experience at least 5 of these symptoms on most days, and for longer than a 2-week period, this may be indicative of major depression.

Persistent Depressive Disorder

Persistent Depressive Disorder, also known as PDD, is the term that is used when a patient has had major depression for 2 or more years. Along with symptoms of major depression, you may also develop changes in your appetite, find you are sleeping too much or not getting enough sleep, have a lack of energy and have low self-esteem.

Bipolar Disorder

Bipolar disorder, also called “manic depression”, is described as having an elevated or “high” mood, as well as periods where you feel low and depressed. The changes in mood can occur quite rapidly. Symptoms, when feeling low and depressed, are similar to that of major depression.

Seasonal Affective Disorder

Seasonal Affective Disorder, also known as SAD, generally occurs in the winter months due to reduced levels of sunlight. While rare, you can still develop Seasonal Affective Disorder in other months, such as spring and summer. This is known as Reverse Seasonal Affective Disorder or RSAD.

These are just some of the most common types of depression. You can find a longer list by clicking here. Don’t forget you can also follow Dr. Ali Ghahary on Twitter, Facebook and Instagram for more information on depression in the coming weeks.

How This Latest Internet Trend Can Harm Your Health

How This Latest Internet Trend Can Harm Your Health

The internet is no stranger when it comes to memes and trends; first it was the ‘Cinnamon Challenge’, followed by the ‘Mannequin Challenge’, and the ‘Whisper Challenge’ made popular by late-night television host Jimmy Fallon – all relatively harmless. However, there is one new trend that has recently picked up steam and has caught the attention of health officials all across Canada, the United States, and around the world – prompting those officials to issue warnings.

While it’s unknown how it first got started, the latest challenge, known as the ‘Tide Pod Challenge’, sees young children and teenagers sharing videos of themselves on social media that shows them biting into laundry detergent pods and consuming/swallowing the liquid inside. While it might simply sound like a challenge that tastes awful, health officials and physicians like Dr. Ali Ghahary say the challenge does more than just leave a bad taste in your mouth. It’s outright dangerous. Why? Because the liquid detergent inside of laundry pods is highly concentrated and toxic.

Back in 2012 there were 8 reported deaths of children under the age of 5 that were directly related to the ingestion of laundry detergent pods. This year alone there have been an estimated 40 cases of serious illness reported amongst children and teenagers, though the number of individuals partaking in this dangerous challenge is thought to be much higher. As a result of the toxicity, consumption of these pods can result in anything from drowsiness, vomiting, swelling of the throat, trouble breathing, and loss of consciousness…as well as eye irritation and temporary loss of vision. Having underlying medical conditions, such as asthma, can also put you at a greater risk of developing certain complications.

Given the dangers associated with this latest trend, YouTube says they are in the process of removing any ‘Tide Pod Challenge’ videos, telling Fast Company, “YouTube’s Community Guidelines prohibit content that’s intended to encourage dangerous activities that have an inherent risk of physical harm.”

Because laundry detergent pods are colourful, young children can often be drawn to them without even knowing about their dangers. Thus, it is important to keep them stored in an area out of reach of children. If your kids are old enough to understand, teach them that products intended to keep clothes clean should not be used for any other purpose.

If you believe your child may have consumed liquid from one of these pods, Dr. Ali Ghahary says it’s important that you seek immediate medical attention; either by contacting your local poison control centre or by calling 911. You can find a list of poison control centres in your area by clicking here.

Eastern Health Authority Investigating Mumps Outbreak

Eastern Health Authority Investigating Mumps Outbreak | Dr. Ali Ghahary

The Eastern Health authority says there have been at least 6 cases of confirmed mumps in Newfoundland since December, with as many as 13 others being tested for the virus.

As you may recall, the mumps made headlines across Canada and the United States early last year when as many as 14 players from 5 different NHL teams became sidelined with the contagious virus. While there is currently no risk towards other parts of Canada with this latest mumps outbreak, it’s still a good idea to educate yourself on what the mumps are and how you can protect yourself against it.

The mumps is a condition that affects the salivary glands, which are found on each side of the neck (located just behind/below the ears) and are responsible for producing saliva. When you have the mumps, these salivary glands can become tender and painful, as well as swollen. You can also develop flu-like symptoms such as body aches and pains, headache, fatigue, loss of appetite, and a low-grade fever. The mumps is spread through saliva and mucus from the nose, mouth and throat. This can happen as a result of sneezing or coughing, sharing drinks and utensils, or direct physical contact with an infected individual (i.e. kissing.) The mumps can be present in your body for as many as 2 weeks before you notice any symptoms, therefore you could also be unknowingly infecting others.

In order to prevent mumps, Dr. Ali Ghahary recommends getting the MMR vaccine. This vaccine not only protects against the mumps, but also against the measles and rubella. This vaccine is typically given in 2 doses, with the first dose being given to children between the ages of 12 months and 15 months, and the second dose between ages 4 and 6 years. Teenagers and adults can also get this vaccine. The MMRV vaccine can also be given; this not only protects against the mumps, measles and rubella, but against the chickenpox virus known as varicella, too.

Since the mumps is a virus, it will not respond to antibiotics. The best course of treatment that Dr. Ali Ghahary recommends is making sure you’re getting plenty of rest. In order to reduce fever you should take over-the-counter medications such as ibuprofen or acetaminophen, as well as making sure you’re drinking plenty of fluids (water!), as a fever can lead to dehydration. Chewing can also be painful as a result of having swollen glands, so make sure you’re sticking to a softer diet (i.e. yogurt, soup, etc.)

For more information on the MMR and MMRV vaccines in British Columbia, visit HealthLink BC’s website at

How to Overcome Weight Loss Discouragement

How to Overcome Weight Loss Discouragement | Dr. Ali Ghahary

If one of your goals for 2018 was to try and lose weight, you’re not alone, as more than half of Canadians say they resolve to become more physically active and healthy as part of their New Year’s resolutions. That being said, weight loss is also one of the most common resolutions that Canadians struggle with the most, and oftentimes fail at. Not necessarily because they don’t want to do the things they need to do in order to lose weight, but because of the pressure that comes along with it. For example, by saying you want to lose X amount of weight by a certain date. When that date comes and goes and you haven’t achieved the goal you were hoping to reach, that often leaves a person feeling discouraged and hopeless, and as though they have failed.

When it comes to setting and achieving New Year’s resolutions that relate to your health, it’s all about mentality and the way you view yourself. Rather than focusing on how much weight you want to lose and when, you should instead be focusing on the activities you can do and the lifestyle changes you can make in order to make your weight loss goals happen, says Leigh Vanderloo, a health promoter and physical activity researcher with ParticipACTION – a non-profit organization that has been helping Canadians reach their potential in making physical activity a part of their daily routines since 1971.

By setting very specific resolutions revolving around weight loss, it can sometimes feel more like a chore than something you actually look forward to doing. Walking, for example, while a very healthy activity to engage in, but for some it can feel a bit redundant and “boring”, so try making fitness more fun. Dr. Ali Ghahary suggests taking up new activities, such as swimming or ice-skating, or going for a bike ride or a hike on the Grouse Grind (weather permitting, of course.) If you’re not an outdoorsy person, you could also join a gym. Most gyms around Vancouver offer free 7-day trial memberships, that way you don’t have to commit to something right away. Alternatively, many recreation centres in and around Vancouver also have exercise equipment and have gym classes that you can sign up for – and you can even take a friend! It’s all about finding the best exercise routine for you and making sure it’s something you enjoy, that way you’re more likely to stick to it and less likely to fail.

Similarly, Bethany Vessey, a registered dietitian and personal trainer from Prince Edward Island, also encourages patients to throw away the scale. While you may need to know your weight for certain health purposes, a scale isn’t necessary for anything beyond that. When you focus on a number, that number can turn into an obsession, and that obsession can lead to one of two things: Failure and feeling discouraged and therefore not bothering to continue with exercising or healthy eating, or the complete opposite – developing an eating disorder (i.e. anorexia). A scale can often be a tool for individuals to determine their self-worth, which can also lead to mental illness such as depression and anxiety.

The amount of weight you lose is just a small factor in your success. While losing weight is certainly an accomplishment in and of itself, you should also focus on how making necessary lifestyle changes makes you feel. By making healthier choices and noticing the benefits, you not only improve your quality of life, but you also feel much happier as a result.

Hypothyroidism vs. Hyperthyroidism

Hypothyroidism vs. Hyperthyroidism | Dr. Ali Ghahary

January is Thyroid Awareness Month. In this article, Vancouver family physician, Dr. Ali Ghahary, shares a more in-depth look at both hypothyroidism and hyperthyroidism.

Hypothyroidism (an under-active thyroid) occurs when your body is unable to produce enough hormones. This results in your body’s metabolism slowing down and can lead to weight gain, which is a very common symptom of hypothyroidism along with other weight-related issues, such as the inability to lose weight and the accumulation of abdominal fluid (also known as ascites.) Individuals with hypothyroidism can also experience extreme fatigue, have an inability to concentrate, have trouble with body temperature (such as feeling cold all the time or having night sweats), slow reflexes, a compromised immune system, frequent infections (i.e. recurrent sinus, ear, throat, skin, respiratory and urinary tract infections), difficulty swallowing, pelvic inflammatory disease, celiac disease, a higher risk of developing type I and type II diabetes, rheumatoid arthritis, multiple sclerosis, psoriasis, tinnitus, vision problems and dry eye, as well as loss of hair, and even depression. These are just some of the many symptoms and health conditions that can be associated with hypothyroidism. You can find a complete list of the more than 300+ symptoms by clicking here.

When it comes to hyperthyroidism (over-active thyroid), think of it as a fast moving car. Unlike hypothyroidism, those with hyperthyroidism tend to have much quicker metabolism. This means you may notice weight loss and experience symptoms such as sweating, insomnia, forgetfulness, heart palpitations, anxiety, irritability, and menstrual problems.

Leaving both hypothyroidism and hyperthyroidism untreated can result in the worsening of any of these symptoms as well as other health complications.

To determine whether or not you have thyroid disease, Dr. Ali Ghahary suggests patients see their family physician for regular check-ups. Diagnosing things like thyroid disease if often based on the symptoms you’re experiencing. Dr. Ali Ghahary will also often send patients for routine blood testing as part of an annual check-up to ensure their TSH levels are where they need to be. If they’re low, this generally means that you have an under-active thyroid; if they’re high, this means your thyroid is over-active.

Whether you have an under-active or over-active thyroid, you need to treat the condition with medication to get your thyroid levels back to normal. Once on thyroid replacement therapy, regular blood tests will follow, as the dose of your medication may also need to be adjusted from time to time. There are also certain lifestyle changes you can make – such as eating healthy and getting regular exercise.

For more tips on diet and fitness and how both can impact your health, follow Dr. Ali Ghahary on Twitter at @DrAliGhahary.

Early Prevention of Heart Disease Starts in Childhood

Early Prevention of Heart Disease Starts in Childhood | Dr. Ali Ghahary

When it comes to keeping your heart healthy, Dr. Ali Ghahary says early prevention is key.

While heart disease can and does run in families, diet and exercise also both play a huge factor, especially in childhood. Some of the most common health problems in children that can ultimately lead to developing heart disease include obesity, diabetes, high blood pressure, high cholesterol, and the build-up of plaque in the arteries.

In order to prevent heart disease, Dr. Ali Ghahary says parents should urge their children and teenagers to live healthy lifestyles.

First and foremost: Exercise. It’s recommended that children get at least 30 to 60 minutes of exercise per day. While most schools in Canada require children to be in PE (physical education) classes, that physical education can also go beyond the school and at home. For example, partaking in after-school sporting activities or walking the family dog (if you have one.) Try to keep your child or teenager’s TV and computer time limited to 2 hours per day (unless of course they’re doing homework.) It’s a good way to teach children that staying physically fit is important, but that it can also be fun.

As children develop into teenagers, they’re also more likely to experiment with things they shouldn’t. Smoking, for example, is unfortunately quite common amongst high-schoolers. It’s important to be a role model for your children and teach them that they need to make heart-healthy choices. Let them know the dangers of smoking, ban smoking from your home, and don’t allow them to hang around individuals that might be bad influences on them. Smoking significantly increases the risk of heart disease, and if they start smoking early on it can also do damage to their health at a much younger age.

While high blood pressure is rather uncommon in children, developing it is still a possibility, especially if it runs in the families. If you are aware that high blood pressure does, in fact, run in your family, it’s important to have your child’s blood pressure checked on a regular basis, as children often do not develop any symptoms associated with it. High blood pressure can also develop in children as a result of certain health conditions such as heart or kidney disease. This is known as secondary hypertension.

Similarly, high cholesterol can also run in those whose families also have the condition. This is known as familial hypercholesterolemia, which affects 1 to 2 percent of children.

As mentioned above, exercise is a great way to reduce the risk of heart disease, and even better when it’s done in combination with healthy eating. This means urging your child to eat more fruits and vegetables as well as whole grains, as well as making sure they’re consuming foods that are low in fat.