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What Causes Hair Loss?

When it comes to hair thinning and hair loss, it isn’t just a natural part of the aging process – it’s also a natural cycle of our hair growth, rest, shedding and replacement process. In fact, we can shed anywhere from 50 to 100 hairs in a single day. That being said, there are certain medical conditions that can also attribute to the loss of hair, including hormonal changes (i.e., pregnancy, childbirth and menopause), certain medical conditions (i.e. thyroid disease, alopecia areata, scalp infections, lichen planus, stress/anxiety, vitamin deficiencies, dandruff/eczema), and medications (such as those used to treat cancer, high blood pressure, heart problems, arthritis, and depression.) Hair loss can cause feelings of embarrassment and may negatively impact some individuals, leading to low self-esteem even social isolation.

The cause of your hair loss can be diagnosed by both your general physician or a dermatologist by going through your medical history as well as based on a physical examination. If you have hair loss that is persistent, this is a potential indicator that an underlying health issue (such as thyroid disease, as previously mentioned) could be playing a role, and you would need to have additional tests, such as blood work, to rule out any other medical causes. If your hair loss is the result of a skin or autoimmune disease, a dermatologist may opt to take a small biopsy of the skin on your scalp and send it to a laboratory for further testing. Once you receive your test results back and potential underlying causes are either ruled out or confirmed, the next step is the treatment process.

In some causes, hair loss can be the result of being deficient in certain vitamins and other nutrients that are vital to your health. If it is suspected that you are vitamin/nutrient deficient (which can also be determined through blood work), then you may need to make some dietary changes. Among some of the best foods for hair growth are eggs, which are a great source of protein, as well as berries which are packed with vitamins and other beneficial compounds known to promote hair growth – in addition to foods such as spinach, avocado, sweet potato, fatty fish (i.e. salmon), nuts and seeds.

If, after implementing changes to your diet you’re still not noticing an improvement and a decline in how much hair you’re losing, medications are typically the next go-to treatment method that doctors will recommend, including both over-the-counter and prescription medication, like Minoxidil (also known as Rogaine) or Finasteride (also known as Propecia.) As all medications do, these too can come with side effects, such as irritation of the scalp as well as additional hair growth on other areas including the face and forehead. In some cases, doctors will also prescribe a corticosteroid, such as Prednisone, to individuals with alopecia areata, as this is a medication that mimics hormones created by the adrenal glands and will also help reduce inflammation – though it is important to note that corticosteroids also come with side effects, especially when taken at larger doses or for longer periods of time. Side effects that are associated with use of corticosteroids include certain eye diseases (such as glaucoma or cataracts), high blood sugar and high blood pressure, as well as fluid retention and swelling of the lower legs. Corticosteroids can also increase your risk of infection (due to weakening your immune system), calcium loss, make you more susceptible to bruising, cause thinning of the skin, and sore throat/hoarse voice. However, if your doctor has prescribed a corticosteroid then they have done so upon weighing the risks vs. benefits – just be sure to report any side effects that you experience to your physician if you do happen to be taking a corticosteroid (or any of the other aforementioned medications used to treat hair loss.)

Managing Psoriasis in Colder Weather

With the winter season not too far off, cooler temperatures and a change in the weather will soon follow suit – and the colder the season, the drier, itchier and inflamed the skin can become.

Psoriasis, a common autoimmune disorder that affects as many as 1 million Canadians and 125 million individuals, manifests itself as a skin problem. With Psoriasis, skin may feel itchy and/or sore and appear scaly and/or red. While the exact cause of Psoriasis is unknown, a combination of genetics and certain triggers (such as stress) are likely to play a part in the disorder; and while family physicians may need to prescribe medication to individuals with Psoriasis, there are also some steps that you can first try in order to help soothe the skin as well as prevent flare-ups of the disorder. The following steps are also beneficial to anyone who might be suffering from dry skin.

First and foremost, individuals suffering from dry skin should moisturize daily. Moisturizer will not only leave your skin feeling smoother and softer, but also help to prevent irritation. The thicker the moisturizer, the better, as it well help to lock water into the skin, leaving it moist. If you have sensitive skin then you should make sure you use products that are perfume and lanolin-free. Cleansing skin is also important, but make sure you do not overdo it as you may actually wind up stripping the skin of its natural moisturizing factors. 15-minute oatmeal or Epsom salt baths will also help to sooth dry, irritated skin.

Protecting exposed areas of the skin while out in cold, windy weather is another important factor as Psoriasis can oftentimes be exacerbated by the cooler elements. When outdoors you should always wear soft, warm layers of clothing, as well as hats, gloves and scarves.

If you find that following these steps do not improve the skin’s appearance, you should talk with your doctor so that an effective treatment plan can be put into place.

The Paleo Diet

Diets are not always easy to maintain. However, with the appropriate knowledge on exactly what it means to “diet” and the types of foods that you are putting into your body, as well as a little bit of tenacity and the will to follow through, you’ll actually be surprised by just how easy dieting and healthy eating is to sustain. With 60% of Canadian adults and over 20% of Canadian children struggling with obesity, I am a strong advocate of low-carb diets and physical activity being implemented into patient’s health care regimens.

Unlike certain fad diets that focus solely on fast weight loss and counting calories, diets such as the Paleo diet (also known as the Hunter-Gatherer diet) are designed to be long-term and help control your glycemic levels, increase your HDL cholesterol levels (otherwise known as the “good” cholesterol), and restrict certain (but not all!) carbohydrates, with the focal point being on your overall well-being. While the Paleo diet is not low-carb by definition – it tends to be in practice. Following a Paleo-based diet is beneficial to your health and can help decrease your risk of  developing certain conditions such as diabetes, cardiovascular disease, Alzheimer’s, arthritis, osteoporosis, and even certain types of cancer. Accompanying weight loss, a Paleo-based diet can also improve your digestion, reduce chronic inflammation, and give you more energy.

The term “Paleo” comes from the prehistoric era from over 2 million years ago known as Paleolithic. If you think about it, processed foods and many of the ingredients that we are ingesting into our systems today did not exist back then – food had to be found or hunted. The Paleo diet gets back to basics, so to speak, and was established upon the foods and lifestyles of our prehistoric ancestors. It predominantly consists of grass-produced meats, omega-3 fatty acids (salmon, walnuts, flaxseed oil, soybeans), rich antioxidants (fruits and vegetables), while it excludes things like processed foods, dairy, grain products, salt and sugar.

The Paleo diet is all about limiting certain foods and strategically choosing others, and it is one of the best diets to follow to preserve a healthy body and mind. One incentive of following a Paleo-based diet is the fact that you don’t have to count calories and can even indulge in some of your favourite foods and beverages, as long as it’s done in moderation. For example, dark chocolate with a cocoa content of 70% or higher is a great source of antioxidants and can lower your risk of heart disease; and while the Paleo diet doesn’t encourage anyone to start drinking alcohol, studies have also suggested that two antioxidants found in red wine, Polyphenol and Resveratrol, can also improve heart health.

Meal planning can be the most difficult part of finding success with any diet, but is an important factor of the Paleo diet, and below are just a few small examples of Paleo-based foods. There are also many different Paleo recipes available online.

Breakfast:
Eggs (scrambled in olive oil)
Kiwi and kale smoothie
Seasonal fresh fruit

Lunch:
Salad & grilled chicken (drizzled with olive oil and freshly squeezed lemon juice)

Dinner:
Spaghetti squash (instead of pasta) topped with marinara sauce
Pork
Turkey breast (skinless)
Salmon (drizzled with olive oil and minced fresh garlic)
Steamed vegetables

Snacks:
Dried fruit and nut mix
Seasonal fresh fruit
Celery and/or carrot sticks

Beverages:
Water
Green tea
Almond milk
Decaffeinated coffee
Homemade fruit juice

Health Benefits of Eating Breakfast

If you’re thinking about skipping breakfast this morning, you might want to reconsider! According to a study conducted by Mayo Clinic researchers, findings suggested that eating meals in the mornings may actually help keep you slimmer and promote weight loss, as those who ate breakfast compared to those who didn’t were less likely to gain weight and accumulate belly fat. The study, which analyzed the breakfast habits of approximately 350 individuals, found that those who ate breakfast on a regular basis gained an average of 3 pounds in a year, while those who only ate breakfast occasionally gained approximately 5 pounds, and those who skipped breakfast all together gained 8 to 10 pounds. In addition, consuming breakfast each day also provides your body with essential vitamins, minerals and nutrients, restores energy, boosts brainpower, and helps reduce the risk of illness.

While it’s easy to skip out on meals if you’re busy or in a rush and don’t have enough time to prepare something, it’s widely known that if you eat breakfast in the morning then you’re less likely to feel hungry throughout the day, meaning you won’t want to snack as frequently and indulge in things that aren’t necessarily good for you.

Of course it’s not just about how frequently you eat. It’s also about what you eat. Just as you would with lunch and dinner, you need to make sure your breakfast choices are just as healthy. That means avoiding carbohydrates, sugar-filled foods and fruit juices. Some of the best foods that you can eat in the mornings include eggs, Greek yogurt, and oatmeal. You can also add things like chia seeds, flax seeds, and nuts to your breakfast meals, as these are packed with fibre and can also prevent you from unnecessary snacking in the middle of the day. If you’re unsure what to make for breakfast or are in a hurry, a smoothie can be a quick, easy and healthy alternative to a larger meal. Simply blend together some of your favourite fruits and ice (with or without a little bit of Greek yogurt.) Another great way to kick off your morning is by making a protein-based shake.

Just as healthy eating is important for adults, it’s also important to make it a habit for young children. However, kids can be picky eaters, so the best way to get them to eat healthy is to make it fun and set up a reward system. Also think beyond breakfast food. If you had ham for dinner, it also works as a great breakfast food. For example, in an omelette.

What is Insomnia?

Insomnia, the most common sleep disorder, affects up to 40 percent of the Canadian population with more than 30 percent of adults suffering from this condition. If left untreated, insomnia can affect your quality of life as well as your performance at school and/or work.

“Insomnia” itself is a broad term that includes several different types of sleeping disorders. The most common forms of sleeping disorders that individuals are diagnosed with include acute insomnia, chronic insomnia, and transient insomnia. It is a condition that can affect people of all ages, especially adult women, and may have various causes such as stress, depression, anxiety, chronic pain, as well as consumption of alcohol and caffeine. It may also be caused by other sleep disorders such as narcolepsy and sleep apnea. Genetics can also increase your risk of developing insomnia, with there being a family history of insomnia in 35% of individuals who are diagnosed; while other risk factors include things like aging and hyperthyroidism.

Most people with insomnia only sleep for short periods of time, are awake for hours before falling asleep, or wake up too early. A common complaint is feeling tired and fatigued, and as if they haven’t slept at all. Chronic insomnia, which can last for years, causes mood disturbances, daytime sleepiness, poor memory, headaches, inability to focus, low motivation and even gastrointestinal issues. Insomnia symptoms may vary from one person to another and can be both short or long-term.

Treatment for insomnia can be as simple as adjusting your daily routine to introducing music therapy or requiring dimmer lights in your home or office. In severe cases, medication is something that may also be considered.

Types of Arthritis

There are an estimated 350 million people living with arthritis worldwide. In Canada, there are more than 4 and a half million people living with some form of the inflammatory disease. There are many different forms of arthritis, though the most common include osteoarthritis, rheumatoid arthritis, psoriatic arthritis and gout. While all types of arthritis cause pain, they differ based on the nature of the disease. For example, osteoarthritis is a degenerative form of the disease as a result of wear and tear on the joints, while rheumatoid arthritis is considered an autoimmune disorder that results in painful joints throughout the body.

First, we’ll start with osteoarthritis (also sometimes referred to as degenerative joint disease.) As mentioned, osteoarthritis is something that develops over time due to normal wear and tear on our joints due to the breakdown of cartilage. This breakdown is what leads to pain. While it can affect any joints, it commonly causes pain in the neck, lower back, knees, hips, and joints in the fingers. In addition to the breakdown of cartilage, bones can also breakdown, and you may also develop something known as bone spurs. Because osteoarthritis takes time to develop, it’s not typically a condition that is seen in younger individuals – though it is possible. However, it is more commonly seen in individuals over the age of 65. Along with age, other risk factors include weight (such as obesity), as well as if you are overusing your joints or have had any previous joint injuries. Genetics can also play a role. In order to determine whether or not a patient has osteoarthritis, a physician will often ask the patient a series of questions pertaining to their medical history, taking note of any medications they may be taking, as well as asking the patient to describe their symptoms and finding out whether or not the symptoms affect their daily lives. To further help in the diagnosis of osteoarthritis, your doctor will also perform a physical exam to test range of motion and look for any areas that may be tender or swollen. Diagnostic testing, such as an MRI or X-ray, will also be ordered. When it comes to treating osteoarthritis, one of the best things you can do is stay physically active. Even something as simple as taking a short 20 or 30-minute walk around your neighbourhood has been shown to reduce pain associated with OA. If you are overweight, then weight management also becomes part of the treatment plan. Physical activity is essential for weight loss, as is eating healthy. By losing weight, you will be putting less stress on your joints and prevent further damage. In some cases, patients may be referred for physical and occupational therapy. Physical and occupational therapists can teach you the proper ways to use your joints as well as teach you different range of motion and flexibility exercises, and can show you how to use assistive devices (such as scooters, walkers, canes and splints.)

Rheumatoid arthritis is a condition that occurs when the body’s immune system mistakenly attacks the joints. With rheumatoid arthritis, the fluid that normally lubricates joints and gives us the ability to move them – known as the synovium – ends up thickening. This then results in inflammation, swelling and pain. Joints commonly affected by RA include the knees, ankles, feet, wrists, hands and elbows. It’s also considered a symmetrical condition; meaning that if your left wrist is affected, your right wrist usually is too. Rheumatoid arthritis tends to affect more women than men and can begin as early as age 30 all the way through age 60. While genetics can play a role, many people with rheumatoid arthritis do not have a family history of the disease. Other than an abnormal response of the immune system, the exact cause of rheumatoid arthritis is unknown. Along with painful joints, RA can affect other parts of the body, including the eyes, mouth, skin, lungs, blood and blood vessels. Things like dry eyes and dry mouth, gum irritation, lung scarring, and anemia can all occur if there are high levels of inflammation in the body as a result of RA. To diagnose rheumatoid arthritis, you will undergo a complete medical history as well as a physical exam, may require medical imaging tests, and will also need to have blood tests to check for certain antibodies. If it is suspected that you have rheumatoid arthritis, a patient will often then be referred to a Rheumatologist – a type of doctor who specializes in the diagnosis, care and treatment of individuals with RA.

In a previous article, psoriatic arthritis and its link to psoriasis was also explained. In individuals with psoriatic arthritis, common symptoms include pain and stiffness of the joints, as well as possible joint deformity. The joints that are typically affected by psoriatic arthritis include the fingers and spine. Because there is no cure for psoriatic arthritis, treatment is solely based on focusing on reducing the symptoms that the patient is experiencing, such as pain.

Another condition that you may not be familiar with is reactive arthritis – previously referred to as Reiter’s syndrome. It is an inflammatory condition that can affect not just the joints, but also the eyes (causing redness, pain, irritation, and even blurred vision), the skin (causing a rash), the mouth (causing mouth sores), and even the urinary tract (causing things such as painful urination or the urge to urinate more frequently.) In the early stages of reactive arthritis, symptoms can be mild. They can also come and go. Reactive arthritis occurs when bacteria caused by other medical conditions, such as chlamydia (a sexually transmitted disease) or salmonella, enters the blood stream. There is no cure for reactive arthritis, so the goal is to reduce and manage the symptoms that are associated with it.

When it comes to reducing the symptoms that are associated with arthritis, analgesics and non-steroidal anti-inflammatory drugs (also known as NSAIDs) tend to be the go-to treatment for mild cases. These can include acetaminophen, aspirin, ibuprofen, and naproxen. In severe cases, corticosteroids may also be prescribed, which can either be taken orally or given via injection and is administered directly into the affected joint(s).

For more information on arthritis, visit the Arthritis Society website at arthritis.ca.

Breast Cancer

There are as many as 200,000 new cases of breast cancer diagnosed every year. It is the most common type of cancer among Canadian women, and it is the second leading cause of cancer-related deaths. While there’s no easy answer when it comes to avoiding breast cancer all together, there are certain precautions you can take to mitigate your risk – and that first means knowing what those risk factors are.

Among the two highest risk factors for breast cancer are age and gender. While breast cancer can occur in individuals of all ages, as well as affect men, incidences of breast cancer below the age of 40 are considerably lower; while other risk factors related to breast cancer may include things like weight, alcohol consumption, as well as there being a potential link to certain chemicals.When it comes to weight, research suggests that obesity increases the risk of breast cancer. Along with the potential risk of breast cancer, obesity also comes with the risk of developing other health problems, including high blood pressure, high cholesterol, as well as cardiovascular disease – which then increases your risk of heart attack or stroke. The best thing you can do to prevent breast cancer and the aforementioned heart-related problems is to make sure you’re eating healthy and staying physically fit, and all you need is 30 minutes of moderate exercise each day to reap the benefits. Something people may not be aware of is the fact that alcohol can also increase the risk of breast cancer. Wine (red wine, in particular) is a carcinogen that is sensitive for breast cancer, and even drinking a small amount can increase that risk. If you are going to consume alcohol, the Canadian Cancer Society says you should not drink more than one glass of wine per day. As for household chemicals, while there has not been any kind of scientific evidence to suggest that there is a direct link between them and breast cancer, some experts say that we should err on the side of caution and decrease our exposure to endocrine-disrupting chemicals commonly used for household cleaning, as well as certain personal care products.

As another preventive measure, it’s also recommended that you do breast self-exams every 2 to 3 months. To make sure you’ve done a proper and complete self-exam, click here for HealthLink BC’s how-to guide. Because breast cancer can also affect men, they should not be excluded from doing this type of exam. Women should avoid doing a self-exam during their period, as breast tissue will tend to feel lumpier and fuller during that time. It’s also not uncommon for women to experience breast tenderness during their menstrual cycle. If you notice any changes with your breasts, such as lumps or bumps, or have nipple discharge, crusting, or thickening, you should let your family physician know immediately. He or she will refer you for a breast cancer screening test known as a mammogram. In some cases, an ultrasound or MRI may also be ordered. If you are between the ages of 50 and 74, it’s recommended that you get a mammogram every 2 years. You can find more information on breast cancer screening here.

Vertigo

Vertigo is a type of disorder that affects your balance. It is often characterized by dizziness or a sensation that you or the room you are in is spinning. In instances where it feels as though you yourself are moving, this is known as subjective vertigo. If it feels like objects are moving or the room you’re in is spinning, this is known as objective vertigo. As a result of these sensations, it is also not uncommon to experience other symptoms such as nausea and vomiting, headaches, and even sweating.

When it comes to diagnosing vertigo, it is important to understand that it is not the same as dizziness despite the two words sometimes being used interchangeably. When you are dizzy, you will feel faint, lightheaded, and unsteady…whereas with vertigo, you will perceive yourself or objects to be moving.

Vertigo can last a few hours to a few days, and in some cases may even take several weeks before it settles down completely. There are many reasons why an individual might develop vertigo, including inner ear infections, such as vestibular neuritis. Vestibular neuritis causes the vestibular nerve to become inflamed and disrupts your sense of balance. You can also develop vertigo as a result of a traumatic head injury, or even by moving a certain way – such as standing up or bending over. This is known as Benign Paroxysmal Positional Vertigo or BPPV. It can also be a common side effect of medications. If you notice any abnormalities (such as vertigo) while you are taking medications, it is important to avoid operating heavy machinery or driving until you know the side effects have subsided. You should always address any concerns you have about the medications you are taking with your doctor or pharmacy, and also be sure notify them right away of any abnormal side effects. In some cases, your physician may want to change the dose of your medication, or will prescribe you a different medication all together.

Treating vertigo will depend on how severe it is. The best way to prevent vertigo from worsening is to rest in bed and avoid movement as much as possible. When getting out of bed or moving around, it is important to do so slowly and carefully. To treat some of the symptoms that are associated with vertigo, like nausea and vomiting, Dr. Ali Ghahary recommends trying over-the-counter antiemetic medications such as Gravol. If that is unsuccessful, a stronger medication called Ondansetron may be prescribed.

If your vertigo worsens or persists, your family physician may need to refer you to an ENT (Ear, Nose and Throat) specialist or a Neurologist.

COVID-19 Q&A: Part 14

“What makes the Delta variant of COVID-19 more transmissible?”
The viral load is roughly 1,000 times higher in those who contract this particular variant of COVID-19, making it twice as contagious as other variants. According to a study published in this summer, it was found that the Delta variant grows much more rapidly – and at higher levels – in people’s respiratory tracts, resulting in higher rates of illness and hospitalization. Furthermore, individuals who contract the Delta variant are infectious much sooner compared to the original strain of the virus.

“Who’s most at risk of contracting the Delta variant?”
Individuals who are not vaccinated or only partially vaccinated are most at risk of contracting not just the Delta variant, but any variant of COVID-19. In addition to all of our other layers of protection, getting vaccinated is the number one thing you can do to protect yourself and others from this virus. While vaccines aren’t 100% effective, you are much less likely to get severely ill from COVID-19, and less likely to pass it on to others.

“If I am fully vaccinated, do I need to continue to wear a mask?”
As of August 25th, 2021, masks are required to be worn in all indoor public places. This includes malls/shopping centres, coffee shops, grocery and other retail stores, drug stores, airports, libraries, recreation centres, restaurants, and on public transportation. You can find a full list of places where masks are required by clicking here. This mask mandate applies regardless of vaccine status; however, individuals who are unable to wear a mask due to certain health, psychological, or behavioural conditions or have a physical, cognitive or mental impairment are exempt. You may also remove a mask temporarily indoors if you are eating or drinking.

“How can I get my child to keep their mask on?”
With younger children, there may be some challenges in getting them to keep their masks on. To help a child feel more comfortable about wearing a mask, try considering the type of mask they wear – such as the design. They may be more inclined to want to wear a mask if it’s their favourite colour, or has a print of their favourite cartoon character. Parents can also talk to children about the importance of mask wearing, as well as model mask wearing at home and in public. If a mask is uncomfortable for a child, things like face mask extenders or ear savers can also be helpful.

“When can kids under 12 get vaccinated? How would a vaccine for a child differ?”
Currently, children under the age of 12 are not able to get vaccinated in Canada. However, in a recent briefing, Dr. Bonnie Henry has said that those in the below 12 age-group may be able to get vaccinated by the end of October dependent on review of data by Health Canada. As for how the vaccine differs for younger children, it is a smaller dose – 10 micrograms (rather than 30) of the antigen (molecules that are capable of stimulating an immune response.)

Staying Healthy in the Fall

As flu season approaches in November (and with scientists predicting the possibility of this year’s flu season being worse than the last), it’s not a bad idea to get the flu shot a bit early. Typically, many clinics and pharmacies around Vancouver and surrounding areas will offer the flu shot as early as October. If you are high-risk (such as a senior over the age of 65, have a previously diagnosed chronic illness, have a weakened immune system or are pregnant), I recommend getting the flu shot. It is also recommended for children under the age of 5. There are many types of flu strains and it is a highly contagious illness, so it’s always a good idea to protect yourself against it. To avoid influenza, always practice good hygiene habits such as regular hand washing, keeping your mouth and nose covered when coughing, and avoiding contact with others who are sick. It’s also important to note that the COVID-19 vaccines do not protect against influenza – but still just as important to get that vaccine as well.

Along with the fall also comes gloomier weather – this means more clouds and rain than sunshine. As a result, we’ll be spending more time indoors than out, which means our intake of Vitamin D will be decreased. To ensure you’re getting enough Vitamin D, I recommends taking a Vitamin D supplement. Taking Vitamin D helps with calcium absorption, and it also boosts your immune system and your mood.

Daylight savings also occurs in the fall. On November 7th, we’ll be turning our clocks behind an hour. This means that there will be longer periods of darkness, and as a result you will be getting some extra sleep. However, some people often have trouble with daylight savings as it can make them feel as though their sleep pattern has been significantly disrupted. Despite getting that extra hour of sleep, it’s still important to go to bed at a decent time and make sure you’re getting at least 8 hours of sleep each night so you’re feeling well-rested the next day. You can learn more about the importance of sleep by watching my  Vitamin Sleep series on YouTube.

You may also notice a change in your skin during the colder fall months, and even into winter. Cooler temperatures can cause skin to become pale, dry and flaky, so it is important to keep your skin moisturized. You can also still wear a sunscreen. If you have sensitive skin, your family physician or dermatologist will be able to recommend something to you.

Staying active is also important! With the change in weather you may be less inclined to exercise outdoors. However, there are still ways you can keep fit at home. If you don’t have exercise equipment, doing stretches and yoga are great ways to stay physically active. Many community centres also have drop-in sessions available and some even offer free fitness classes.

Also remember to keep eating healthy. In-season vegetables broccoli, squash, kale, cabbage, and other dark, leafy green vegetables such as spinach and romaine lettuce.

To find out where you can get your flu vaccine, visit www.immunizebc.ca.