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How to Tell If Your Infant Is Sick

By
Dr. Ali Ghahary
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Dealing with a sick child can be difficult on any parent. It can be especially hard, however, for parents of infants.

As babies cannot yet communicate by speaking, the only way for a parent to be able to tell if their child is unwell is by noticing any abnormalities or unusual changes in their behaviour. For example, if your child is general quiet and well behaved but becomes fussier, more irritable, and cries more frequently, this may be an indicator that something is wrong. Constant crying could be a sign of something as simple as needing a diaper change, feeding, or wanting to be held; it could also be a sign of infection (viral or bacterial), constipation, or something more serious.

If your baby is normally quite active and alert but becomes lethargic, appears to have less energy, sleeps for longer periods of time, has difficulty waking and trouble paying attention to visual sounds and stimulations, this could be a sign of a common cold or an infection such as influenza or meningitis, both of which can be serious and life-threatening. A blood condition known as thalassemia can also contribute to lethargy, as can many other medical conditions. It is a symptom associated with many different health problems not just in infants, but in individuals of all ages.

Fever is another tell-tale sign that your child is sick. Fevers generally occur whenever a viral or bacterial infection is present and they happen as a result of the body trying to fight that infection. The type of infection present could be anything from influenza to an ear infection. Sometimes you can tell your infant has a fever simply by looking at them or by feeling the temperature of their skin with your hand. However, you should always check your infant’s temperature with a thermometer, as this will provide you with a definitive answer. There are two different ways in which you can check an infant’s temperature: Rectally, which tends to provide a more accurate reading (though can cause the infant to fuss), or under their armpit. When a temperature is taken rectally, the normal range is 36.6°C to 38°C. When a temperature is taken under the armpit, the normal range is 36.7°C to 37.5°C. A temperature of 37.2°C (99°F) or higher is considered a fever.

If your child’s fever is caused from a viral infection, acetaminophen (Tylenol) is often the only recommended treatment in order to help reduce the fever. If the infection is bacterial, it should be treated with a course of antibiotics. While taking antibiotics you may notice that your infant has looser stools. If this persists, speak to the prescribing physician. If a rash develops, this could be a sign of an allergic reaction, so before giving your infant their next dose you should have them checked out by a medical professional to determine whether or not the rash is a true allergy.

For more information on the health of newborns and children, including common illnesses, BC Children’s Hospital offers a wide range of information via their website at bcchildrens.ca.

As always, if you have any questions or concerns about your newborn’s health, do not hesitate to seek the advice of a medical professional – either in an emergency room or at a medical clinic. If, for some reason, you are unable to see your regular physician or pediatrician, Dr. Ali Ghahary is available to see walk-ins at Brentwood Medical Clinic in Burnaby.

Non-Allergic Rhinitis

By
Dr. Ali Ghahary
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Your nose is stuffy but you don’t have a cold, so what’s causing all that congestion?

Well, for starters, while it is a common culprit, colds aren’t the only reason that you might be feeling congested. Dr. Ali Ghahary, a family physician from Vancouver, says there can be many different factors that can cause nasal congestion – including things like dust, as well as pollen (which is more prevalent in the spring and summer months) – also known as hay fever.

However, when things like allergies or a common cold aren’t contributing to your nasal congestion, you may have a condition known as non-allergic rhinopathy, previously known as vasomotor rhinitis. With non-allergic rhinopathy you may experience things like a runny nose and sneezing along with nasal congestion. Unlike nasal congestion, which is caused due to allergies, allergic rhinopathy is not. Instead, your symptoms are simply the result of something in your environment causing your nose to become irritated. This could be anything from dry air or air pollution, certain medications, spicy foods, alcohol, certain odours such as perfumes or other household products, and even severe stress and anxiety.

In order to figure out what’s causing your nasal congestion, Dr. Ali Ghahary will ask patients to take note of when the congestion occurs and what, if anything, seems to trigger that congestion – both at home and in their work environments. Sometimes writing these triggers (and the symptoms you experience) down in a diary can help you keep better track and provide your physician with more detailed information. In cases where triggers cannot be easily identified, Dr. Ali Ghahary recommends patients go for allergy testing. Once certain triggers have been identified, you will be able to avoid them and hopefully reduce the nasal congestion you’re experiencing.

Along with avoiding known irritants, Dr. Ali Ghahary may also recommend patients take antihistamines or use a corticosteroid nasal spray, which can help reduce the symptoms of non-allergic rhinopathy. There are many nasal decongestants that can also be found over the counter. However, many of these OTC sprays are not recommended for long-term use, and anything past 3 to 5 days could actually worsen nasal congestion and result in a condition known as rebound congestion.

Are Your Headphones Harming Your Hearing?

By
Dr. Ali Ghahary
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We live in a society that loves listening to music. Thanks to technology and the many different devices that are available on the market today, music is something we’ve also been able to listen to while on the go for many decades; while at work, at school, at the gym, etc. As a result, we’re spending a lot more time with headphones on our ears…but is this necessarily a good thing?

There are two key factors that Dr. Ali Ghahary says patients should consider when using headphones to listen to music: The volume level of the music and the duration of which you’re listening to the music. By listening to your music too loud or for extended periods of time, family physicians like Dr. Ali Ghahary as well as audiologists say you could be doing serious damage to your ears; specifically, your hearing, and you may also develop frequent ear aches.

So just how do you know whether or not listening to music is causing your ears any damage? First and foremost, know that when using headphones, the audio is going directly into your ears, therefore making it easier for damage to your hearing to occur. Another example of volume being too loud is if people around you can hear the music you’re listening to – or vice versa. Dr. Ali Ghahary recommends not exceeding volume levels past 60 dBHL (decibels hearing level) to keep your ears protected. 60 dBHL is the approximate volume of a normal conversation. If your volume levels exceed 90 decibels, this can result in hearing complications, and music that exceeds 100 decibels can result in hearing loss, which may or may not be permanent, and all it takes is 10 to 15 minutes for that damage to occur.

Headphones have also been linked to many accidents involving vehicles and pedestrians, and those types of accidents have increased at an alarming rate. As a safety precaution, Dr. Ali Ghahary suggests keeping your headphones off so that you are able to pay attention to what’s happening around you as well as able to hear any sirens, car horns, etcetera.

If you want to listen to headphones, you’re still able to do so. However, it’s important you keep the volume at a low and comfortable listening level. Just as someone with carpal tunnel syndrome would take breaks from typing or writing, those listening to music should also take breaks from their headphones to avoid the risk of causing permanent damage to their ears. It’s also a good idea to choose your headphones carefully when shopping for a pair. Ear buds are quite popular these days, but they sit much closer to the eardrum than a pair of normal, noise-cancelling/over-ear headphones would, and can cause more damage.

While it’s not uncommon to share headphones with friends or family, you could actually develop an ear infection as a result of doing this due to the transfer of bacteria. If you are going to share headphones, make sure you sanitize them prior to use – or simply don’t share them at all.

Medication Sensitivity vs. Allergies

By
Dr. Ali Ghahary
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When it comes to medications, many patients often mistake drug intolerance for allergies. However, the two are vastly different.

Drug intolerance (or medication sensitivity) is characterized by a patient’s inability to tolerate certain medications when they are taken at sub-therapeutic or therapeutic doses. Having sensitivity to medications can mean many different things, and that sensitivity can also manifest in many different ways.

For example, many medications come with a long list of potential side effects ranging from mild to severe. Common side effects to medication include headache, dry mouth, nausea, vomiting, and diarrhea. These side effects generally go away after a few days, though some side effects may take 1 to 2 weeks to subside depending on the type of medication you have been prescribed. These symptoms can sometimes be relieved with antiemetic medications or probiotics. Taking a probiotic is especially important while on antibiotics, as many antibiotics can disrupt the gut and cause gastrointestinal related problems. Alternatively, less common (but severe) side effects to medications can include abnormal heart rhythm, suicidal thoughts, and internal bleeding. If you notice any of these symptoms you should seek immediate medical attention.

Because medication side effects generally do not persist longer than the timeframe provided by your physician or pharmacy, individuals often find that they are able to tolerate many medications without any long-lasting problems or effects. However, those with medication sensitivities may actually find that even the most common of symptoms are more severe than they ought to be. It’s also not uncommon to experience drug intolerance even when prescribed the smallest dose of medication. In some cases, a dose as small as 10 milligrams might “feel” more like a dose of 100 milligrams. Dr. Ali Ghahary, a family physician in Vancouver, says it’s important for patients to report any adverse reactions such as these to their doctor or pharmacist; that way a note can be placed on your file for future reference and to avoid any potential adverse effects in the future.

When it comes to medication allergies, they are considered much more severe and can even be life threatening. Patients with drug allergies can develop a reaction regardless of the dose and form of their medication (i.e. pill form, liquid, or injectable), and allergic reactions range from mild to severe. Common symptoms of drug allergies include itching, rash and/or hives. This kind of reaction will often subside by taking a dose of an antihistamine (such as Benadryl), which is available in both pill and liquid form. A patient may also go into anaphylaxis – a reaction that results in difficulty breathing and can be lethal if medical attention is not sought immediately by calling 911.

The most common medications that can trigger these types of allergic reactions include Penicillin, Sulfa drugs, anticonvulsant drugs, ibuprofen or other NSAIDs, as well as chemotherapy.

In order to confirm suspected drug allergies, Dr. Ali Ghahary will refer patients to see an allergist. Allergists will often perform what’s known as a skin test on patients. For a more accurate diagnosis, an allergist may also recommend blood work to measure the amount of allergen-specific antibodies found in your blood.

Different Types of Wounds and Wound Treatment

By
Dr. Ali Ghahary
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At Brentwood Medical Clinic, Dr. Ali Ghahary not only treats patients suffering from minor to complex health matters – he is also able to treat minor wounds.

An open wound occurs when there is an injury that involves the body tissue – typically affecting the skin. An open wound can result from sharp objects or tools (such as glass or knives), falls, or even from car accidents. Because wounds can range from minor to severe, they are classified into the following categories:

  • Abrasions
  • Lacerations
  • Punctures
  • Avulsions

An abrasion is the most minor of the four wound categories, and there is typically very little or no bleeding with this type of injury. However, you do need to take extra precautions to ensure the wound does not worsen as well as to avoid infection.

A puncture is a wound that is often caused by a sharp and/or pointy object – i.e. a needle or shard of glass, or even an animal bite. Similar to abrasions, punctures may not bleed much, but they can also cause deep enough damage to your internal organs depending on the area of the body that is affected. Even if you think your wound is not severe, Dr. Ali Ghahary still recommends being seen by a physician in order to prevent infection. In some cases, and depending on the severity of the wound, patients may also require a tetanus shot.

An avulsion is considered the most severe type of wound and is generally caused during major accidents to the body (i.e. serious motor vehicle accidents, workplace accidents, or even gunshot wounds.) With an avulsion, there may be partial or complete tearing of skin as well as the tissue located underneath. Avulsions often result in heavy and rapid bleeding and are considered medical emergencies.

How Are Wounds Treated?

Many wounds can be treated with some simple at-home first aid care. If you develop a wound, it is important to wash and disinfect the affected area in order to remove any dirt or debris. This helps to prevent infection. If bleeding is present, apply pressure to the affected area and make sure you keep it elevated to control the bleeding and reduce any swelling. Wounds should also be wrapped with a sterile dressing/bandage. As pain can also accompany wounds, you can find relief by taking over-the-counter acetaminophen. It is important to avoid NSAIDs as these can actually increase bleeding.

If your wound is severe, you may require treatment from a physician – either at a doctor’s office or in an emergency room. Signs you may need to see a medical professional include wounds that are deeper than half an inch and bleeding that lasts longer than 20 minutes or does not go away when pressure is applied.

Common Causes of Body Aches and Pains

By
Dr. Ali Ghahary
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Vancouver physician, Dr. Ali Ghahary, talks about some of the most common causes of body aches and pains, and how you can find relief.

Aches and pains are something we’ve all experienced and they can be a symptom of many different health conditions – the most common reason being influenza. The common cold or flu is usually the result of a viral or bacterial infection. As a result, your immune system works in overdrive in effort to fight off the infection, leaving you feeling fatigued, unwell, and can even cause general body aches and pains. In order to relieve these symptoms, Dr. Ali Ghahary recommends, first and foremost, getting plenty of rest. Without rest, you will take longer to recover. He also recommends taking over-the-counter medications such as Tylenol (acetaminophen) or Advil (ibuprofen) for pain relief. If after more than 2 weeks your symptoms do not get better or worsen, it is recommended that you see a physician.

Dr. Ali Ghahary is available to see patients at Brentwood Medical Clinic on a walk-in basis. You can find his clinic schedule by clicking here.

It is also not uncommon to develop body aches and pains as we get older. As we age, so do our bones and joints. The most common pain-related conditions affecting Canadian geriatric patients today include osteoarthritis and rheumatoid arthritis. Osteoarthritis is a result of wear and tear on the bones and joints over time, while rheumatoid arthritis is considered an autoimmune disease where the immune system attacks the joints.

Did you know that anemia could also cause body aches and pains? Anemia is a condition that occurs when the body is not getting enough red blood cells – usually from lack of iron in the diet. Females with heavy menstrual cycles can also become anemic. As a result of lack of oxygen-carrying red blood cells, many parts of your body can feel fatigued and you may develop pain. To avoid anemia and its symptoms, it is important that you ensure you’re getting enough iron, folate and vitamin B12 in your diet. You can also increase iron by taking supplements, which can be found at most pharmacies.

You might also be aware of a condition known as fibromyalgia. Fibromyalgia is characterized by unexplained body pain, typically affecting areas such as the arms, hands, and legs. Paints with fibromyalgia often complain that they have aching bones and joints. While the cause of fibromyalgia is unknown (therefore making it a complex and difficult condition to treat), there may be certain factors that contribute to a flare-up of symptoms, such as stress and anxiety, surgery, and physical trauma.

As mentioned, many body aches and pains can be relieved with OTC pain medications. You may also find it helpful to alternate between applying ice and heat on the affected areas.

For more information on some of the most common conditions that can cause body aches and pains, follow Dr. Ali Ghahary on Twitter at @DrAliGhahary, or visit Heathline’s website.

What Makes Fibre Good for You?

By
Dr. Ali Ghahary
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Along with promoting healthy eating, Dr. Ali Ghahary also wants patients to know that it’s important to have a diet that is high in fibre.

Including fibre as part of a healthy, well-balanced diet can help ward off many different illnesses, such as heart disease, diabetes and cancer. It can also help you maintain a healthy body weight and improve your digestive health.

While many Canadians think they might be getting enough fibre in their diets, chances are you’re not.

So just how much fibre is needed? Well, that all depends on your age. For children between the ages of 1 and 3, Dr. Ali Ghahary recommends at least 19 grams of fibre per day, while children between the ages of 4 and 12 can have anywhere from 25 to 30 grams per day, and teenagers and adults anywhere from 25 to 40 grams.

There are two different types of fibre: Insoluble fibre and soluble fibre. Insoluble fibre is found in things like fruits and vegetables, whole grains, and wheat bran, while soluble fibre is found in oats, barley, and legumes such as beans and lentils. To ensure you’re getting both types of fibre, it is important to include a variety of fibre-rich foods in your diet so that you can reap the health benefits.

In order to ensure you’re getting enough fibre in your diet each day, Dr. Ali Ghahary shares the following tips:

1. As an increase of fibre can cause gas and bloating, it’s important to make sure you’re also drinking plenty of fluids (water!) and getting regular exercise.

2. When eating breakfast cereal, try to choose ones that contain at least 4 grams of fibre per serving. You will be able to find this information on the nutrition label, which is generally found on the back or side of the box.

3. Eat whole fruits rather than fruit juice. Fruit juice contains a significantly lower amount of fibre than whole fruit, and sometimes a significantly high amount of sugar, which isn’t good for you.

4. When making soups, casseroles or salads, add things like beans, lentils, flaxseeds and unsalted sunflower seeds for extra fibre.

5. Sunflower seeds and almost also make for a great, healthy snack.

Find more information on fibre by visiting the Dietitians of Canada website at @DrAliGhahary.

What is Gout?

By
Dr. Ali Ghahary
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Gout is a type of inflammatory arthritis that is the result of a build-up of uric acid crystals in the joints, causing sudden and severe pain.

The Four Stages of Gout

The four stages of gout include asymptomatic hyperuricemia, acute gout, interval gout, and chronic gout.

With asymptomatic hyperuricemia, symptoms of gout generally are not present but your blood uric acid levels will be high. Acute gout happens as a result of something causing your uric acid levels to spike (such as drinking alcohol), resulting in pain and inflammation. The symptoms of an acute gout attack usually ease after a few days and will go away within 7 to 10 days. Similar to asymptomatic hyperuricemia, pain is often not experienced with interval gout. However, inflammation may be damaging joints. Lastly, we’ll take a look at chronic gout. Individuals with chronic gout usually have high uric acid levels over a number of years with an increase in attacks as well as joint damage. By paying close attention to your lifestyle and making any necessary changes as outlined by Dr. Ali Ghahary below, you can often avoid this stage of gout all together.

What Causes Gout?

As mentioned, gout is due to a build-up of uric acid crystals. Knowing what causes these crystals to form in the first place is a key factor in avoiding developing gout, and lifestyle plays a major role. Your diet, for example. Things like red meats and organ meats (i.e. liver), shellfish (i.e. lobster and shrimp), redefined carbs (i.e. white rice, white bread, and pasta), processed foods (i.e. frozen dinners, potato chips and other snack foods), sugary beverages and alcohol should all be avoided. Crash diets, fasting and dehydration can also contribute to gout. There are also medical reasons that can cause gout to develop, such as injuries to joints, surgery, sudden or severe illness, infections, diuretic medications, and even chemotherapy.

Who Gets Gout?

Although gout typically affects more men in Canada than it does women, females can also still develop gout. The first gout attack can be experienced anywhere from the age of 30 to 50. Along with some of the aforementioned causes, you are also at risk of developing gout if there is a history of it in your family, are overweight, or have undergone bypass surgery.

How is Gout Diagnosed?

In order to accurately diagnose gout, Dr. Ali Ghahary will look at a patient’s complete medical history and examine the affected joints. Typically, the areas of the body that gout affects the most are the feet, ankles or knees. Dr. Ali Ghahary will then refer patients for a blood test to check their uric acid levels, in addition to medical imaging tests such as X-rays, ultrasounds, an MRI or CT scan to examine the soft tissue and bone.

How is Gout Treated?

Gout is commonly treated with NSAIDs (non-steroidal anti-inflammatory drugs) as well as medication to reduce the production of uric acid. If you are experiencing an acute attack, Dr. Ali Ghahary recommends icing the affected area and keeping the joint elevated. It’s also important to stay as relaxed as possible, as stress and anxiety can also trigger gout. As you may have trouble performing daily tasks during a gout attack, you may require assistance from friends or family members, so don’t feel bad about reaching out for help if you need it.

More information on this and other inflammatory conditions, including arthritis, can be found by visiting arthritis.ca.

Health Canada’s Proposed Trans Fat Ban to Take Effect Later This Year

By
Dr. Ali Ghahary
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In April of 2017, Health Canada proposed a ban on trans fats. Now, that ban is set to become a reality and will go into effect on September 18th.

Health Canada’s Notice of Proposal calls for prohibiting the use of partially hydrogenated oils – also known as PHOs, which are considered to be much more dangerous that saturated fats. When oils (such as vegetable oil) are hydrogenated, they are turned into solid fat; and while studies have shown that Canadians do consume much less tarns fats today, Health Canada says more needs to be done to reduce trans fat intake in order to decrease the risk of heart disease, which is one of the main reasons why the ban is being put into place.

Where Are Trans Fats Found?

Trans fats are found in many different foods, but they are especially prevalent in fried foods, such as fries, donuts, cakes (and cake frosting), pies, muffins, cookies, crackers, candies, breakfast sandwiches, waffles and pancakes, butter, and even microwave popcorn – as well as any foods that are battered, such as fish & chips and onion rings. Trans fats can also occur naturally in certain meat products, such as beef and lamb.

Health Risks of Trans Fats

While the aforementioned foods might taste good, they can do some serious damage to your health. Not only do trans fats raise your bad levels of cholesterol (also known as your LDL levels) and decrease your good levels of cholesterol (also known as your HDL levels), trans fats also increase your risk of heart disease and stroke, as well as increase your risk of developing Type II diabetes.

Reducing Consumption of Trans Fats

To reduce your consumption of trans fats, Dr. Ali Ghahary, a family physician from Vancouver, Canada, recommends significantly cutting back on eating foods that contain partially hydrogenated vegetable oils. When buying foods, always be sure to read the nutrition facts found on the backs of packaging, and when dining out at restaurants always ask your server which kinds of oils their foods are cooked in. Many restaurants in and around British Columbia also offer healthier meal alternatives on their menu.

It’s also easy to reduce your intake of trans fats at home. In order to achieve optimal health, Dr. Ali Ghahary recommends having a diet that is high in fruits and vegetables, poultry, fish, nuts, whole grains and low-fat dairy products. You should limit foods and beverages that contain sugar, and of course avoid fried foods.

For more healthy eating tips from Dr. Ali Ghahary, click here.

How RNs Play an Important Role in Patient Care

By
Dr. Ali Ghahary
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When visiting an emergency room, an RN (Registered Nurse) is often the first point of contact that you will have with a medical professional.

Aside from emergency rooms, RNs can be found in many different healthcare facilities – such as a physician’s office, nursing home and other long-term care facilities, and outpatient clinics. Registered nurses can also often be found in schools, community centres, and some even serve in the military.

Nurses help take care of patients of all ages, genders, ethnicities and social situations. As such, they are required to have broad depth and knowledge about all aspects of health and illnesses, global health issues, the different healthcare systems, as well as the pathophysiology of different diseases and health conditions. In addition to being the first point of contact for patients, nurses also help to plan and coordinate ongoing care for individuals and their families.

As dealing with a health crisis can often cause patients to feel anxious and overwhelmed, it is a RNs job – though sometimes challenging – to help create a friendly environment and put patients at ease. Patients should feel comfortable in asking nurses any questions relating to their health, which can then be deferred to the patients’ attending physician. These could be questions about what type of medical care they should expect, to questions about any procedures such as diagnostic tests (i.e. medical imaging.)

Some other responsibilities for RNs include taking patient health histories, performing physical exams or being on hand when a physical exam is performed by a physician, coordinate care with other health professionals, direct and supervise the care that is provided by other medical staff, counsel patients on their health, provide patients with health promotion and education, conduct health research, as well as help make critical decisions relating to patient care, and administer medications, treat wounds, and other types of interventions.

It is important to note, however, that RNs are not the only type of nurse. There are also RPNs (Registered Practical Nurses). The main focus of an RPN is on those with less severe, less complex health situations that are easily treatable; as well as NPs (Nurse Practitioners). Unlike RNs, a Nurse Practitioner can see a patient on their own without referring cases to a physician if they deem a doctor’s opinion isn’t necessary. NPs are able to diagnose and treat acute illness, as well as administer and prescribe patients with any necessary medications.

You can find more information on nursing by visiting the website of the College of Registered Nurses of British Columbia at @DrAliGhahary.
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