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Osteoporosis Awareness Month

Affecting as many as 2 million Canadians and 44 million Americans, osteoporosis is a condition that causes the quality and the density of your bones and bone tissue to deteriorate over time, leading to an increased risk of bone fractures and breaks. The most common injuries that are related to osteoporosis include the shoulders, spine, hips, and wrists.

While there is no known cause of osteoporosis, there are certain factors that put you at risk of developing osteoporosis. Those who are over the age of 50 are at a much higher risk of developing osteoporosis than those under the age of 50. It is also more likely to affect females than it is males, though it certainly affects both genders. Having a low body weight as well as a past history of fractures can also put you at risk.

Aside from osteoporosis, certain medical conditions can also put you at risk of falls and/or fractures. For example, rheumatological conditions – such as rheumatoid arthritis – a disease that causes the joints to become inflamed and painful, as well as diseases that are associated with Vitamin D deficiency, including chronic kidney disease, chronic liver disease, malabsorption syndrome, as well as certain neurological conditions due to the increased risk of falls.

Whenever Dr. Ali Ghahary, a family physician in Vancouver, BC, suspects that a patient might have osteoporosis, he will send them for a scan that is able to measure their bone mineral density. The bones that are most commonly looked at during this scan are the bones in the lower spine, thighbone, and forearm, as well as the bones in your heels, wrists and fingers. During a bone density scan you are exposed to very little radiation, and the test itself can last as little as 10 minutes or up to 30 minutes.

To reduce the risk of osteoporosis or to minimize its effects, Dr. Ali Ghahary recommends that patients make sure they’re getting enough Vitamin D, calcium and protein. It’s important to try and get these from food sources. However, if you are unable to do so, Vitamin D and calcium come in supplements that are readily available at any pharmacy or drug store. Dr. Ali Ghahary also recommends that patients get regular exercise, as physical activity can help strengthen the bones and muscles. You should also avoid smoking and alcohol, as these habits can not only increase your risk of osteoporosis, but also increase the risk of falls.

You can find much more information on Osteoporosis can be found by visiting the Osteoporosis Canada website at osteoporosis.ca. Additional information can also be found by following Dr. Ali Ghahary on Twitter as well as by using the hashtag #OsteoporosisMonth.

The Different Types of Sleep Disorders

Dr. Ali Ghahary, a family physician from Vancouver, Canada, recommends adults get anywhere from 7 to 9 hours of sleep each night, while children and teenagers between the ages of 3 to 17 need anywhere from 8 to 10 hours of sleep each night.

Getting a good night’s rest not only leaves you feeling rejuvenated the next day, but it also plays a vital role in many areas of your health. Getting proper sleep can improve heart health and concentration – and studies have also suggested that individuals who are looking to lose weight who get adequate sleep also tend to lose more body fat than those who don’t get enough sleep.

While a lack of sleep can be caused by a number of factors including drinking too much caffeine, watching too much television or spending too much time on the computer late at night, or by noise, there are also certain sleep disorders that can disrupt one’s ability to get a good night’s rest. At least 40% of Canadians and 70% of Americans have some form of a sleep disorder. The most commonly diagnosed sleep disorders include insomnia, sleep apnea, restless leg syndrome, and narcolepsy.

Individuals with insomnia will often complain of difficulty falling asleep or having a hard time staying asleep. You may also wake up several times throughout the night, wake up too early, feel fatigued throughout the day, have an inability to be able to concentrate at work or school. Persons with insomnia should also avoid driving, as the risk of car accidents is higher in those with sleep disorders. In certain cases, insomnia may be treated with medication. In other cases, it is also treated with cognitive behavioural therapy (CBT) in order to determine the root cause of the insomnia – stress and anxiety often being one of the causes. Reducing anxiety can significantly improve one’s sleeping habits.

Sleep apnea is a much more serious form of sleep disorder that can cause your breathing to be interrupted. There are two forms of sleep apnea – OSA, also known as Obstructive sleep apnea, and CSA – also known as Central sleep apnea. With OSCA, the airway becomes blocked as a result of the throat’s soft tissue collapsing as we sleep. With CSA, the airway does not become blocked – however, the brain fails to send the signal to the body that tells it to breathe. Some of the most common symptoms of sleep apnea include snoring, choking or gasping for air, and feeling fatigued throughout the day. Sleep apnea can be life threatening, therefore it is important to not ignore the symptoms and speak to your family physician as soon as possible.

To accurately diagnose a sleep disorder, Dr. Ali Ghahary may request that a sleep study be performed. A sleep study is administered by wearing a special device that records your sleeping patterns which is then turned into data to be analyzed. This is a non-invasive procedure and can be done in the comfort of your own home.

For more information on these and other sleep disorders, visit the Canadian Sleep Society website at css-scs.ca.

Health Benefits of Drinking Water

While not everyone considers water to be an important factor in his or her everyday health, it is actually a key component to staying healthy and is fundamental in keeping nutrients circulating properly in your body. The human body is composed of at least 60% of water and plays an integral role in many different bodily functions including digestion, absorption, and maintenance and regulation of body temperature. Drinking water is also a great way to quench your thirst without having to worry about calories that are found in soda and other sugary beverages, which can be low in nutrients and not provide any benefit whatsoever in terms of your health.

If you do not drink enough water each day, you may wind up suffering from dehydration. Symptoms of dehydration include dry mouth, dry eyes, urine that is dark in colour, fatigue or dizziness, and nausea that worsens after exercise. When the body is dehydrated, your brain will trigger its thirst mechanism, which is not something you should ignore.

For individuals looking to lose weight, substituting water for beverages that are high in calories can help. It’s also imperative to include foods that are water-rich in your diet, as these are more filling and can also help to decrease your calorie intake. Water-rich foods include fruits and vegetables, beans, oatmeal and broth-based soups. The body absorbs these foods slower, making you feel full.

Staying hydrated also helps with muscle performance and keeps them feeling energized. If you are not getting enough water, muscles will not work as well. It is recommended that you drink at least 17 ounces (a little over 2 cups) of water prior to exercising, and you should also drink water at regular intervals during physical activity to replace the fluids you lose from sweating. Water also plays a significant role in kidney function. The kidneys are responsible for flushing out toxins. However, if you are not getting enough fluid intake then this becomes difficult for the body to do and you may be at an increased risk of developing kidney stones. As you can see, not only does water help with various parts of your health, but the effects of drinking water can also be noticeable from the outside, too, and keeps the skin looking good. If you don’t drink enough water, your skin can appear dry and wrinkled.

Dr. Ali Ghahary, a physician in the Greater Vancouver area, recommends patients make water their go-to beverage of choice. The Canadian Food Guide also recommends that individuals drink water each day, limiting the intake of carbonated/soft drinks, energy and sports drinks, sweetened beverages and alcohol. These are extremely high in calories and low in nutrients. If you are turned off by water due to its lack of flavour, try adding things like orange wedges, lemon, lime, berries or mint. Other healthy options include 100% fruit juices and fortified soy beverages.

The Opioid Crisis in Vancouver

In 2016, there were 922 overdose deaths in British Columbia. In Vancouver, 15 people died from opioid-related overdoses in just one week alone, and the number of opioid deaths in the Province is expected to reach as high as 1,400 by the end of 2017, making it a public health emergency.

As a result of the increased number of opioid-related deaths across the Province, new guidelines based on one similar to the US Centers for Disease Control and Prevention were established for physicians and the prescribing of opioids and other highly addictive drugs, making British Columbia the first in Canada to be bound, legally, by such guidelines. Medications such as opioids often act as a band-aid when treating chronic pain disorders or other health problems, and they can actually make pain worse.

Patients can often develop a high tolerance to opioids over time, which can then lead to addiction and dependency, and can also ultimately result in individuals turning to other unsafe ways to get the drug – which is often off the street, and is why we have heard of so many cases of drugs being laced with Fentanyl, or its more potent cousin, Carfentanil. Even when ingested in small amounts, these drugs can be deadly.

Under the new guidelines, physicians must sit down and discuss with patients the dangers of opioids and offer alternatives for chronic conditions such as back pain, headaches and other ailments. It is important for physicians like Dr. Ali Ghahary to also carefully analyze a patient’s personal and medical history, as some patients may be more vulnerable to addiction such as those who have been abused, or those who come from families with a history of addiction or have previously battled addiction themselves. Doctors should not only weigh the risks and benefits of opioids, but all types of medications, and should also review the patient’s PharmaNet file, as those who are prone to addiction will often do what is called “doctor-shopping” and collect multiple prescriptions from different healthcare professionals…to either get more pulls for themselves, pills to give to others, or pills to sell.

More information on the dangers of opioids and alternative treatment options for chronic pain can be found by clicking here.

Discover Vancouver’s Top Spots for Fitness

As a family physician in British Columbia, I not only evaluate and treat patients with everyday common health issues, but also counsel patients on the importance of physical activity, putting an emphasis on the important role it plays in attaining optimal health.

The city of Vancouver is known as being one of the most illustrious outdoor regions in Canada, with plenty of easy access and available transportation to several parks, beaches and hiking spots around the Lower Mainland, including but not limited to Stanley Park, False Creek, English Bay, and the Grouse Grind – also commonly referred to as the “Stairmaster of Mother Nature” – a physically challenging 2.9 kilometre trail up Grouse Mountain in North Vancouver.

There are over 220 parks and beaches in Vancouver, so it goes without saying that Vancouver residents have an abundance of options when it comes to keeping physically fit. If outdoor activity isn’t something you are fond of, there are also several community centres or gyms to join, or you can even implement physical activity in your home by doing yoga or lifting weights. That being said, while research has shown Vancouverites to be much more physically active than those in other Canadian cities and Provinces, many individuals have a BMI over 30 (which is considered obese or overweight), and as many as 85% of Canadians still, unfortunately, do not meet the required guidelines of physical activity, which is 150 minutes of moderate-level exercise each week, or 30 minutes per day.

Individuals who are inactive can develop serious health complications including an increased risk of coronary heart disease and increased blood pressure levels (also known as hypertension.) Being immobile also increases the risk of developing adult-onset Type II diabetes, making you resistant to insulin, as well as stiff joints, poor posture, and osteoporosis, which can cause bones to fracture easily. Other risks of physical inactivity include mental illness such as depression and anxiety, as well as an increased risk of being diagnosed with certain cancers such as colon cancer and breast cancer. Canadians who keep fit on a regular basis have reported decreased stress levels, decreased blood pressure levels, and weight loss or improvement in weight management.

Whether you prefer outdoor activities, gym memberships, or home workouts, there is something for everyone in Vancouver. So, embrace the city’s fitness-friendly atmosphere and start working towards a healthier, happier you! By making small improvements to your physical activity, you will notice astronomical rewards to your health.

Understanding Inflammation

When Canadians think of inflammation, we often think of it as damage to the body that causes pain and swelling, and even infection. While this is true to a certain extent, inflammation is actually the body’s natural response to something it perceives to be harmful. So while infection is oftentimes easily associated with inflammation, inflammation does not necessarily mean an infection is present. Inflammation occurs by releasing chemicals from the white blood cells, which assists in protecting the body from and removing any damaged pathogens, cells or other irritants. A bacterium, fungus or virus causes infection, and inflammation is simply the body’s response to it. When inflammation is present, this means that the body is trying to heal itself. If inflammation did not occur, our bodies would never properly heal.

There are two types of inflammation that can occur. Acute and Chronic. Acute means the rapid onset of inflammation, which can become severe but has a short healing period. Acute inflammation can be the result of having a sore or scratch throat caused by the common cold or flu, bronchitis, skin wounds, dermatitis, appendicitis or sinusitis. Unlike acute inflammation, chronic inflammation is long-term and can last from months to years. Chronic inflammation can be caused by the failure to eliminate acute inflammation as well as other persisting irritants. It can result in several diseases such as rheumatoid arthritis, hay fever, and even certain cancers. Chronic sinusitis, asthma, and digestive orders such as Crohn’s disease are also linked to chronic inflammation. Signs and symptoms of inflammation can include pain to the affected areas (especially upon touch), redness, swelling, and the feeling of warmth.

Autoimmune diseases can also result in inflammation. An autoimmune disease is when the body’s immune system issues a response to otherwise healthy tissues and mistakes them for pathogens or irritants that are harmful. Examples of autoimmune diseases include rheumatoid arthritis, celiac disease, lupus, psoriasis, and fibromyalgia.

In certain cases, Dr. Ali Ghahary, a family physician in Vancouver, Canada, will prescribe medication to alleviate the symptoms associated with inflammation. These medications include anti-inflammatories known as NSAIDs – such as Aspirin or Ibuprofen, and are used to treat inflammation and pain. Corticosteroids such as Prednisone are also commonly usedn. As these drugs can result in serious side effects and other health conditions, it is not recommended that they are taken long-term unless otherwise noted by your physician.

Hepatitis B (HBV)

Hepatitis B Virus, also known as HBV, is a potentially life-threatening liver disease that can be either acute or chronic.

More infectious than HIV, Hepatitis B is contracted through contact with bodily fluids or blood of a person already infected with the disease. While less than 2% of the Canadian population is infected with HBV, it affects an estimated 1.2 million individuals in the United States and over 300 million individuals worldwide, resulting in the deaths of over 600,000 patients each year due to complications from the disease including cirrhosis – a condition that results in scarring of the liver usually as a result of exorbitant alcohol consumption, viral Hepatitis B and C, and other causes, in addition to liver cancer.

Symptoms of Hepatitis B Virus include fatigue, nausea, vomiting, loss of appetite, dark urine, pale stools, joint pain, stomach pain and jaundice (yellowing of the skin.) However, more than half of those with Hepatitis B usually do not develop symptoms until their liver has been affected.

As mentioned, HBV is spread through contact with blood and bodily fluids. It can also be contracted through using unsterile tattooing or body piercing equipment, sharing personal hygiene items with another infected individual such as razors, toothbrushes, scissors and nail clippers, by sharing contaminated drug-use items (i.e. needles), as well as unprotected sex and/or having multiple sexual partners. It is important to note that HBV is not spread by having casual contact with someone…such as kissing, hugging, shaking hands, or being around individuals who may be coughing or sneezing.

Taking preventive measures to avoid contracting HBV is important. In Canada, all Provinces offer free immunizations to children and certain groups of adults who may be at risk of developing HBV. The vaccine is routinely given to children in Grade 6 who have not yet been vaccinated. It is also typically recommended to children under the age of 12 whose families have emigrated from countries that have a high HBV risk rate and to individuals who have had multiple sexual partners or a recent sexually transmitted infection (commonly referred to as an STI), individuals with chronic liver disease, and health care practitioners who are at risk of coming into contact with blood or bodily fluids as a result of their job.

In acute cases, Hepatitis B will clear on its on – usually within 6 months of first contracting the disease. This means that you will no longer be infected with HBV and also will not put others at risk of developing it. However, in chronic cases, long-term treatment is required.

In order to manage symptoms associated with HBV, Vancouver physicians like Dr. Ali Ghahary focus on relieving the patient’s symptoms, preventing any complications that may arise, as well as preventing transmission of the disease.

To start, Dr. Ali Ghahary will monitor patients with blood tests to keep a close eye on the health of the liver. Medications such as Epvir, Hepsera, Tyzeka and Baraclude will also be prescribed. These are antiviral medications that help to slow down the progression of the virus. In severe cases, a liver transplant may be necessary.

To cope with the diagnosis of HPB, it is important to educate yourself on the disease. Speaking to your physician is always a great place to start, and there are various libraries around Vancouver and the surrounding area that will likely have books available on the disease. The Vancouver Infectious Disease Centre also offers support and educational tools on HBV and other acute and chronic diseases, including HIV and HCV.

If diagnosed with HBV you should ensure that you are taking care of your liver by avoiding alcohol consumption, ensure that you have a healthy diet, are getting regular exercise, as well as getting enough sleep.

Struggling With Mental Health and Addiction in Canada

In any given year, 1 in 5 Canadians will experience mental health or addiction problems. While women tend to have an increased rate of mood and anxiety disorders, men tend to have higher addiction rates. However, it is not unusual for mental health and addiction problems to co-occur. Patients who are already suffering from a mental illness are 2x more likely to develop substance abuse problems in comparison to otherwise healthy individuals, while patients already dealing with substance abuse problems are 3x more likely to develop a mental illness.

Mental health and addiction problems can cut up to 20 years from ones’ life expectancy, and is a leading cause of premature mortality in this country. Thus, it is imperative to be proactive and treat these issues early on in order to lead a healthy, well-balanced life. As a physician, it is my priority to ensure that mental health disorders and substance abuse/addiction is treated the same as any other illness would be treated – seriously, with the utmost compassion, and effectively.

There are many different ways that mental health disorders and addiction can be treated, with the most common course of treatment being a combination of medications and behavioural therapy such as outpatient counselling from a clinical psychologist or a referral to a psychiatrist via Burnaby Mental Health. Behavioural therapy is greatly beneficial in helping the patient further understand the symptoms that they may be experiencing, the risks of substance abuse, and will hugely benefit the patient in helping them on their road to recovery as well as be instrumental for the patient in maintaining their sobriety as they move forward. As mental health and addiction can also have a significant impact on ones’ personal lives, including performance in school or at work, seeking the help of a family physician, clinical psychologist or psychiatrist may also help to repair those fractured relationships and allow for better, open and honest communication in families, with friends, teachers, and with co-workers.

Caring for Geriatric Patients in Canada

As of 2014, nearly 16 percent (just over 6 million) of Canadians were made up of geriatric patients aged 65 or older. By 2030, that number is expected to rise by 7 percent to 9.5 million seniors, making them an expeditiously expanding part of Canada’s population. The average life expectancy of elderly patients is 84.2 (women) and 80 (men.) By 2036, the average life expectancy is anticipated to rise to 86.2 (women) and 82.9 (men) due to the fact that seniors are seemingly living healthier, longer lives than ever before.

While the Canadian government works to provide a number of different programs and initiatives for elderly patients and their families, much of the responsibility of care for geriatric patients falls on their caregivers (i.e. family members and friends) and general practitioners. Prior to joining Brentwood Medical Clinic in Burnaby, Dr. Ali Ghahary worked with largely geriatric communities in various parts of Canada – including the Louis Brier Home and Hospital in Vancouver. With Dr. Ghahary’s expertise brought forth to Brentwood Medical Clinic, Burnaby’s geriatric community is in great hands.

Unlike younger, healthier patients, seniors require a more comprehensive and extensive approach to their medical care. This includes frequent and/or prolonged visits with their physician, routine screening, medication adjustments, and specialist referrals in addition to dealing with their basic medical needs as well as home-care and other daily-living necessities. Common health problems found in seniors range from musculoskeletal problems such as osteoporosis (bone loss), osteoarthritis (inflammation of the joints), gout and fractures. Visual problems such as glaucoma, cataracts and macular degeneration. Cardiovascular problems such as congestive heart failure, atrial fibrillation and high blood pressure. Hormonal changes such as increased cholesterol and slower metabolism. Seniors are also at an increased risk of developing infections like shingles, pneumonia, or urinary tract infections, and other general complaints such as fatigue, decreased appetite, forgetfulness and weight loss.

To ensure optimal health, elderly patients should not only go for regular check-ups with their physician, but also ensure that they are getting enough sleep, include vitamin-rich diets that include calcium and Vitamin D to prevent bone disease, and limit salt intake in order to control blood pressure levels. Eating foods that are higher in antioxidants will also help lessen the risk of vision loss as a result of macular degeneration, and living an overall healthy lifestyle can decrease the risk of developing heart disease by as much as 80%.

Understanding Anxiety

Whether it’s starting a new job, taking care of family matters, or speaking in front of large groups, we all experience anxiety from time to time; and while this kind of anxiety generally does not affect one’s ability to get through their everyday lives, it can be quite debilitating for other individuals and put them at risk of developing further mental illness.

Below is a look at some of the common disorders that are associated with anxiety.

The strong, relentless and troublesome feeling of fear around any given situation, person, object or animal. People who suffer from phobias will go out of their way to avoid potential triggers, lessening their quality of life as a result. Similarly, those with agoraphobia also suffer from the same kinds of fears in addition to feeling as though they are trapped and unable to escape certain situations.

Panic Disorders
What would be considered a normal reaction to an otherwise stressful situation for those who don’t suffer from anxiety would be an extreme reaction for those who do – with symptoms such as the feeling of intense fear, constant worry, rapid heartbeat, sweaty palms, shortness of breath and nausea.

Generalized Anxiety
Those with generalized anxiety are oftentimes still able to function in social settings – however, they will excessively worry over what are considered to be mundane, everyday problems, have difficulty sleeping as well as muscle tension.

Social Anxiety Disorder
Unlike generalized anxiety, those who suffer from social anxiety disorder will avoid social situations whenever possible. They fear being judged by others. Social anxiety can have a severe impact on one’s performance in school or at work, as well as impinge on relationships.

Obsessive-Compulsive Disorder
Commonly referred to as OCD, obsessive-compulsive disorder is an assemblage of unwanted thoughts and urges, and abnormal and repeated actions in effort to diminish anxiety.

Post-Traumatic Stress Disorder
Also known as PTSD, post-traumatic stress disorder is a result of a traumatic life event. Those with PTSD will experience extreme panic, have harrowing flashbacks, and will feel unsafe even when they are not in danger.

Regardless of age, education, income or cultural background, no one is exempt from anxiety or mental illness. At least 20% of Canadian adults will be diagnosed with a mental illness at some point in their lifetime, with 8% of those experiencing major depression. The stats are even more staggering when it comes to children: Up to 20% between the ages of 12 and 19 have already experienced anxiety or a major depressive episode, and as many as 4 million children are currently at risk of developing a mental illness in the future.

Regrettably, at least half of the individuals who say they suffer from mental illness will not see a physician; this is due in part to the stigma that surrounds mental illness and the fear of being discriminated against as a result. However, if left untreated, it can lead to serious and sometimes life-threatening problems, including other mental disorders, so it is important to recognize that with the right support, mental illness can be managed.

At Brentwood Medical Clinic in Burnaby, British Columbia, Dr. Ali Ghahary works in conjecture with patients, clinical psychologists and psychiatrists. While treatment varies from patient to patient, medication is oftentimes used to manage depression and anxiety. However, there are also some other commonly recommended suggestions that have been proven to be beneficial for those suffering from mental illness including CBT (cognitive behavioural therapy) and physical activity.