HealthChoicesFirst Practitioners

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  Mr. Jackson Sayers

  BSc.,

  Kinesiologist

  Vancouver, BC

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  VIDEOBoxx Communication Software

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  Lower Back Pain Caused From Inactivity and Muscle Weakness " Bill is a 37-year-old ad executive who travels a lot on planes "

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  Mr. Jackson Sayers

  , Kinesiologist, at HealthChoicesFirst in Vancouver, BC commented on: Your Optimal Daily FOOD Intake: A straightforward guide to help you.
  
  

  Portion Control and Mindful Eating: Importance: Controlling portion sizes helps manage calorie intake and promotes weight maintenance. Strategies: Be mindful of appropriate serving sizes. Eat balanced meals and avoid overeating. Pay attention to hunger cues and savor each bite slowly. Focus on the eating experience to prevent mindless overeating. Incorporating Exercise: Role in Weight Management: Regular physical activity is crucial for burning calories and supporting weight loss efforts. Benefits: Burns additional calories beyond those reduced from diet alone. Elevates mood and increases energy levels. Reduces the risk of chronic illnesses. Recommended Exercise Guidelines: Aim for 150 minutes per week of moderate-intensity exercise or 75 minutes per week of vigorous activity for weight loss. Include muscle-strengthening activities to boost metabolism and enhance calorie burn. By following these strategies, individuals can create a sustainable approach to weight loss that includes both dietary modifications and regular physical activity. This holistic approach fosters a healthier lifestyle and improves long-term weight management outcomes. Remember to consult with a healthcare professional before starting any new diet or exercise regimen, especially if you have underlying health conditions.

  See the whole conversation: Your Optimal Daily FOOD Intake: A straightforward guide to help you

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  Mr. Jackson Sayers

  , Kinesiologist, at HealthChoicesFirst in Vancouver, BC commented on: Your Optimal Daily FOOD Intake: A straightforward guide to help you.
  
  

  By considering these factors and maintaining a balanced approach to calorie intake, you can support your overall health, energy levels, and weight management goals effectively. Dark chocolate: dark chocolate is rich in antioxidants called flavonoids, which can help protect your skin from damage caused by free radicals and UV radiation, ultimately promoting a more youthful complexion. Avocados are loaded with healthy fats, vitamins and antioxidants that nourish your skin from the inside out. The monounsaturated fats and avocados help keep your skin hydrated and supple, while the antioxidants combat oxidative stress and inflammation, reducing the appearance of wrinkles and fine lines. Olive oil: rich and monounsaturated fats and antioxidants like vitamin E. Olive oil helps protect your skin from damage, improve elasticity and promote a youthful glow for kimchi. They are packed with probiotics and antioxidants that support gut health and promote overall well being. A healthy gut is essential for optimal nutrient absorption and digestion which can contribute to radiant skin and a youthful appearance. Carrots: carrots are rich in beta carotene, a precursor to vitamin A, which is essential for healthy skin. Beta carotene helps protect your skin from sun damage, reduce inflammation and promote collagen production resulting in firmer, smoother skin with fewer wrinkles.

  See the whole conversation: Your Optimal Daily FOOD Intake: A straightforward guide to help you

• 

  Dr. John Wade

  MD, FRCPC

  Rheumatologist

  Vancouver, BC

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  Understanding and Diagnosing Pseudogout

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  Diagnosis and Treatment of Gout " George is a 46-year-old plumber with pain and swelling in his big toe"

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  Dr. John Wade

  , Rheumatologist, at HealthChoicesFirst in Vancouver, BC commented on: Why Am I So Tired? : Hypothyroidism.
  
  

  hypothyroidism can present with a wide range of symptoms, many of which can significantly impact an individual's quality of life. The most common symptoms, as you mentioned, include fatigue, sensitivity to cold, weight gain, hair loss, dry skin, and constipation. Additionally, changes in menstrual cycles for women and difficulties with erectile function for men can occur. One of the challenging aspects of hypothyroidism is its potential to mimic depression. The psychological and psychiatric changes associated with hypothyroidism can include a lack of motivation, depressive mood, and overall feeling of low energy. Distinguishing between mild depression and hypothyroidism can be difficult for both patients and physicians, as the symptoms can overlap. Therefore, thorough evaluation and testing are essential for an accurate diagnosis and appropriate treatment.

  See the whole conversation: Why Am I So Tired? : Hypothyroidism

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  Dr. John Wade

  , Rheumatologist, at HealthChoicesFirst in Vancouver, BC commented on: Diagnosing and Managing Raynaud's Disease " Shelley is a 21-year-old woman ".
  
  

  We make vitamin D in our skin. So, if you have sun exposure on your skin you will make vitamin D. Experts have suggested that 10 to 30 minutes of sunshine, a day should make enough vitamin D on a daily basis and vitamin D is a fat-soluble vitamin so you can store it up over a period of time.

  See the whole conversation: Diagnosing and Managing Raynaud's Disease " Shelley is a 21-year-old woman "

• 

  Dr. Graham Wong

  MPH, FRCPC

  Cardiologist

  Vancouver, BC

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  The Heart Health Benefits of Tomatoes

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  How a Pacemaker Treats an Irregular Heartbeat " Shirley a 75-year-old previously healthy woman"

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  Dr. Graham Wong

  , Cardiologist, at HealthChoicesFirst in Vancouver, BC commented on: How a Pacemaker Treats an Irregular Heartbeat " Shirley a 75-year-old previously healthy woman".
  
  

  After a heart attack, making healthy lifestyle choices is crucial in addition to medical treatment. These lifestyle changes have both direct and indirect effects on the heart. A significant study showed that nine modifiable risk factors can predict around 90 percent of all heart attacks, and these factors can be positively influenced by adopting a healthier lifestyle. The modifiable risk factors that can be addressed through lifestyle changes include: Smoking: Quitting smoking is one of the most important steps in reducing the risk of heart attacks. High cholesterol: Following a heart-healthy diet low in saturated and trans fats, as well as maintaining a healthy weight, can help manage cholesterol levels. High blood pressure: Regular exercise, reducing sodium intake, adopting a healthy diet, limiting alcohol consumption, and managing stress are all effective in controlling blood pressure. Diabetes: Managing blood sugar levels through a balanced diet, regular exercise, and appropriate medication or insulin use is essential for individuals with diabetes. Fruit and vegetable intake: Consuming a diet rich in fruits and vegetables provides essential vitamins, minerals, and antioxidants that promote heart health. Truncal obesity: Maintaining a healthy weight, particularly around the waist, is beneficial for heart health. Regular exercise and a balanced diet can help achieve and maintain a healthy weight. Physical inactivity: Engaging in regular physical activity, such as aerobic exercises, can improve cardiovascular fitness and reduce the risk of heart attacks. High levels of psychosocial stress: Managing stress through relaxation techniques, counseling, and social support can help reduce the risk of heart problems. Moderate alcohol intake: If alcohol is consumed, it should be done in moderation, as excessive alcohol consumption can have detrimental effects on heart health. These lifestyle changes work synergistically with any prescribed medications from healthcare providers following a heart attack. Adopting a heart-healthy diet, engaging in regular exercise, and employing stress reduction techniques are crucial components of post-heart attack care and can significantly improve long-term outcomes and reduce the risk of future cardiovascular events. It is important to work closely with healthcare professionals to develop an individualized plan that addresses these lifestyle factors.

  See the whole conversation: How a Pacemaker Treats an Irregular Heartbeat " Shirley a 75-year-old previously healthy woman"

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  Dr. Graham Wong

  , Cardiologist, at HealthChoicesFirst in Vancouver, BC commented on: What is a Heart Attack? " Patrick a 70-year-old diabetic man with a 2-year history of stable chest pain".
  
  

  A myocardial infarction, commonly known as a heart attack, is an acute event that occurs as a result of a chronic condition called atherosclerotic heart disease. During a heart attack, there is a blockage in the blood flow to the heart muscle, leading to the death of heart muscle tissue. The primary treatment for heart attacks involves the use of blood-thinning drugs, with aspirin being the most commonly prescribed. In certain cases, additional blood-thinning medications may be used alongside aspirin. One such medication is clopidogrel, also known as Plavix, and there are newer drugs available, such as prasugrel (Effient) and ticagrelor (Brilinta), that show promise in enhancing the efficacy of clopidogrel. It is important to note that all medications can have side effects, although their prevalence may vary. When it comes to blood-thinning drugs, including clopidogrel, aspirin, prasugrel, and ticagrelor, the most common side effect is bleeding. This can manifest as easy bruising or prolonged bleeding from minor cuts or injuries. Severe bleeding, such as gastrointestinal bleeding or bleeding in the head or eyes, is very rare and not typically associated with these medications. While bleeding can be bothersome and inconvenient, it is rarely life-threatening. However, it is important for individuals taking these medications to exercise caution to prevent accidents or injuries that could lead to bleeding. Another class of medications commonly used in heart attack treatment is ACE inhibitors. The most common side effect of ACE inhibitors is a dry, persistent cough. While this side effect can be irritating, it is not considered dangerous. If patients find the cough intolerable, alternatives can be explored. A rare but more concerning side effect of ACE inhibitors is angioedema, an allergic reaction characterized by pronounced swelling, particularly around the airways, which can cause difficulty in breathing. Although angioedema is uncommon, if breathing difficulties occur while taking an ACE inhibitor, it is crucial to seek immediate medical attention as it can be a medical emergency. While the aforementioned side effects are the more common ones associated with these medications, there may be idiosyncratic or rare reactions that are not as prevalent. If you suspect you are experiencing a side effect from a particular drug, it is recommended to consult your physician or pharmacist promptly. Since each individual's medical conditions and biology are unique, medication choices may vary for different individuals. If you have any concerns or issues related to medication, it is best to consult your own healthcare provider for personalized guidance.

  See the whole conversation: What is a Heart Attack? " Patrick a 70-year-old diabetic man with a 2-year history of stable chest pain"

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  Mr. Colin Holyk

  BSc (Pharm)

  Pharmacist

  Vancouver, BC

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  Asthma and COPD Treatment With Inhalers

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  Mr. Colin Holyk

  , Pharmacist, at HealthChoicesFirst in Vancouver, BC commented on: Osteoporosis Treatment.
  
  

  It's important if you have any questions or any concerns that you make an appointment to speak to your physician or your local expert, so once again make an appointment and speak to your physician.

  See the whole conversation: Osteoporosis Treatment

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  Mr. Colin Holyk

  , Pharmacist, at HealthChoicesFirst in Vancouver, BC commented on: Osteoporosis Treatment.
  
  

  It's important if you have any questions or any concerns that you make an appointment to speak to your physician or your local expert, so once again make an appointment and speak to your physician.

  See the whole conversation: Osteoporosis Treatment

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  Dr. Bertrand Perey

  MD, FSRC

  Orthopaedic Surgeon

  New Westminster, BC

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  What causes trigger finger

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  Carpal Tunnel Syndrome " Sheila a 52-year-old woman visits her family doctor "

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  Dr. Bertrand Perey

  , Orthopaedic Surgeon, at HealthChoicesFirst in New Westminster, BC commented on: Patellofemoral Syndrome - Knee Pain " Brooke is a 15-year-old female volleyball player ".
  
  

  The unhappy triad is a significant knee injury that often occurs in contact sports or motor vehicle accidents. It involves a force applied to the knee, resulting in simultaneous damage to three key structures: the medial collateral ligament (MCL), the medial and lateral meniscus, and the anterior cruciate ligament (ACL). To illustrate the injury, imagine this knee model. The front of the kneecap is here, the outside of the knee is on this side, and the inside of the knee is here. Symptoms of the unhappy triad may include hearing a popping sound at the time of the injury, intense pain, and swelling. There might be difficulty straightening or bending the leg, and the knee may feel unstable. A torn meniscus can cause sensations of catching or locking in the knee while walking, and putting weight on the knee can be challenging, especially when standing up from a seated position. Treatment for the unhappy triad often involves surgical intervention, particularly for the ACL and the meniscus. The MCL may be managed with non-operative treatment in some cases. Regardless of the treatment approach, a comprehensive rehabilitation process with physical therapy is crucial. Physical therapy focuses on controlling pain and swelling immediately after the injury, as well as regaining range of motion and facilitating proper tissue healing. Knee braces may be prescribed to aid in daily activities and support the rehabilitation process, helping to increase strength, range of motion, and overall function for a quicker return to normal activities. If you suspect that you have a knee injury resembling the unhappy triad, it is essential to consult with your physician or physiotherapist for a proper diagnosis and appropriate treatment plan. Early intervention and proper rehabilitation are vital to optimize recovery and get you back to work or sports activities as soon as possible.

  See the whole conversation: Patellofemoral Syndrome - Knee Pain " Brooke is a 15-year-old female volleyball player "

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  Dr. Bertrand Perey

  , Orthopaedic Surgeon, at HealthChoicesFirst in New Westminster, BC commented on: Living With and Treating Thumb Arthritis " Anna a 59-year-old woman with pain at the base of her right thumb ".
  
  

  Carpal Tunnel Syndrome (CTS) is a condition that may worsen over time if left untreated. As people age, the flexor tendons in the wrist can naturally increase in size, putting more pressure on the median nerve in the carpal tunnel. Non-surgical treatments can help slow down the progression of symptoms, but they may not completely stop it. Using a brace or splint at night to keep the wrist in a neutral position can reduce pressure on the nerve. Wearing a splint during the daytime can also be beneficial to avoid extreme wrist positions. Modifying job or recreational activities that may contribute to CTS can also help slow down the condition. Anti-inflammatory medications and cortisone injections may offer temporary relief from pain and inflammation associated with CTS, but they rarely lead to a permanent resolution of symptoms. If symptoms of CTS occur on a daily basis and non-surgical treatments have failed, surgery may be recommended. Ideally, surgery should be performed before constant numbness occurs in the hands, as this may indicate permanent nerve damage. The surgical procedure for CTS is called a Carpal Tunnel Release. It involves cutting the transverse retinacular ligament to release the pressure within the carpal tunnel. The procedure is typically performed under local anesthesia and takes less than 15 minutes. Most patients do not require narcotic pain medication after surgery, and the wound is usually closed with sutures. Recovery from surgery involves avoiding soaking the wound and engaging in light washing for the first 10 to 14 days. Patients are encouraged to move their fingers actively to reduce swelling and prevent stiffness. Most patients can resume light activities within 3 weeks and heavier activities within 6 weeks. The surgical site may remain tender for several months, and deep massage is recommended after 2 weeks to accelerate scar softening. Grip and pinch strength usually return within 3 to 6 months after surgery, and intermittent symptoms of numbness typically resolve rapidly. However, if constant numbness was present before surgery, it may not completely resolve over time. Infection at the surgical site is a possible complication, but it can be treated with oral antibiotics if detected early. Any concerns should be discussed with the surgeon or a healthcare provider promptly.

  See the whole conversation: Living With and Treating Thumb Arthritis " Anna a 59-year-old woman with pain at the base of her right thumb "

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  Dr. Jordan Leith

  MD, MHSc, FRCSC

  Orthopaedic Surgeon

  Vancouver, BC

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  MCL (Medial Collateral Ligament) knee injuries.

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  A Rotator Cuff Injury from Snowboarding " Tom a 25-year-old right hand dominant snowboarder "

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  Dr. Jordan Leith

  , Orthopaedic Surgeon, at HealthChoicesFirst in Vancouver, BC commented on: Osteoporosis Treatment.
  
  

  Weight bearing exercises strengthen the muscle that support the joints are crucial in the treatment of osteoporosis.

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  Dr. Jordan Leith

  , Orthopaedic Surgeon, at HealthChoicesFirst in Vancouver, BC commented on: Osteoporosis Treatment.
  
  

  Mary would definitely benefit from seeing a Nutritionist like Lisa to help her with proper eating and getting her weight slightly down to help her joints. Being even little over weight does not help in situations where the treatment of osteoporosis is having to deal with multiple things at once.

  See the whole conversation: Osteoporosis Treatment

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  Dr. Alan Low

  BSC (Pharm), PharmD, ACPR, FCSHP, CCD, RPh

  Pharmacist

  Vancouver, BC

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  Chicken Pox and Its Link To Shingles " Monica 51-years-old a new grandmother "

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  Dr. Alan Low

  , Pharmacist, at HealthChoicesFirst in Vancouver, BC commented on: Osteoporosis Treatment.
  
  

  If we are looking at what's happening in our population, in Canada, 1 in 3 women will suffer an osteoporotic fracture in their lifetime and it is only a little less in men at 1 in 5. Those who survive a hip fracture, 17% will go to a long-term care facility because they cannot return to living at home. The best thing to do is to discuss with your healthcare provider and identify your risk of fracture. If it is deemed to be high, you should take actions to reduce your risk, this may include ensuring an adequate calcium intake, vitamin D, regular weight-bearing exercise, and in higher risk situations or if you have had an osteoporotic fracture already, to begin prescription medications which help to preserve and strengthen bone to reduce the fracture risk.

  See the whole conversation: Osteoporosis Treatment

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  Dr. Alan Low

  , Pharmacist, at HealthChoicesFirst in Vancouver, BC commented on: Chicken Pox and Its Link To Shingles " Monica 51-years-old a new grandmother ".
  
  

  About 90% of people born before 1995 have had chicken pox, and about one-third of these people develop shingles when they are older, generally at ages over 50. Although there has been a shingles vaccine available for many years, the uptake of the vaccine has been low in those who need it, around 30% received the vaccine (depending on what area is being measured). A new vaccine was introduced earlier this year which showed a very high effectiveness rate in clinical trials. The new vaccine, called Shingrix, in a study evaluating over 15,000 subjects who were aged 50 and up, found the vaccine reduced the number of people developing shingles from about 91 people per 10,000 to 6 people per 10,000 which is over a 90% reduction in the incidence of shingles. Those over 50 may want to speak with their healthcare professional about being vaccinated against shingles and discuss the benefits and risks of the new vaccine. Your pharmacist, in most jurisdictions, can provide not only information, but also the injection without the need for a prescription from your physician. If you have health insurance benefits which may cover the vaccine, you may require a prescription.

  See the whole conversation: Chicken Pox and Its Link To Shingles " Monica 51-years-old a new grandmother "

• 

  Dr. David Maberley

  MD, FRCS(C), MSc

  Ophthalmologist

  Ottawa, ON

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  Understanding Geographic Atrophy

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  Age-Related Macular Degeneration? " Betty a 75-year-old female with sudden onset of central vision loss in her right eye "

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  Dr. David Maberley

  , Ophthalmologist, at HealthChoicesFirst in Ottawa, ON commented on: Eye Health and Night Vision Problems - " Stephanie is a 35-year-old figure skating coach".
  
  

  Macular degeneration is primarily a genetic disease, and this understanding has emerged more prominently in the past decade or two. Many cases of macular degeneration are believed to have a genetic predisposition that is determined at birth, so there may be limited control over its development. However, certain behavioral factors like smoking and exposure to sunlight or UV rays may modify the genes associated with macular degeneration, potentially increasing the risk for specific types of gene problems. If you have a strong family history of macular degeneration and wish to know more about your genetic risk factors, there are tests available for assessing these factors. To assess macular degeneration, you will need to visit an ophthalmologist for an examination, which typically involves dilating your pupils with drops. It is advisable to have someone accompany you to drive you home afterward, and wearing sunglasses can help with comfort following the examination. During the examination, your ophthalmologist will carefully examine your eyes, looking for any changes, hemorrhaging, or other signs related to macular degeneration. Based on the findings, additional tests may be conducted to confirm the diagnosis. The most common and traditional test is a fluorescein angiogram, which involves injecting a dye into your arm and taking photographs of your eye to assess blood flow and examine the back of the eye in detail. This test may be supplemented by an optical coherence tomograph, which provides laser images of the layers in the back of the eye, offering additional information. Another test called auto-fluorescence uses a bright blue flash of light to evaluate the health of the pigment layers beneath the retina. This test aids in diagnosing the dry form of macular degeneration and monitoring its progression. After the assessment and initial examination, your physician will have a good sense of whether further testing is necessary. In many cases, the testing can be performed and interpreted on the same day, and treatment may also be initiated on the same day, depending on the logistics of the clinic. The diagnosis and treatment processes for macular degeneration can often be bundled together to provide timely and comprehensive care. If you have additional questions or concerns about macular degeneration, it is recommended to consult with your family physician. If they are unable to address all your inquiries, an ophthalmologist will be able to provide further information and guidance.

  See the whole conversation: Eye Health and Night Vision Problems - " Stephanie is a 35-year-old figure skating coach"

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  Dr. David Maberley

  , Ophthalmologist, at HealthChoicesFirst in Ottawa, ON commented on: Diagnosing Diabetic Retinopathy.
  
  

  Laser treatment is a conventional approach used for diabetic retinopathy for various reasons. The laser treatment is typically performed around the edges of the eye. During the procedure, you will be seated at a slit lamp, which is similar to the machine used during regular eye examinations. To begin, anesthetic eye drops will be administered, followed by the placement of a contact lens on the eye. This contact lens helps control blinking and directs the laser treatment. It allows the doctor to examine the inside of the eye. Within the eye, the doctor will apply controlled and fine laser spots, measured in sizes of 100, 200, or 300 microns, for a brief duration. These laser spots appear as flashes of light entering the eye. The main discomfort reported by patients is the brightness of the light, but the light itself is not damaging. The laser creates small cauterizations or burns in the areas of the retina that are not functioning well. This laser treatment can be compared to pruning a tree, where unwanted branches are removed to help the rest of the tree thrive. Similarly, the laser is applied to areas of the retina that are not functioning properly to promote the survival and health of the remaining retina. Another type of laser treatment, known as focal laser, focuses on areas closer to the center of vision. The procedure is similar to the laser treatment described above, with the administration of anesthetic eye drops, placement of a contact lens, and flashes of light. However, in focal laser treatment, there are fewer laser spots applied, and they are done more gently to address specific issues such as controlling leakage that causes vision loss. While laser treatment has been a common approach, injections have become a preferred alternative, especially for the central part of vision. However, there may be cases where laser treatment is necessary in addition to injections or when injections are not available. For more detailed information about laser treatment for diabetic retinopathy, it is best to consult with your eye doctor. They will provide you with specific information about the procedure, its benefits, and any potential risks or considerations based on your individual situation.

  See the whole conversation: Diagnosing Diabetic Retinopathy