STIs rates in Canada are rising — decline in condom use may be to blame – National

17Jul

STIs rates in Canada are rising — decline in condom use may be to blame – National

by BBG Hub


With the recent news of STI outbreaks in Alberta, experts are wondering if a decline in condom use may be to blame.

Nathan Lachowsky, an assistant professor at the University of Victoria, told Global News we need more sexual health research in Canada in general to explain trends like this one.

“A lot is changing about the ways that Canadians are having sex, but we don’t why as we don’t have nationally representative surveys like many other nations,” he said.

Lachowsky presented findings on condom use practices, focusing on gay men, at the STI & HIV World Congress in Vancouver this week.

READ MORE: Syphilis outbreak declared in Alberta amid ‘rapid increase’ in cases

Lachowsky said rates of some sexually transmitted infections continue to increase across the country, and this is partly due to people using condoms less.

The importance of sex ed

He added that much of this comes down to a lack of sex education.

“We can absolutely improve the quality and depth of sex education in schools, which requires both stronger curriculum and implementation,” he explained. “Youth should be learning about condoms and practise how to use them before they are in the moments of having sex with someone else for the first time.”

He said that as a society, we also need to remove the stigma related to STIs.

“That is what shuts down conversations within schools, within families, and between partners,” he said. “How much more pleasurable would sex be if you weren’t concerned about getting an STI?”

Samantha Bitty, a Toronto-based sexual health and consent educator, added that sex education also has to be inclusive.

“If the types of sex you’re having isn’t represented in the sex education you receive, you’re less likely to feel empowered to suggest safer sex methods.”

But Lyba Spring, a retired sexual health educator based in Toronto, said education is only one factor.

READ MORE: HIV and syphilis outbreaks declared in northwest Saskatchewan

“Even though there are guidelines for sexual health education, it is unevenly applied throughout the country,” she told Global News. “Young heterosexuals may indeed rely on methods of birth control other than condoms, but there are also other factors which may impede their condom use.

“Negotiating safer sex requires not only an ability to communicate but also a feeling of self-worth.”

Spring added that older Canadians who did not have the benefit of sex ed may not be aware of the risks of STIs in general.

“Canadian seniors for whom pregnancy was once an issue would not necessarily think about STI prevention because they may have been in a long-term relationship before losing their partner to death or divorce,” she added. “They may believe their new partner did not have more than one partner in the past.”

Men who have sex with men may also be at risk without proper sex education of STIs, Spring said.

“Men having sex with men who are at low risk for HIV transmission because they are HIV positive but using medication that keeps their levels undetectable, or men who are using [HIV prevention drug] PrEP may ignore the risk from other STIs aside from HIV.”

Embarrassment buying condoms

For some, there can be a feeling of anxiety or shame when it comes to buying condoms.

“Anyone who is buying condoms and lube should feel great about making sexually healthy choices,” Lachowsky said. “As public health, we should also be making condoms, lubricant and other prevention strategies readily available and easily accessible for everyone.”

READ MORE: 1 million people a day catch sexually transmitted infections, WHO warns

Spring added that where you live may also be a factor.

“It is not clear how easy or difficult it is to obtain/buy condoms in rural or remote areas,” she explained. “Moreover, there can be an embarrassment factor, especially if one is in a smaller town.”

Communication is critical

When it comes down to it, all three experts agree communication between partners or partners is key.

“It’s hard to talk about the kinds of sex you want to have and how to prevent passing an STI, but we need to start practising,” Lachowsky said. “Practice makes perfect. Getting tested for STIs regularly is also a critical part of being a sexually responsible and healthy adult.”

The majority of STIs do not have any symptoms, he said, which is why we should not rely on our own self-assessment.

READ MORE: Canadian youth need access to free contraceptives, Canadian Paediatric Society says

Bitty said these conversations also include talking about pleasure, power dynamics, stigmas around STIs and even shame when it comes to condom use.

Spring agreed and added that people shouldn’t be afraid to ask questions.

“[For example,] ‘After we both get tested for the usual suspects (HIV, chlamydia, gonorrhea, syphilis) what are you comfortable doing without barrier protection?’ or ‘If you have a history of cold sores, I need to know so we can talk about transmission through oral sex.’”

[email protected]

© 2019 Global News, a division of Corus Entertainment Inc.




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17Jul

‘Incredibly concerning’: More U.S. teens are trying to lose weight – National

by BBG Hub

Despite growing awareness around body positivity, new research has found more American teenagers are dieting today than in the past — especially young women.

From 2013 to 2016, nearly 38 per cent of adolescents between the ages of 16 and 19 said they had tried to lose weight during the past year, according to new data from the U.S. Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics.

This number is up from previous years, as around 24 per cent of U.S. adolescents attempted to lose weight between 2009 and 2010.

The CDC found almost half of adolescent girls tried to lose weight compared to almost one-third of boys. For both boys and girls, a higher percentage of Hispanic teenagers tried to lose weight compared to other groups, the centre wrote.

READ MORE: Coping with ‘beach body’ season when you have an eating disorder

The data found that among those who tried to lose weight, the most common ways were through exercise (83.5 per cent), drinking a lot of water (52 per cent) and eating less (nearly 49 per cent). Over 82 per cent of teens said they tried to lose weight using two or more methods.

The recent U.S. data is not surprising to Amanda Raffoul, a PhD candidate in the School of Public Health and Health Systems at the University of Waterloo who researches disordered eating and dieting, largely in adolescents.

Raffoul says there’s reason to believe more Canadian teens are trying to lose weight, too. She says unlike the U.S., Canada does not have consistent weight-loss data for youth.

READ MORE: Men suffer from eating disorders, too — so why do we ignore them?

“A lot of us working in the area have assumed that rates of dieting have gone up, but without consistent data sources, we can’t necessarily track those changes over time as well,” she said. “Seeing results like this sort of confirms our beliefs [in Canada] — but it’s still incredibly concerning.”

Why more youth are trying to lose weight

Raffoul says teens and children are particularly vulnerable to weight-loss messaging in society. As children grow into adolescents, they internalize any pressures from family, friends and the media. This can lead to unhealthy weight-loss behaviours.

“Combine that with the fact that there’s a growing emphasis on health and wellness that proliferates across social media and popular messaging, and [youth] are constantly engaged,” Raffoul said.

WATCH: Eating more plant-based food





Things like weight-loss tea and waist trainers — products often endorsed by celebrities and influencers on Instagram — affect the adolescents that see them. Raffoul says products like these promise “easy and simple weight loss,” which is enticing to young adults.

“When you’re a teenager or child who’s under a lot of pressure to look a certain way and [see] something that’s a promised ‘easy solution,’ that makes you more inclined to want to engage in that,” she explained. “Even though we know that weight is incredibly complex and not something that simple.”

Dieting in youth can affect people into adulthood

As the CDC report found, Raffoul says young women are more likely to engage in weight-loss behaviour or dieting than young men.

A recent report that Raffoul co-authored found women and non-binary individuals had a higher risk of engaging in more weight‐loss behaviours, many of which were unhealthy or dangerous. (It’s important to note than men and adolescents are affected by eating disorders and dieting, too.)

READ MORE: Calorie-tracking apps can help with weight loss, but aren’t perfect, experts say

Developing unhealthy dieting behaviours as an adolescent puts people at a greater risk of having disordered eating habits as an adult, Raffoul says. This is particularly true for women.

“Eating disorders are obviously very complex and have a lot of factors that contribute to them,” Raffoul said. “But dieting at a young age is a pretty major risk factor.”

How to have healthy conversations around weight

To combat the risk of developing an eating disorder or disordered relationship with food, Raffoul says it’s important for youth to see messages that promote health — not weight loss.

Educating children and teens on the importance of regular exercise and a balanced diet is necessary, but the focus around these topics should never be on weight loss.

WATCH: Healthy Living Report — Disordered eating and weight loss





“If we continuously focus on needing to lose weight as an indicator of health, then people will do whatever they can, or feel like they need to do, to lose that weight without focusing on not only their physical health but also their mental health and social well-being,” she said.

[email protected]

© 2019 Global News, a division of Corus Entertainment Inc.




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16Jul

Anorexia may not only be psychiatric, it could be genetic: study – National

by BBG Hub

Anorexia nervosa — an eating disorder characterized by a fear of gaining weight and other life-threatening symptoms — has previously been understood as a psychiatric illness, but that may not be the whole story.

A new study published in Nature Genetics found that problems with metabolism may also be to blame.

Researchers at King’s College London and the University of North Carolina at Chapel Hill worked together to compare the DNA of nearly 17,000 people with anorexia. They found multiple genes which linked those with anorexia to DNA involved with burning fat and being physically active.

READ MORE: Men suffer from eating disorders, too — so why do we ignore them?

More research is needed, but if this is the case, then Dr. Cynthia Bulik believes both the diagnosis and treatment of anorexia nervosa will need an upgrade. She’s one of the lead researchers on this study and the founding director of the University of Northern Carolina Center of Excellence for Eating Disorders.

Bulik uses the example of hyperactivity — a common side effect of anorexia — to illustrate her point.

“We’ve been psychologizing that symptom forever, saying that [anorexia patients] have a drive for thinness or they’re trying to work off the calories,” she said. “And while that might be true, [this data shows us] that they might be genetically prone to high physical activity, as well.”

READ MORE: Coping with ‘beach body’ season when you have an eating disorder

If this is true and researchers are able to pin down biological causes of anorexia, it may be possible to include medication in the treatment plan.

“We’re going to have to get more samples first to get even more confident in these findings… but then, what we hope is that we can engage our psychologist, neuroscientist and pharmacogenetic friends to start figuring out how we can target those pathways and potentially develop medication,” said Bulik.

Currently, there is no medication proven to work in the treatment of anorexia nervosa. “Right now, it’s all re-nourishment and psychotherapy,” she said. “Our patients deserve the next generation of treatments.”

WATCH BELOW: Signs of an eating disorder (that are not obvious)





Researchers also found eight genes which linked anorexia to anxiety, depression and obsessive-compulsive disorder (OCD) — which came as no surprise.

“[The study found that] there’s a high positive genetic correlation between anorexia and other psychiatric disorders, and that’s no surprise because… that’s what we see in the clinic,” said Bulik.

“We see anorexia and OCD go hand-in-hand so often… this is genetic confirmation that what we see in treatment is actually based in biology.”

The difference between a psychiatric and physical illness

For many years, anorexia nervosa was understood to be “some sort of choice” or a “socio-cultural phenomenon,” said Bulik. “Actually, being codified as an illness (even a psychiatric one) is really important.”

READ MORE: Women with celiac disease more likely to develop eating disorder: study

However, the data from this study suggest that the long-time classification of anorexia as a psychiatric disorder still misses a key part of the illness: the biology.

“It’s sort of a false distinction that there’s one set of disorders that happen above the neck and another set that happen below the neck,” she said. “We actually need to stop thinking about things this way because… they’re so interconnected, we can’t pull them apart.”

Dr. Michele Laliberte is cautiously optimistic about this data. She’s the clinical lead of the St. Joseph’s Hospital eating disorders program.

WATCH BELOW: New Canada Food Guide a living document to healthy eating





“Maybe this can help us explain why for some patients, it’s very difficult to help some people weight restore or why it seems like some people go right back to a lower weight,” she said, but she emphasized that more research is needed.

“Metabolic reasons are not going to be the whole explanation for everyone,” she said.

“A person who has anorexia who has just weight-restored are also experiencing a tremendous amount of anxiety at that time and they make actual behavioural changes to their eating which leads them to lose weight… the idea that that’s all explained at the metabolic level doesn’t make sense, either.”

The signs and symptoms of anorexia

According to the Canadian Mental Health Association (CMHA), between 0.5 and four per cent of people in Canada have anorexia nervosa; 90 per cent are women.

It most often affects young people, typically beginning during teenage or young adult years, and it runs in families.

READ MORE: Experts say sharing weight-loss resolutions online can be harmful to those with eating disorders

People who diet and people with body-focused careers (like models, dancers and athletes) are also at a higher risk for developing anorexia.

The most common sign of the disorder is dangerously low body weight, but additional symptoms are often present and are different from person to person.

“[There’s often] an intriguing lack of recognition of the seriousness of their low body weight,” said Bulik.

WATCH BELOW: Your weight affects your cancer risk





People with anorexia may also feel overweight regardless of their actual weight.

An extremely low body weight can cause heart and kidney problems, low blood iron, bone loss, digestive problems and more.

Treatment for anorexia nervosa typically involves some kind of counselling (most commonly, cognitive behavioural therapy). The CMHA also recommends support groups as a good way to share experiences and recovery strategies with other anorexia patients.

Patients are also often referred to nutritional therapy, where they work with a dietitian or a nutritionist to learn healthy eating habits.

If you or someone you know is in crisis and needs help, resources are available. In case of an emergency, please call 911 for immediate help.

The Canadian Association for Suicide Prevention, Depression Hurts and Kids Help Phone 1-800-668-6868 all offer ways of getting help if you, or someone you know, may be suffering from mental health issues.

[email protected]

© 2019 Global News, a division of Corus Entertainment Inc.




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16Jul

Bottled, filtered or tap: Is one water better than the other? – National

by BBG Hub

When it comes to options for safe drinking water, experts say Canadians are often confused.

Some people still hold the belief that tap water in particular isn’t safe to drink, while others believe bottled water is so-called “healthier” than tap or filtered water.

Ronald Gehr, an associate professor at the civil engineering department at McGill University in Montreal, told Global News there’s plenty of misinformation out there about bottled, filtered and tap water.


READ MORE:
Water quality concerns spur state of emergency in Attawapiskat

“There’s a lot of confusion [and] suspicion,” he explained. “It’s too bad because first of all, people are paying for tap water even if they don’t drink it.”

He said sometimes it comes down to taste (people just prefer filtered water vs. tap water), but other times, companies have convinced consumers that their bottled versions of water are supposedly better for you.

According to Health Canada, drinking water in the country comes from either underground sources or lakes and rivers.

“Most Canadians get their drinking water from public water systems that have to meet quality requirements set by provincial and territorial governments. In rural and remote areas, people may get their drinking water from wells or from surface water sources located on their own private property and are individually responsible for the safety of the drinking water,” the site noted.

The Guidelines for Canadian Drinking Water Quality is set by Health Canada, along with the Federal-Provincial-Territorial Committee on Drinking Water.

The differences

Tap water: Tap water is produced by a municipality, city or town, Gehr said, typically through a water treatment plant.

“Tap water is subject to a large number of standards that are set by the province,” he said. “These standards basically follow federal guidelines. [Tap water] has gone through very thorough treatment and very thorough quality control.”

Gehr said this includes disinfection.


READ MORE:
Hedley residents told not to drink local tap water

The addition of fluoride to tap water also continues to be a debate, Gehr added. Montreal, for example, does not include fluoride in their tap water, but Toronto does.

“Despite fluoride being introduced into Canadian communities over 60 years ago, the national average still currently sits at less than 50 per cent. Clearly water fluoridation is not without its detractors, and over the years, the principal arguments for and against water fluoridation have changed very little,” a 2009 report from the Canadian Dental Association noted.

Filtered water: Filtered water takes tap water and processes it through a filtration system at home. This could be through the tap directly or a water filtration system like Brita.

“Generally people use filtered water because they are either suspicious of the health of tap water or because they don’t like the taste of tap water,” Gehr said.

While some believe filter water will improve health, this is not the case, he said. U.S. researchers in the past have said tap water was just as good as bottled water or filtered water when it came to health, NPR reported.

Water filtration systems often trap low concentrations of carbon and other chemicals not removed by treatment plants.

One thing filter water users need to be mindful for is switching out their filters in their pitchers. According to Healthline, make sure you follow the manufacturers’ recommendations or the filtration process actually won’t work.

“Filters that are not changed at the proper time may not work to reduce the contaminants that they were originally designed to address. If it’s not filtered out, that contaminant might result in potentially harmful health effects,” Rick Andrew, director of the NSF International Global Water program, told the site.

Chlorine is another sticking point for some. Health Canada added that chlorine acts as a disinfectant and is added to drinking water “to reduce or eliminate microorganisms, such as bacteria and viruses, which can be present in water supplies.” Adding chlorine (and again, this is a safe amount) will reduce the risk of waterborne diseases.

“The reason why chlorine is in the water is to provide an extra disinfection barrier so it’s safe for our people to drink,” Gehr said.

Bottled water: Companies that create bottled water technically do not follow federal, provincial or municipal guidelines, but as product-makers, most ensure their product is high-quality, Gehr said.

“There are different kids of bottled water,” he continued. “Some bottled water is made from tap water [while] others use spring water,” adding some companies use lake or river water as well.

Bottled water also goes through a purification process. This includes disinfecting the water and sometimes adding minerals. Time.com noted some popular bottled water brands like Dasani, SmartWater and Nestle Pure Life include everything from magnesium sulfate to calcium chloride to salt.

Clean water access

But not all people living in Canada have access to safe drinking water. On Tuesday, A First Nation in northern Ontario declared a state of emergency over its water supply.

The chief of Eabametoong First Nation added tests of water quality showed high levels of chemicals that are byproducts of treatment materials like chlorine interacting with naturally occurring compounds.

WATCH: Should Calgary bring fluoridated water back?





The community continues to be on a boil water advisory for almost two decades. The Council of Canadians added there are more than 100 drinking water advisories in First Nations across the country. 

Bottled water and the plastic problem

Another concern is around bottled water and waste. Sylvia Struck, an adjunct professor with the School of Population and Public Health at the University of British Columbia, told Global News Canadians should consider using tap over bottled water.

“I would advocate for people to consume water from the tap if safe to do so over bottled water due to the additional plastic/container waste produced and the cost incurred,” she said over e-mail.

Last month, Prime Minister Justin Trudeau announced Canada was looking into a ban of single-use plastics by 2021. 


READ MORE:
Whistler launches new campaign telling hotel guests to drink tap water

Gehr added in some cases, bottled water is often more convenient for people on the go — travelling or camping, for example. But he, too, added Canadians need to be aware the cost and resources it takes to bottle water.

“Bottles have to be cleaned, filled, add a label, transported to the store… then people bring it home and dispose it,” he said. “All of this is a tremendous waste of resources, energy and water. Even the water itself is used to clean the bottles.

“I really can’t see this need for society to have huge quantities of bottled water.”

— with files from The Canadian Press

[email protected]

 

© 2019 Global News, a division of Corus Entertainment Inc.




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16Jul

Your kid just caught you having sex — now what? – National

by BBG Hub

Having ‘the talk’ with your kids can be awkward for them, but having them walk in on you in the middle of sex can be, well, very uncomfortable.

“I think a lot depends on what exactly the child sees, along with their age,” said Sara Dimerman, a Toronto-based registered psychologist and parenting expert.

If a child is three or four years old and sees some movement under the covers, Dimerman says they may not realize their parents are being intimate. When it comes to an older child or teen, however, things can get tricky.

WATCH BELOW: Parenting with patience





“If the parents are fully exposed and their bodies are contorted in a way that is foreign for the child to see, and [he or] she is around the age of 11, then it may be upsetting, or even embarrassing,” Dimerman told Global News.

“Around the age of 16… [a child] might find it more ‘gross’ or disgusting because that’s not the image they want to have of their parents.”

If your kid likely knows what they saw, it’s important to talk to them.

How to talk to kids about seeing sex

Dimerman says parents should take cues from their child’s reaction, and respond accordingly.

READ MORE: Why some people have sex even when they aren’t in the mood

If a child is too young to realize what they just saw, or is seemingly unaware of the situation, a parent could “just respond to the child’s need without making a big deal of it,” Dimerman said. But if a kid freaked out or ran away after seeing their parents in the act, it’s important to talk to them quickly.

“A parent might say something like, ‘I know it surprised you to see us naked on the bed together and being intimate,’” Dimerman said.

“Then, validate [their] feelings with: ‘It’s always awkward and uncomfortable to walk in on parents having sex, and that’s why our door was shut; because sex is something private. But we want you to know that you didn’t do anything wrong, and to save you from feeling this way next time, how about knocking first?”

WATCH BELOW: Parenting tips





The important thing is to not pretend the incident didn’t happen. Ignoring sex can stigmatize the act and confuse children, said Sara Moore, an assistant professor of sociology at Salem State University who specializes in sexuality and family life.

“Ignoring it may give the child an impression that sex is something to hide or be ashamed of,” Moore told Global News. “While it may seem easy to ‘save face’ by pretending it didn’t happen, parents then have little influence on how their child interprets what they saw.”

Be honest and open about sex

Moore says children will be less affected if they walk in on their parents having sex if they actually understand what sex is. A lack of understanding can be upsetting for them.

READ MORE: Why most ‘dad shaming’ comes from mom

To help kids develop a healthy attitude towards intercourse, Moore says parents should talk to their kids about it at an early age. She says so many young people get misinformation from the media and pornography, which can harm perceptions of sex.

Planned Parenthood says that when adults talk to their kids about sex, it reduces the likelihood that they’ll engage in risky sexual behaviour. It also helps normalize sex, and create a healthy relationship with sexuality.

Moore says sex conversations should be age-appropriate. For a kid in elementary school, for example, teaching them proper names for body parts and topics of consent are important. Moore says when her daughter was five and started asking where babies came from, she and her husband had a conversation with her about reproduction.

WATCH BELOW: How to be a great role model to your kids





“Having those conversations early and consistently will help children better understand what consensual sex is, and why people have sex to begin with,” Moore said. “Nobody wants to see their parents having sex, but it’s likely much more ‘traumatic’ for children when their experience is filtered through half-formed or ill-informed ideas about what sex is.”

The other thing all parents should remember? Lock the door if you’re going to get intimate.

“We live in a culture that suggests kids should have full access to their parents 100 per cent of the time,” Moore said.

“This isn’t healthy for parents or their kids, and parents should let their kids know they sometimes need private, child-free time together.”

[email protected]

© 2019 Global News, a division of Corus Entertainment Inc.




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15Jul

Therapy is expensive — here’s how to make the most of your sessions – National

by BBG Hub

Private therapy in Canada isn’t cheap — fees can range anywhere between $50 to $240 per hour — so it’s important that you get your money’s worth.

According to Dr. Lynda Ashbourne, associate professor at the University of Guelph, feeling heard is a telltale sign of a good therapy session.

“You should feel as if… the therapist heard and understood what you’ve talked about, what is important to you, who you are and something of your current situation — either what’s working or what’s troubling,” she said.

READ MORE: Psychotherapist vs. psychologist vs. psychiatrist: Which one should you choose?

By the end of your first session with a new therapist, you should also have a solid grasp on “how they work and what to expect.”

“The questions that your therapist asks should be helpful to you in thinking about yourself, the broader picture of your life as well as the specifics of your concern,” said Ashbourne.

Don’t expect to have all of your problems resolved after one hour, but you should leave your initial appointment feeling like you have a clearer understanding of what you want to work on.

READ MORE: As a person of colour, it’s a struggle to find therapists who look like you

“How it’s affecting you, how it’s affecting others, what has worked for you in the past or in other contexts of your life that you might be able to learn from and apply… and how the therapist could be helpful to you” are all things you should feel good about when you finish your first session, said Ashbourne.

She defines a “good” therapy session as one which involves your therapist taking time to ask about and listen to “the unique context in which you live.” This includes what you understand to be your culture, age, gender identity and sexual orientation, spiritual or religious beliefs, values and priorities, life experience, ethnicity and class roots.

This is what a therapist should do, said Ashbourne — not “provide you with suggestions or prescriptions that seem oriented to a generic person or relationship.”

WATCH BELOW: Healing through the Arthouse: Cancer patients, survivors finding therapy through art





All your subsequent sessions should give you both insight and action items that you can start working on as soon as you leave the room.

“[They] should leave you feeling that you have some new ideas and new insight into what’s going on for you and how you can address that,” she said. “[You should have] steps you can take [and tips for] how you can continue self-reflection in a constructive manner between sessions.”

Here are some things you can do to ensure you’re making the best of your next therapy session.

Before your first appointment…

Why are you going to therapy? Asking yourself that question (and answering it) will ensure your first session is productive, Ashbourne said.

“How do you understand the ‘problem’? What do you call it? How does it affect you? Who else does it affect? How will you know if it’s getting better or worse?” he said. “How will you know if therapy is helping? What are your expectations of therapy?”

She would also recommend keeping a list of all the questions you immediately have for your therapist, so you don’t get flustered and miss something.

WATCH BELOW: U of S study finds therapy dogs improve hospital patient experience





“That can include what training they have, what experience informs their work, what… they think is most helpful about therapy, how they work, the number of sessions” and more, said Ashbourne.

While there is some preparation necessary on your end, Ashbourne also recommends that you try to stay open-minded.

“Let the therapist do their job in understanding your current situation and inviting you to reflect on this differently or try something new in response,” she said.

READ MORE: Can cooking become a form of therapy?

It’s important to remember that what you’ve tried before wasn’t working, and that’s why you decided to go to therapy.

If your therapist attempts to use an unorthodox method, try it out before shutting it down — it could be the angle you’ve been missing.

“Sometimes the therapist might ask you about something that seems unrelated… it’s a good idea to let that conversation unfold for a bit as there may be ideas there that are linked to how you are seeing or responding to the current dilemma, or where you might be getting stuck,” said Ashbourne.

Use your time wisely, be nonjudgmental

Not only does an agenda keep a session on track, but it offers transparency and stability to both patient and clinician.

Dr. Christine Korol of the Vancouver Anxiety Centre always uses an agenda, and she likes it because it ensures that nothing is missed or skipped.

WATCH BELOW: The physical symptoms of being depressed





“It doesn’t feel good when you wanted to talk about something in particular and you don’t get to it by the end of the session,” Korol said.

“[An agenda] makes sure that you’ve covered everything… and if there is too much to talk about in one session, you know that you can prioritize at the beginning.”

In a typical session, Korol allows a few minutes at the beginning for client and patient to “go over how the last week went.” Then, together, they make a plan for the rest of the session.

READ MORE: Ketamine for depression divides experts: ‘I’ve seen these drugs come and go’

“[For example,] 10 minutes on homework, 15 minutes on a work situation, 15 minutes on an upcoming visit home, 10 minutes to review the session and make a plan for the next week,” she said.

It’s also a better use of your time if you’re completely honest and vulnerable from the outset.

“[Therapy] is where you can explore exactly how you have been feeling. This is especially important for those who are learning to set boundaries or set limits with others,” said Korol. “Telling yourself that something you’re feeling is bad or wrong will slow you down from exploring those feelings… [feelings which] may not be bad or wrong.”

Use a journal to track your thoughts and feelings

A therapist can start to feel like a friend after a few sessions, but talking about your day or your social outings are not an effective use of time.

“[Journals] can help you collect data and keep you on track in between sessions,” Korol said.

WATCH BELOW: Working women with children are up to 40% more stressed: study





Ashbourne agrees — writing down how you felt at the end of the last session will allow you to pick up where you left off with ease.

Use journal prompts like “what stuck with you from last time? What happened this week with regard to your problem that was different? What did you try that worked or didn’t work, and what do you think that tells you?” said Ashbourne.

If you’re still not getting what you want…

According to Ashbourne, you should feel like there have been some “beginning shifts” in how you are dealing with your concerns after three to four sessions.

If you don’t feel anything after that amount of time, it might be time to have an honest conversation with your therapist.

READ MORE: Tracking your symptoms might make you feel worse, experts say

“They may have ideas for doing something different, or they may suggest another therapist who might be a better fit for who you are,” said Ashbourne.

“Neither of these are indications that you or the therapist is flawed in some way… they simply reflect that we’re not all the same.”

[email protected]

© 2019 Global News, a division of Corus Entertainment Inc.




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14Jul

Caring for the caregiver: Raising children with a disability or chronic disease – National

by BBG Hub

Amy Illingworth’s world was turned upside down when her two-year-old daughter, Victoria, was diagnosed with cerebral palsy.

“It felt like the ground had fallen out from under my feet,” she said.

But she wasn’t idle for long — within months she had quit her job, devoting all her time and energy to Victoria’s care.

READ MORE: Caregivers of loved ones with dementia experience distress, isolation, study says

“I entrenched myself in the care and diagnostics of Victoria… that was my focus,” Illingworth told Global News.

“I wasn’t really talking to my friends or former colleagues, I was avoiding social media, I shut down my LinkedIn account. I wasn’t doing the things I loved to do.”

It wasn’t until her husband said something that she realized her lack of self-care was harming both her and her child.

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“He said, ‘You want to care for Victoria in the best way that you can, [but] it’s important for you to be healthy, too,’” Illingworth said. “That felt like a luxury I didn’t have time for because of all the appointments.”

Since the diagnosis, Illingworth’s life had been consumed by brochures, research and meetings with specialists. She realized quickly that she knew nothing about how to care for someone with a physical disability.

“From an education standpoint, it’s very challenging. From an emotional standpoint, it’s very challenging,” she said.

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More than eight million Canadians provide unpaid care to loved ones with health issues, saving the health-care system more than $26 billion per year. Unfortunately, since caregivers are preoccupied with someone else’s needs, it often comes at the cost of their own health.

A 2016 study by the Canadian Public Health Association found that caregivers reported being anxious or worried about their responsibilities, and had increased levels of stress, and depression as well as low levels of subjective well-being. Sixteen per cent of caregivers reported “very high” levels of stress.

Dr. Dorian Traube, an associate professor in the school of social work at the University of Southern California, believes those effects can get much worse when caring for your own child.

“There’s widely documented caregiver stress… but there’s an element of having an ill child that I think triggers something particularly acute,” she said. “You have an intrinsic devotion to your child.”

The burden of having a sick child

When a child becomes sick, the parent’s entire ecosystem is disrupted.

“You have to quit your job or you may lose your job… you may lose social relationships, because human relationships take effort and nurturing and you may not have the ability to focus on those,” Traube added.

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For Payal K., the stress of her daughter’s illness was compounded by the shock and confusion of recently immigrating to Canada from India. (She has asked that her last name and her daughter’s diagnosis not be shared to protect their privacy.)

“As with any immigrant, [we had] the universal challenges of finding a job, settling, acclimatizing to the weather… then you add another layer of having a child who has these needs,” said Payal.

Suddenly, Payal was going through a massive life change without any family support or community connections. She also had to learn how to navigate a brand new healthcare system — one riddled with forms and procedures that can often be confusing for people who grew up here.

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“It was a very daunting task,” she said. “[My needs] had to take a backseat.”

According to Traube, even thinking about yourself when all these other people are relying on you can cause immense feelings of guilt.

“It becomes something that your entire brain capacity is taken up with… but humans need balance,” said Traube. “There’s not room for anything else, including self-care.”

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Without balance, there’s stress — and stress can wreak “all sorts of havoc” on your biological system.

It can cause “everything from weight gain to issues with blood pressure,” Traube explained. “There are even concerns about a linkage between acute stress and higher risk for autoimmune diseases.”

Despite all this, Illingworth believes most healthcare centres fail to prioritize parents of sick children.

“Some of the advertisements — when it’s like mothers bawling their eyes out in a shower and then they have to shake themselves off — that is accurate,” she said. “You are alone.”

A gap in the health-care system

Parenting expert Ann Douglas agrees with Illingworth. She has four kids, all of whom had a number of mental health and neurological challenges throughout childhood. She wrote about her experiences in her book Parenting Through the Storm

“There are all these different layers of worry,” she told Global News. “There’s exhaustion and worry… a lot of mental and emotional labour is involved in researching the systems and supports available… work-life balance issues… and the financial impact.”

The biggest thing a hospital can do, in Douglas’s view, is put together a peer support network for parents to get practical assistance from “other parents who have walked this walk.”

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Traube echos the need for “social support.”

“Making sure you have the ability to reach out… if it’s family, friends, your significant other,” she said. “You need to be able to talk about your feelings… you need to be able to ask somebody to bring you dinner.”

She also encourages parents to find “purpose in the process,” or a way to grow from their child’s illness.

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“For example, lots of parents who have children with cancer become heavily involved in the world of cancer fundraising,” said Traube. “It’s about deciding to have another interest that you can devote at least a small amount of time to… and having a place to go and things to do with your time.”

This offers parents a chance to regain control. Traube said this is critical for the well-being of both parent and child.

“There’s a reason why, when you’re on an airplane, they always say that if the airbags deploy, you should put yours on first and then your child’s.”

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Illingworth and Payal both credit the Holland Bloorview Kids Rehabilitation Centre in Toronto as being the first place they understood the need for self-care and peer support.

Now, they’re family leaders at the centre, working to support other families with similar stories.

The right way to support caregivers

Jean Hammond, family partnerships specialist at Holland Bloorview first discovered the centre when her daughter was a patient. She said there is a “spectrum of caregiver needs” among the parents she works with, and providing for those needs is one of their top priorities.

“What we’re hoping to create is a group of caregivers who feel supported, who have been given education, training and support in order to do their very important job,” she said. “Caregivers provide 80 per cent of the care, and that helps [doctors] provide the other 20 per cent.”

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With that in mind, Holland Bloorview has a number of programs available to the parents of its patients.

The first is an informal peer support group, where some parents (called family leaders) are identified as having experience as a caregiver and they offer their knowledge to new parents.

“For a parent of a special needs child meeting another parent of a special needs child, there’s an automatic connection and a sense of ‘getting it,’” Hammond said.

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Her team also organizes frequent coffee nights and potlucks, which offer parents of inpatient children a break within the hospital walls.

“We also have an online resource hub for caregivers, and we have education workshops for caregivers on topics such as self-care, resiliency, mindfulness and nutrition,” said Hammond.

Recently, parents at Holland Bloorview met for a “paperwork party,” where they were invited to bring forms and applications they found lengthy or confusing.

“Caregivers have to fill out a form for just about everything,” said Hammond. “Understandably, these get pushed to the bottom of the to-do list frequently.”

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Members of Hammond’s team and a social worker were present to offer support. They also taught parents new to the centre how to most effectively apply for funding.

Illingworth says nights like these have been “life-changing” for her family.

“I have a better understanding of how to raise this child, and not just take her to appointments. It’s about the bigger picture,” she said.

“I would love for other hospitals to see the benefit of the holistic, client-centred, team approach. I think it makes a huge difference in the psychology of the whole family.”

For families that may not have this sort of centre as an option, experts suggest looking for support groups in the community or online.

[email protected]

© 2019 Global News, a division of Corus Entertainment Inc.




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14Jul

What are fibroids? Here’s what women need to know – National

by BBG Hub

You can think of a fibroid as a hard ball of muscle.

Dr. Yolanda Kirkham, obstetrician gynecologist at Women’s College Hospital in Toronto, told Global News that fibroids are common, and more than 50 per cent of women have them.

“It’s very unusual for someone under 30, for example, to have many or large fibroids,” she explained. “By menopause, or age 50 to 70, sometimes up to 80 per cent of people may have fibroids by that time.”

Fibroids — also called leiomyomas or myomas — are types of growth that can be found in or on a woman’s uterus. They can also grow over time.

“It usually just starts from one type of smooth muscle cell that just keeps proliferating,” Kirkham said.


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A fibroid is different than cysts or polyps, Kirkham added, but there’s often confusion among the three. A cyst is a soft balloon of either fluid or blood.

“[Cysts] don’t grow in or on the uterus,” Kirkham explained. “Cysts usually grow on an ovary or sometimes on our skin.”

A polyp, meanwhile, is a soft, fleshy tissue that grows on the inside of the uterus.

But fibroids aren’t necessarily dangerous — more than 99 per cent are benign. Sometimes, women can have them with no symptoms; other times, they may have to be removed.

“It may not be clinically significant, meaning that it may not impact their life,” she said.

There is no one cause of fibroids, but Kirkham added they have been linked to genetics, race (Black women are more likely to have fibroids), hormones, environmental factors and other causes.

“There is nothing you can do to prevent that.”

Where do they grow?

There are three main types of uterine fibroids.

Subserosal fibroids are found on the outside of your uterus. Fibroids found within the wall of the uterus are called intramural fibroids.


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And those balls of muscle that grow in the cavity of the uterus are called submucosal fibroids.


Credit: Getty Images

“Symptoms depend on where the fibroids are located,” she continued. “For example, if you have a little one-centimeter or two-centimeter muscle ball in the wall, that doesn’t really cause any problems at all.”

Subserosal fibroids can get quite big (up to 10 to 15 cm) which can cause pressure on your bladder.

“Same with the intramural and submucosal,” Kirkham explained. “Anything in the wall that big would cause pressure.”

Your period can also be affected

One of the biggest symptoms of fibroids is a heavy period for women in their 40s and women who are pre-menopausal.

“Fibroids on the outside of the uterus would not affect a period, but the ones in the lining can cause period problems.”

These fibroids “impeded contractions,” meaning it becomes difficult for your period to stop flowing. Submucosal fibroids can also change your bleeding patterns.


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A heavy period, she added, is using more than three to five pads or tampons a day, leaking through your clothing or changing your pad or tampon overnight multiple times.

They may be overflowing or their flow may be going on for a week and even months,” Kirkham said.

Treatment options

Fibroids only become an issue if they are symptomatic (and this is often the case for women over the age 40), but for others, treatment is not required.

Kirkham said treatment is often managing heavy bleeding or any type of cramping. This can be done with off-the-counter medicine. There is also now medication that can reduce the size of a fibroid.

“Because some people are bleeding for months on end and they’re becoming quite anemic (low blood and iron) so they can become anemic, this [medication] can help improve their anemia.”

Speak with your doctor to figure out which medication is right for you.


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Kirkham said doctors often start with oral medication or an injection, but for others, surgery may be required.

“This can be done either by laparoscopy which is minimally invasive with a telescope through the belly button,” she explained. “Or can be done by an open incision on the abdomen to shell out all of the fibroids from the uterus.”

She added some people may never need surgery, but it all comes down to the size of fibroid.

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Submucosal fibroids can even sometimes come out of the uterus and make its way into the vagina. This surgery is often more urgent.

Healthline.com added endometrial ablation “involves inserting a special instrument into your uterus to destroy the uterine lining using heat, electric current, or hot water.”

There are also treatments where the fibroids are shrunk with a laser or frozen.

“We also have a hysterectomy which removes the entire uterus with the fibroids together.”

She added they also shrink on their own during menopause.

If you are ever concerned or experience any of these symptoms, talk to your doctor right away, she added. The most important thing women can do is be clear of what fibroids are and where they live.

[email protected]

© 2019 Global News, a division of Corus Entertainment Inc.




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13Jul

From bridesmaid to stranger: How weddings can destroy friendships – National

by BBG Hub

The bachelorette started with a luxurious morning of pampering, and ended in a fight with a tiara being ripped off the bride’s head.

Jaclyn*, who asked Global News to change her name to protect her identity, had planned a lavish, fun day for the bride and a few of her closest friends earlier this year in Toronto. Jaclyn said the bride drank too much throughout the day, and had a meltdown at the end of the night.

At one point in the night when the group was at a club, Jaclyn stepped outside for fresh air. When she returned, the bride was angry with her for leaving.

“The bride stormed out of the club,” she told Global News.

“Incomprehensible and nearly foaming at the mouth, she announced we were leaving,” she said. “She charged across the street and was almost hit by a few cars. We made it back to the hotel where she proceeded to scream at me for leaving the bar.”

Jaclyn tried to get the bride to stop talking by pulling her tiara off her head. Unfortunately, she forgot it was pinned to her hair.

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Jaclyn realized this was the wrong thing to do, and in turn, the bride tried to fight her. She says “chaos ensued” and the bride’s sister got involved. After Jaclyn threatened to call hotel security, the bride backed off.

Suffice to say, Jaclyn did not attend her wedding.

“[The bachelorette] was expensive and beautiful, and took a tonne of time, money and effort,” Jaclyn said. “I bent over backwards for this woman, and no, we’re no longer friends.”

Why weddings cause conflict

According to Nicole McCance, a Toronto-based registered psychologist and relationship expert, it’s not uncommon for tensions to rise during wedding planning. While acting out violently or aggressively is never acceptable behaviour, McCance says that stress can affect people in negative ways.


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“For a lot of people, [a wedding] might be the very first time in their life that they’ve had to lead such a major event,” McCance told Global News.

“This is the event that you’ve maybe been fantasizing about since you were younger; this is the event that your mom is always talking about, so [there’s] all that pressure.”

This pressure can affect people in negative ways, especially brides and grooms, and can cause feelings of irritability and anxiety. When people get overly stressed, McCance says they can act in a way that’s out of character. This can be jarring for family and friends involved in the wedding planning.

“I don’t think a wedding creates this ‘other’ personality… but now you see this person under extreme stress and pressure,” McCance explained. “And if they’re at all perfectionists and are attached to having [the wedding] go a very specific way, then this is them on stress on steroids.”

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The stress of planning her own wedding ended Marie’s* friendship with her best friend of 20 years. Marie, who asked Global News to change her name, asked her longtime pal to be her maid of honour, but they had a massive disagreement three weeks before the wedding.

“We both become so stressed and got into a blow-out fight at the bachelorette party,” Marie said.

“I think it built up over the year of planning. She was really involved and was taking things really seriously, but I felt annoyed that her stress was actually stressing me out. It felt like the opposite of what was supposed to happen. I feel pretty selfish looking back, because that probably wasn’t the most mature of me.”


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Marie said her maid of honour came to the wedding, but left early. The women spoke after the wedding but decided they couldn’t move past what had happened at the bachelorette.

“We are no longer in communication,” Marie said. “Part of me hopes we will reconcile eventually… it’s upsetting that such an important female friendship ended over something so trivial.”

Unappreciated efforts

Catherine*, who also asked Global News to change her name, says being involved in her friend’s 2017 wedding planning caused a huge divide in their friendship. The 32-year-old says that when she was asked to be a bridesmaid, she stepped up to the plate, but her efforts never seemed to be good enough.

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“[The bride] asked me to help plan the bachelorette party,” Catherine told Global News. “This resulted in me meal planning, grocery and booze shopping for 20 girls (with crazy dietary restrictions) for a three-day bachelorette.”

Catherine says all the women had a great time, but the bride started acting “weird” after the weekend getaway.

“She never even acknowledged my birthday a few weeks after the bachelorette, [and] leading up to the wedding, she was pretty distant with not telling me about plans and key information,” she said.


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“I kept making excuses for her, [like] ‘she must be so stressed with the wedding.’”

But after the wedding, Catherine says the bride ignored her and didn’t talk to her for weeks. Eventually, Catherine says the bride texted her to tell her she wanted to end their 10-year friendship.

“After weeks of negotiating with her, I managed to get her to agree to jump on a call on a Tuesday night — this is the only time she would give me — to hear about what I did that upset her so much,” she said.

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“She felt I had a bad reaction to being asked to be a bridesmaid, [that] I never said thank you for the thank-you card she gave me (to thank me for the bachelorette weekend planning), [and that] I didn’t donate to [her] charity bike ride.

“I was beyond upset.”

Communicating expectations

Andrea Syrtash, a New York-based relationship expert and the author of Cheat On Your Husband (With Your Husband), says if expectations are not clearly communicated, resentment can build. If a bride really wants her maid of honour to throw a big bridal shower, for example, she needs to be honest and upfront about it. Otherwise, reality may not meet the expectations she has in her head.

“The person getting married is coming in with his/her own grand expectations and desires for the day, and friends may not contribute to the planning the way the people getting married expected,” she explained.


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“And, if a friend [is] going through a rough patch in her own relationship or is unhappily single, sometimes resentments or a strange dynamic pop-up at this time.”

To combat this, Syrtash says having honest conversations with friends and family is vital. They can be hard, but they’re important to protect and maintain friendships.

“When disappointment sets in, the way you share feedback is also important,” she added.

“Rather than accuse someone of doing something with bad intentions or attacking their character… it’s worth sharing how you feel and what you want. Try not to accuse people without honestly sharing your feelings, listening to them and hearing their perspective.”

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McCance says a falling out from a wedding can sometimes highlight the quality of a friendship. She says that all relationships have their own dynamics, and if you’ve sometimes felt taken advantaged of before, or underappreciated, wedding planning can only “magnify” those issues.

“If you feel [a certain way] in the friendship a little bit normally, that will come out even more when the wedding planning comes because everything is to an extreme,” she said.

“In that case, you need to ask yourself the hard questions, like do you want to sit down with this person and fight for this relationship? Or do you want to remove yourself a little bit after the wedding?”


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Today, two years after the wedding, Catherine says she talks to her former best friend, but they aren’t close. The way the bride acted really hurt her, and she hasn’t forgotten what went down.

“We agreed to remain friendly for the sake of our larger group of friends,” she said.

“Gradually our interactions have become more normal, but I keep her at a very big arm’s length away.”

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© 2019 Global News, a division of Corus Entertainment Inc.




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11Jul

Don’t skip out on travel vaccinations — they could save your life – National

by BBG Hub

It’s a step experts say you shouldn’t skip — when you’re travelling abroad, make sure you have the right vaccinations.

Dr. Suni Boraston, medical director at Travel Clinic – Vancouver Coastal Health in Vancouver, told Global News that while there’s no data that tracks how many Canadians get travel vaccinations, she believes the majority of travellers don’t get vaccinated.

“Canadians need to know that vaccines are safe and still the best way to prevent many diseases,” she said.

“Travel medicine is hard to keep up with, most [general practitioners] are too busy doing other things so ideally one would see a specialist [like an emporiatrician] at a travel clinic prior to travel.”


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A travel clinic can recommend and administer vaccines, but also give travellers prescriptions for malaria, travellers’ diarrhea, altitude illness, leptospirosis (bacterial disease) prevention, among others.

“Ideally you would get vaccinated four to six weeks before travel, but we can protect you against many diseases the day you leave.”

How much will it cost?

Prices for travel vaccinations vary depending on where you live and where you go.

Some clinics are owned and run by public health and while others are private. Some clinics also require a consultation fee. And while government-run health insurance plans won’t cover the cost, some insurance companies may offer coverage.


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At Travel Medicine & Vaccination Centre, based in B.C., a consultation can cost $50, while vaccines for hepatitis A and B range from $30 to $70 (depending on the dose).

In Toronto, The Travel Doctor charges $50 for Dukoral and $165 for a full dose of the yellow fever vaccination.

Before you go to a clinic, request to see a price list to make your decision.

According to Canada’s Travel and Tourism department, travellers should also review their immunization history to see which type of dose they need.

“You may need additional vaccinations depending on your age, planned travel activities and local conditions. Preventing disease through vaccination is a lifelong process,” the site noted. 

The site allows you to see vaccination recommendations based on the destination you are travelling to. 

What Canadians need to know

Canada currently is facing a shortage of yellow fever vaccinations, the site noted. Travellers who need the shot should contact a designated Yellow Fever Vaccination Centre in advance to see if it is available.

“Some countries require proof that you have received a yellow fever vaccination before allowing you to enter the country. Consult an embassy or consulate of your destination country in Canada for up-to-date information on its entry and exit requirements before you travel abroad.”

Some countries may need proof of a yellow fever vaccination — do you research before you travel.

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According to experts at Shoppers Drug Mart, the most common illness Canadians pick up in other countries is travellers’ diarrhea (TD).

“It is an acute diarrheal illness that usually lasts two or three days. It can be caused by any of a number of bacteria (and, less often, parasites), which are usually different from home-based varieties and therefore pose a temporary challenge to the immune system,” experts noted.

“There is no vaccination against all organisms that can cause travellers’ diarrhea. There is an oral vaccine against cholera and a specific strain of E. coli bacteria that is sometimes recommended.”

TD can also be prevented or treated with off-the-counter medications.

Common vaccinations

“Everyone who is going to a developing country should at the very least have their tetanus vaccine updated, two doses of measles vaccine (unless they’ve had the disease) and hepatitis A vaccine,” Boraston said.

“Ideally tetanus would be combined with diphtheria and pertussis which is $50. Measles is free, hepatitis A vaccine costs $65 and is two doses six to 12 months apart.”

Boraston said most people born after 1982 in Canada have had the hepatitis B vaccine.

The shots can be given as a combination or separately, and she added hepatitis A is recommended for all travellers. Experts at Shoppers Drug Mark noted the vaccine can last a lifetime, or may need a booster shot in 10 to 15 years.

Twinrix is a combination of hepatitis A and B. “Only use if the patient needs both vaccines. Many Canadians have already had hepatitis B vaccine,” she explained.


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For measles, mumps, and rubella, Boraston said there are two vaccinations recommended for everyone (unless they have already had disease).

Yellow fever vaccine is needed and recommended for some parts of South America and Africa, and because of the current shortage, travellers should contact a clinic ahead of time.

The typhoid fever vaccine is recommended for anyone travelling to the Indian Subcontinent (Afghanistan, India, Nepal Bangladesh, Maldives and Sri Lanka) or taking long trips to developing countries, Boraston said.

According to HealthlinkBC, travellers are more likely to be exposed to contaminated food and water in these countries. The vaccine can be taken orally or injected.

Japanese encephalitis vaccine is needed for for parts of Asia, especially if you are travelling to rural destinations between the months of June and October, Boraston said.  HealthlinkBC noted the infection can be spread through mosquitos and infants and the elderly are most at risk.

The meningococcal meningitis is required for anyone travelling to Sub-Saharan Africa.  Boraston also recommends it for anyone travelling to Saudi Arabia for Hajj (you will need to show proof of vaccination). This disease is very dangerous and can be spread through coughing and sneezing (it is contagious). 

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© 2019 Global News, a division of Corus Entertainment Inc.




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