David J. Widmann

Getting off the couch while staying close to the couch.
Like many men in their mid-30s, I learned the hard way that my health is no longer something that will just take care of itself.  After seeing the doctor for a flu that just wouldn’t go away, a blood test revealed elevated bad cholesterol levels and dangerously high liver enzymes.  After several other blood tests, various comments on how my body weight was distributed, an ultrasound, and a trip to the hospital, the advice I received was: Join a gym.

Again, like many men my age, I have gone through having monthly charges appear on my credit card for a health club that I couldn’t find anymore without asking for directions.  The gym option was out, but with adult-onset diabetes striking both sides of my family in the last few years, I knew it was time to make some lifestyle changes.  But where to start?  How much physical activity would I need to do to get and stay healthy?

“The general guideline that has been issued by Health Canada (http://www.eatwellbeactive.gc.ca) is that everyone should participate in at least 60 minutes of physical activity on most, if not all, days of the week,” says Daniela Durante, Treatment Plan Co-Ordinator and Conditioning Specialist at SHAPE Health and Wellness Inc. in Toronto.

60 minutes?  To those of us for whom “exercise” is a dirty word, it sounds like a prison sentence.  Daniela explains, however, that 60 minutes of exercise doesn’t mean spending an hour on the stair-climbing machine.  “For example, you can do 10 minutes of activity at six different times of the day,” she says.

It still sounds like a lot, doesn’t it?  After all, between work, family, friends, daily chores and the limitless viewing options provided by digital television, squeezing even 10 minutes of physical activity into our day, never mind doing it six times, seems virtually impossible.

You’ll be shocked to find out how easy it is.  I was.

Of course we’ve all heard that walking more and taking the stairs instead of the elevator is an easy way to lead more active lives.  I actually gave this one a try, and was amazed at the results.  I started by just walking up the stairs instead of taking the escalator out of the subway.  When I started, I could barely make it to the top of the stairs.  In just a few months, I’m not only walking up the stairs more easily, I’m taking the stairs two subway stops early and walking the rest of the way to work.  10 minutes down.

Oh, and those daily chores I mentioned?  Things like cleaning the bathroom, washing windows and vacuuming count as physical activity.  If you live alone, you’ll be doing all this work yourself.  If not, help out; it’s good for you.

Still, after work and chores, who wants to spend time exercising?  I, for one, would rather spend my free time in front of the television.  Many of us have felt guilty at one time or another for spending too much time watching the box instead of doing… well, just about anything else.  Believe it or not, TV time offers yet another opportunity to raise our fitness levels.

“There are plenty of exercises that can be done at home and use your own body weight,” Daniela says.  “Squats and lunges can be done while standing in front of the TV during commercials.  Abdominal crunches and push-ups can be done on the floor, and you can use the edge of the couch to do body dips.”

There are many resources online that can help you design a home-based workout plan of your own.  Medbroadcast’s fitness channel (http://www.medbroadcast.com/fitness) for example has several exercises that can be done without any special equipment.  There are also feature articles and online tools that can help you get motivated.

If you want to increase the intensity of your workout, things like thera-bands and resistance tubing can offer increased benefits at very little cost.

“These items add external resistance which helps make the exercise more intense than just using your own body weight, Daniela says.  “The more intense the exercise, the more calories are burned, and thus the better the workout.  You can stand on the middle of the thera-band or tubing (to anchor it) and stretch the tubing up over your head to work your shoulders,” among other exercises.  Thera-bands and resistance tubing are very versatile.

The age-old dumbbell can also be easily integrated into a couch-centric workout.  “You can put dumbbells in your hands as you do squats and lunges,” Daniela says.  “You can even lie down on the couch and do dome dumbbell bench presses.”

In the few months since I started with extra walking and a simple thera-band routine, I’ve noticed the difference that just a little exercise can make.  I haven’t seen any drastic transformation, but I have tightened my belt a notch and can lift heavier dumbbells.  If a TV junkie such as myself can stick with it, it must be easy.  My next blood test is in November, and I’m actually looking forward to it.

For years, television commercials have perpetuated the image of the hair transplant client: an affluent, middle-aged man driving a convertible or diving into a swimming pool, surrounded by women half his age marvelling at his youthful appearance. However, hair restoration surgery can be used as more than just a means to ease a mid-life crisis.

“There was a misconception with some plastic surgeons that you couldn’t put hair into a scar,” Dr. Paul Cotterill says from his clinic at 199 Avenue Road in Toronto.  “You can, you just don’t pack the transplanted hair too densely, and you leave more time intervals between sessions. If it’s not too big an area, and they have enough donor hair to allow to transplant, there’s no problem transplanting into a scar. If it’s a big scar you might want to make it smaller first.”
Dr. David Seager at the Seager Hair Transplant Centre in Toronto says that hair restoration surgery can be useful after other cosmetic procedures.
“Ladies that have had face lifts, with scars in front of their ears or behind their ears or across the scalp, can benefit from this procedure,” he says.
People who have suffered burns can have hair successfully transplanted into their scars.
“Burns are excellent reasons for hair transplants,” says Dr. Cotterill. “Whether it’s the hairline, the scalp, or the eyebrows after accidents.”
“Sometimes a skin graft is necessary first,” says Dr. Seager. “If we can graft the skin, we can transplant hair.”
“If you’ve got a burn to the scalp the size of the palm of your hand, that’s a big area,” Dr. Cotterill explains. “The first thing you might want to do is a scalp reduction where you take out some of the bald scalp to make it smaller. You can also put an expander – a device similar to a balloon – under the hair-bearing portion of the skin. You expand that area, then pull it over. Once you’ve made the scarred area as small as you can, then we can do transplants.”
Hair loss can be the result of a variety of other causes as well. Special consideration must be taken in cases where hair loss has been caused by an infection or an autoimmune disease. Conditions such as discoid lupus (a chronic skin condition causing scarring and inflammation) and alopecia areata (the result of the body’s immune system attacking the hair follicles) should only be treated after they have run their course.
“If you transplant into an active area of inflammation, the transplanted hair would fall out,” Dr. Cotterill says. “If those areas haven’t been active for several years, you could transplant those areas. Still, if it reactivated, there’s a risk the hair loss could return.”
If a consultation deems a patient a good candidate for hair transplantation, Dr. Cotterill says that recovery for a burn or inflammation patient is no different than that of any other hair transplant client.
“With transplants, there’s a short-term hassle for a long term gain,” he says. “For the first week you might have a little bit of swelling. You have to be careful with the grafts for the first week to 12 days so you don’t knock one out, but they’re in there pretty secure. The hairs will initially fall out then go into a three-month sleeping phase. At three months, they’ll start to kick in and grow normally.”

Thermage (also called Therma-Cool and Thermalift), the latest weapon in the war against aging. The procedure uses radio frequencies directed at the deep layers of the skin to tighten facial wrinkles without the need for invasive surgery.

It’s one of the few procedures that can actually give lifting and tightening of the skin without any surgery or downtime,” says Dr. Nowell Solish, a dermatologist at Women’s College Hospital in Toronto. “Patients get a procedure done where they go home and you cannot tell they’ve had anything done.”

As well as eliminating the recovery time invovled with many cosmetic procedures, Thermage doesn’t carry the risks of scarring, discolouration or infection associated with traditional skin rejuvenation techniques.

“I used to do a lot of laser resurfacing, Dr. Goldhar says. “I don’t do it any more. As a physician, I’d have my heart in my mouth and say a little prayer, hoping that the person heals up again. A procedure like ThermaCool can give that dermal tightening without breaking down the epidermis.”

Although Thermage is a valuabgle tool when it comes to improving skin’s appearance, Dr. Goldhar is quick to point out that it is not the “medical miracle” that many television programs and magazine articles have made it out to be.

“At this point in time, everybody is touting it as a ‘non-surgical facelift,’” he explains. “ThermaCool is a process that takes 2 to 6 months to see results. This is not a major facelift. What the procedure will do is tighten the skin a little bit, by about two or three millimetres around the jawline, a little bit of a pull-back on those nasal labial folds, and some tightening along the forehead.”

Dr. Solish agrees that Thermage is “not a perfect technology,” but that the majority of patients respond “very well” to treatment.

“I’ve never seen anyone that didn’t get improvement,” he says. “There are people that will get milder improvements, but the majority of patients that get it done are satisfied with the tightening that they get.”

“The bottom line is, ThermaCool is an excellent addition to the armament of new tools that are available to rejuvenate the face,” says Dr. Goldhar, who uses Intense Pulse Light treatments and microdermabrasion in conjunction with Thermage therapy. “The main theme of these new tools is that you can do the rejuvenation without the risks that we had with previous laser and chemical treatment regimes.”

Despite their name, love handles are something that most men would rather not hold on to. These folds of fat spilling over our belts have always been tough to deal with. It seems they’re resistant to diet, exercise, weight-loss supplements; just about anything. As much as we might want to get rid of them, for most of us the liposuction approach seems a bit too drastic. Luckily, there’s a new procedure available to help smooth love handles away quickly and painlessly.

“LipoLite is a non-surgical procedure to contour unwanted collections of fat,” says Dr. Stephen Mulholland of SpaMedica Infinite Vitality Clinics (www.spamedica.com).

At the centre of LipoLite is the VelaSmooth device.

The VelaSmooth sends the deep-heat radio frequency current into the fat,” Dr. Mulholland explains. “This stimulates lipolosys, the breakdown of the contents of a fat cell into free fatty acids and glycerol. The device is passed over your love handles for about 35-40 minutes. Every time you come into the doctor’s office, you would get a VelaSmooth treatment.”

Along with the VelaSmooth device, LipoLite uses mesotherapy (the injection of metabolically-active drugs directly into the fat) and carboxytherapy (infusing small quantities of carbon dioxide into the fat). This happens every fourth treatment, and helps to further break down the fat deposits.

“Caloric restriction will do that, too,” Dr. Mulholland says. “It just doesn’t focus where you lose the fat. You lose it off other areas except your love handles, usually. This focuses that lipolosys on just the love handles.”

The LipoLite program takes 8 weeks to complete, and has an exceptionally high rate of success.

“At the end of 8 weeks, 90% will have a noticeable and measurable reduction of their areas of fat,” Dr. Mulholland says. “The range of response is anywhere from 1 centimetre to 8 centimetres of reduction.”

To maintain the benefits of a LipoLite treatment, clients need only keep their weight under control.

“If you don’t put on the weight, if you don’t feed the fat cells again, you don’t have to worry about it,” Dr. Mulholland says. “If you feed you fat cell its calories, it’ll grow again. Weight maintenance is critical. This is not good for yo-yo dieters.”

Risks are minimal, and due to teh fact that the fat reduction is gradual, the procedure has virtually no impact on cholesterol levels, liver enzymes or kidney function. Dr. Mulholland stresses, however, that LipoLite is a body contouring technique and not intended for weight loss.

“If you need to lose weight, loose weight,” Dr. Mulholland says. “This is for shaping your figure.”

For people with slightly greater fat-loss demands,, or those few who don’t respond to the LipoLite treatment, another new procedure called Liposound can provide results less invasively that traditional liposuction treatments.

“People have seen the Learning Channel or Skin Deep, and they see liposuction as pretty crude,” says Dr. Mulholland. “Liposound is a more refined, gentle technique. It’s a very gentle ultrasonic probe, almost like bursting a kidney stone or something like that. You put it under the fat, melt it, then gently extract it. You have almost no bruising; you don’t have the same numbness and tingling as with liposuction.”

With these new targeted fat-reducing programs, it has just become easier to say good-bye to those handles we love to hate.

New Products Transform the Routine

According to archaeologists, men have shaved their faces for about 20,000 years. For much of that time, men had a simple choice to make before applying the shark tooth, flint blade or razor to their faces: soap or no soap.
Frank B. Shields changed the course of history when, in 1920, he invented Barbasol – the first “brushless shaving cream” to hit the market.

“Barbasol is one of the most recognized names in the shave industry,” says Janis Morgan, product manager at Perio Inc., current owners of Barbasol. “Since it went into the aerosol can, the formula has stayed pretty much the same.”

Shaving cream in an aerosol can was introduced in the 1950s. It would be over 20 years before shave gels, the next big thing in shaving, would come along to challenge the shave cream market.

Fast forward to the 21st century. A look at any department store, salon, or catalogue finds the once-simple shaving market evolving to a new level.

“There is a whole range of new products that men are looking for,” Ross Barclay says. Mr. Barclay is the proprietor of The Trafalgar Shop (www.trafalgarshop.com), an online store specializing in high-quality men’s grooming products. “They want natural products, a variety of fragrances, different styles of packaging, and they also like to have an eclectic selection.”

Mr. Barclay says that the most important factor in driving this new market is that men are starting to let a little luxury into their lives.

“Overhauling the shaving routine, which most men do every day, is a natural and straightforward place to start,” he says. “With a badger hair shaving brush, a British shaving cream, and a few minutes of peace and quiet, it’s possible for a man to match the type of enjoyment women have been getting from things like facials or manicures.”

Brands such as Nivea and Neutrogena, enjoyed by women for years, have recently released skin care and shaving products for men. This is not only seen as proof that the market for luxury men’s shaving products has reached the mainstream, but it has also worked to raise awareness of other brands that may be hard to find.

“When a man tries one different product, he’ll usually start looking for others,” says Mr. Barclay. “A man may start with a heavily-advertised product and enjoy it, which will make him all the more likely to seek out and find smaller manufacturers without advertising budgets.”

The growth of these higher-end shaving lines has not gone unnoticed by stalwarts such as Barbasol. A lot of boys grew up watching their dads work the foam from those rusty-bottomed cans into their faces before a shave, and Ms. Morgan says her company will use that brand recognition to expand its own line.

“I don’t know how soon that will be, but you’re always looking at what’s out there, what people are concerned with,” she says.

Still, there is room in the market for those who prefer to stick to tradition.

“Classic shave creams is a declining category,” says Ms. Morgan. “We are the only brand that is growing in sales in a declining category, which is amazing. We’ve been taking over a lot of competitors’ business.”

Botox appeals to the masses

“I’m very happy with it, and that’s the most important thing,” says 49-year-old Renee Schachter. About a year ago, she became one of a growing number of Botox advocates. “When some of my friends started to do it I saw results, and I really liked what I was seeing. In the beginning, I just did the area between my eyebrows. The last time I did it, I also did the horizontal lines up my forehead.”

Ms. Schachter is part of a trend that has taken the word “Botox” out of the celebrity gossip pages and into everyday language.

“Botox is the number one cosmetic procedure in North America,” says Dr. Fred Weksberg, cosmetic dermatologist at Toronto’s Centre for Cosmetic Dermatology. “A lot of people look at celebrities and emulate them in many ways, but I think Botox stands on its own merits. It’s an excellent treatment.”

So what is it about Botox that has so appealed to the general public?

“It’s easy to do,” cosmetic plastic surgeon Dr. Trevor Born says. Dr. Born has been administering Botox at 199 Avenue Road in Toronto since 1997, and has seen business increase rapidly in the last three years. “It takes only a couple of minutes and there’s no downtime with it. It’s almost an immediate result in the first three to five days and it lasts three to four months. When something is that effective, people adapt it very quickly.”

“It’s been so successful that individuals will flock to it,” says Dr. Weksberg. “If it’s important to them, they will do it. We have a lot of individuals who I would not consider wealthy, but still come to have Botox done.”

Satisfied patients have been the biggest boost in the popularity of Botox.

“I think that it’s a great treatment,” Ms. Schachter says. “I have encouraged my mother and my sister to do it, and they both have.”

“My patient base is still increasing,” Dr. Weksberg says. “I don’t see it decreasing at this point. I still think it’s going to increase for quite a long time.”

According to the National Eating Disorder Information Centre, most women and a growing number of men are dissatisfied with their bodies.

“The beauty ideal today is thin, able-bodied, smooth-skinned, young and glamorous,” said Rachel Moon Kelly, public health nutritionist at the Haliburton, Kawartha, Pine Ridge District Health unit.  “The reality is that less than one per cent of us fits this ideal.”

The quest to fit into this ideal has led many people, — up to 15 per cent of the population — to fall into a pattern of eating disorders.

Ms. Moon Kelly said that dealing with an unhealthy body image is difficult, and can lead to depression, low self-esteem, and harmful eating habits.

“How we picture ourselves in the mirror and our minds has tremendous impact on how we act,” she said.  “With media influences and other factors, it’s easy to fall into the trap of unhealthy weight loss diets and the like.”

To help combat this trend, the HKPR District Health Unit is using Eating Disorders Awareness Week, which runs until Feb. 8, as a forum to lay the groundwork for a new Body Image Group in Northumberland.

“We are starting a body image coalition, beginning with a focus group on Tuesday evening,” said Ms. Moon Kelly.

The focus group was expected to include representatives from the medical, mental health, dietetics, and educational communities, teens and parents.

“My mother had Alzheimer’s,” said Joyce McCormick of Webbwood. “From there, it went on to be in my brother-in-law, and then my father-in-law. It really hit our family.”

McCormick is part of a group in Webbwood that has banded together to raise money and awareness for Alzheimer’s disease.

“They have raised money holding various events,” said Patricia Montpetit, executive director of the Alzheimer Society of Sudbury- Manitoulin.

“For the past four or five years, they have held coffee break functions on our behalf, and each year they have raised more than $800,” Montpetit said.

“What is most amazing to us is that the entire population of Webbwood is only 600 people.”

Montpetit said the society is “very appreciative of the efforts of this small group in Webbwood.”

The community has pulled together through the years to help each other cope with Alzheimer’s disease, and raising money has been a big part of that.

“Annually we have to raise about $50,000 to augment the funding we receive from the government for some of our programs,” Montpetit said.

“There are some things we have that just don’t fall under any categories they fund. For example, we have a resource library for our families to borrow books and videos about Alzheimer’s disease, behaviours, and how to cope. The government does not fund resource libraries.”

McCormick’s daughter Chrissie has also helped raise funds for the Alzheimer’s Society.

“She held a yard sale one year,” McCormick said. “She went through the house and found things we weren’t using. Then some of her friends and other family members gave her some stuff. She ended up raising $1,000.”

Fund-raising efforts can get quite creative, says Ellen Roque, another resident of Webbwood who helps raise funds for the Alzheimer’s Society.

“We have a lot of support from the community, and a lot of people who are generous enough to help us,” said Roque. “We can’t take all this credit, because it’s not all ours.”

‘Like a bag woman’

As well as joining McCormick in her fund-raising efforts, Roque organizes a can-recycling drive that aids the Alzheimer’s Society.

“It’s embarrassing,” she laughs. “I feel like a bag woman or something.”

Joking aside, Roque feels that, although the can drive doesn’t raise a great deal of money for Alzheimer’s disease, every little bit is important.

“I lost a cousin whom I liked very, very much to it,” she said. “It’s horrible. We are so very fortunate that people really support us on this. It let’s us feel like we’re doing something for these people who are gone.”

“It may not help my husband and I, but we have kids and a new little granddaughter,” said McCormick. “As long as there’s money going into research, we can help others down the line.”

Currently, the Alzheimer Society of Sudbury-Manitoulin is in the midst of a fund-raising drive to renovate a section of the Pioneer Manor on Notre Dame Avenue.

“We’ve been offered the opportunity to renovate 10,000-square- feet and move out of our temporary portable building,” Montpetit said. “We have to pay for the renovations ourselves.”

For more information on the Alzheimer Society of Sudbury- Manitoulin, call 1-800-407-6369, or e-mail alzhsud@isys.ca.

Sudbury a natural location for rural research centre proposed in the Romanow Commission on health care

Greater Sudbury councillors say the city is an ideal place to house one of four centres of health innovation as proposed by Roy Romanow in his report on the future of health care in Canada .

“We set out 10 years ago to make sure that Sudbury would be the health-care referral centre for northeastern Ontario,” said Ward 5 Coun. Doug Craig.

“We followed the provincial government’s instructions in terms of a brand new large single-site hospital, said Craig, co-chair of the city’s physician and allied health care recruitment and retention committee.

“We’ve also lobbied long and hard for a Northern medical school. If the health innovation centre is going to be located anywhere in northeastern Ontario, then Sudbury would be the logical place for it.”

As part of his report, released last Nov. 28, Romanow said the federal government should create four centres of health innovation.

Sudbury ‘a model’

“I think that when the criteria is out and the applications are made and the proposals written, we’ll stand an excellent chance of being the centre for that particular endeavour.”

Last month, city council passed a resolution supporting the creation of a centre for health innovation dedicated to rural and remote health-care issues.

The resolution also supports Romanow’s proposed Rural and Remote Access Fund, which is supposed to total $1.5 billion over two years to improve timely access to care in rural and remote areas.

Craig said that should Romanow’s recommendations become health- care policy, the benefits to Sudbury would go beyond advances in medical care.

“A healthy community is one thing that has to happen before you can have a prosperous community,” he said.

“These kinds of jobs are the jobs that bring people here and allow them a quality of life that is appealing and inviting to young people who may otherwise consider leaving the North for more opportunities.

“I think some of the ideas and some of the jobs that will emanate from the health-care sector that’s going to evolve in this community will be the largest economic driver that we have, surpassing mining, education, and whatever else we’ve had in the past or present.”

Even if Romanow’s recommendations are not adopted by the federal government, Craig sees Sudbury as a leader in the development of new health-care policy and procedures.

“I go back to the medical school, the hospital, the cancer treatment centre, and some of the great work that we’re doing in the province regarding long-term care,” Craig said.

“I think we’re a model for some of the things that are occurring province-wide. It’s a natural outgrowth of an aging population. Those four areas are the pillars of the health-care areas that’ll continue to grow in our city.

“If the innovation centre remains an idea and never does come to fruition in the near future, I think those four areas will stand in good stead.”

Education campaign will target high-risk populations

Health officials in the Sudbury area will be ready this spring to more aggressively monitor, track and deal with West Nile virus.

“We are going to beef up education through advertising in regards to avoidance of mosquitoes or mosquito-infested areas,” said Ed Wierzbicki of the Sudbury and District Health Unit.

“We’ll target high-risk populations such as the elderly, who are highly susceptible to any kind of illness, including West Nile virus.

“Our focus will be toward educating the public as much as we can. A lot of people are educated just because West Nile’s been around. It spread a lot faster than we expected last year.”

The health unit recorded two cases of West Nile-infected birds in late summer.

Wierzbicki said the discovery came after the mosquito threat had passed, but the knowledge that West Nile is in the region means the health unit will be ready this year.

“In 2002, we were following a general program of dead-bird surveillance, submitting reports of dead birds,” said Wierzbicki. “That was the main focus of our whole program, to see if we did have it in the area.”

In 2003, however, “if you have a positive crow or raven for West Nile, that area is designated a hot spot and mosquito trapping is undertaken.

“For 2003, we’re looking to be trained and possibly set up traps in the two hot spots that we found last year. We’ll continue to do dead-bird surveillance in other municipalities.”

Wierzbicki said the health unit’s West Nile-monitoring activities are still in the proposal stage. However, health unit officials are thinking of either enlisting the aid of university students or training staff in identifying mosquitoes.

He said that a high-powered microscope would be needed to identify whether mosquito larvae in an area are of a bird-biting variety.

Wierzbicki said that Canada is behind in this area of mosquito research, mainly because “mosquitoes were more of a nuisance rather than a vector for disease in the past.

Virus: not serious for majority of people

“Now that mosquitoes seem to be transmitting diseases within Canada, we have to look seriously at what type of mosquitoes we have and what controls we can put in place.”

Although it is a public health risk, for most people the West Nile virus will manifest itself as no more than a run-of-the-mill mosquito bite.

“The majority of people will have no symptoms,” said Wierzbicki. “We might be bitten by an infected mosquito and never know it.

“Some people may get mild, flu-like symptoms. Very few people will have the encephalitis-like symptoms.”

Those symptoms can include fever, muscle aches, stiff neck and confusion.
“Something symptomatically similar to encephalitis or meningitis, which can be fatal,” Wierzbicki said. “Our medical officer of health will be corresponding with and consulting with our other medical professionals in the city so that they clearly identify an encephalitis-type symptom, take the blood samples and report to find out if it’s West Nile.”