Podcasts about alberta hospital

Welcome to our first episode in a series on Cardiac Intensive Care, recorded live at the Critical Care Canada Forum 2024. We kick off by looking at the latest Clinical Practice Update on post cardiac arrest care and refractory cardiac arrest. The "Canadian Cardiovascular Society/Canadian Cardiovascular Critical Care Society/Canadian Association of Interventional Cardiology Clinical Practice Update on Optimal Post Cardiac Arrest and Refractory Cardiac Arrest Patient Care" CCS was published in 2024, and provides comprehensive recommendations for the management of patients following cardiac arrest. Join us as Dr Janek Senaratne unpacks this Clinical Practice Update (CPU), and guides us through the evidence for the recommendations made. Dr. Janek Senaratne is a dual-trained cardiologist and intensivist based in Edmonton, Alberta. He serves as an Associate Clinical Professor in the Department of Medicine at the University of Alberta. University of Alberta In his clinical roles, Dr. Senaratne practices at the University of Alberta Hospital and Grey Nuns Hospital, and is one of the Vital Heart Response physicians for the province. Further Reading:

Opioid Crisis Part 2? On an important follow up to last weeks round table discussion with advocate Guy Felicella and columnist Adam Zivo, we're sitting down with an expert in addictions and addiction treatment, Dr. Monty Ghosh to fact check what was said as well as ensure the context of our episode is set where it should be!! From his U of C bio where he is a Clinical Assistant Professor at the Cumming School of Medicine, "Monty Ghosh is an Internist and Addiction Specialist who works at the University of Alberta Hospital in Edmonton as an Internist as well as the Foothills and Rockyview Hospitals doing Addiction Medicine in Calgary.  He works with multiple community based not for profit organizations to provide support for marginalized populations including The Alex and The Calgary Drop-In Centre. He also helps foster and create unique programs to support those living with substance use, experiencing homelessness, and with other vulnerabilities.  He is the Medical Co-Lead for the AHS Rapid Access Addiction Medicine (RAAM) Program." Don't forget, we have merch that's available at www.abpoli.ca! As always, if you appreciate the kind of content that we're trying to produce here at The Breakdown, please consider signing up as a monthly supporter at our Patreon site at www.patreon.com/ thebreakdownab and we can now accept e-transfers at info@thebreakdownab.ca! If you're listening to the audio version of our podcast, please consider leaving us a review and a rating, and don't forget to like and follow us on Facebook, Twitter, Instagram and Threads!

Join us in this podcast episode featuring Spencer Beach, a burn survivor who shares his incredible journey of finding positivity and resilience in the face of unimaginable trauma. After a devastating workplace accident that left him with severe burns and a slim chance of survival, Spencer defied the odds and emerged stronger than ever. Through his story, he emphasizes the importance of support from loved ones, finding meaning in the midst of struggle, and shifting perspectives to overcome challenges. This episode offers a powerful reminder that even in the darkest moments, there is always hope for a brighter future. ..................................................................................... Spencer's links: www.spencerspeaks.ca Instagram: @spencer.beach LinkedIn ...................................................................................... RISING STRONG links; Get new episode notifications: bit.ly/risingstrongupdates Follow us on Instagram: www.instagram.com/risingstrongpodcast Facebook page - send your reviews and comments via the 'comment' button here: www.facebook.com/risingstrongpodcast WIN SWAG: · Email a screenshot of your 5-star review for a chance to win some Rising Strong swag! Lisa@LisaKBoehm.com ............................................................................ TRANSCRIPT: Host/Lisa: How is it possible to find positivity and resilience when 90% of your body has been burnt and you're given a 5% chance to live? Stay tuned because my guest today is going to tell you exactly how he did. That's about ten years ago. A friend of mine attended a presentation at her workplace about workplace safety and the keynote speaker was Spencer beach. My friend said, you have to read his book. He has quite an amazing story. So I did. And unlike other books, Spencer has always been in the back of my mind. I've been a fan of his for years and I'm thrilled he accepted my invitation to be a guest on the Rising Strong podcast. Welcome to the show, Spencer. Spencer: Thank you, Lisa. Host/Lisa: So in 2003, you were involved in all I can say is a horrific workplace accident. Can you take us back to that day? Spencer: Sure. So I woke up in the morning, average, ordinary day. I've done a lot of mentoring over the years and I found everybody's story starts out the same way. On an average, ordinary day, you never expect trauma to enter your life. And then it does. I had a feeling in my gut that I was being asked to do a job that I didn't feel was right. I told my wife that I was concerned about it, but that gut feeling. I did what everybody does when your gut's talking to you. I ignored it. Right. That's what we tend to do. I convinced myself everything was going to be great and said, I love my wife. Have a good day. See you later. And went to work. I was a flooring installer. My specific role was the flooring the service guy. So basically I drove around Edmonton, Alberta, going from new home to new home, fixing other qualified installers mistakes. I was extremely skilled at what I did and the reason being was I grew up in the industry. I went on my first job when I was six years old with my dad. Anyways, the job I was being asked to do was to go and remove vinyl flooring because another crew installed the wrong color. And my dad had taught me that you use a sharp scraper and it's going to take a lot of elbow grease and lots of sweat. It's really hard work and lots of time. But my employer had a method where you use a chemical, it's a contact thinner, really close to a paint thinner, and you dump it all over the floor, skipping some steps. So nobody can do what I did, but you dump it all over the floor and it would absorb through the material, reactivate the glue and the flooring would peel up in sheets. So what used to be really hard work of days of two people working really hard, my employer had a service guy doing his off time, saved tons of time and loads of money. Unfortunately, I was never trained in Wimis. We had zero safety systems at work. Even if I had any personal protective equipment, it was because I purchased it, not because my employer supplied it or encouraged it. So I walked into there blind when it came to my rights, my roles and my responsibilities and safety. And all I had was that gut feeling as my defense, which I ignored. And it was about four in the afternoon when I heard a loud whistle. And that whistle was a precursor that something bad was going to about to happen. And that whistle was all the air being pulled into the house from the outside because I was in a flashfire and that flashfire required a lot of oxygen. So there was a loud whistle and then bang. It was an extremely loud bang. Technically they called it an explosion and I was engulfed in flames. The biggest issue with being engulfed into flames in a chemical fire is the average fire burns at about 700 degrees celsius. But because it was fueled by a chemical, the fire burnt out the properties of the chemical. So my fire was 1500 degrees celsius. It was more than twice the heat of the average house fire. When the fire did start, honestly, I didn't know what happened. All of a sudden I was in the normal home and all. Now I'm surrounded in flames and I can honestly tell you, your first instinct is just, holy ****, I need to get out of here. So I purely worked on instinct. When the fire happened, I was right at the front door on my knees, working away. I was almost done for the day. Honestly, I had maybe five more minutes of work to go. So I sprung up from my knees and I reached out and grabbed onto the front door. And that loud whistle I heard pulling all the air into the house to feed the fire also created a pressure difference, so it sealed the door shut. And I'm six foot, 2220 pounds, I'm a big guy and I'm used to carrying full rolls of carpet on my shoulder and big boxes of tools and buckets of glue. Like man, I didn't have the strength to open that door and break that seal. So again, working on instinct, I just like I need to get to the next closest exit. And because I'm in surrounded by fire, your eyes and your mouth will naturally shut on a fire. So everything I did was not only on instinct, but I also did it blindly. So I let go of the door handle and I turned to my right and 10ft away from me, down the hallway that I just removed all the flooring from, was the garage door. So I ran into the laundry room where the garage door was, and tried that door, and it didn't open. Now I'm trapped because the only way out of that laundry room is the hall I just came down or the door that's not opening. So I let go of the door handle, I went back into the front entry, tried that door again. It didn't open. And people always ask about sensations. They always want to know, did it hurt or anything? It was like, yeah, it hurt more than you can imagine. I often will joke and saying that women in childbirth have nothing on me, but the pain was different. We've all been burnt before. That's one unique thing about burns, is not everyone will experience a car accident or go through cancer, but everyone will have a burn. The only difference is usually they're pretty minor, but it was nothing like any burn you've ever had. I could feel the heat inside of me, and honestly, it was so intense that I could also feel my life being drained from me. I knew I was in trouble when this door didn't open. I knew if I didn't get out soon, I wasn't getting out. So I let go of the door handle. I ran back through the hallway to that laundry room, tried that door again. It didn't open. And I estimate it took no more than 20 seconds for me to do all that when I'd had enough. Now I couldn't take it anymore. I just wanted it over. I collapsed into a ball and interlocked my fingers with the back of my head. I tucked my face as close to that floor as I could, and I gave up. It was horrific. I could feel my hair being burned off of me, my skin. Out of all the sensations, the one that I remember the most is how the skin on my face felt like it was shrinking as it was melting to my skull and tightening up. And it was horrible. Host/Lisa: I truly believe that you were made for more. There must have been some divine intervention or something that day. As a medical professional, I am shocked and surprised that you lived through that. You had a near death experience, and you say that that resulted in your greatest message. Can you expand on that a little bit? Spencer: Yeah. So when I gave up, you got to put yourself in my shoes. At this moment, I'm in a raging fire. Like, the howl of the fire was intense, and the heat was more than you can imagine, and the pain was unbearable. And I got all these extreme sensations going on at once, and then I just slipped into this place. The way I describe it is like going to sleep. When you're comfy in your bed and you're tired and you're just ready to go to bed, and you just let yourself go there. You let yourself fall asleep. That's kind of what I was doing, was letting myself go to the next realm. And when I did, everything became really peaceful. All those extreme sensations totally disappeared. It was the most euphoric feeling of my entire life. And in that moment, all I could think about was my wife, Tina, and she was four months pregnant with our first child. It took me a long time to truly break down what was occurring in this experience. But if you back up just a millisecond prior to that experience of dying and prior to the fire, it was like I was worried about getting a job done, living up to my commitments, making money, paying bills. I was worried about what I had to do tomorrow. This was a rushed job. I had to be out of there that day. I was being pressured to do that. I had his going home to plan my friend's bachelor party that night. I had all these commitments that were dictating my day and also dictating my responses in my day. And now, on the verge of death, I didn't care about my bills, I didn't care about my job. I didn't care about that house. I didn't care about my friend's bachelor party. I didn't care about anything other than my wife and my unborn child. And what I came to determine or appreciate, and it took a long time to figure this out, was my near death experience, was I was thinking about my last thoughts. And if they're my last thoughts on this world, I'm pretty confident they're probably going to be my most important thoughts. And it turned out that what was important to me weren't all those things that dictated my day or also the responses in my day. It just turned out to be the people I loved. So my greatest message to people is it's really hard to give me a bad day. And the reason being is I know what my most important thoughts are. And my most important thoughts are not anything that's happening on social media, not any political thing going on, not any restructuring of any government agency, not any bill that I might be tight on or living paycheck to paycheck. My greatest thoughts every day is the people I love. So I measure my success of every day like this. If at the end of the day, my family is happy, healthy and safe. I had a real good day. I can honestly tell you nothing will matter beyond that. And what I found really interesting. And being a motivational speaker, you're always looking for the similarities between me and other people. Everyone has the same most important thoughts. Everybody has people that they live for, that they love, that love them. And I can promise you, like, death is a natural thing, it's going to happen to everybody and we're all going to experience that moment when we get to have our most important thought. But I had to learn mine, actually dying. Everyone else just has to appreciate what it is because I guarantee you already have it. We let all these other things dictate and distract us in our day when they're really meaningless. Thinking about my wife and the baby, I relived all the things I was going to miss with them and the things I was never going to see, like no bad a boy or girl or what the name of my child would be or walking them to school or dating my wife again or anything. So I tried for them one more time and when I did, the flash fire was burning itself down because the fumes were dissipating. So the seal, that vacuum was being also decreased. And I now had the strength to open the door. Door opened. I jumped into the garage, created another fire because that's where all the garbage from the construction was. And on the top was all the flooring I removed, soaking the same chemical, and I'm on fire. So I created the second fire when I landed on that garbage pile. But the overhead door was open, so I just regained my balance and ran to the end of the driveway and collapsed on my back. So then now emergency services came. It took eleven minutes for them to come. 13, I believe 13 calls went out to 911. And my first experience actually with the healthcare system was lying on the ground screaming. My life was over waiting for the ambulance when an off duty nurse came and muscled her way through the group of tradespeople gathered from their homes. And she told me she was an off duty nurse. She tried to keep me calm. She found out I was married and my wife was pregnant. She did everything she could to get me to focus on those things and I'm very thankful for her because I was really screaming. My life was over. I didn't see me ever getting to the hospital, but her training kicked in and it's what I needed right then. Paramedic came. I don't really remember the ride to the ambulance because I'm being heavily medicated now, but I did get to the University of Alberta Hospital. We have the best burn unit in Canada and it's the third best burn unit in North America. They took me right into a private room in the emergency and there was this massive team waiting for me, consisting of probably about seven to ten people. And it was basically all the heads of the departments on the burn unit. So the charge nurse, the doctors, a few doctors, occupational therapists, physiotherapists, dietitians, psychologists, everybody it was going to take, if I survived, to help me get back. The first thing the doctor did was introduce himself, Dr. Trejit, and reassured me I was in a great hospital. And then he asked me how I was burned. I didn't understand the question. So actually, just a couple of weeks ago, I run a charity event called it's over burn Awareness week, and there I educate. We speak to me and another burn survivor speak to nine schools over five days and we reach about 5000 students and we talk about burn awareness. But he was trying to find out the type of burn I had. I didn't know you could have more than one type of burn. So he asked how I was burned and I didn't understand the question. So I told him that I was burned in a fire. Probably wasn't the most helpful answer, but it was the only answer I had. He then asked a couple more questions. What were you doing, what were you working with? And determined it was a chemical fire I was in. After he found that out, it was my turn to start asking questions. And the first question asked was how bad it was. I could have looked at any time like I was naked, my clothes were burnt off of me, but I was too afraid. I didn't want to see the damage. I wasn't ready to see the damage. So he looked me up and down and told me I had third and fourth degree burns to 90% to my body. That made no sense to me because at the time I couldn't tell you the difference of degrees of burns. And now I have these burns to most of my body. Well, what does that mean? And he told me I had a 5% chance to live. The reason he gave me a 5% chance to live was because when the fire started, I also had the fumes. I'd breathed in the fumes, so my lungs actually ignited as well and I had a huge lung injury. Now if you get a big burn with no lung injury, your odds of surviving are actually pretty good. But the moment you have a lung injury, even with a small burn, your odds of surviving are really low. I've come to appreciate that that 5% was a generous number. Honestly, I don't think I should be here. From other burn survivors journeys, I've seen that they didn't make it anyways. So after he gave me that 5% chance to live, he then asked me if I wanted to live or die. And the reality is I'm very thankful I had that. Normally, I'm the first person I'm told by him that he's ever given that option to. Normally, it would have gone to my wife or closest relative. And I'm thankful that it went to me because there was no right answer for my wife if she would have said, let Spencer live. And then I have a horrible quality of life, and I do survive, and I chase a woman on my life, and I become addicted. She's probably like, well, maybe it was better to let him not live. Or what if she said, die, let him go. And then five years later, she's walking down the mall with my daughter, and she sees a burned survivor with his head up high in their family and smiling and having a good time. And she's like, that could be Spencer. There's no right answer for her. The right answer is honestly. When I woke up in the morning and had that gut feeling, so I chose to live, and that was the start of my journey. Host/Lisa: You were, thankfully, in a state where you could receive that question and answer it. Tell us about your thoughts as you were in the hospital. I mean, I cannot imagine everything that went through your head. Spencer: Well, first I went into coma for six weeks, and they gave you a medication called ketamine to create amnesia. There's a very small percentage of the population it doesn't work for. I'm one of them. So not only do I remember going through a fire, but I remember going through a coma. And all my dreams are the same. I was cold, helpless, alone, hungry. And that's my reality. I took what was happening in isolation in the burn unit and twisted it around in a dream state so my mind knew what was happening to me, although I couldn't really feel it or emote it. But I came out of a coma six weeks later, and I went from having nightmares to living one. At first, and I say this generously for the first couple of days, it wasn't super bad when I came out of a coma. And the reason being is I remembered everything. Yeah, I was severely injured. I had tubes all over a tube in my mouth. I couldn't talk, but I knew where I was, and it was the right place to be. But I did what everybody does. I fell into a trap. And I think it's a natural process. But if you can identify this trap, you can get out of it a lot faster and a lot easier. But I started to replay all the events over and over again. What could I have done differently? What went wrong? Why did my life have to change? Why did I have to have go through this fire? Right, sorry, my lung damage happens every morning. But I really boil it down to just two words now. And I think there are phenomenal words everybody says in life in one time or another. And that's why me. Why did my life have to change? And why me is the key to anger and depression, anxiety. It what opens the door for those things to be possible. Because you're anchored to a moment or an event or a feeling that you don't like. And you will examine that, looking for an answer. And how can I get out of here? But you can't get out of an anchor. An anchor is like sitting there, holding you there. So by asking, why me? You're not going to find an answer to it. Instead, what you're going to do is be anchored to it. And then it's going to open that door to where you're going to get angry, and the anger is going to bleed into depression, anxiety, and it's going to turn to addictions or chase people out of your life, or it's the source of everything is anger. And I got trapped into that. Eventually, I did find the answer to why me? Host/Lisa: Hey, rising strong listeners. If you've been enjoying the inspiring interviews on the podcast, we'd love your support to help us reach more listeners and hopefully gain some sponsorship. To do that, please, like, follow and subscribe wherever you listen to podcast. And here's a little extra incentive. Leave us a five star review and you'll be entered to win some cool rising strong swag. Your support means the world to me. Now back to the show. Spencer: I am an expert at YMe. I've asked that question more than a million times, probably a thousand times a day. I was asking it, and I couldn't understand why my life had to change. Eventually. When I did find the answer, though, I looked to Prince Henry and William, and because I wanted to find someone with a perfect life, someone who's never had any reason to experience hardship. And then I was like, well, have they ever had a bad day? Because honestly, that's what I boiled down to. I had a bad day. That's what you see on me? And I'm like, well, when they lost their mother in that car accident and the Princess Diana died, pretty sure they felt bad and had a bad day, and they asked, why me? Why did my mom have to die? In that know? I found that it's so universal, not only why me, but bad days, that I started to change the question, and I didn't mean to do this, but I started to do it by overcoming things, I convinced myself I was never going to do again. And every time I overcame something I thought I could never do again, I started to be like, well, what else could I do? What else can I do? So I've condensed that question down now to, what can I do for me? And honestly, I don't use that question a lot. But when Covid hit, I put it right back into play because I had another bad day. I lost all my business in three days. So many people experience that, right? So at first I felt what I was feeling. I'm a huge believer in feel your feelings, but know, to cap them off and then start moving forward, but to go back. You asked about my mental health, my thoughts. So the anger was first. After Yme came, anger. I was ****** off. Someone had to pay for this. I was angry at my boss. There was another tradesperson that just left. I was angry that he didn't come to help me. I was angry at the hospital because ultimately their care wasn't good enough, which is just bs, but I was angry at a lot of things. One time, I told my wife when they pulled the ventilator, I was so angry, I told her she could leave me. Anger does that. It chases people out of your life, and then it boils to depression. And the depression I found is what I found about depression is it took my morals and my values, and it threw them out the window. And now anything's possible. So when I was depressed, I'm not a suicidal person. I believe everyone contemplates suicide to the point, like, if I died, who would show up at my funeral? But that's kind of like, see if we're loved, right? But when you start deeply, how can I kill myself? That's a different type of suicide. That's when you're really into it. I'm not that type of person. I've never contemplated it, except for when I was in the hospital and I played that game. If I could kill myself, how would I do it? I was completely immobile. I couldn't move. I couldn't do anything. So the depression led me there. It took my morals and values and it threw them out the window. And what I found with depression is you're not going to make good decisions, although you feel like you are and you don't see it, you're actually making bad decisions. And you can see it when you're opposing people that love you and you're, like, pushing them or you're getting mad at them because they didn't say something in the right form or they didn't know exactly how to help you, and you get mad at them and you push them out of your life because of the anger. And what you need to do when you're depressed is you actually need to lean on those people. You need to have them help you navigate better decisions so that you make less damage in your life while you're depressed. Part of coming out of depression is you actually have to go and repair the damage you've done while depressed as well. And then the anxiety came. Anxiety is the weirdest thing in the world. I described it like having a sumo wrestler sitting on my chest and I just couldn't breathe. Honestly, I could not breathe. And what I've come to appreciate is nothing was stopping me from breathing. It was things in my head I had going on that I wasn't tackling or taken care of. And it was creating these physical repercussions to me. And I can tell you there was a time in the hospital when they'd take the ventilator out and then bring me down to surgery and they'd have to beg me for air. And every once in a while, the nurse would forget to give me a breath of air. I tried to breathe. I really did. I can tell you, being completely mobile, extremely underweight, heavily medicated, tubes going in, every part of my body stuck in isolation. The most helpless feeling I had in the hospital was when the nurse forgot to give me a breath. And that's what I describe anxiety as, like not being able to breathe. The most helpless feeling in the world. Host/Lisa: There was a time during all these deep, dark feelings you were feeling. Your wife gave birth. Unfortunately, you couldn't be at the birth, but she came to visit you soon after with this new little bundle. Can you tell us about that moment? Spencer: Sure. So, first of all, the only regret I have is missing the birth of my child. And the reason being is that's supposed to be your happiest day in your life, and I missed it and I don't get it back. You don't get the birth of your first child back. Once it's gone. It's gone. So when people look at me and they see the burns in that, they also see a guy that will never have a happiest day. I've come to face that. I've come to appreciate it. But that's another thing. The fire stole from me was my happiest day, but it also was a great blessing at the same time. And I've chosen to look at the blessing more than the Regret. The day after my daughter was born. My wife is an extremely strong lady, and she hates me saying that. She's also very humble. But from what I'm told, giving birth is not an easy process. It's painful. It's exhausting. There's healing that needs to occur after. And usually mother and child both want to sleep like, and go and start healing. So they brought him to the misery Cordy hospital. She actually gave birth at home. She gave birth so fast to our first child. So ladies get to the hospital fast. But the Iowans picked him up, took him to the misery Cordy hospital, which is where she was to give birth, but that's also the wrong hospital. I was at the university hospital, so that was like. And you take those small little things like, I'm in the wrong hospital, and that's enough to crack open the anger. And so they checked them both out. Both mother and child were healthy. And then the next day, they released them. So September 20 eigth is the birth of my daughter. 29th, they released them. And instead of Tina going home to rest, she was like, everyone knew how angry and depressed it was. They would have done anything to cheer me up. So instead, Tina jumped in the minivan my father in law was driving. And they came right to the university hospital so that I could meet my daughter. And when they got to the hospital to enter my isolation room, he had to put on sterile garments. So sterile gowns, gloves, masks, and a hat. They don't make little baby sterile garments. So they put Amber into. Amber is the name of our child into a sterile pillowcase. And we called her Amber because Amb is for ambulance and ER is for emergency room because she spent a lot of time in the first nine months of her life in the hospital coming to see me as well as Amber goes really great with my last name. So Beach. Amber beach is just a beautiful name. But they brought Amber in to meet me, and I couldn't hold her. I was that weak. So Tina raised the railing with the hospital bed up, and then she put a blanket over it and laid Amber right here on the crook of my arm when she laid there, I looked at her hair and her nose because I was missing a big chunk of my nose. So it was really important that she had a nose and her ears. I counted all her fingers because mine are all messed up. And I'm a religious person, always have been. I did fight with God in the hospital, but I've come to really appreciate. There were so many times I prayed in my life, Lord, find me a girlfriend or a wife. Have a good job. Help me through this time in my life. So many things I've prayed for to either get me through something or improve my life. I never once prayed for hair or nose or ears or fingers. And I kind of looked at my daughter and I'm like, well, everything I lost, she has. She has a fresh start. And to me, that was really important, because part of that fresh start is she also needed two things in that fresh start. She needed her mom and her dad. She had the mum, but at that moment, she didn't have a dad physically. She had a dad emotionally, mentally, she did not have a dad. What my daughter did for me that day, figuratively. And I have to say that because I've actually had a child ask if she really did do this. I'm like, no, it's figuratively. But up until the first five months of my incident, up until the birth of my daughter, I found my eyes were looking the wrong way. My eyes were turned inward, and they were examining everything about my life that had changed. And they didn't like anything they saw. I hated it all. And that was a big cause of that anger. Was that why me? But my eyes were looking the wrong way. And when my daughter was born and laid my arms, what she did is she forced me to look outside of myself. And that was really the first time I truly did look outside. And when I looked outside, I saw my wife and supporting, becoming every single day, wanting nothing more. She only had one want, and that was try, try to get better. I'd convinced myself there was no point in even trying to get better. I saw a daughter who needed a dad. I saw this hospital, this amazing hospital with all these people, like extreme professionals, doing everything they can for my care. I saw my friends and family and doing what they could to support me, mostly by supporting my wife and doing things around the house for her that as a pregnant lady, it's a little difficult for her to do. I saw all these things in my life, these people, these most important thoughts that I had worth fighting for. And it was because of them. I chose to try. And I share this message with people all the time. I don't care what your eyes see. When you find something worth trying, grab onto it and try. You don't have to want to fight for yourself when you're that deep and dark. But if you see someone or something worth fighting for, fight for it. And eventually your eyes will start to appreciate what they do see within yourself as well. But at the beginning, it may be hard to look at yourself. Host/Lisa: Do you think that shift in focus is really what pulled you through? Spencer: It was the start of the positive journey. The anger didn't disappear overnight, neither the depression or the anxiety. It was a journey I was on, but it was the start of it. There was a few more other stories I could share that really helped to see perspective and engage. For me to really grab onto that, I need to fight. Host/Lisa: Let's dive into that a little bit, because those are the messages that I really like to share with listeners. Because I think when you're in the weeds, when things are so freaking dark, there's not even a glimmer of light anywhere. Sometimes it's perspective, right? It's like you say, flipping the lens. So share some of those stories with us, please. Spencer: I'll share three, and I'll stop at each one so you can ask a deeper question if you want the first one, we got to go backwards in time. My fifth wedding anniversary happened on June 27, 2003. So I'm in the hospital, angry, depressed, and I had ventilator in my mouth and tubes in my lungs and my stomach feeding me and helping me breathe and draining fluid from my lungs. And on my fifth wedding anniversary, I woke up and there was Dr. Trejit at the foot of my bed and the charge nurse and the respiratory therapist, and he's pull, we're going to extubate you today. I'm like, I've just pulled a ventilator. I'm like, okay, great. And this is all in my head because I can't talk. I'm like, I remember all those times going to or when I had to get bagged and I couldn't breathe, and I tried to breathe. Like, what if you're wrong? And you didn't prepare me at all. This is a surprise for me. What if you're wrong and I can't breathe? So they pulled the tube. He asked me to take a deep breath. I did. It was more of a sigh of relief that he wasn't wrong. He asked me to say a few words. My first words were with a really small, scratchy voice were, what do you want me to say? Can you believe six months of being quiet and your first words are angry words? What do you want me to say? And he was testing my vocal cords to see if I even had a voice. He asked me to cough a few times, and the reason being is now I had to start expelling all the fluid from my lungs out myself, which is a long process. But honestly, when I said, what do you want me to say? I was not wasting my voice on that man. There was no way. Prior to that, the way I communicate was by blinking. And they'd have a board, and my wife would spell A-B-C and I'd blink the word, and that's how I communicated. But I was heavily medicated and I was always extremely tired, and it did not take me much to lose focus or not know. And I'm also dyslexic, so if I couldn't spell a word, anything ****** me off. If I missed the letter, if I couldn't spell it, if I made a mistake in any way, I'd just get so mad, and I'd roll my eyes on the back of my head and pretend I was asleep and just get out of my room. Can't even talk to you because I can't say it. And then. So I finally had the chance, and I can't tell you how many times I blinked. I love you. To Tina. But that voice was not being wasted on that doctor. So I waited all day. Tina came every evening, and she got to the hospital. She didn't also know what happened, so the nurses, they couldn't hold back good news, but they also didn't tell her what had happened. So she knew something positive happened that day. And she came into my room, and when she opened up the door, I told her I loved her. That was her fifth anniversary present. It was a present the hospital gave us. I share that story with you because I have come to appreciate that you can't go through life on your own. And when days get hard and we all have bad days, you need to have people there to support you and help you through those bad days. The problem is those when we're hurting, we tend to be like, I can do this on my own. I don't need anyone's help. I'm actually not going to share what's happening with me. And that's a very. Again, that's a dangerous thing. That's the anger taking control of you because you're limiting yourself on success. And the interesting dynamic is, though, is if you see someone you love going through something hard, you want nothing more than to help them. And I find it's a very ironic dynamic that we have is like, when I'm hurting, I don't want any help, but if I see someone I love hurting, I want to do everything I can to help them, which is ironic. We have to learn to accept help. And the reason being is when I was dark and angry and depressed and whatever, the way I look at is like the hand, right? I was this little thumb, and I was trying to solve all my problems by this little thumb, by myself. But the moment I started to accept help, I started to embrace my support of my wife and the doctors and nurses and therapists and all their expertise and my friends and my family. And there was complete strangers. All of a sudden I had all these people trying to help me solve my problems. And I can tell you that the hand is way stronger than the thumb. It's like all these experts and loved ones trying to help me were way stronger and more quick to help me through that problem than me on my own. So that would be the first story I'd share, is that love story of my wife supporting me, telling her I loved her. What's interesting, though, and I'll conclude it with this, that was a high pain to my journey, and I was excited. That was actually the first day I was happy in the hospital. Three days later, Tina came to see me. And that's when I said, this is not the man you married. Take everything and go. I'll completely understand. The anger took control of me again. And it's a journey. You don't get through a journey going through. I had a great day. It's all going to be great now. It's ebbs and flows. You're going to have low points. You're going to have high points. When those low points hit, you're going to want to push people out of your life when that's when you want to bring them back in and be like, you know what? It's hard for me today. And right now I just need your shoulder. I need you to just support me right now. Host/Lisa: I first have to say, that is such a beautiful story. And I think that your message is such a good one. And I think it's relatable to every kind of adversity out there. Whether it's mental health struggles, whether it's enduring the loss of a child, whether it's anything, is that we are stronger together. I am guilty of this as well. Do you think it's not only I can do this myself or that we don't want to burden our loved ones with our troubles? Spencer: I think it's a combination of a lot of things. One of them is we use, I don't want to burden you as an excuse. I don't want to burden you as an actual reason. It's an excuse. But I really do feel like it's more that we don't want to open up. Because to open up and say this is what I'm going through means that I also have to expose who I am and parts of my internal self that I don't show the world every day. And I'm really not comfortable with sharing the world those things every day. And you know what? You're not an expert either. You're probably going to give me advice that I don't want to hear. I find that a lot. I don't like the advice you just gave me. Right. So then I get mad at you or you didn't say it exactly what I wanted you to say it. It's like, who cares? I'm here because I love you and I'm supporting you. I'm not going to have all the perfect answers, but you know what? I'm going to be there perfectly supporting you. And if you let me, let's talk. Host/Lisa: A little bit about resilience. I think you are truly one of the most resilient human beings I know. What makes you resilient? And what do you think makes people in general resilient? Spencer: Well, I've already given you two stories, so we'll go to the third story, which is perfect timing. So the first story is you can't get better on your own. That's the support of my life. Second story is you got to start finding things worth fighting for. Let your eyes turn out and find those most important things. Third story is perspective. I went home to the hospital on boxing, or I went home from the hospital for 2 hours on boxing day. I was supposed to go on christmas, but it didn't work out. It took two paramedics and two nurses and about three bags of medical garments. I stayed in the stretcher the entire time and I dictated. I didn't want a single child in the room because I didn't think any of my nephews or nieces could handle what they're going to see. The only child in the room was amber, and she was my baby, so that made sense. When I did get home, there was my grandpas, my grandmas, aunts, uncles, friends, adults, all adults, brothers, sisters, and they had all these presents and everyone else had already opened their presents, and I couldn't open presents. I was completely useless still at that time. So my wife would open the presents and anger took over me. Every time I saw something, I'm like, well, that's nice. I haven't worn clothes in nine months. Thank you for a sweater I'll never wear again in my mind. That's what I'm saying, right? Or, oh, you got me an xbox. I know it's a $300 gift, but these hands will never play with a controller again. Thank you. I just turned everything into a moment to be angry, this love from people. And then after 2 hours at home, it was time to go back to the hospital. So they loaded me back in the ambulance. And in Edmonton, we have the white mud freeway. I lived on the west end of Edmonton, and the time of year is really important. This is Christmas. So four in the afternoon, the sun's already setting here in northern Canada, and I'm going from west to east to the hospital. So I'm looking at the sunset the entire Way, going down the white mud freeway. And as the sun set, all I could see looking out the Back of the ambulance was red and orange and yellow painted right across the sky. And it was just super beautiful. And in my mind, I sat there so quietly, lied there so quietly, just looking at that sunset, taking it in. And what the Paramedic didn't realize was the Perspective I was gaining. The last time I saw red, orange and yellow, my life was being destroyed. And now it's painted right across the sky in the most beautiful way I could ever picture it. And in my mind, I'm like, maybe the Fire didn't have to be destructive. Maybe this could be a Sunset. And it really changed my perspective on what was possible. And so when Tiana came to visit me that night after my family left, about an hour and a half later, she walked by the window. There's a big Bay window for isolation that they can observe you. And as soon as I saw her, I was like, here comes my Sunshine. Sorry, I don't get to tell that story a lot. Honestly, that moment, I needed to see a Sunset. Put it that way. I needed to see some hope. And that hope came from realizing that fire can be beautiful, and maybe I could be, too. Host/Lisa: I absolutely love that story, and I'm so glad that you told us, and maybe you weren't ready to see the sunset before that, but I am so, so happy that. That did help you on your journey. Can you share with us? As you said, I think anything after trauma, after something terrible in your life has happened, I call it a roller coaster. After losing Katie, I would say that I was on, like, a Six Flags scream the whole way, want to vomit kind of roller coaster. And now I'm more on the kitty roller coaster. How do you cope? How did you cope? How have your coping skills changed over the years? Spencer: That is so funny that you describe it as a roller coaster, because I do as well. So your screaming moment, Six Flags roller coaster. For me, it was my life changed, and you hit rock bottom, and it's a far fall and it's a hard fall, and that's the screaming part. Right. And then you get to that low point. And I'm sure you had this ultimate low point, was that initial despair of grief and overwhelming emotions of finding out your daughter is no longer here. But what ended up happening is after you hit that low point, you actually start going up, but you don't realize it because you're now in the healing journey forward. So, for me, it was physical and emotional, mental. For you, it'd be, and spiritual. For you, the physical part wouldn't be there, but I'm sure all the emotional, spiritual, and mental stuff would all be there. But you start finding this way to heal, and then you hit a high point. And you hit those points where you wake up one day or halfway through your day or whatever, you find yourself laughing. You haven't laughed in a week, and now you do. So for me, I say the first high point was when I came out of a coma, right? Because it wasn't that bad. That was the first time I was like, okay, it's not so bad. But then after I found that high point, I hit a low point again. Because what ended up happening is I gained something that day. Like, I'm now awake, right? And for you, it was like, oh, I can laugh again, right? Or I can smile again, or I can hold my husband again or something, right? Something hit that high point. What happens when you hit that high point? You get to keep it. You can't be taken away from you. It's something I gained now, but I still have a lot more journey to go through. That one thing on its own is not enough. So you hit a low point again. But what's interesting is you don't fall as far because you actually got something, you got to keep something. And then you hit that low point, which would be like, after I told Tina I loved her three days later or after I woke up, I was like, I became angry really quick or told Tina she could leave me after I told her I loved know I hit those low points every single time in my journey. Whenever I had a point that I was high, I have found that within an hour or a day or three days, I hit this low point where I tried to push something out of my life. But then what I came to realize I kept what I gained. So the next climb wasn't as high and the next drop wasn't as low. Which is weird that you then get to, like, an amonic kitty roller coaster. That's how I exactly describe it. It's like everyday life is little ups and downs, right? We don't have these huge drops and huge ups, but we're back to everyday life where we have ups and downs. What? I will go back to my near death experience a little. I say what happened to me was a bad day, right? But I challenge people in my presentations. I'm like, have you ever had a bad day? Everyone's like, yeah. I'm like, I bet you you've had so many bad days, you can't remember them all. Am I right? But then I go even further. I'm like, tell me a bad day you had three months ago or six months ago. And most people can't even tell me what their bad day was three months ago or six months ago. Yet I guarantee you had one then. And then it's like, well, and when you have those bad days, they consume you. They absolutely consume you. It's like they change the whole outcome of your day sometimes. And yet they were so meaningless, you don't even remember it three months later. The only time anyone can ever say, I do have a bad day, I can share with you. Six months ago was when they lost somebody or when they lost a job or they had something that affected their most important thoughts. When you have something that affects those most important thoughts, you remember those days. But short of that, our bad days usually are so meaningless, we don't even remember them. Host/Lisa: Yeah, they're blips in the big scheme of thing, right? I think both of us comparing our journeys to a roller coaster, I think that that is a good analogy, in my mind, at least, of resilience. And I think resilience is keep staying on the darn roller coaster and accepting that the ride is not always fun and accepting that the ride is hard and that the drops are going to come and that those moments that you want to scream and barf are going to come, but to keep going. And I think we get a little bit stronger, right. Every time that we have a really tough time on our journey, that makes us stronger. I know in the beginning I hated when people said, oh, you're so strong. And I just wanted to scream, I have no option. And you probably felt the same way as well. Nobody gave me a choice in this, but I truly think that when you go through hard times, you do become strong. Do you think that as humans, we have to go through adversity in order to become resilient? Spencer: Yes and no. In a perfect world, no, we shouldn't have to go through these things to become resilient. And your listeners are going to be like, oh, that so makes sense. But then the next time you have a bad day, are you really going to think back to, well, what did Spencer say and how do I apply? Like, that's what I did with COVID because I have been through it, that I know these tools and I know first you feel what you're feeling, right? Then you have to be, instead of letting that trap happen and catch you, you cap it off. Like, I give myself three days. I don't care what the situation is. Three days I will grieve. After three days, I will start to move forward. It doesn't mean I give up the grieving instantly, but I'm now on a path of moving forward. But you have to flex those muscles. You have to grow them. And the way you do it is by putting into practice positive habits when things get hard, because then you become more resilient on being able to get through things. So you say resiliency is these ebbs and flows and going through the roller coaster thing. I say resiliency is having the strength to get out of your own way. Host/Lisa: That is so good and so true. I know there's some people that are listening that are going to want to look you up. They're going to want to find your book and they're going to want to find your website, maybe book you as a speaker. Where's the best place for them to go? Spencer: Well, you can google my name, Spencer beach. There's two Spencer beaches in the world. One's a real beach in Hawaii, which I've been to. It's a beautiful beach. Please don't pee on it. There's public washrooms there. The other is me. Or you can go to Spencerspeaks, ca. The book can only be found on my website. You can get used books through Amazon. If you are looking for saving money, and I'm completely fine with that. I wrote the book to help people. And I think the worst thing for a book, once it's read, is to sit on a shelf and never be read again. So yeah, if you can find a cheaper way of getting the book, take advantage of it. And you can also get the book as an ebook as well. It's called in case of Fire. Host/Lisa: Yes. And read it. Like I say, it was amazing. I don't remember many of the books that I read, but I will always, always remember yours. Spencer, you truly define resilience. Massive gratitude for being here today. Spencer: Thank you. Host/Lisa: And to our listeners, be well and stay resilient and we'll catch you next time. Remember, you were made for more.

Dr. Monty Ghosh, Internist and Addiction Specialist who works at the University of Alberta Hospital in Edmonton, and the Foothills and Rockyview Hospitals in Calgary Learn more about your ad choices. Visit megaphone.fm/adchoices

Antibiotics treat bacterial infections and save lives when used appropriately, but when they aren't needed, they can cause adverse effects and other harms — including antibiotic resistance, a growing global health threat. Dr. Lynora Saxinger, an infectious diseases specialist at the University of Alberta Hospital in Edmonton, explains what conditions antibiotics do — and don't — treat, why new antibiotics are limited and how resistance is affecting patients in hospital. For transcripts of The Dose, please visit: lnk.to/dose-transcripts. Transcripts of each episode will be made available by the next workday.

Courts in dissaray in Ontario at this time because of staffing issues and health concerns within courtrooms (mold). Hundreds of criminal cases (and maybe more) may be thrown out because of not meeting required timelines from charges being laid to a trial concluded, per the Supreme Court Jordan decision of 2016. Might killers walk?Not the first time. In 2017 a report by the Senate standing committee on legal and constitutional affairs, revealed tens of thousands of criminal cases may have to be thrown out for the same reason. And then there's the issue of NCR. Not Criminally Responsible. NCR has been a national headlines creating reality and is again in British Columbia with premier David Eby "whitel hot" angry over the release of an NCR psychiatric patient, Blair Evan Donnelly, who stabbed his teenage daughter to death and last weekend stabbed three people at the Light Up Chinatown festival in Vancouver. Also making news this week, Matthew de Grood of Calgary who stabbed 5 university students to death at a Calgary house party in 2014. de Grood was found to be NCR 2 years later because of undiagnosed schizophrenia and was sent to the Alberta Hospital in Edmonton where he receives ongoing psychiatric treatment. Last year the Alberta Review Board assessed de Grood as a continuing significant threat to the public and not entitiled to an absolute discharge. Now de Grood is appealing to the Supreme Court of Canada in order to gain a conditional discharge with additional freedoms. Guest: Scott Newark. Former Alberta Crown prosecutor, Fmr executive officer of the Canadian Police Association, Vice-chair of the Ontario Office for Victims of Crime and senior policy advisor to the federal and Ontario Public Safety Ministers. Learn more about your ad choices. Visit megaphone.fm/adchoices

What an episode! In this amazing show we meet Dee Walker! Dee shares her journey as a young female navigating the law enforcement world including working with some of Edmonton's most vulnerable populations downtown in our shelters, our Addictions and Recovery centre, and at Alberta Hospital.  She also shares a story of disappointment and a life altering curve ball that was thrown at her and how she overcame that to become the founder of True Haven.  True Haven is a Canada-wide non-profit started to help those individuals who are living with violence. Currently focusing on 4 main branches of support, which include Moving Support, Tech Services Support, Protective Services, and our Threat Risk Vulnerability Assessments. Every client goes through an intake assessment which will help determine the risk level and what services they need.  If you or anyone you know may be living with violence, please do not hesitate to reach out 1 800 884 8185 or by email info@truehaven.ca. You can also visit their website at www.truehaven.ca for more information or to explore ways to help.Season 3 is proudly sponsored by Alberta Defensive Tactics Training owned by local Peace Officer Jamie Erickson. Check out all the training and courses that ADTT offers and follow them on IG @erickson_adttSupport the showFill out our survey with all your questions, feedback and ideas for new episodes or leave us a voicemail here! Follow our show on Apple Podcasts so that you get notified each time a new episode is available!If you already follow our show, help a friend follow the show too. Want to support this podcast even more! Make a monthly subscription for only $3 a month here! Interested in becoming a female first responder? Reach out to learn more! Email - info@bluelinefitnesstesting.comBlue Line Fitness TestingFacebook - https://www.facebook.com/bluelinefitnesstestingInstagram - https://www.instagram.com/bluelinefitnesstesting/LinkedIn - Nikki Cloutier

"Combating the Opioid Crisis: An Unexpected Collaboration", by Michiko Maruyama, MD, BDes, Cardiac Surgery Perioperative Care Physician, Department of Surgery; Vivian Ip, MBChB, FRCA, Clinical Professor, Department of Anesthesia and Pain Medicine; and Cheryl Mack, MD, FRCPC, Anesthesiologist and Chair of Clinical Ethics, Department of Anesthesiology and Pain Medicine; all of the University of Alberta Hospital, Edmonton, Canada; and "The Chapter of the Doctors Against Tragedies Card Game in Eastern Canada," by Jennifer Szerb, MD, Professor, Department of Anesthesia, Perioperative Medicine and Pain Management, Dalhousie University, Halifax, Canada. From ASRA Pain Medicine News, November 2022. See original article at www.asra.com/nov22news for figures and references. This material is copyrighted.    

Join us on this podcast as we discuss Renal Replacement Therapy with Professor Sean Bagshaw from the University of Alberta Hospital, Edmonton, Canada. Dr. Bagshaw is Professor and Chair for the Department of Critical Care Medicine at the University of Alberta in Edmonton, Canada. He completed medical school and residency training at the University of Calgary (Doctor of Medicine – 2000; Internal Medicine – 2003; Critical Care Medicine – 2005; Master of Science in Epidemiology – 2005) prior to completing a Critical Care Nephrology fellowship in the Department of Intensive Care Medicine, at the Austin Hospital in Melbourne, Australia. Dr. Bagshaw works as a full-time staff intensivist in two of the busiest and highest acuity intensive care units in Alberta – the General Systems ICU at the University of Alberta Hospital and the Cardiovascular Surgical ICU at the Mazankowski Alberta Health Institute. Dr. Bagshaw has expertise in acute kidney injury, renal replacement therapy, frailty and vulnerable patients and end-of-life care in ICU settings. He has published over 400 peer-reviewed articles and it was our absolute privilege to have him on the show. In this episode we talk about timing of replacement therapy, data around continuous and intermittent therapy, intensity of dialysis, fluid management, anticoagulation and weaning of renal replacement therapy. Articles of Interest: 1. Timing of Initiation of  Renal-Replacement Therapy in Acute Kidney Injury. New England Journal of  Medicine. 2020 Jul 16;383(3):240–51. 2. Zarbock A, Kellum JA, Schmidt C, van  Aken H, Wempe C, Pavenstädt H, et al. Effect of Early vs Delayed Initiation of  Renal Replacement Therapy on Mortality in Critically Ill Patients With Acute  Kidney Injury. JAMA. 2016 May 24;315(20):2190. 3. Barbar SD, Clere-Jehl R, Bourredjem A,  Hernu R, Montini F, Bruyère R, et al. Timing of Renal-Replacement Therapy in  Patients with Acute Kidney Injury and Sepsis. New England Journal of Medicine.  2018 Oct 11;379(15):1431–42. 4. Gaudry S, Hajage D, Schortgen F,  Martin-Lefevre L, Pons B, Boulet E, et al. Initiation Strategies for  Renal-Replacement Therapy in the Intensive Care Unit. New England Journal of  Medicine. 2016 Jul 14;375(2):122–33. 5. Jaber S, Paugam C, Futier E, Lefrant  JY, Lasocki S, Lescot T, et al. Sodium bicarbonate therapy for patients with  severe metabolic acidaemia in the intensive care unit (BICAR-ICU): a  multicentre, open-label, randomised controlled, phase 3 trial. The Lancet.  2018 Jul;392(10141):31–40. 6. Intensity of Continuous  Renal-Replacement Therapy in Critically Ill Patients. New England Journal of  Medicine. 2009 Oct 22;361(17):1627–38. 7. Intensity of Renal Support in  Critically Ill Patients with Acute Kidney Injury. New England Journal of  Medicine. 2008 Jul 3;359(1):7–20.

Join us as we discuss early burns resuscitation with Dr. Dennis Djogovic. Dennis Djogovic is an emergency physician, trauma team leader and intensivist at the University of Alberta Hospital in Edmonton Alberta. He is the medical director for the HOPE organ donation organization, medical director for the Garner King General Systems Intensive Care Unit, and medical director for the Biggs and Allen Neurosciences Intensive Care Unit. The Garner King GSICU also incorporates the Edmonton Firefighters Burn Treatment unit, an American Burn Association verified burn centre and is a major burn referral centre in Western Canada, where Dennis is an instructor and course director for the Advanced Burn Life Support course. The following make up the major learning points in this episode: 1. Ignore the burn. Burns patients are trauma patients with thermal traumas. Primary survey first! 2. Early on, only note extent as more than, or less than 20% BSA. 3. Airway decompensation is usually slow. Outward appearance may not indicate the presence of an airway injury, if in doubt, intubate. 4. If you are unsure of the exact extent of burns, start with Ringers Lactate at 500cc per hour for all patients who have more than 20% BSA burns and who are older than 14 years of age. If you are sure of extent, use the ABLS formula in place of the traditional (and old) Parkland formula, which is 2cc/kg/BSA divided by 2 and then by 8 for the first hour's starting rate. Changes to fluid administration rate then gets made in accordance to urine output and hemodynamic parameters. 5. Hypotension in the burns patient, especially early on, is usually not due to the burn. Seek other etiologies to explain hypotension early on. 6. Referral criteria include: More than 10% BSA involvement, involvement of special areas like hand, genitals and face, all pediatric burns, burns involving the joints and patients with major comorbidities. Further reading: State of the Art: An Update on Adult Burn Resuscitation. Causbie, J.M.; Sattler, L.A.; Basel, A.P.; Britton, G.W.; Cancio, L.C. . Eur. Burn J. 2021, 2, 152–167. https://doi.org/10.3390/ ebj2030012. Here Nebulized heparin for inhalation injury in burn patients: a systematic review and meta-analysis Xiaodong Lan1, Zhiyong Huang, Ziming Tan, Zhenjia Huang1, Dehuai Wang, and Yuesheng Huang. Here The Physiologic Basis of Burn Shock and the Need for Aggressive Fluid Resuscitation Lisa Rae, Philip Fidler, Nicole Gibran. Here

Guest:  Dr. Stephanie Smith, University of Alberta Hospital physician and infectious disease specialist. 

My guest today is Nese Yuksel, a North American Menopause Society Certified Menopause Practitioner who practices at both the Multidisciplinary Bone Health Clinic at the University of Alberta Hospital and the Menopause Clinic At Lois Hole Hospital for Women while also being a full professor of pharmacy and pharmaceutical sciences at the University of Alberta. She is also a member of the Executive Committee of the Scientific Advisory Council of Osteoporosis Canada. You get your mammogram & pap smear. You pay attention to your blood pressure. But have you spent much time considering your bone health? Not the sexiest of topics I know! But listen to the first 5 minutes of the episode at minimum to hear Dr. Nese Yuksel's elevator pitch as to why bone health should be on your radar. Dr. Yuksel and I cover: What osteoporosis is Assessing your risk of osteoporosis Prevention: including nutrition, exercise and lifestyle modifications Resources mentioned: Osteoporosis Canada Bone health and Osteoporosis Foundation

Dr. Ron Brown graduated with a degree in family medicine in 1983 and went on to specialize in OBGYN at the University of Alberta Hospital in 1995. He is board-certified in Functional and Regenerative Medicine, which led to his primary interest in bioidentical hormone replacement therapy (BHRT). His book, “Discovering Your Truebalance with Bioidentical Hormones”, documents his years of extensive research and accumulated knowledge. Since publication, he has helped thousands of patients improve their quality of life with BHRT and TRT and now leads the largest hormone therapy clinic in Canada. In this episode, Dr. Brown explains his work and research in BHRT, the correlation between pharmacies and available knowledge and treatments to patients and doctors alike, the ways in which these treatments have helped improve people's quality of life as they age, and so much more. This episode is incredibly rich with information that may come as a surprise to many women and men alike. See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Guest: Donald McCaffrey - President and CEO of Resverlogix Corp.

Guest: Dr. Peter Brindley - Full-time Critical Care Physician at the University of Alberta Hospital in the General Systems Intensive Care Unit and its NeuroSciences Intensive Care Unit. See omnystudio.com/listener for privacy information.

SUMMARY The over-65 age group is the fastest-growing demographic in Canada, with rates of mental illness for seniors over 70 projected to be the highest of any age group by 2041. Add to that the impacts of COVID-19, and you have a complex and costly national challenge that requires urgent attention from all sectors, in the move toward upstream seniors' mental health care. Join Marjorie Horne (seniors' advocate and founder of CareSmart Seniors Consulting), Naomi Mison (caregiver and founder of Discuss Dementia), and Dr. Anna Wisniewska (geriatric psychiatrist) in Part 1, as they share their personal stories and professional insights about the mental health challenges seniors face, and the opportunities that abound for improved care and enhanced quality of life. TAKEAWAYS This Part 1 podcast will help you understand: Current and projected statistics related to seniors' mental health and care Personal stories of caring for family members Reflections on COVID from caregivers and a geriatric psychiatrist Lessons learned from COVID to improve the mental healthcare system Common myths associated with seniors' mental health Common mental health challenges (e.g., depression/anxiety) and opportunities for care available to seniors and their families Risks of marginalized groups, experiences of men vs. women, and roles of ethnicity, genetics, ACEs (Adverse Childhood Experiences), epigenetics Common mental health challenges for seniors in residential care and their families Challenges and opportunities associated with caregiving and advocacy Transitional challenges experienced by seniors of all ages Need for intergenerational knowledge and connection Terms such as “eldering well”, “eldercare”, “death cafes”, “end-of-life doulas” SPONSOR The Social Planning & Research Council of British Columbia (SPARC BC) is a leader in applied social research, social policy analysis, and community development approaches to social justice. The SPARC team supports the council's 16,000 members, and works with communities to build a just and healthy society for all. THANK YOU for supporting the HEADS UP! Community Mental Health Summit and the HEADS UP! Community Mental Health Podcast.   RESOURCES World Health Organization Canadian Coalition for Seniors' Mental Health Mental Health Commission of Canada Active Aging Canada Alzheimer Society CanAge Canadian Association for Retired Persons (CARP) Canadian Centre on Substance Use and Addiction Canadian Frailty Network Canadian Mental Health Association Canadian Suicide Prevention Network Deprescribing Network Elder Abuse Prevention Ontario National Institute for Care of the Elderly (NICE) Seniors First British Columbia The Centre for Addiction and Mental Health Caregivers Alberta Carers Canada Caregivers Nova Scotia Canadian Hospice Palliative Care Association Families for Addiction Recovery: FAR Canada Family Caregivers of British Columbia Canadian Research Centres on Aging   GUESTS  Marjorie Horne, Dipl. T. Nursing Marjorie Horne was 16 when she knew that the way we see and treat elders had to change. Her journey involved training as a registered nurse, becoming the Executive Director of the Central Okanagan Hospice Society, working in management in seniors housing and, finally, starting her own business, CareSmart Seniors Consulting Inc. She is also a Conscious Aging Facilitator and a Certified Professional Consultant on Aging. As an entrepreneur, Marjorie's goal was to bring a holistic, ‘Circle of Care' approach to supporting seniors and their families through the many transitions encountered in the third chapter of life. Her community endeavors of creating and hosting her own radio show, Engaging in Aging, every Sunday morning on AM1150, writing a bi-weekly column, facilitating workshops on Conscious Aging, and speaking at local events, are all driven by the desire to be part of a new paradigm where we reimagine later life with courage, resilience, passion, and purpose. Phone: 250-863-9577 Email: resources@caresmart.ca Website: www.caresmart.ca Facebook: https://www.facebook.com/caresmartseniorsconsulting Twitter: https://twitter.com/caresmartsenior Linkedin: https://www.linkedin.com/in/marjorie-horne-46bb8937/ Naomi Mison, BA Naomi Mison is a public speaker, vocal advocate, and a champion of change. She has spent the last four years bravely sharing her journey as she cares for her mother who was diagnosed with frontotemporal dementia, when Naomi was just 22 years old. She has spoken publicly through the Alzheimer Society of Canada National Anti-Stigma Campaign, CBC's Out in the Open podcast, Globe and Mail, Embrace Aging Okanagan, Pecha Kucha, and many more. Naomi volunteers with the Alzheimer Society of BC's Leadership Group of Caregivers, is on the planning committee for IG Wealth Management Walk for Alzheimer's, and for the Seniors Outreach and Resource Centre. Naomi holds a Bachelor of Arts in Political Science and English, and a Diploma in Public Relations.  Phone: 780-885-3956 Email: mailto:naomi@discussdementia.com Facebook: https://www.facebook.com/nam956 Twitter: https://twitter.com/NaomiMison Linkedin: https://www.linkedin.com/in/naomimison/ Dr. Anna Wisniewska, MD, FRCPC Anna Wisniewska completed her undergraduate medical training at the University of British Columbia and her postgraduate training in psychiatry at the University of Calgary. Her clinical career has always focused on the care of the elderly and their families. Dr. Wisniewska is currently a consulting geriatric psychiatrist at the Kelowna General Hospital and the Kelowna Mental Health Centre. She also works in her private practice in Kelowna and is a sub-investigator with Medical Arts Research.  Her passion for her work and compassion for her patients were inspired early on by her very close relationship with her grandparents, and maintained by the many wonderful patients, families, and colleagues met along the professional path. Email: DrAWisniewska@gmail.com HOST Jo de Vries is a community education and engagement specialist with 30 years of experience helping local governments in British Columbia connect with their citizens about important sustainability issues. In 2006, she established the Fresh Outlook Foundation (FOF) to “inspire community conversations for sustainable change.” FOF's highly acclaimed events include Building SustainABLE Communities conferences, Reel Change SustainAbility Film Fest, Eco-Blast Kids' Camps, CommUnity Innovation Lab, Breakfast of Champions, and Women 4 SustainAbility. FOF's newest ventures are the HEADS UP! Community Mental Health Summit and HEADS UP! Community Mental Health Podcast. Website: Fresh Outlook Foundation Phone: 250-300-8797   PLAY IT FORWARD The move toward optimal mental health becomes possible as more people learn about the challenges, successes, and opportunities. To that end, please share this podcast with anyone who has an interest or stake in the future of mental health and wellness. FOLLOW US For more information about the Fresh Outlook Foundation (FOF) and our programs and events, visit our website, sign up for our newsletter, and like us on Facebook and Twitter.   HELP US As a charity, FOF relies on support from grants, sponsors, and donors to continue its valuable work. If you benefited from the podcast, please help fund future episodes by making a one-time or monthly donation. Marjorie Horne, Naomi Mison, Anna Wisniewska Interview Transcript You can download a pdf of the transcript here. The entire transcript is also found below: RICK  0:00 Welcome to the HEADS UP Community Mental Health Podcast. Join our host Jo de Vries with the Fresh Outlook Foundation, as she combines science with storytelling to explore a variety of mental health issues with people from all walks of life. Stay tuned! JO  0:05 Hey, Jo here. Thanks for joining me as we explore the complex world of seniors' mental health. In this two-part podcast, brought to you by the Social Planning and Research Council of BC, we'll study the challenges, gaps, successes, and opportunities for seniors through the eyes of a geriatric psychiatrist, a young caregiver, and a seniors' advocate and entrepreneur. But before I jump into our discussion with these amazing women, I'd like to set the stage for you. Given that the over-65 age group is the fastest-growing demographic in Canada, seniors' mental health will be an increasingly critical issue for healthcare systems, all levels of government, academic institutions, healthcare-related businesses, and nonprofits that focus on either seniors' mental health or specific mental health conditions such as mood or cognitive disorders. Taking a closer look, we see that almost seven million Canadians, or about 18% of Canada's 38 million residents, are 65 or older. The rates of mental illness for seniors over 70 are projected to be higher than for any other age group by 2041. This scenario presents serious social, cultural, and economic challenges for individuals, families, and communities in Canada and beyond. On the bright side, a Statistics Canada study showed that almost 70% of seniors consistently report having good or excellent mental health, and that they are more satisfied with their lives than those in younger age groups. More than eight in ten seniors reported they always or often have someone they can depend on to help when they really need it. On the other hand, about 20%, or almost 1.5 million Canadian seniors, experience mental health challenges caused by a range of medical conditions, social situations, lifestyle choices, cultural influences, and economic circumstances. To help us dig deeper into this vitally important topic, Rick joins me to share what he learned from a variety of research and advocacy organizations in Canada. RICK  0:30 Up to 20% of older adults, or as many as 1.4 million people, report being depressed. And 40% of seniors in long-term care homes are depressed. More than 10% of seniors, and up to 30% of those with major late-life depression, misuse alcohol. JO  0:30 What about anxiety? RICK  0:30 About 10% of seniors, or about 700,000 people, have diagnosed anxiety disorders, and seniors have the highest rate of hospitalization for those disorders. JO  3:37 What about other kinds of mental health challenges? NAOMI  3:41 More than 500,000 seniors in Canada have dementia, of which there are more than 130 types. And more than 90,000 seniors have schizophrenia or other delusional disorders. JO  3:55 What about seniors and suicide? NAOMI  4:00 More than 10% of seniors seriously thought about suicide in the last year that was studied. That's probably higher now due to COVID. The overall rate for death by suicide is about 11 per 100,000. And the rate for men 85 and older is 29 per 100,000. JO  4:20 Great info, I just hit the big 66 so your stats hit a little close to home for me. Did you find evidence of personal traits that predispose seniors to mental health challenges? NAOMI  4:35 I did. mental health conditions are often affected by innate characteristics such as gender, ethnicity, and genetics. Developmental factors such as childhood experiences and educational status also play a role. JO  4:45 How does a senior's circumstances affect his or her mental health outcomes? Mental health challenges are often intensified by factors such as poverty, poor health, loneliness, inadequate nutrition and or housing, lack of independence, and loss of loved ones. NAOMI  4:59 We'll talk about those more later on in the podcast. But for now, what about more broad-based social risk factors? JO  5:06 Society-wide, or what are sometimes called macro-social risk factors, include lack of available health resources and the impacts of negative social influences such as stigma, ageism, inequality, systemic racism, and gender bias. NAOMI  5:21 Thanks, Rick. We're going to talk about those a little later as well. When you take all of that into account, seniors' mental health is staggeringly important, and needs to be addressed at all scales. JO  5:31 To help with that I welcome our first guest, Marjorie Horne, a community seniors' advocate and entrepreneur. She has diverse experience as a registered nurse, hospice volunteer and executive, residential care services manager, columnist, broadcaster, and founder of CareSmart Seniors Consulting. As a Certified Professional consultant on aging, she uses her education and work experience to meet the transitioning needs of seniors and their families. She was also a caregiver for her elderly mother, caring for her in her own home for the last year of her mother's life. Welcome, Marjorie, and thanks so much for joining us. Oh, thanks for having me, Jo. JO 6:25 Marjorie, first, can you share the parts of your personal story that pertain to seniors' mental health. MARJORIE  6:27 My journey in seniors' care began really when I was 15 years old here in Kelowna, and I decided to go and work in what we used to call residential care, then in care homes. And that was an experience that really affected me very deeply. And it was where I really felt and was part of this sense of isolation that so many of the residents felt, and they would talk to me about their families not coming to visit. That they didn't feel that anybody really heard them. And I just, for some reason, found this just so touching, and I wanted to be there for them individually. So, when I began listening to their stories and just being really present for them... this was even in my teenage years... I began to see a light come back in their eyes that was sort of deadened when I started working there. And it really had a profound impact on me. And it led me into nursing when I graduated from high school. And I think it's what still really drives me to this day, in wanting to make things better for our older population. When I was caring for my own mom in my home, the last year of her life, it gave me a really close and real personal experience. Even though I do this professionally, it's different with your parent, and I was there for her for a good part of the day, hearing her go through her life review and reflection of her life experiences. And my mom had been diagnosed as being bipolar in her late 30s, and she had been put on a combination of quite a number of psychotropic drugs at that time, which she has stayed on for over 35 years. And of course, this really impacted me and my three sisters and our family life. And when she was 75, we actually took her off everything to have some major surgery done. And all of a sudden, I had gone to stay with her, and I saw this light come back in her eyes that had been really missing for about 35 years. So, this has had a dramatic influence on my life, around my thoughts around mental health, by living that experience for so many years. And she began to tell me once we had her off these drugs about sexual abuse that happened her life that she had never told anyone. She talked to me about some very traumatic experiences she'd gone through, that again she just hadn't shared with anyone. And it was quite heartbreaking to hear her in her early 80s tell me about a roommate that had hung herself, and my mom came home and found her. And that all of the emotion and everything around this had really been locked inside of her. As she began to verbalize this to me over sort of a ten-year period, and especially when she was coming to the end of her life, I think it affected me in a way where I really feel that just listening sometimes to our older seniors, as they're going through their aging journey is such a very important relevant thing. And the grief that my mom had held inside of her for so long, I really feel that it influences how our older adults are doing as they're getting older. JO  10:20 Thanks for sharing, Marjorie, I know that each person is unique. But given that you've worked with hundreds of seniors in transition, can you paint us a picture that reflects your observation about what that looks like? MARJORIE  10:35 I do think everybody's unique. And that's a very important thing to remember... that we don't lump people together and try to label them. I so often hear from seniors, as they're growing older, that they tell me they begin to feel invisible. They don't feel seen anymore, and they don't feel valued. Even my older sister who's had a remarkable career, earned every type of award that you can imagine and has had such a successful life. But five years after she retired, she said to me that she was beginning to feel invisible. And it shocked me, but it's an expression that people start to look at you differently as you're growing older, as the wrinkles are starting to come and maybe you're walking a little bit slower. And she was verbalizing to me how she just isn't asked for her input on things. And she was quite shocked within herself that she's beginning to feel depressed at this realization. That after everything she's been through, society really doesn't honor us as we're aging. I think you know, when you have that personal experience for somebody, you're looking at admire, and they're telling you that, you can see how across the board that I think, no matter what you've done over your life, we start to feel this way. And we find it hard, I think to reach out for support. So many people just start to turn in, I even saw this with her, separating herself more being quieter or for somebody who had been so outgoing. And so, I think this, of course, affects our physical health and our sense of joy in life tremendously. And I think I see in many, many seniors that I am involved with, it can begin sort of a downward physical cycle as well. And that becomes sort of the centre of their life talking about that. There's a lot of different things around how society views, people as they're aging that I think we need to have a shift in. JO  12:40 Marjorie, is there a flip side to the heartbreak you see? What do you see, that's heartwarming in your work? MARJORIE  12:48 I have many, many heartwarming things. I'm working with somebody who's 93 right now, and I go over and play crib with her, and I thank God she says sharp is a tack. I really have to work hard at beating her at the crib. And I see a lot of people in their late 80s and 90s that really still have a sparkle in their eye. Even people with quite severe physical handicaps. They have a mindset that they have chosen. They want to stay optimistic, they want to stay involved, they want to be sharing their wisdom. And I have many, many experiences of that. And it inspires me on my own aging journey, to remain openminded and optimistic about my future. They inspire me to keep becoming better, because there are many people out there aging that have that mindset. And I think we need to help it flourish. JO  13:49 Thanks, Marjorie, great insights. Next, I'd like to introduce our second guest, Naomi Mison, founder and CEO of Discuss Dimentia and an advocate for the Alzheimer's Society of BC, Cycling Without Age, and BrainTrust. For 13 years, since she was 22, Naomi has been caring for her mother, who was diagnosed with early onset dementia when she was only 53. Naomi, thanks for joining us and agreeing to tell your story and how it brought you to where you're at now. NAOMI  14:26 Thanks, Jo, for allowing me to share my story with you and with your listeners today. So, from a young age, my mother had lived with mental illness. But in 2006, when she was found wandering outside of a train station in her nightgown, it had surpassed a regular dealing with mental illness and moved into a different area. I got a call that she was being placed in an institution. So, I flew to the UK where she was living to bring her back to Canada. When we arrived, she was quite delusional and at risk for wandering. While her GP recognized that there was an issue, she did make a referral to her neurologist,  but the symptoms continued to progress and worsen. And my brother and I grew more desperate for answers. We took her to an emergency room, and unfortunately were chastised for bringing her there under perceived false pretenses as I mean, I don't know how much and direction you have in this regard. But I find sometimes when you're caring for somebody with mental illness, they know when to really show that they are thinking clearly and making the right decisions, when you actually need them to show the struggle that they're facing. So, after some more incidences of trying to find support, we were finally able to locate a crisis team who came and conducted an assessment on my mother's mental health. And at that time, they recognized that she was really struggling and recommended that she be hospitalized and was admitted into Alberta Hospital. So, at the time, she was initially treated for bipolar disorder, and that was about six months when they were trying different methodologies to see if they could stabilize her symptoms. But after a PET scan showed atrophy of the brain, we were given a diagnosis of Pick's Disease, what is now commonly referred to as frontotemporal dementia. And then instance, we were asked to make a life-altering decision on her behalf. And unfortunately, there was no time to really accept, grieve, or even wrap my head around her diagnosis. In that moment, my life was never the same again. Eventually, my mother's condition stabilized, but we could not provide her the level of care she needed. So, when a bed became available, we moved her into long-term care and into the home that she presently lives at today. So, after 10 years of caregiving, I decided I wanted to become a public speaker and advocate for people living with dementia and their caregivers. I want to share my story in hopes of meaning other people like me, and I want to fight on behalf of people and for people that don't have this strength, energy, or capacity. And that's what brought me here to where I am today. JO  17:29 Thank you for your candor. Naomi, it takes courage to be so vulnerable. Can you share with us the toll this multi-year commitment has taken on you personally? NAOMI  17:41 Having this level of responsibility thrust on me at such a young age was life altering, to say the least, I really lost out on the majority of my 20s and the dreams I held. For myself, I always wanted to be a world traveler. I had big grandiose dreams of going to a different country every year and working on a holiday visa. I even had an idea of possibly having a family one day, but that for me is no longer a consideration. When I received the diagnosis, I essentially became the mother to my mother. I've lost out on a chance to have those Mother's Days that you share celebrating your mother's life and contribution, brunch at my house on a Sunday, maybe sharing some bubbles together. Or even the comfort of calling her when I've had a hard day and you just need your mom. The consequences of this disease are a measurable and suffice to say, my life has never been the same. JO  18:47 Are there any silver linings to this experience? Maybe what you've learned about yourself that you can put to good use. NAOMI  18:55 I've really learned that the caregiving journey is not linear. A lot of things are learned through trials and tribulations. And this can cause a lot of stress, especially coupled with your loved one's behavioral changes... it can be trying. From that extreme difficulty, I should say, this experience has taught me how determined and resilient I truly am. From these experiences I have found my passion, even my calling. I am determined to make systemic change to honor my mom. I believe that by sharing my story, it shows vulnerability. And I hope that it will build awareness, understanding, and bridges. Most people have a connection to dementia in one way or another, and I can empathize with that struggle. But if we don't stand up and share our story, then we won't build the awareness needed to make the changes. JO  19:52 Thanks Naomi. We'll bring both you and Marjorie back in after we hear from our third guest, Dr. Anna Wizniewska, a geriatric psychiatrist with Interior Health in British Columbia, Canada. Great to have you aboard, Ania. ANIA  20:09 Thank you, Jo. It's lovely to be here with you, and Marjorie and Naomi. JO  20:14 So, given all of your medical training and all the opportunities available in medicine, what drew you to geriatric psychiatry? ANIA  20:23 Thank you for asking, Jo. It's interesting that the three of us probably reflect on our experience and where we are right now in our lives, going back to our family, and our sometimes formative years. And I think when I look back on my own decision to pursue this career, I really think started in my childhood. I was especially close to by grandparents, and especially my grandfather. And it's sort of, I think, developed a sense of affinity and closeness with seniors in general. It also offered me an opportunity because I grew up with my grandparents living next door to listen to their life stories and to be very interested in their experience. They both survived the war, my grandfather was a POW for six years... there was a lot to learn from them, and a lot to really come to understand through their experience of their lives. And then later on, once I became a teenager, my grandmother, unfortunately, developed dementia. And her dementia was particularly challenging because she had a lot of psychosis. She was quite delusional, particularly around my grandfather. And that led to a lot of distress for our whole family, understandably, but most of all, for my grandfather. And what I always found so fascinating about that relationship was, even though my grandmother would do things that are really quite awful when she was ill, my grandfather never complained. And I always felt that it was so fascinating that, in spite of the things that were happening to him, he never had a word of complaint. And as a teenager, I found it difficult to understand. Why would he be so understanding so forgiving, and seemingly so uninfected? And of course, as I got older, I think I came to understand it a lot more, I hope. And I came to understand it as basically a sense of love and a sense of devotion. And I think that's, in the end, what actually led me to this field. I always wanted to be a doctor, that wasn't something that came later in life. And I think I was always drawn to the idea of helping others and caring for other people. And when my long journey into medicine kind of came to fruition, I actually had an interest more in the opposite-end age spectrum... and that is a care of children. I was quite interested in pediatrics. And I was also very interested in psychiatry, and specifically child and adolescent psychiatry. So, when I actually got into training in psychiatry, it was with the idea of becoming a child adolescent psychiatrist... but I kind of ended up at the other end of the spectrum. That occurred primarily, I think, through the fact that I realized that child and adolescent psychiatry was not really for me for various reasons. And then being influenced by preceptors, who were really quite outstanding, and really showed me how enriching the work can be and how wonderful that work can be. And I think for me, the reason for choosing geriatric psychiatry, and staying in it for almost 20 years, and looking forward to every day that I got to work, is I really like my patients. And that includes patients who, by some standards, may be perceived as quite difficult and unreasonable because of their illness. Because I still see that humanity and the stories that they have in their lives, with our children and grandchildren. As I said, it's that sense of affinity for them, and the appreciation of the stories of their lives and the desire to understand them as people not just in the moment that they are ill or unwell, but to understand them through their whole life experience. The other part of what I love about my job, of course, is our job is challenging and it's stimulating. In geriatric psychiatry, we have to pay a lot of attention to general medical conditions, medications that our patients take. There's not a boring day when I go to work, which again, I appreciate. I know it sounds a bit selfish, but it's also wonderful to have that stimulation. And in the end, it's just extremely rewarding. Many of my patients I have known for more than ten years, and their families have known for more than ten years. I have multi-generational patients, so patients who are from the same family but from different generations, because I have been in this community for so long to see improvement in symptoms or sometimes maybe symptoms can be improved by the quality of life can. It's extremely rewarding to see my patients improved to see their families maybe feel a bit less distressed or feel a little bit more at ease. really wonderful to see. JO  25:02 Another wonderful story... thank you. We know that each senior's mental health journey is unique, but do you see patterns, say of symptoms, of experiences, of behaviors that you can weave into a composite story for us. ANIA  25:20 The one thing that I mentioned is, I sort of see myself as someone who's sort of in the trenches. And so, I typically really look at people as kind of an individual story or individual family. And yes, there can be some patterns. But I think it's important also appreciate that every experience is very, very unique. And even certain elements of the story that may be similar for one family or one patient can lead to sort of different outcomes because of the age group of my patients. My practice is sort of from late 40s to over 100, but I would say the average age my patients is into their 80s. Many of my patients have experienced or were affected by the depression in the 1930s, quite a few of them by war, during World War II, mental displacement and the trauma that came with it. So those are some of the fairly common themes that I hear from my patients and their families. Other things that tend to sort of be maybe a bit of a pattern is, of course, adjusting to the process of aging. Some patients may be a bit more concerned about some of the more superficial changes that come with aging. But for many of my patients, the adjustment to the loss of physical stamina, or occurrence of physical disability, and of course, quite often concerns about cognitive decline as well. So, I think those would be some of the parents that I see. But again, I do need to emphasize that every experience is very individual. JO  26:49 What are the most common myths about seniors' mental health? ANIA  26:53 Things that typically I hear about from either families or patients is that having some forgetfulness as we age is a definite confirmation of a diagnosis of dementia. That is, quite often what I hear from patients when I see them about cognitive decline. So, it's the sort of worry that as we age, if we started becoming a bit forgetful, that necessarily means that we have dementia, which is usually not the case. Another one is, I guess, more so perceptions from the society that as we age, we become somewhat less useful. And I think that was reflected in some of Marjorie's comments, that sense of being invisible. So that's one of the worries that my patients will describe as their concern that they may be sort of perceived as less useful or a burden on their families or societies. JO  27:41 Rick noted earlier that depression and anxiety are the most common mental health challenges experienced by seniors. Why are they so prevalent? ANIA  27:51 I think part of it comes from the fact that we're much better at recognizing their existence. I'm not sure that they were necessarily less noted before or experienced before, I think it's more that we are better, at least I'm hoping we're better, at recognizing the presence of depression or anxiety. And I think seniors are becoming a little bit more open about actually reaching out for help sometimes. And we have to keep in mind that there are very generational differences in approach to how we deal with mental illness or mental health in general. So, I think part of it is that seniors are becoming, some of them anyway, becoming a little bit more open or the idea of reaching out for help when they are unwell. There are other reasons for it, however. Patients that I look after, because of their age, are more likely to experience loss. So that could be a loss of a spouse or a partner. Unfortunately, even loss of other family members, including children, who, depending on what's going on, may have their own health concerns. So, there are a lot of losses of course, loss of friendships, those who have friends in the similar age group will unfortunately lose their friends because of the age and the risk that comes with that. There are also changes that happened physically... certain medical conditions will increase the risk of depression or anxiety. Certain medications can also cause increased depression and anxiety, and, of course, seniors are more likely to take multiple medications. But unfortunately, depression and anxiety are fairly common amongst all age groups. But as I said, I think we're just a little bit better at recognizing it in seniors and looking for it when we see patients, especially in primary care. JO  29:27 So, in that seniors age group, are the treatments for anxiety and depression different than for other age groups? ANIA  29:37 The treatments in general are essentially identical. What makes the seniors more unique, compared to say a younger adult patient, is that the treatment becomes a bit more complicated because of the fact that older patients are more likely to have other medical conditions... so some medications may be contraindicated with some medical conditions. They are also more likely to be taking more medications, and again, you have to consider interactions with other medications that you're thinking of prescribing. So, there are some differences in terms of your approach. But in terms of the actual treatments that we would prescribe, be it medications or electroconvulsive therapy, commonly known as shock treatments, or psychotherapy... the approaches can be more or less identical, except for consideration of medications, medical conditions, and things like that. JO  30:28 What's the link between seniors' mental health and healthy lifestyle choices? ANIA  30:34 Well, I'm glad you bring that up, Jo. I think we need to get a little bit better at having those discussions around lifestyle factors and choices. There is no doubt that certain lifestyle choices are detrimental to not just physical well being, but also mental well being. For example, let's say increased BMI or obesity is associated with decreased well-being. And that can lead you to say, pain, because if you are overweight, you're more likely to have joint issues, particularly in your lower extremities. Issues that relate to poor mobility, for example, that can come from it. And that could lead to isolation. And pain, of course, can also increase the risk of depression, especially. So, certainly the lifestyle choices we make a great difference, say alcohol or smoking, be another lifestyle factor that would be important to consider. So, I do think we need to get a little bit better or a lot better at promoting healthy lifestyle choices. And helping people understand that the decisions we make now will have some consequences even later on in our lives. JO  31:42 So, Marjorie, you've been watching seniors in a variety of settings for decades. What are the most common transitional challenges you've seen? And why are they so difficult? MARJORIE  31:55 Well, the third chapter of life brings around many, many changes. And when I was doing work within residential care settings and seniors living sites, I saw just such an angst developed within a family when an older adult was becoming frailer. And there was just so much stress involved. Everybody was in more reaction around whatever change was happening. And so, when I decided to start sort of a holistic model of elder care and move into running my own business, it was because all of these transitions, and there's so many aren't there... when I started, it was the older, frailer senior. And often they were having to look at making a move out of perhaps the family home or a home that they had been in for a long time. And there'd be so much disagreement that would come up within the family and different ideas about what should be done. I think we all like to hang on to our independence, and so that was one of the major transitions that I was dealing with a lot was trying to support the family, looking at the physical change or transition that might need to happen as far as their living environment. But then try to help the family to understand all the emotional aspects that were going on, from the different perspectives of the older senior. And then often the adult children, and everybody was viewing things differently. So that's one of the major things that I have been supporting people with initially, to try to help the family as a whole move through this and stay supportive of each other, and also compassionate and understanding of the loss that is occurring, because any transition we make in life, whether is moving from a position that we're in, thinking about retirement, letting go of that part of our identity, if it's a loss of a family member, spouse or child... this deep loss in a lot of ways we don't understand that any transition brings forward losses that perhaps we haven't felt or dealt with that have occurred over our lifetime. Especially the silent generation, often, they weren't given permission to feel the emotions of loss when there was something that really was needing that. And so that grief comes forward. And I think people don't understand that. And so there becomes a lot of reactionary difficulty that comes up with families. So that's one of the big transitions is actually, even though 90% of seniors when studied want to age in place in their home, that's just not always practical. And so, it kind of evolved as I was supporting families as a whole and going through that type of transition. I then began to hear more from the adult children. And this just happened organically that were beginning to consider retirement. And they seem to need a lot of support. mostly as boomers, wondering how they were going to cope with this. Who were they going to be? How are they going to see themselves? How were other people going to see them? And so that is a lot of transition I deal with now, of the sort of the journey of moving into the eldering years, and how we need to change our way of thinking about ourselves... often let go of the past, of things that we're regretting or holding on to that will continue to cause us stress if we can embrace kind of... well, I call it conscious eldering, but it's really looking at all the different aspects of aging. So, of course loss for me, as I've been working with this so intimately for 10 years in this way, is the loss that comes forward over and over and over again, and how people are afraid to be vulnerable within perhaps a grieving that hasn't been resolved. But also thinking and knowing that as we go through all these transitions in the third chapter, whether it's physically, emotionally, cognitively, or perhaps we are developing a different spiritual attitude towards life, as our death is coming closer, and I know we're going to talk about this more, but that just seems to be the majority of my work now is trying to help people to talk about that, as they're going through transition. JO  36:45 Given that we all face transitional challenges in the third chapter of our lives... and at 66 I'm already starting to feel some of those... what is 'eldering well'? I know you talk about that as a concept. And also 'elder care', can you tell us more about those. MARJORIE  37:04 I've just turned 70 myself, so I am definitely well into this whole process myself. And it's kind of an interesting journey to the aging at this point, and still involved in working. So, the things that I am trying to talk to other people about, obviously, I'm having to look at within myself, as I'm now really moving through my own eldering journey. There are so many people as they're going through these transitions in this chapter that they fight against getting older. I do a lot of teaching and workshops, and I just hear it so much. And I watched my own mom, too, because she was living with me as she was going through her last year of her life, fighting it the whole way. And I came to realize that this is really such a key aspect of how we go through this stage of our life. Do we fight it? Do we fight that even having to become a little more interdependent, that is part of this stage of life? And if we fight it, wanting to use this word, "I want my independence, I want my independence," we're actually shutting ourselves off from what I think are some of the gifts of this circle of life that we are all in. And so, I talk to people a lot about that. This stage of life is, I realize every year that passes now, you know, even between 65 and 70, is very different, the changes we're going through than in our middle years. Being present with where you're at whether you're in your 60s or 70s, your 80s, or for more and more people who are living into their 90s now, I think elder care is, to me, it's really understanding that growing older does take resilience. We have to cultivate a resilience because there's a great sense of impermanence as you're getting older. And as you see friends die suddenly, or your spouse die much sooner than what's expected, it takes resilience. And I think the more we can improve how well we elder is taking and looking at each other from a more holistic viewpoint of all the emotional changes, the physical changes, the cognitive changes, and also how do we move towards accepting that death? We are all going to go through that. JO  39:36 Well, and that's a perfect segue into my next question. When you and I were preparing for this episode, we talked about dying well, and how death cafes and end of life. doulas can help. Tell us more about that. MARJORIE  39:52 I've done a lot of palliative care and I was intimately involved with both of my parents' final year of life. My dad, when he was dying with cancer, and I left my job to take care of him. And with my mom as well, from really not dying from cancer, but dying, really from old age. I really had to look at this and explore my own fears of death, even though I thought I was more comfortable with it than some people, having gone through that with my parents so closely. I think this is another big part of, I guess, us opening more to the vulnerability that we're all going to die. And we're all going to experience more death, particularly at this stage of life. And so, understanding that it's closer as we crossover into our 60s... I think right then you start to feel... wow, gee, this came awful fast. And we know that the completion of our life comes at the end of this chapter. But can we really talk about that? Can we really face what our fears might be about that? I think it's a very important part of shifting this paradigm to embracing this stage of life, both the challenges of it... and also, as we embrace the challenges, I think we can open more to the joys that there are at this stage of life. There are many... even sitting with your parents as they're coming to their death. There are so many gifts in that, I think as we can talk about this more and be more willing to embrace the aspect of our parents coming to their death, and being with them, I just can't tell you the gifts I received from that. And then it has helped me from how I watched my parents come to their deaths, one fighting at completely and the other just surrendering to it. It showed me that I wanted to just start surrendering and letting go more at this stage of my life. JO  42:02 My mom and I were very close. She died when she was 88 and she had two requests. One was that she die at home, and that she die in my arms. And that actually unfolded that way. And I have to say that it was one of the most, if not the most meaningful, experience of my whole life. It was transformative. MARJORIE  42:26 It was for me, too. It absolutely transformed me going through at the age of 40 my dad's death and that time I spent with him. I think there's a real trend moving to end of life doulas... I have two on staff myself because I feel it's an important part. People need support with it. It is not easy to sit with somebody you love who is dying. It's hard. It's hard. It's rewarding. But I think that we are seeing more and more end-of-life doulas being educated. I talk a lot to families of how much value I got from this, and encourage and support them, and that's what end-of- life doulas do. That's important part of us moving forward to embracing death in a much healthier way. I think society is still in the dark ages around it, to be honest. JO  43:20 Naomi, let's bring you now back into the conversation. I so admire your devotion to your mother's care. I'm really interested to know what drives this devotion. NAOMI  43:33 For me really, when I was growing up, my mother was my best friend. We talked about all kinds of different things, she was very open, and created a safe space for me to share. So, we were quite close. And I'll always hold those memories at the forefront of my mind, even as her behavior changes, or her cognition declines, I just still hold those memories ever present. And so that really does inspire my devotion, as well as I know that if the roles were reversed, she would do her best to care for me. So, I feel inclined and really drawn to do the best for her. And moreover, if I don't provide the care, who will? Who is there to step up and provide that level of care? So, it's both an obligation as well as a gift. JO  44:27 One of the things we talked about while preparing for this podcast was the need for intergenerational knowledge and support related to seniors' mental health issues. As a young person who lives in that world, what do you think other young people need to know? NAOMI  44:46 There seems to be a stigma around aging, which we've touched on, and I know we will talk about later, where somehow older adults aren't always held in the same regard as youth. And that goes to show as well for dementia, where it's more of an out of sight out of mind, where we've really constructed our society around that. And I find that extremely disheartening, because I think there's exceptional knowledge to be gained from engaging older adults, as well as people living with dementia. I really think that there's immense knowledge that can be derived from building these relationships with older adults. And I'll just give you an example for myself. I know at the onset of the pandemic, I really wanted to try to make a difference, and I know there was a lot of seniors being isolated. So, I had reached out to the Seniors' Outreach and Resource Center locally and just express my interest in helping out. I was paired with a senior that was also looking for support. And basically, what I would do was to call her once a week for about a ten-minute conversation... just ask her about how her day was, what her plan was for the weekend, how she was feeling. And I couldn't believe the immense amount of gratitude I felt for my time... it was just so touching and rewarding. She had expressed how it was really helping her... I actually really felt like it was helping me, and I was really making a difference in contributing in a meaningful way. I really think to foster these intergenerational discussions is really about seeing the value that can be offered by really just engaging that conversation and engaging older adults. JO  46:40 Along that same vein, we talked about bringing young people into the conversation early, by way of what you call "courageous conversations." Tell us about that. NAOMI  46:52 I've been advocating for this for years, because realistically, aging and death is a part of life and an inevitability. Yet I find that we don't often have open and honest discussions about this topic. So, I routinely encourage people to have these courageous conversations... to really talk about those hard, often not discussed, topics so that you can have these discussions while your loved one still has all of their faculties and can express their wishes. For instance, asking a parent if they would prefer to be buried or cremated, or do they want to do-not-resuscitate order in place? If they were on a ventilator, and they were in a vegetative state, would they want to continue in that state? Or would they want to move past that? These conversations that you have, while difficult will really inform future decisions. That way, you won't have to run into the same scenario, or people will not have to run into the same scenario as I did, where I'm making a decision on behalf of someone else, rather than bringing their wishes to actualization. You'll be more grateful and thankful that you had these conversations than if you had not. JO  48:12 Tell us about other opportunities we have to help seniors mental health by bridging that generation gap. NAOMI  48:20 By bridging this intergenerational gap. It can really fight isolation and loneliness, which we know is so prevalent at the moment. And I think one way to do that is really working towards intergenerational programming. So really bringing together people from different age populations around activities that focus either on young children or older adults. And there are some examples where this is being undertaken successfully. There is a St. Joseph's Home for the Asian Hospice in Singapore, that's not really adhering to the typical nursing home. The facility includes a childcare centre that accommodates about 50 children. And at the centre of St. Joseph's courtyard is an intergenerational playground that really fosters spontaneous interactions between older adults living in the nursing home and the little ones that are being cared for at the childcare centre. And I think these creative solutions really do promote that intergenerational and community connection that's needed to combat isolation and loneliness. JO  49:30 Earlier, Rick talked about the onset and extent of seniors' mental health challenges being affected by innate personal characteristics such as age, gender, ethnicity, and genetics, and developmental factors such as childhood experiences and educational status. So, let's have a bit of a free for all here. First of all, how do risks and experiences differ between younger seniors and elderly ones? Ania, maybe you could jump in first. ANIA  50:04 I think one way that I think of it is, unfortunately, as we become older, there are some risks that increase the numbers will be risks of, say, for example, cognitive impairment or dementia. So, of course, much older seniors will have a higher risk of developing a cognitive disorder. Other factors that come in through, again, increasing frailty or other medical conditions as increased risk of falling or mobility issues. And of course, that can result in increased risk of isolation, decreased quality of life, as say, an arthritic condition advances that can cause more pain. So, that again, impacts the sense of well-being as well as a sense of decrease in quality of life, or decrease access to activities because of pain or stiffness, and things like that. So, I would say there's definitely a difference there. JO  50:53 Marjorie, what do you see? MARJORIE  50:56 We're seeing, obviously, as people are getting into their upper 80s, definitely, I see a lot more risk and with people living in their own home, and with the cognitive changes that do occur. It seems we're seeing more of the early onset types of dementia as well, which is quite shocking and worrisome. There's risk at any stage of life, because of the unexpected physical things that can happen. My brother-in-law had a massive stroke at the age of 61. And no one expected that at all to happen at that time. We may be faced with extreme physical challenges. So, it sort of runs the whole gamut, I think, between this stage of life. JO  51:40 Naomi, any comments? NAOMI  51:42 I have a unique case because my mom was diagnosed at such a young age. And I found for me personally, what I find is that in terms of accessibility, and funding for services, is quite a bit of a disparity between a younger senior and an older senior. So, I find that if you're 65 and under, and you're looking for services, it seems that the responsibility often falls to the family to cover expenses. Whereas once you pass the age of retirement and go to 65, then there's old age security, guaranteed income supplement, and so on different medical and government benefits that kick in that do assist, and the financial responsibilities not in the same way to families. I find that's what I have been seeing, and it is a concern for me as Marjorie had mentioned, with the increased prevalence of diagnosis around younger onset. JO  52:44 What are the risks for men versus women? MARJORIE  52:47 Men, in my experience, as I see them going through the transitions, particularly moving from their work positions into retirement, seem to have a higher risk of depression. Often their identity was very well defined within their work environment. Somebody that I've experienced that went through that and shared his story with me, it's quite interesting, after his wife died and he had moved into retirement, he did find himself becoming very depressed. I think men and women respond to this differently. I think women reach out much more to their women friends and tend to be able to talk about that more openly sometimes the men can. JO  53:36 Ania, what does your clinical practice show? ANIA  53:39 One of the things that I think that's what Marjorie has spoken to is the increase in depression amongst men. And I think the big thing that I always think of in terms of those differences is that men are at a much higher risk of completing suicide, in terms of senior women versus senior men. So that's always a big concern. When we do see depression or severe depression is that increased risk of suicide. In terms of women one thing is that, unfortunately, women are more likely to develop cognitive disorder or dementia type of illness. And because they live longer on average than men, they may experience more sense of isolation or loneliness because of losing a partner or losing their friends or other family members. So that can also be a concern. NAOMI  54:22 If I might interject, one thing I find that's very interesting in this regard, and I don't know if you guys have heard about this, but it's called the widowhood effect. When it comes to life expectancy, after a spouse dies, if the husband dies, her life expectancy is twelve-and-a-half years. However, if the husband is the surviving spouse, that life expectancy is about nine-and-a-half years. So, it's quite a big disparity between those two life expectancies, and I do think it has to do a lot with connection. Husbands and men often turn to their wives for that social connection, whereas, and this is a generalization, women often have friends that they seek out and are more able to discuss what's going on in their life. And so, I see this as part of the reason for this discrepancy in life expectancy. JO  55:16 What about the mental health risks for marginalized communities such as indigenous folks, or LGBTQ communities? MARJORIE  55:27 I was asked to come and just talk to a seniors' group of LGBTQ here in our community, because the person running the group felt that there's just so much pain and sadness being expressed by people who were dealing with so much negativity around, non inclusiveness of this group. Many of them felt that they didn't know where to turn as they were getting older, because there doesn't seem to be an openness, even within seniors housing, to even talk to them about it, or create a space where they feel accepted. There was just so much pain expressed in that meeting that I had with them. I did go and talk to a couple of the retirement communities hear about it, and just started trying to create a dialogue. Because I think it's just something they don't think about, that there are a large number of people in this group, and they're seeming to suffer with it. So, I think it's another area where there needs to be a lot more discussion and dialogue and creating an openness that they need to feel included, and they still have the barriers that have sort of been there for a long time for them. JO  56:46 So, Ania, what's your experience with people from marginalized communities? ANIA  56:52 I think it's definitely an important topic to discuss, as Marjorie has mentioned. One of the things that I've noticed is, as we get older, we sort of carry with us our life experiences. And looking at Indigenous elders, a number of them would have likely experienced the residential school system, and the trauma associated with that separation from family... potential for abuse. So, those are the kinds of traumas that they will carry on. We know that Indigenous folks also are at much higher risk for struggling with adequate housing or adequate supports. I know within our communities, there are more resources,  but if you look at smaller communities, that becomes a significant concern. And also, some of the difficulties they experienced within their families, because we know that Indigenous people are, unfortunately, more affected by violence and substance use. So of course, that has an impact on the elderly as well. And then in terms of LGBTQ patients... one thing that I find interesting talking with my patients who have lived these lives for so many decades, is obviously being a member of an LGBTQ [community] is much more accepted now in our society. But it wasn't always the case, and sometimes it was completely unacceptable so-called lifestyle. And so to speak to my patients about their experience, and it was like for them to eventually come out or to transition to a different gender and what I was like them in terms of the impact that had on them, personally, their families, their job opportunities, and things like that, and our younger adult life is really humbling to hear what they have had to go through and how much it's still impacting them now. So, I do agree, I think we need to pay more attention. I'm not suggesting that being a member of the LGBT group is now easy, because there are certainly challenges and struggles that continue. But I do think that for the folks in the age group of my patients, that definitely was a very different experience than it's the one that after decades can be very traumatizing for my patients. JO  58:54 Naomi, what do you see in your work? NAOMI  58:57 I really see... especially in long-term care, homes... customs, and traditions that are outside of, I guess, the norm, or what's been created around or not really being considered, let alone incorporated into programming. So, I find that when these marginalized communities, or if they do actually seek support, the supports that are available to them aren't really designed for them, and don't help in the way that they need. So, I definitely think having them play a part in the creation of programming and designing of programs is really crucial to ensure that we're accounting for those considerations, those customs, those traditions that maybe are not thought of otherwise. JO  59:49 This is amazing! I'm just so thrilled that you're all coming at this from such different perspectives. It's very robust. Ania, this is a question for you. What about the role of genetics? ANIA  1:00:02 Genetics definitely will play a role in certain aspects of our physical and mental well being. There are certain conditions that are more likely to be impacted by genetic influences. For example, early onset Alzheimer's Disease is unfortunately associated with higher risk because of genetic influences. Certain other conditions, for example depression, can also have a genetic component to it as well. And then, of course, genetics around other medical conditions that will impact the quality of life and sense of well-being of a senior can also be important. For example, breast cancer... there are some types of breast cancers that are very strongly associated with a genetic risk and can result in developing cancer in your 20s or 30s even. There's certainly a role there to be considered for patients who may have a family history of particular conditions. NAOMI  1:00:55 Genetics does play a role. I also think prevention does play a key role. But for me, as a child of someone that was diagnosed with younger onset dementia, that means I have a 50% likelihood of developing the disease. I already have genetics working against me. So realistically, I only have prevention at this point, especially given that there is no treatment or cure for dementia at this point. So, I'm taking every precaution, but that's something that is already working against me. JO  1:01:30 What does prevention look like in your particular case? NAOMI  1:01:34 Personally, staying mentally well is very important. Continuing to expand my mind, continuing to really stretch my cognitive activity, whether it's learning a new language, or doing anything outside of my comfort zone, that's really going to push me... that's another way. Really maintaining those social connections. One thing I've definitely been trying to work on because my mom was a bit of a worrier, herself. So, unfortunately, whether genetic or not, I seem to have taken on that attribute, as well. So, I've really been working to be a bit more mindful and really harness the practice of meditation, to calm the mind and really get connected and rooted. Healthy eating... some things that we know through research that have a dramatic impact on the likelihood of developing a cognitive impairment. JO  1:02:33 Marjorie, any observations? MARJORIE  1:02:36 I think this is so significant, Jo, and what Naomi is saying, because having grown up with a parent that when I was eight was diagnosed as being bipolar... and living in really an environment that is traumatic in itself because of the uncertainty that went on constantly... and the behaviors that you didn't understand as a child. And so, I think for both Naomi and myself, having experienced this with a parent... having very difficult mental health issue... there almost isn't enough support, I don't think, for the children of parents that do have mental health major concerns. Because it really plays on you just even this aspects of the genetics, because I used to often be thinking and worrying about it, because there's history genetically too with bipolar, but it creates a fear. And I think sometimes we need to be providing more support in different ways for children of parents with mental health concerns. I don't think we do enough with that, to be honest. JO  1:03:44 We touched on the risks for people from marginalized communities. What about ethnicity? Are certain racial groups more prone to specific mental health challenges? Ania, let's start with you. ANIA  1:03:59 One of the things that comes up in research, and it's not necessarily maybe an issue of ethnicity but more of immigration, is that some studies have shown that immigrants are at a higher risk of developing an illness that involves psychosis. So, that could be schizophrenia, for example. And that seems to be a factor. The thing that I think about the most in terms of my own experience within my family, or my experience as a physician... treating patients from different ethnic backgrounds... it's more really about cultural expectations that families and patients bring into the discussion. This may be around accepting of diagnoses. This may be around expectations around caregiving. In many cultures, different ethnicities, there is definitely a different approach to providing care to elders, typically in the home and typically by the family, which is a little bit different from some of the more kind of Anglo-Saxon Western nations. And also, expectations around seeking help and even accepting mental illness for what it is because of stigma... or even very practical things like challenges around language, especially for more recent immigrants that may be a challenge or senior immigrants who come to Canada who have not had an opportunity to learn English to express some of their concerns. And sometimes it's about access as well. And again, that ties in to the maybe sometimes the language concerns. So those are the kinds of things that I sort of look at, in terms of impact of maybe ethnicity or cultural differences. JO  1:05:33 Marjorie or Naomi, any comments? NAOMI  1:05:36 It's like she took the words right out of my mouth, I was going to say the exact same thing, I think cultural sensitivity about mental health. In a lot of different cultures that's not accepted to talk about, or it's not recognized in the same way. So, I wholeheart

Lois Edey, retired nurse See omnystudio.com/listener for privacy information.

Guest: Dr. Peter Brindley - Full-time Critical Care Physician at the University of Alberta Hospital in the General Systems Intensive Care Unit and its NeuroSciences Intensive Care Unit. 

"What Have You Done for Me Lately? – A Personal Perspective on the Benefits of ASRA Membership for Members" by Alberto Ardon, MD, MPH, Assistant Professor, Mayo Clinic, Jacksonville, Florida; and "Membership Engagement – How Do I Get Involved?" by Vivian Ip, MBChB, FRCA, Associate Clinical Professor, University of Alberta Hospital, Edmonton, Alberta, Canada. From ASRA News, May 2021. See original article at www.asra.com/asra-news for figures and references. This material is copyrighted.

Today on Sleep Cues we have Dr. Stephanie Liu aka Dr. Mom - sharing her expertise on Baby Reflux. In this episode she explains the difference  between  gastroesophageal reflux (GER) and  gastroesophageal reflux  disease (GERD), insight into what she looks for with babies and reflux, what can increase reflux and steps to minimize before needing the route of medication. She practices community family medicine and acute care at the University of Alberta Hospital. She has sat on numerous boards and is a Clinical Lecturer at the University of Alberta. She is wife to Graeme, Otolaryngologists Head and Neck Surgeon and mommy to Madi, her sweet and spunky little girl.Life of Dr. Mom is a health and medical mom blog designed for the modern parent whom struggles with balancing family, work, and fun. With her experience working in women health, postnatal care, mental health, and Pediatrics, Dr. Mom works to educate the modern mom with the most relevant up-to-date medical evidence to support families and the healthy development of their children.GuestDr. Stephanie Liu@lifeofdrmomlifeofdrmom.comShop at @bydrmomErin Junker | Paediatric Sleep ConsultantInstagram @thehappysleepcompanyWebsite www.thehappysleepcompany.com

Masks are no longer mandatory in some Canadian provinces, but some fear it's too soon to relax rules, with vaccination campaigns ongoing and concerns about the spread of variants. We talk to Edmonton business owner Katy Ingraham, who says she'll still ask customers to mask up; Dr. Kwadwo Kyeremanteng, an intensive and palliative care physician at the Montfort and Ottawa hospitals; and Dr. Stephanie Smith, an infectious disease physician at the University of Alberta Hospital in Edmonton.

Guest: Dr. Peter Brindley, Full-time Critical Care Physician at the University of Alberta Hospital in the General Systems Intensive Care Unit and its NeuroSciences Intensive Care Unit. See omnystudio.com/listener for privacy information.

Guest: Dr. Peter Brindley, Full-time Critical Care Physician at the University of Alberta Hospital in the General Systems Intensive Care Unit and its NeuroSciences Intensive Care Unit.  See omnystudio.com/listener for privacy information.

Guest: Dr. Peter Brindley, Full-time Critical Care Physician at the University of Alberta Hospital in the General Systems Intensive Care Unit and its NeuroSciences Intensive Care Unit.  See omnystudio.com/listener for privacy information.

Guest: Dr. Peter Brindley, Full-time Critical Care Physician at the University of Alberta Hospital in the General Systems Intensive Care Unit and its NeuroSciences Intensive Care Unit.  See omnystudio.com/listener for privacy information.

In this episode, Zach is joined by Monty Ghosh, an Internist and Addiction Specialist at the University of Alberta Hospital. The two discuss harm reduction in Canada, as well as problems with tainted drug supplies.

Dr. Jodi Abbott is President & CEO of the University Hospital Foundation. Dr. Jodi Abbott joined the University Hospital Foundation in January 2020, after nine years in post-secondary education, as President and CEO of NorQuest College. Prior to joining NorQuest, she served as a Senior Vice President with Alberta Health Services. The University Hospital Foundation The University Hospital Foundation raises funds to support innovation and excellence at the University of Alberta Hospital, the Mazankowski Alberta Heart Institute and the Kaye Edmonton Clinic. The Mazankowski Alberta Heart Institute provides gold standard care to the most complex cardiac patients in western and northern Canada. Donors to the University Hospital Foundation support all areas of care at the Maz, from advanced technology and state-of-the-art equipment to recruiting the best and brightest medical minds in cardiovascular care. See omnystudio.com/listener for privacy information.

"Dr. Jeanine Wiener-Kronish: Women in Medicine and Progressing Toward a Healthier Working Environment," by Vivian Ip, MB, ChB, Clinical Associate Professor, University of Alberta Hospital, Edmonton, Canada. From ASRA News, November 2019, pp. 42-43. See original article at www.asra.com/asra-news for figures and references. This material is copyrighted. 

Guest: Dr. Peter Brindley, Full-time Critical Care Physician at the University of Alberta Hospital in the General Systems Intensive Care Unit and its NeuroSciences Intensive Care Unit See omnystudio.com/listener for privacy information.

Guest: Dr. Peter Brindley, Full-time Critical Care Physician at the University of Alberta Hospital in the General Systems Intensive Care Unit and its NeuroSciences Intensive Care Unit.  See omnystudio.com/listener for privacy information.

"Nerve Stimulator in Regional Anesthesia: Is it Out of Vogue?" by Jaasmit Khurana, MD, Resident Year 2; Vivian Ip, MBChB, FRCA, Clinical Associate Professor; both of the Department of Anesthesia and Pain Medicine, University of Alberta Hospital, Edmonton, Alberta, Canada; Rakesh Sondekoppam, MBBS, MD, Associate Professor, Department of Anesthesiology, University of Iowa Hospital, Iowa City, Iowa; and Ban Tsui MD, FRCPC, Professor, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, California.  From ASRA News, November 2020. See original article at www.asra.com/asra-news for figures and references. This material is copyrighted.   

Guest: Dr. Peter Brindley, Full-time Critical Care Physician at the University of Alberta Hospital in the General Systems Intensive Care Unit and its NeuroSciences Intensive Care Unit. 

In this episode, we were lucky enough to have Dr. Clarence Wong. Dr. Wong is an interventional gastroenterologist at the University of Alberta. He gave us a masterclass on the approach to large polyp. We also talked about the development of screening guidelines in Alberta, and way to improve the quality of colonoscopies on a very practical level. Tweet at us @CanJSurg or email us at podcast.cjs@gmail.com. Links: 1. Is 45 the new 50 in colorectal cancer screening? https://pubmed.ncbi.nlm.nih.gov/33077453/ 2. https://www.healio.com/news/hematology-oncology/20201027/uspstf-expands-colorectal-cancer-screening-recommendation-to-include-adults-age-45-years#:~:text=All%20adults%20should%20begin%20to,initiation%20at%20age%2045%20years. 3. Managing difficult polyps: techniques and pitfalls. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3959925/ 4. Geographic variation in the provider of screening colonoscopy in Canada: a population-based cohort study. http://cmajopen.ca/content/6/1/E126.full. 5. Alberta CRC Screening Guidelines: https://actt.albertadoctors.org/CPGs/Lists/CPGDocumentList/colorectal-cancer-screening-guideline.pdf 6. DOPS Program in BC for Colon Screening: http://www.bccancer.bc.ca/screening/Documents/COLON_GuidelinesManual-DOPSCandidateResourceBooklet.pdf 7. CAG SEE course: https://www.cag-acg.org/education/see-program Dr. Wong is a gastroenterologist and Associate Professor with the Division of Gastroenterology at the University of Alberta. He is an Attending Staff gastroenterologist at the Royal Alexandra Hospital, University of Alberta Hospital and the Cross Cancer Institute. He holds a BSc in Cellular and Molecular Biology from the University of Calgary and a MD degree from the University of Alberta. He is a Fellow of the Royal College of Physicians and Surgeons of Canada (RCPSC) in Internal Medicine and Gastroenterology having completed medical residency at McMaster University in Hamilton and the University of Alberta. During his training, Dr. Wong was awarded research fellowships from both the Alberta Heritage Foundation for Medical Research and the Canadian Association of Gastroenterology for translational research in Experimental Oncology. He has also completed a fellowship in endoscopic ultrasound and is a therapeutic endoscopist focusing on gastrointestinal cancers. He is the medical director of the Edmonton Endoscopic Ablation Program which treats Barrett’s esophagus and early upper gastrointestinal tract cancers. He is also the provincial medical director of the Alberta Colorectal Cancer Screening program (ACRCSP). His research interests include clinical and laboratory innovations in colon cancer screening and Barrett’s esophagus. He received funding from AHFMR and Alberta Innovates. Dr. Wong is a Past-President of the Alberta Society of Gastroenterology. He has received regional and national teaching awards for excellence in medical education including Endoscopy & Teacher of the Year from the UofA GI Residency Training Program, the University of Alberta Medical Students’ Association Teacher of the Year Award, the Canadian Association of Medical Education (CAME) Certificate of Merit, and the University of Alberta Rutherford Award for Excellence in Undergraduate Teaching.

Guest:  Dr. Peter Brindley, Full-time Critical Care Physician at the University of Alberta Hospital in the General Systems Intensive Care Unit and its NeuroSciences Intensive Care Unit.

After graduating from the University of Alberta with a Bachelor of Science and M.D in 1990, Dr. Logsetty obtained his Diploma in Clinical Epidemiology from the University of Toronto in 1996 garnering many awards along the way. Dr Logsetty completed the Surgical-Scientist Program at University of Toronto in 1994-1996. He continued his training in fellowships in Acute Burn Care & Reconstructive Surgery at Ross Tilley Burn Centre in Wellesley Hospital in Toronto, Ontario (1996-1998) and in Critical Care of Burns at Harborview Medical Centre in Seattle, Washington (1998-1999). He was appointed to the position of Associate Director of the Firefighters Burn Treatment Unit at the University of Alberta Hospital in 1999. He was also the Director of Resident Research for the General Surgery Department at the University of Alberta Hospital from 2005 to 2007. During his time at the University of Alberta Hospital he was promoted from Assistant Professor to Associate Professor. In 2007 he was recruited by the University of Manitoba and the Health Sciences Centre to take on the position of Director of the brand new Burn Unit located at Health Sciences Centre in Winnipeg. He remains an Associate Professor of Surgery at the University of Manitoba and was appointed the Director of Research for the Section of Plastic Surgery. In this episode, we get all fired up about burn care. We talk about training pathways for burn surgeons, burn resuscitation, operative management of burns, and finally about Dr. Logsetty’s innovative research into burn wound management. Links: 1. Dr. Logsetty’s nature review on burns: https://pubmed.ncbi.nlm.nih.gov/32054846/ 2. Clinical Value of Debriding Enzymes as an Adjunct to Standard Early Surgical Excision in Human Burns; A Systematic Review: https://academic.oup.com/jbcr/advance-article-abstract/doi/10.1093/jbcr/iraa074/5840378?redirectedFrom=fulltext 3. Simple Derivation of the Initial Fluid Rate for the Resuscitation of Severely Burned Adult Combat Casualties: In Silico Validation of the Rule of 10. https://pubmed.ncbi.nlm.nih.gov/20622619/ 4. Mental health outcomes of burn: A longitudinal population-based study of adults hospitalized for burns. https://europepmc.org/article/med/27049068 5. Bacteria-Responsive Single and Core-Shell Nanofibrous Membranes Based on Polycaprolactone/Poly(ethylene Succinate) for On-Demand Release of Biocides. https://pubs.acs.org/doi/10.1021/acsomega.8b03137

Guest: Dr. Peter Brindley, Full-time Critical Care Physician at the University of Alberta Hospital in the General Systems Intensive Care Unit and its NeuroSciences Intensive Care Unit. 

"How I Do It: The Anterior Sciatic Nerve Block in the Original Ultrasound-Guided, Long-Axis, In-Plane Approach," by Timur Özelsel, MD, DESA, Associate Clinical Professor, Vivian Ip, MBChB, MRCP, FRCA, Associate Clinical Professor, both of the Department of Anesthesia and Pain Medicine, University of Alberta Hospital, Edmonton, Alberta, Canada; Rakesh Sondekoppam, MD, Associate Clinical Professor, Department of Anesthesia, University of Iowa, Iowa City, Iowa; and Ban Tsui, MD, FRCPC, PG Dip Echo, Professor, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, Stanford, California. From ASRA News, May 2020, pp. 27-32. See original article at www.asra.com/asra-news for figures and references. This material is copyrighted.     

Guest: Dr. Peter Brindley, Full-time Critical Care Physician at the University of Alberta Hospital in the General Systems Intensive Care Unit and its NeuroSciences Intensive Care Unit. 

Guest: Dr. Peter Brindley, Full-time Critical Care Physician at the University of Alberta Hospital in the General Systems Intensive Care Unit and its NeuroSciences Intensive Care Unit.

Guest: Dr. Peter Brindley, Full-Time Critical Care Physician at the University of Alberta Hospital in the General Systems Intensive Care Unit and it's NeuroSciences Intensive Care Unit.  

"Curb Your Enthusiasm: Erector Spinae Plane Block—‘Because It Is Easy' Is Not a Good Reason to Do It!" by Vishal Uppal, MBBS, FRCA, EDRA, Assistant Professor and Director of Regional Anesthesia Fellowship Program, Department of Anesthesia Pain Management and Perioperative Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; and Vivian Ip, MBChB, MRCP, FRCA, Clinical Associate Professor, University of Alberta Hospital, Edmonton, Alberta, Canada. From ASRA News, November 2019, pp. 8-12. See original article at www.asra.com/asra-news for figures and references. This material is copyrighted.

"PBLD: Neuraxial Blockade and Issues Around Consent, Coagulation Conundrum," by Vivian Ipm MB, ChB, Clinical Associate Professor, University of Alberta Hospital, Edmonton, Alberta, Canada; Edward Mariano, MD, MAS, Chief, Anesthesiology and Perioperative Care, VA Palo Alto Health Care System, Palo Alto, California; and Kristopher Schroeder, MD, Associate Professor, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. From ASRA News, August 2019, pp. 22-29. See original article at www.asra.com/asra-news for figures and references. This material is copyrighted.

Join us as we explore some of the most common eating disorders: anorexia, bulimia and binge eating disorder. Learn everything from the development, management and recovery - to the physical, social and emotional impacts that an eating disorder can have on a person and their loved ones. Featuring special guest Dr. Ostolosky, a psychiatrist and program director for the Eating Disorders Program at the University of Alberta Hospital.  Resources: National Eating Disorder Information Centre: http://nedic.ca/ Eating Disorder Support Network of Alberta: https://edsna.ca/ Canadian Mental Health Association (Eating Disorders): https://cmha.ca/mental-health/understanding-mental-illness/eating-disorders National Initiative for Eating Disorders: http://nied.ca/ Families Empowered and Supporting Treatment of Eating Disorders (F.E.A.S.T.): https://www.feast-ed.org/ Government of Canada (Mental Health Services): https://www.canada.ca/en/public-health/services/mental-health-services.htm Summary Sheet:EatingDisordersSummarySheet.html

"Interview With a Prominent Female Leader in Regional Anesthesia in Canada: Jennifer Szerb, MD, FRCPC," by Vivian Ip, MB, ChB, Clinical Associate Professor, University of Alberta Hospital, Edmonton, Alberta, Canada. From ASRA News, May 2019, pp. 7-9. See original article at www.asra.com/asra-news for figures and references. This material is copyrighted.

A group of chronic pain patients is calling on the Alberta Minister of Health to investigate the College of Physicians and Surgeons of Alberta to investigate the College for its "unwarranted and secretive cautioning and sanctioning of doctors " who prescribe or continue long in-place prescribing of opioids to provide pain (agony) patients with some degree of quality of life. Guest: Tracy Fossum. Founder: Helpalbertaspain.com.  Multi-decade chronic pain patient who, while displaying symptoms of a heart attack, was turned away by an Alberta hospital as a "drug seeker".  Tracy Fossum later presented back at hospital with a heart attack in progress.  See omnystudio.com/listener for privacy information.

University of Alberta Hospital neurologist Dr. Brian Buck discusses the case of André Therriault, a Donnelly farmer who survived and recovered from a serious stroke despite falling ill hundreds of kilometres away from a major stroke centre. This story is told in the video: Stroke program has rural Albertans covered [add hyperlink] on YouTube. In this podcast, Dr. Buck — Co-chair of the Acute Stroke Expert Working Group of the Cardiovascular Health & Stroke Strategic Clinical Network — talks about the Alberta Health Services stroke program and how it ensures Albertans in rural and remote communities can receive prompt, outstanding stroke care when they need it. “In terms of an integrated strategy to dealing with stroke patients, Alberta is unmatched,” says Dr. Buck.

Family Doctor Dr. Stephanie Liu joins Sleep Expert Alanna McGinn today to answer your top child medical questions. Stephanie completed her undergraduate degree at the University of Calgary in Health Sciences and a Masters of Science in Clinical Nutrition at Columbia University in New York City. Her medical school and residency in Family Medicine were completed at the University of Alberta. And currently, she practices community family medicine and acute care at the University of Alberta Hospital. Alanna has had the pleasure of contributing to Stephanie's popular blog over at lifeofdrmom.com and today Stephanie answers your top child medical questions!  This is the perfect episode for pregnant moms and new parents. Tag your favourite soon-to-be or new parents as we dive into: Is sleep training safe? When can baby go the whole night without a feed? What to expect from your baby's visit with their doctor? When to introduce peanuts? When to introduce solids to a baby? How to treat constipation? Should you vaccinate your baby? What are the real risks of screen time? ⠀⠀ Keep the Conversation Going: Join the conversations and submit your own sleep questions to Alanna on Instagram and Twitter: @GNSleepSite. She may answer them during a future This Girl Loves Sleep segment! Website: https://goodnightsleepsite.com Instagram: https://www.instagram.com/gnsleepsite Facebook Page: https://www.facebook.com/GoodNightSleepSite/ Facebook Group: https://www.facebook.com/groups/GoodNightSleepSite/ Twitter: https://twitter.com/GNSleepSite Pinterest: https://www.pinterest.ca/gnsleepsite/ Life of Dr. Mom: https://lifeofdrmom.com Dr. Stephanie Liu Instagram: https://www.instagram.com/lifeofdrmom/ This Girl Loves Sleep's theme music is "Until the End" by Ryan Andersen from the album "Happy Life - Americana Volume One," from the Free Music Archive at http://freemusicarchive.org/music/Ryan_Andersen/Happy_Life_-_Americana_Volume_One/Until_The_End

"Edmonton Holds Innovative Celebration for World Anesthesia Day" by Timur J.P. Ozelsel, MD, Rakesh Sondekoppam Vijayashankar, MD, and Vivian H.Y. Ip, MB, ChB, FRCA, all of the University of Alberta Hospital in Edmonton, Canada. From ASRA News, February 2019, pp. 17-19. See original article at www.asra.com/asra-news for figures and references. This material is copyrighted.

Peter G. Brindley MD, FRCPC, FRCP (Edin) FRCP (Lond). Peter is a full-time Critical Care Physician at the University of Alberta Hospital, Canada and professor of Critical Care Medicine, Anaesthesiology, and Medical Ethics. He has 100 peer-reviewed manuscripts, 30 book chapters, over 70 lesser manuscripts and one textbook focusing on resuscitation; crisis management; human factors; and improving teamwork & communication.  He was a founding member of the Canadian Resuscitation Institute; former Medical-Lead for Simulation, and prior Education Lead for Surgery, Anaesthesia and Critical Care at the UofA. He is on the Board for the Canadian Critical Care Society, and the organizing committee for five major conferences. He has delivered over 400 invited presentations in ten countries, and over 50 plenaries. He welcomes disagreements because he doesn’t want to be wrong a moment longer than necessary.   

Imagine having your brain operated on without having to wait for an incision to heal afterwards. This is now a possibility at the University of Alberta Hospital in Edmonton. Our guest is Max Findlay, Clinical Professor and Neurosurgeon working with this technology. 

Whilst the skills of applying life support and resuscitation take up most of our training, they are relatively easier to master than the skills that allow us to become good at diagnosis, good at communication, and most of all good at being resilient over a whole career so we can satisfactorily work with others and deal with the stress of working in intensive care. Peter Brindley, a Canadian intensivist from Edmonton, thinks that these “human factors” are crucial for us to master, especially in the second half of our careers, when we should be striving to be simply “a good person”. In this episode Peter reflects, tells some stories, and invites us to consider many important topics that will help us become better people. These include reflection, simulation, mental rehearsal, debriefing, dealing with upset people and the feeling of being an “imposter”. Peter is a full-time critical care doctor at the University of Alberta Hospital. He is a Professor of Critical Care Medicine, Anaesthesiology, and Medical Ethics. He has published papers and given talks widely. He was a founding member of the Canadian Resuscitation Institute; and was previously Medical-Lead for Simulation, Residency Program Director, and Education Lead at the University of Alberta. He is proudest of his two children, neither of whom care one iota what titles he may or may not possess. He is convinced that happiness rests in finding meaning and showing gratitude - he occasionally succeeds. This is the second in a series of DasSMACC special episodes, where I interviewed speakers from the recent DasSMACC conference held in Berlin. In addition to the human factors described above, we also spoke at length about burnout, its relationship to resilience, and the potential benefits of both working less (like part-time) and of having eccentric hobbies or passions. Peter spoke on several other topics including: His life journey from growing up in the United Kingdom to becoming a Canadian for all of his adult life The country of Canada, it’s national identity and it’s intensive care system The hallmarks of good teams Rudeness and its iatrogenic effects (including when family members are rude) The components of communication – including verbal, paraverbal and non-verbal A situation when Peter was accused of unprofessional behaviour and how he dealt with that How Peter has used a mini-sabbatical to reflect and to think about the next part of his career Exercise and the risk that it, other hobbies and material things can become like fetishes How our careers can be broken into thirds of “learning, earning and returning” but that we should consider all three in even the smaller periods like weeks or months The benefits of having an identity that is more than simply being a doctor His time on a cruise ship where he worked as an anonymous doctor How he is more proud of his writing of poetry and travel-writing than some of the medical papers he has published. With this podcast, and the previous episodes, please help me in my quest to improve patient care, in ICUs all round the world, by inspiring all of us to bring our best selves to work to more masterfully interact with our patients, their families, ourselves and our fellow healthcare professionals so that we can achieve the most satisfactory outcomes for all. You can send any comments through the Life In The Fast Lane website, facebook (masteringintensivecare), twitter (@andrewdavies66) or by simply emailing andrew@masteringintensivecare.com.   Show notes (people, organisations, resources or links mentioned in the episode): Dr Peter Brindley: https://www.ualberta.ca/medicine/about/people/peter-brindley DasSMACC website: https://www.smacc.net.au/ Dr Sara Gray: https://saragray.org/ Dr Chris Hicks: http://stmichaelshospitalresearch.ca/researchers/christopher-hicks/

Is the hype around Lyme Disease leading to unnecessary treatment? Lynora Saxinger, infectious disease specialist at the University of Alberta Hospital, joined Rob to chat about her thoughts on this. 

This video presents an approach to pediatric abdominal x-rays.  By the end of this video, you should be able to describe common radiographic findings in the pediatric population, including foreign body ingestion, duodenal atresia, and pneumoperitoneum. This podcast and video are developed by Ben Pi, a medical student at the University of Alberta, with the help of Dr. Jacob Jaremko, a pediatric MSK radiologist at the University of Alberta Hospital.   Related Content: Podcast: Approach to Pediatric Chest X-rays Case: Abdominal Pain in a 4 month old female

This video presents an approach to pediatric abdominal x-rays.  By the end of this video, you should be able to describe common radiographic findings in the pediatric population, including foreign body ingestion, duodenal atresia, and pneumoperitoneum. This podcast and video are developed by Ben Pi, a medical student at the University of Alberta, with the help of Dr. Jacob Jaremko, a pediatric MSK radiologist at the University of Alberta Hospital.    Related Content: Podcast: Approach to Pediatric Chest X-rays Case: Abdominal Pain in a 4 month old female